Beginners Guide to Mixing Modafinil and Birth Control

Modafinil is one of the world’s most potent & safest nootropics offering heightened focus, increased alertness, and all-day concentration. However, birth control is a different product. It is used by ladies as a contraceptive to avoid getting pregnant & is available in many different forms.

 

The question is, Can modafinil, dubbed a “smart tab,” & birth control be safely used together? Are there any visible positive outcomes, or is it unsafe to administer both meds at the same time? Here are the revelations you need to know. Let’s take a look at the basic benefits of each product from a scientific point of view & give a verdict on whether it’s safe to mix them, if interested. Take note that the given contents are for informational & educational objectives only.

What Is Modafinil Drug?

Modafinil, sold under the trade name Provigil® among others, is a prescription medicine designed to treat excessive sleepiness caused by narcolepsy, shift work sleep disorder (SWSD), or obstructive sleep apnea (OSA). It was approved for medical use by the United States Food and Drug Administration (FDA) in 1998.

Those who have a prescription for it primarily use it to stay awake for a longer time — up to 13+ hours. It’s typically ingested during the day; however, its real effect shines through when it promotes wakefulness during an all-nighter session.

There are other similar conditions physicians can prescribe modafinil for. Since its endorsement, medical specialists have used it as the most effective product to treat jet lag disorder (or desynchronosis) and attention deficit hyperactivity disorder (ADHD). Besides, various physicians across the globe are now prescribing it off-label to treat Alzheimer’s disease, depression, Parkinson’s disease, memory decline in elderly people, & several other health conditions.

Apart from its medical use, modafinil is often taken off-prescription by healthy individuals including cellists, judges, military, airline pilots, astronauts, students, business executives (especially from Silicon Valley), astronauts, & scientists, among others, as a nootropic, or a “smart drug,” to become more productive during the day and to ameliorate attention, focus, concentration, mental acuity, memory, thinking, as well as learning, among other cognitive benefits [1][2].

Modafinil inhibits sleepiness by acting on specific chemicals in the brain that control our waking state. By stimulating them, it makes us feel awake and at the same time offers various cognitive benefits. Generally, it is a life-saving drug for those who experience certain types of sleep disorders.

In the United States, the remedy is currently categorized as a Schedule IV controlled substance. Other countries have different modafinil classification & legality, but the good news is that it’s not an illicit substance. Here’s our superb guide titled Is Modafinil Legal? #1 Guide for All Countries. If you’re eager to comprehend the legality of this drug in your country, check out this article.

Unlike other nootropics & stimulants, modafinil doesn’t make you feel the jitters you would with caffeine & meds used to treat the symptoms of ADHD. Since it is a eugeroic, your normal sleep patterns won’t be compromised once its effects wear off. Nonetheless, where does birth control fit into this? What could the “smart tab” & birth control have in common?

Basics about Modafinil and Birth Control

Any health remedy that may interfere with the efficacy of birth control can lead to undesirable or unplanned pregnancy. Leaning on certain medications may also influence the growth & health of the fetus. You may ask, “Which method can I use to better control pregnancy?”

If a female is sexually active & has no plan on having kids, she can decide to use some form of hormonal birth control. Besides, it’s ideal for hormone regulation. The most prevalent forms of birth control are as follows:

• pills;
• skin patches;
• vaginal rings;
• IUDs (or intrauterine devices).

As any user of birth control realizes, mood swings are one of the most frequent negative effects of any form of contraception. If a female decides to use the “smart tab” to assist her to get a great deal of work done in a short time, she will be more likely to have no idea how it’ll interact with her birth control. The science behind how birth control influences brain structure, as well as function, is unexpectedly non-existent, even though the pill has been around for more than half a century [3].

On the other hand, the “smart tab” is more clear-cut in its use and purpose. It has insanely great benefits beyond ameliorating wakefulness. This was extensively demonstrated in military soldiers who’ve used it to remain awake & focused for several hours. Used by the military, the “smart tab” could ameliorate wakefulness & augment cognitive performance during sustained periods of sleep deprivation linked with military operations [4].

Together with a magnificent safety profile & very low potential for abuse, a user has the greatest recipe for a near-perfect nootropic. However, this begs the question, Can the “smart tab” & birth control be safely coadministered, or will one med lessen the efficacy of the other? Initially, it’s necessary to get a comprehensible perspective of the scientific studies done on both meds.

Modafinil & Birth Control from a Scientific Point of View

The “smart tab” is an enzyme inducer. It heightens the action of enzymes found in the liver. These enzymes are also applied to break down the contraceptive. When the action of the liver enzymes is enhanced, the contraceptive in the body is broken down more swiftly, giving it less time to work as intended [5].

Modafinil also interacts with certain kinds of contraceptives, making them less efficacious & enhancing the probability of becoming pregnant. It can also induce birth defects in an unborn child & must never be used if intending to be pregnant [6]. It’s very crucial to ensure you’re using the right contraceptive practice when taking the “smart tab.”

Consider that there are no sweeping trials that have specifically tested modafinil with the various contraceptives available. However, according to several studies, mixing some other meds that are also enzyme inducers with contraceptives has depicted that the latter become less powerful with these enzyme inducers. The point will also happen with the “smart tab.”

Furthermore, the barrier methods, which include diaphragms, condoms, caps that can be applied alongside a spermicide (e.g., Gygel), as well as the female condom, are considered a less reliable form of contraception. Although they don’t interact with the “smart tab,” applying them alone may not avoid getting pregnant. We recommend that you do not rely on these practices while on the nootropic.

The other big question is, How long must you use contraceptives when taking modafinil? Unquestionably, you must continue using an efficacious contraceptive as long as you are still consuming the “smart tab.” If you stop the eugeroic for any reason, you must keep using birth control for 60 or so days after discontinuing. This is because the body requires some time for the enzyme action, which the “smart tab” interferes with, to turn to normal.

Benefits of Modafinil

Modafinil was designed to lessen extreme sleepiness linked to various sleep disorders. However, now it’s more well-known for its cognitive-augmenting, mood-brightening, & memory-enhancing effects. Although its impact on the brain is not fully comprehended yet, the “smart tab” is known to work by stimulating dopamine, serotonin, histamine, norepinephrine, as well as orexin systems in the brain.

Let’s discuss a few but chief advantages of the “smart tab.”

Long-Lasting Wakefulness Effects

As mentioned earlier, modafinil elevates wakefulness by stimulating certain chemicals in the brain. According to a study, modafinil blocks the reuptake of noradrenaline by the noradrenergic terminals on sleep-ameliorating neurons from the ventrolateral preoptic nucleus (VLPO). Such a mechanism could be at least somewhat responsible for the wake-augmenting effect of the medicine [7].

In another study, half of the participants were given the typical 200 mg dose of modafinil (6 times over 60 hours) while they were deprived of sleep. Despite this, the subjects were able to achieve the same level of focus, alertness, vigilance, & cognitive performance across various tests including reaction time plus mathematical processing [8]. As for individuals taking the placebo, their performance carried on lessening across all cognitive measures.

Because modafinil contains the R-enantiomer & S-enantiomer as a racemic compound & the waking effect of R-enantiomer has a longer duration, the normal half-life of the “smart tab” in humans is between 12 to 15 hours [9]. In trials on healthy people, modafinil allowed users to stay up for almost 2 days while remaining nearly as alert, vigilant, focused, & capable of problem-solving as the well-rested. After 8 hours of quality sleep, users can rise & go another 40 hours. Reportedly, the “smart tab” users don’t experience jitters or addiction [10].

Helps Highly Impulsive Individuals Inhibit Bad Behaviors

Modafinil has been depicted to lessen impulsivity in some individuals with addictions. If you are impulsive, the “smart tab” may aid your self-control. In research, modafinil ameliorated response inhibition in alcohol-dependent participants with initially poor response inhibition. However, response inhibition was diminished in individuals who initially performed better. The “smart tab” also modulated brain activation in key brain regions directly necessitating response inhibition but only in patients with poor baseline response inhibition [11]. This finding implies that the “smart tab” may be used to treat non-stimulant addictions & perhaps behavioral addictions such as gambling.

Improves Logical & Emotional Intelligence

Cognitive dysfunction may be a particularly important emerging treatment target for modafinil. There are 2 types of cognition: “hot” & “cold.” “Hot” cognition has to do with information processing (colored by emotion), whereas “cold” cognition is about emotional intelligence, or cognitive processing of information that’s independent of emotional involvement [12].

It turns out that the “smart tab” can efficiently heighten both kinds of cognition, which could make any human being a superior version of themselves for a few hours [13].

Ameliorates Memory and Executive Function

Although a low dose of modafinil works, one study suggested that the standard dosage (200 mg) of the “smart tab” could better ameliorate episodic memory & working memory performance in people with remitted depression. The drug may also have the potential as a therapeutic agent to aid remitted depressed patients with persistent cognitive hurdles [14].

It is also known to heighten executive functioning, or the capability to properly manage time & resources to fulfill planned goals [15].

Beats Fatigue

The “smart tab” powerfully cuts down fatigue & gives the required energy to work for hours on end. Without a doubt, modafinil will make you feel fresh & active and able to perform better. Tons of studies on this are based on several varying populations, together with those with various health conditions, healthy people, & even pilots in the military. In every group study, the “smart tab” was found to significantly lessen fatigue [16][17].

Ameliorates Cognitive Performance in Non-Sleep-Deprived Individuals

The “smart tab” isn’t just awesome if you haven’t slept well. It’s prominent for everyone. As depicted in a study, this nootropic ameliorated cognitive function in patients suffering from a brain tumor [18]. From other studies, modafinil has been shown to improve visual pattern recognition, spatial planning, reaction time, strategic planning, & decision-making skills, & visual processing [19][20][21].

Improves Mood and Motivation for Work

Research has consistently discovered that the “smart tab” provides a small but notable improvement to mood. Some modafinil users even refer to it as a kind of “euphoria” [22]. Its mood enhancing effect is partly one of the reasons why it is sometimes applied as a complementary therapy for those diagnosed with depression [23].

Even if you’re awake and focused, you don’t constantly want to do work, particularly if that work is wearisome. However, the “smart tab” aids there too. A study discovered that it heightened the pleasure in work in participants & assisted them to feel extra motivated to continue working [20].

Weight Loss

Surprisingly, the “smart tab” offers advantages to users looking to lose weight [24]. When you wonder, What is the “smart tab” used for? you probably don’t think that it can be used for weight loss. However, weight loss is one of the latest & unofficial “smart tab” negative effects seen to be beneficial to obese people looking for an efficacious yet safe strategy to lose weight.

What causes weight loss when taking modafinil? There seem to be a few pointers. First, many users that are prescribed the “smart tab” for OSA are overweight – excess body weight is one of the causes of this condition. Second, one of the drug’s effects is to suppress appetite. Done in the long term (applying safe use of modafinil), somewhat suppressed appetite a few days in a week might significantly lead to a remarkable reduction in calories, which finally results in weight loss.

Modafinil isn’t a diet. It won’t aid you in “getting thin quickly,” and apparently, it won’t have much of an effect on “smart tab” users who already have a healthy weight. However, if you do appear to be overweight, you might discover that weight loss is a positive side effect of the drug.

Those have been some of the prime benefits of modafinil. Overall, it is considered a safe cognitive augmenter and a super eugeroic without causing any serious negative effects if consumed correctly without misusing or abusing.

Benefits of Birth Control

Birth control is a lifesaver for females seeking to prevent unwanted pregnancy. However, hormonal options of contraception may offer a range of advantages beyond pregnancy prevention. Here are some of the benefits of birth control.

May Ameliorate Verbal Memory

A well-organized review examining the effect of oral contraceptives on cognition observed an enhancement in verbal memory to be the most consistent result [25]. To nobody’s surprise, it is still highly contested, as there aren’t any printed studies that state the opposite effect.

Some research hinted that it’s estrogen that is responsible for ameliorating verbal memory. In one study, for instance, ladies taking oral contraceptives demonstrated better recall of words on the active hormone days of their tablet cycle than on days when they didn’t take active pills or non-hormonal substitutes [26].

May Foster Working Memory and Attention

Research conducted in 2014 discovered that ladies who took oral contraceptives had better working memory, attention, & concentration [25]. Working memory is a cognitive system with a limited capacity that can temporarily hold information. It is paramount for reasoning & the guidance of decision-making as well as behavior.

Could Elevate Resilience to Stress

When stressed out, the body produces the stress hormone identified as cortisol, which is often considered to impair memory recall. It seems as if ladies taking oral contraceptives have lessened sensitivity to sudden rises in cortisol, and thus their memory recall is not as severely impacted [27].

Still, some evidence for the association between sex & stress hormone activity comes from studies confirming that hormonal contraception use notably lessens stress hormone responses to a stressor.

We’ve covered the main effects of contraceptives beyond preventing pregnancy. Now let’s have a look at the benefits of mixing the “smart tab” + birth control pills.

Benefits of Mixing Birth Control Pills and Modafinil

Here we aren’t attempting to suggest that people should mix the “smart tab” & birth control for an ameliorated nootropic effect.

It is NOT advisable to ingest modafinil when on birth control pills. As mentioned earlier, the “smart tab” interacts with certain types of contraceptives, making them less efficacious, which can heighten your possibility of getting pregnant.

We want to inform you as best we can. The following are hypothetical advantages that one may experience when both meds are coadministered.

Can Ameliorate Emotional Memory

We already know the power of modafinil to heighten emotional intelligence. However, what are the probable effects of birth control on a female’s emotions?

Hormonal contraceptives are known to foster emotional memory — the kinds of memories linked to a deep emotion within our psyche [28]. If you’re consuming both meds at once and a significant & striking event occurs, you will be more likely to remember it for a long time.

May Lessen ADHD Symptoms

It is believed that a woman with ADHD may respond to the prescribed medicine such as Adderall or Ritalin differently — based on which hormone is most uplifted. If it’s estrogen, she’ll have a superior response. If it’s progesterone, the response will be diminished [29]. If the “smart tab” ameliorates focus, then theoretically, a woman with ADHD & high levels of estrogen will fare excellently when taking her medication. Modafinil is effective in treating ADHD, and mixing it with birth control can significantly lessen the symptoms of the disorder.

Can Ameliorate Quality of Sleep

As mentioned earlier, the “smart tab” doesn’t affect sleep patterns once its effects wear off. With birth control, it is hypothesized that a lady’s sexual hormones are pivotal in acquiring good sleep during nighttime. A systematic review issued in 2018, focusing on a few human trials encompassing oral contraceptives, conclusively revealed that females on hormonal contraceptives tended to snore less, wake up fewer times during the night, & experience more efficient sleep overall [30].

Can Help Control Depression

Depression & mood swings are frequent negative effects of birth control meds. Nonetheless, research has been unable to demonstrate or disprove a link. The study of such scenarios is often conflicting. A pilot study depicted that depression was the most frequent reason women stop using birth control pills [31].

However, the analysis revealed that modafinil together with antidepressants reduces the severity of depression as well as remission rates. It also showed beneficial effects on fatigue as well as sleepiness, with the added advantage of the comparable negative effects to placebo [32]. The combination of modafinil with antidepressants synergically lessens the symptoms of depression without any serious negative effects. Generally, the latter do not interact with the effectiveness of birth control medicines. If you coadminister modafinil plus an antidepressant, e.g., Zoloft or Prozac, with birth control, you will reduce the symptoms of depression associated with the use of contraceptives.

Possible Side Effects of Taking These Drugs Together

The advantages of birth control & modafinil if coadministered are merely speculative. Besides, the negative effects are better confirmed & are worth the attention. This is the most important section you must acquaint yourself with if you think about taking the two as a mix.

Take note that the “smart tab” literally lessens the efficaciousness of birth control. For a lady reading this guide, the possibility of being pregnant is enormously higher if using modafinil concurrently. In a study on drug interactions, the “smart tab” lowers the bodily levels of ethinyl estradiol by as much as 18% [33].

Ethinyl estradiol is frequently used in birth control pills alongside other hormones.

This is due to the “smart tab” ability to boost the activity of the CYP3A4/5 enzyme, which is employed to metabolize hormonal contraceptives.

The 4 kinds of birth control negatively affected by the “smart tab” use are patches, vaginal rings, subdermal implants, and pills comprising one or several hormones. On the other hand, the 3 kinds of birth control that aren’t affected by the “smart tab” are the depot medroxyprogesterone acetate (DMPA), copper IUD, & levonorgestrel releasing intrauterine system (LNG-IUS) [34].

Another unfortunate outcome of using both meds concurrently could be fetal harm. The FDA categorizes the “smart tab” as a “Category C” drug [35]:

Animal reproduction studies depicted an adverse effect on the fetus, and there aren’t adequate & well-controlled studies in humans. However, potential advantages may warrant the use of the medicine in pregnant women despite potential risks.

Some of the probable birth defects include fetal toxicity, heart deformations, & poor physical development. Health Canada issued a notification concerning this finding, and every label affixed to the “smart tab” lists birth defects as a potential negative effect in pregnant women [36].

Another side effect is shown from a single scientific study claiming that females using birth control experience lower levels of perseverance when performing cognitive tasks, regardless of how complex or simple the tasks are [37]. However, the “smart tab” can assist you to persevere through tasks that seem otherwise impossible to accomplish. Generally, it would appear as if birth control lowers the mental edge being offered by modafinil.

Apart from the research perspectives, note that each medicine has its side effects. The most frequent negative effects of modafinil are as follows:

• headache;
• drowsiness;
• trouble falling asleep or staying asleep;
• diarrhea;
• nausea;
• dizziness;
• constipation;
• gas.

Some negative effects can be serious. If you experience any of these symptoms or even those not listed above, let your physician know abruptly [38].

Birth control pills can also be associated with the following negative effects:

• acne;
• weight gain;
• nausea;
• vomiting;
• skin discoloration;
• mood swings;
• bleeding between periods or spotting;
• change in menstrual flow.

There can be other negative effects not listed in this guide [39]. Take note that blood clots, heart attacks, & strokes are possible complications of oral contraceptives.

The principle of informed consent obliges medical specialists to explain possible negative effects when prescribing health remedies. Always ensure you have full consent about taking either of the products and be aware of possible side effects. Take the medication as advised without going astray.

Modafinil & Birth Control Tabs: Is It Worth the Risk?

Ladies who use birth control meds while taking the “smart tab” should be aware that the latter may decrease the effectiveness of the former. It means you can get pregnant even if you plan to avoid it.

Ensure that you use an additional method of contraception while you are taking the “smart tab” & for one month after discontinuing this medication. Modafinil is a “Category C” drug, meaning that it should only be applied in pregnant women if the advantages outweigh the risks.

Note that coadministering discussed meds heighten the likelihood of being pregnant.

References

1. Modafinil | Occupational use. Retrieved: May 27, 2021. Wikipedia.org.
2. How Many Silicon Valley Startup Executives Are Hopped Up On Provigil? By Michael Arrington. Published: July 15, 2008. Techcrunch.com.
3. We Know Surprisingly Little About How Birth Control Affects Our Brains. By Kasandra Brabaw. Updated: March 1, 2019. Retrieved: May 27, 2021. Health.com.
4. Modafinil, sleep deprivation, and cognitive function in military and medical settings. By Kelli J. Westcott. Published: April 2005. Pubmed.ncbi.nlm.nih.gov.
5. Modafinil in women of childbearing potential (pdf). Retrieved: May 27, 2021. Qvh.nhs.uk.
6. Are Your Sleep Drugs Hurting Your Contraceptives? By The Society for Women’s Health Research, Contributor. Updated: September 17, 2014. Retrieved: May 27, 2021. Huffpost.com.
7. Effect of the wake-promoting agent modafinil on sleep-promoting neurons from the ventrolateral preoptic nucleus: an in vitro pharmacologic study. By Thierry Gallopin, Pierre-Hervé Luppi, Francis A. Rambert, Armand Frydman, and Patrice Fort. Published: February 2004. Pubmed.ncbi.nlm.nih.gov.
8. Disrupted Sleep-Wake Rhythm and Performance: Advantages of Modafinil. By Didier Lagarde & Denise Batejat. Published: November 17, 2009. Tandfonline.com.
9. Practical Use and Risk of Modafinil, a Novel Waking Drug. By Dongsoo Kim. Published: February 22, 2012. Ncbi.nlm.nih.gov.
10. Staying Awake to Modafinil’s Possibilities. By Donna Britt. Published: June 21, 2002. Washingtonpost.com.
11. If you are impulsive, take modafinil and count to ten, research suggests. Published: February 1, 2013. Sciencedaily.com.
12. Hot and cold cognition. Retrieved: May 27, 2021. Wikipedia.org.
13. Neuroethical issues in cognitive enhancement: Modafinil as the example of a workplace drug? By Annette B. Brühl, Camilla d’Angelo, and Barbara J. Sahakian. Published: February 15, 2009. Ncbi.nlm.nih.gov.
14. Modafinil Improves Episodic Memory and Working Memory Cognition in Patients With Remitted Depression: A Double-Blind, Randomized, Placebo-Controlled Study. By Muzaffer Kaser, Julia B. Deakin, Albert Michael, et al. Published: March 2017. Ncbi.nlm.nih.gov.
15. Modafinil Improves Alertness, Vigilance, and Executive Function During Simulated Night Shifts. By James K. Walsh, Angela C. Randazzo, Kara L. Stone, and Paula K. Schweitzer. Published: May 1, 2004. Academic.oup.com.
16. A phase 3 randomized, placebo-controlled, double-blind, clinical trial of the effect of modafinil on cancer-related fatigue among 631 patients receiving chemotherapy: a University of Rochester Cancer Center Community Clinical Oncology Program Research base study. By Pascal Jean-Pierre, Gary R. Morrow, Joseph A. Roscoe, et al. Published: July 2010. Pubmed.ncbi.nlm.nih.gov.
17. Modafinil, d-amphetamine, and placebo during 64 hours of sustained mental work. I. Effects on mood, fatigue, cognitive performance, and body temperature. By R. Pigeau, P. Naitoh, A. Buguet, et al. Published: December 1995. Pubmed.ncbi.nlm.nih.gov.
18. A randomized trial on the efficacy of methylphenidate and modafinil for improving cognitive functioning and symptoms in patients with a primary brain tumor. By K. Gehring, S. Y. Patwardhan, R. Collins, et al. Published: October 2, 2011. Pubmed.ncbi.nlm.nih.gov.
19. Cognitive enhancing effects of modafinil in healthy volunteers. By Danielle C. Turner, Trevor W. Robbins, Luke Clark, et al. Published: January 2003. Link.springer.com.
20. Effects of modafinil on non-verbal cognition, task enjoyment, and creative thinking in healthy volunteers. By U. Müller, J. B. Rowe, T. Rittman, C. Lewis, T. W. Robbins, and B. J. Sahakian. Published: July 20, 2012. Pubmed.ncbi.nlm.nih.gov.
21. Modafinil and cognitive enhancement in schizophrenia and healthy volunteers: the effects of test battery in a randomized controlled trial. By J. Lees, P. G. Michalopoulou, S. W, Lewis, et al. Retrieved: May 27, 2021. Discovery.ucl.ac.uk.
22. Effects of Modafinil on Dopamine and Dopamine Transporters in the Male Human Brain. By Nora D. Volkow, Joanna S. Fowler, Jean Logan, et al. Published: March 18, 2009. Jamanetwork.com.
23. Modafinil: past, present, and future. By Christos A. Ballas, Deborah Kim, Claudia F. Baldassano, and Nicholas Hoeh. Published: January 10, 2014. Tandfonline.com.
24. Modafinil for atypical depression: effects of open-label and double-blind discontinuation treatment. By Sandeep Vaishnavi, Kishore Gadde, Sayed Alamy, et al. Published: August 2006. Pubmed.ncbi.nlm.nih.gov.
25. A systematic review of the impact of oral contraceptives on cognition. By Annabelle Warren, Caroline Gurvich, Roisin Worsley, and Jayashri Kulkarni. Published: August 2014. Researchgate.net.
26. Could Taking Birth Control Pills Make Women’s Memory More Like Men’s? By Alice Park. Published: September 22, 2011. Healthland.time.com.
27. Cortisol and memory retrieval in women: influence of menstrual cycle and oral contraceptives. By Sabrina Kuhlmann and Oliver T. Wolf. Published: October 22, 2005. Pubmed.ncbi.nlm.nih.gov.
28. Women using hormonal contraceptives show increased valence ratings and memory performance for emotional information. By Klara Spalek, Eva Loos, Nathalie Schicktanz, et al. Published: March 5, 2019. Nature.com.
29. Women, Hormones, and ADHD. By Laura Flynn McCarthy. Medically reviewed by Michele Novotni on October 10, 2019. Retrieved: May 27, 2021. Additudemag.com.
30. Effects of hormonal contraceptives on sleep – A possible treatment for insomnia in premenopausal women. By Andreia Gomes Bezerra, Monica Levy Andersen, Gabriel Natan Pires, Sergio Tufik, and Helena Hachul. Published: May-June 2018. Ncbi.nlm.nih.gov.
31. Can Birth Control Cause Depression? By Annette McDermott. Medically reviewed by Nicole Galan, RN. Updated: August 20, 2018. Retrieved: May 27, 2021. Healthline.com.
32. Modafinil reduces depression’s severity when taken with antidepressants. Published: November 27, 2013. Sciencedaily.com
33. Sleep Medications and Women: a Review of Issues to Consider for Optimizing the Care of Women with Sleep Disorders. By Andrew Krystal and Hrayr Attarian. Published: October 26, 2016. Researchgate.net.
34. Modafinil taken by students as a “smart drug” could reduce the effectiveness of hormonal contraception: CEU Clinical Update. Published: October 13, 2016. Fsrh.org.
35. FDA Pregnancy Categories. Retrieved: May 27, 2021. Drugs.com.
36. Preliminary Data Raises Concerns about Modafinil Use in Pregnancy. By MGH Center for Women’s Mental Health. Published: January 31, 2020. Womensmentalhealth.org.
37. Women taking hormonal contraceptives have reduced perseverance on cognitive tasks, study finds. By Eric W. Dolan. Published: January 23, 2020. Psypost.org.
38. Modafinil. Last Revised: February 15, 2016. Retrieved: May 27, 2021. Medlineplus.gov.
39. Birth Control Options | Hormonal birth control (birth control pills) types and side effects. By Melissa Conrad Stöppler, MD. Edited by Jerry R. Balentine, DO, FACEP. Medically reviewed on March 1, 2021. Medicinenet.com.