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Modafinil is a non-amphetamine CNS stimulant primarily used to promote wakefulness but its off-label use is much wider. Learn key information about the drug in our article.
Modafinil is a non-amphetamine CNS stimulant that promotes wakefulness and alertness. It is manufactured as oral-administration tablets and under a lot of brand names:
In some countries, use of Modafinil is illegal; however, in the USA it is FDA-approved and is available for patients with a doctor’s prescription. Because of its mind-altering properties, modafinil drugs often become a subject of abuse, therefore, it is considered a Schedule IV controlled substance.
Modafinil (Provigil) promotes wakefulness similarly to sympathomimetic agents, such as amphetamine and methylphenidate.
However, the chemistry behind the process is not the same. The exact mechanism of action through which modafinil makes the patient alert has not been established.
In vitro, the substance has shown an ability to inhibit dopamine reuptake. In vivo, it increased extracellular dopamine levels in some brain regions of animals which may be connected.
When studied on genetically engineered mice that lacked DAT (the dopamine transporter), modafinil’s wake-promoting activity was much weaker.
This allows a suggestion that this pharmacological effect is connected to DAT. Nevertheless, unlike amphetamine, the wake-promoting effects of modafinil were not antagonized by the dopamine receptor antagonist haloperidol in rats.
In another study, alpha-methyl-p-tyrosine, a compound that inhibits dopamine synthesis, does not suppress modafinil-induced locomotor activity and does it when amphetamine is used.
Besides inducing awakeness and stimulating locomotor activity, modafinil demonstrated euphoric and psychoactive effects. It also causes mood, thinking, perception, and feeling alterations that are typical of other CNS stimulants in humans.
Modanifil is FDA-approved for:
Besides that, modafinil (provigil) is often used off-label. This means that this particular application was not FDA-approved but has shown potential during studies and proved to be beneficial for patients.
For example, modafinil was considered a reasonable therapeutic option in studies focused on multiple sclerosis-related fatigues. Off-label prescription of modafinil is also possible in cases of:
Due to its pharmacological effects, modafinil is often viewed as a “brain enhancer” in healthy patients who are interested in taking it to improve their performance at work or for studying. However, results are mixed, and the precise risk-benefit ratio is unclear.
The standard modafinil dosage is 200 mg once per day. In the case of narcolepsy or obstructive sleep apnea, it is recommended to take the medication in the morning; for SWSD management, the patient should take modafinil about an hour prior to the start of their work shift.
Modafinil is contraindicated for patients with known hypersensitivity. There is also a list of cases when special consideration and caution are required.
They include the appearance of severe rash, including Stevens-Johnson syndrome, preexisting tic disorders, chronic cardiovascular issues, acute hypersensitivity reactions, etc. Modafinil is very cautiously prescribed to patients with a history of mania, psychosis, or both.
They are monitored for the development of hallucinations, aggression, suicidal thoughts, etc. If monitoring revealed a serious negative impact from modafinil treatment, immediate discontinuation of the therapy is in order.
There is no sufficient evidence that modafinil exerts into breast milk or causes pregnancy complications and birth defects.
In animal studies, however, intrauterine growth restriction and spontaneous abortion have been reported.
Modafinil is classified as a category C drug which means that the risk cannot be ruled out. Therefore, careful evaluation of the risk-benefit ratio is necessary.
Modafinil can reduce levels of the following medications to a clinically significant degree (e.g. altering their efficacy):
The following medications can significantly increase modafinil levels:
And these drugs can do the opposite:
We remind you to always tell your doctors about all the medications you are currently taking before starting a new treatment.
The most common side effects of modafinil were reported by 5% to 10% of users and include:
Modafinil is a CNS stimulant primarily used to induce wakefulness in patients with SWSD or narcolepsy.
It is also used as an addition to a CPAP in patients with obstructive sleep apnea, and there is also an occurrence of off-label use, in cases of ADHD, MS-related fatigue, and other health issues related to fatigue, drug dependence, or mental status.
Modafinil is a mind-altering substance that makes it a subject of abuse and self-treatment in persons who seek to improve performance and experience a state of euphoria.
What is Modafinil?
It is a CNS-stimulating substance that promotes wakefulness and alertness. Modafinil is considered a first-line treatment method for patients who suffer from narcolepsy or SWSD.
Is modafinil dangerous?
No, the drug is generally well-tolerated. However, it should be taken precisely as the doctor ordered and under regular monitoring.
Does modafinil have side effects?
Yes, modafinil can cause some adverse reactions. The most common of them were reported by 5% to 10% of patients and include headache, GI disorders, insomnia, and anxiety (due to CNS stimulation).
How to take modafinil?
The patient should follow the doctor’s instructions. The standard dosage is 200 mg in the morning or an hour before starting a work shift (for SWSD management).
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