Modafinil

Overview of Modafinil

Modafinil, sold under the brand name Provigil among others, is a central nervous system (CNS) stimulant and eugeroic (wakefulness promoter) medication used primarily to treat narcolepsy, a sleep disorder characterized by excessive daytime sleepiness and sudden sleep attacks. Modafinil is also approved for stimulating wakefulness in people with sleep apnea and shift work sleep disorder. It is taken by mouth.

While modafinil is used as a cognitive enhancer, or "smart drug", among healthy individuals seeking improved focus and productivity, its use outside medical supervision raises concerns regarding potential misuse or abuse. Research on the cognitive enhancement effects of modafinil in non-sleep deprived individuals has yielded mixed results, with some studies suggesting modest improvements in attention and executive functions, while others show no significant benefits or a decline in cognitive functions at high doses.

Side Effects

Common side effects of modafinil include anxiety, insomnia, dizziness, and headache. Modafinil has potential for causing severe allergic reactions, psychiatric effects, hypersensitivity, adverse interactions with prescription drugs, and misuse or abuse. Modafinil may harm the fetus if taken during or two months prior to pregnancy.

Less common side effects include and are not limited to: anorexia, dry mouth/skin, nervousness, muscle stiffness, polydipsia, paraesthesia, tremors, vomiting,

Serious side effects include: Mania, delusions, hallucinations, suicidal ideation/aggression, serious rashes, chest pain, cardiac symptoms, t-wave changes.

Common Dosages

Narcolepsy dosing - 200-400mg/day, starting at 100mg or less, and using the minimal amount required to exert desired therapeutic effect.

Drug Interactions

Antifungals, erythromycins, and CYP450 isoenzyme inhibitors can result in increased modafinil concentrations.

Modafinil may decrease plasma concentrations of these drugs. Cyclosporine, hormonal contraceptives, and theophylline.

Modafinil may increase plasma concentrations of the following drugs: Diazepam, phenytoin, propanolol, tricyclic antidepressants, warfarin, and other CYPC19 and CYP2C9 substrates.

Diagnostic Test Effects

Modafinil may increase gamma glutamyltransferase (GGT), and alkaline phosphatase.