Modafinil is a safe and well-tolerated medicine. The FDA approved it for different sleep disorders. However, due to its safety and wide possible drug treatments, it’s been used off-label according to the doctors’ prescription.
What should you know about this drug? This guide contains excellent pointers on Modafinil uses – symptoms for which most doctors prescribed it for, other off-label symptoms for which Modafinil may be helpful are boost energy, high mental activity, focus, and motivation.
Table of Contents
What Is Modafinil?
Modafinil discovery dates back to 1974 with the introduction of adrafinil – a molecule discovered by L. Lafon Ltd – a French company. This new molecule identification was found to cause a significant increase in motor activity as a dose-dependent in mice. This application didn’t exert peripheral sympathomimetic effects.
In the years 1977 to 1978, doctor Michel Jouvet prescribed adrafinil molecule as a medication to narcoleptic patients. With the continual study of the adrafinil molecule, it led to the identification of an active metabolite which has become known as modafinil. In 1983, Jouvet and Bastuji, with a full understanding of modafinil possible remedy, prescribed it to idiopathic hypersomnia and narcoleptic patients. The effect? Patients obtained a significant decrease in excessive daytime sleepiness.
The original company was not interested at first in developing a modafinil molecule for the market. However, with Jouvet’s insistence, this pharmaceutical company decided to start clinical trials in both healthy volunteers and narcoleptic patients as well as carrying out broad conduct animal studies.
Things began to be interesting. Clinical results were excellent and led to the wider use of modafinil substance by the French army during the Gulf War in 1991. In 1992, modafinil became the official registered drug in France.
Modafinil clinical trials extended to North America as well as confirmed impressive findings in Europe. It was later used extensively as a remedy for sleepiness, somnolence, and fatigue in a large number of medical conditions [1].
Modafinil has been prescribed in France under the name Modiodal since 1994, and in the United States since 1998 as Provigil® – after it was approved by the Food and Drug Administration (FDA) as a remedy to narcolepsy. Later, in 2003, the FDA approved it for shift work sleep disorder and obstructive sleep apnea/hypopnea.
This approval was made even though substances such as amphetamine and caffeine were shown to be more potent in promoting wakefulness after a Stanford Sleepiness Scale (SSS), it’s a test that measures the level of sleepiness throughout the day. SSS shows that these substances were at a higher scale than modafinil.
Modafinil is marketed in the USA by Cephalon Pharmaceutical, which originally leased the rights from the original discoverer – L. Lafon, but eventually purchased the company in 2001. With the widespread popularity of modafinil, it was later approved in the United Kingdom in 2012.
What Can a Doctor Prescribe Modafinil For?
What is modafinil prescribed for? The FDA approved modafinil for only a limited number of sleep disorder conditions due to excessive daytime sleepiness associated with narcolepsy, obstructive sleep apnea, and shift work sleep disorder.
Doctors consider prescribing modafinil off-label for other sleep disorder related conditions and also for certain health conditions including attention deficit hyperactivity disorder (ADD/ADHD), depression, chronic fatigue syndrome, multiple sclerosis-induced fatigues, and other related conditions.
Now, the following headers contain pointers on certain modafinil off-label uses that have gained popularity making it the famous medicine applied to various health conditions due to its efficacy.
Modafinil Pills for ADD and ADHD
ADHD is a health condition characterized by symptoms involving impulsive behavior, difficulty paying attention (inconsistent concentration), and hyperactivity. It’s a common experience in children and can extend into adulthood.
ADHD has a significant relationship to the brain neurotransmitter – dopamine. Due to certain chemical neurotransmitters used to send signals to the brain to absorb dopamine, higher absorption of this dopamine leads to low concentration in some brain vital elements such as histamine, orexin, and dopamine. This imbalance tends to affect individual brain communication in regards to wakefulness, cognition, concentration, focus, and other similar brain rewards.
This explains that when it comes to treating a certain health condition, we can try to address the issues caused by the gene variations [2]. By addressing dopamine levels, it’s beneficial in treating ADHD by the use of some medicines including Adderall, Concerta, Ritalin, and Modafinil.
Healthy individuals have sufficient dopamine concentrations in the body and can trigger the reward center effectively – such as building normal habits and remaining focused on a particular thing for an extended time.
However, individuals with ADD and ADHD have issues with the reward center of the brain. Concentrating on a particular task can be difficult as the brain seeks out certain stimulating activities that play an important role in concentration and stimulating reasoning, memory, focus, attention and other effects. This is the need for increasing dopamine levels as it helps consistently the fidgeting and jitteriness associated with patients with ADD/ADHD.
Modafinil boosts dopamine concentrations in the brain similar to the effects of other common ADHD medications like Adderall and Ritalin which have a long history of use for treating symptoms of ADHD.
In the USA and other countries, Modafinil is considered off-label use in treating the symptoms of ADHD. Various studies showed an improvement in ADHD symptoms when using it compared to a placebo.
Modafinil is seen as having great advantages over current remedies for ADHD/ADD in that it can be prescribed once daily according to the doctor’s prescription and has fewer reinforcing properties than other traditional stimulants. According to a study, it is a potentially valuable treatment option for those with symptoms of ADHD [3].
Does It Help Deal with Depression?
What’s the best remedy to treat symptoms of depression? A study published by Cambridge University shows that Modafinil can improve memory in patients recovering from depression.
Although there are many different causes of depression, doctors view it as due to certain deficiencies in neurotransmitters – in either dopamine or serotonin. Antidepressant drugs that work on serotonin levels are considered as today’s common depression remedies.
However, antidepressant medications don’t work effectively on everybody. An estimate of 10% to 30% of patients with major depression do not respond to the most used antidepressant medications. This call for another consideration of drugs for those unresponsive to antidepressants needs trials of a variety of treatment strategies. Also, from the same study, 50% – 66% of individuals with depression do not recover fully on an antidepressant treatment [4].
Since depression might be affected by levels of serotonin and dopamine, Modafinil offers an interesting solution to the problem due to its dopamine reuptake inhibiting benefits. To depressed patients administered Modafinil, it offers several unique improvements. It’s useful as an adjunctive remedy alongside other antidepressant medications (primarily with doctor supervision), as well as on its own (as it has shown a potential choice) for treating both depression causes and its symptoms [5].
Dopamine is one of the most necessary neurotransmitters used in the brain. Modafinil is also an important active ingredient used to regulate different brain regions involving processes such as homeostasis (balance), the formation of habits, the reward center, memory, autonomic nervous function, and at the best level in regulation of mood.
In this regard, traditional antidepressants generally aim at affecting serotonin. Although this substance is a key neurotransmitter in the regulation of mood, it can ultimately become dysfunctional in some individuals due to certain conditions. Serotonin is not the only neurotransmitter involved in depression. That’s why SSRIs don’t always work in the treatment of depression.
Can You Get Modafinil Prescribed for Fatigue?
Chronic fatigue syndrome is a complicated condition characterized by more than 6 months of extreme fatigue that is not relieved by rest alone. It can be associated with a group of additional symptoms that remain constant for at least 6 months. Due to various symptoms associated with chronic fatigue syndrome, the disorder begins suddenly. This can lead to depression – as fatigue and malaise are common negative effects of depression.
Patients suffering from fatigue can have their symptoms dramatically improved with the effective use of wakefulness-promoting drugs such as Modafinil. It functions very effectively by raising norepinephrine levels — a chemical substance in the body responsible for regulating the sympathetic nervous system (SNS).
The SNS controls certain body elements making us feel alert and active when we encounter life experiences causing stress or low mood and is responsible for promoting wakefulness whenever we fall asleep and need to wake up.
Depression and overwork are common causes of chronic fatigue and because of them the SNS often becomes dysfunctional. This leads to negative conditions such as drowsiness, fatigue, and symptoms of oversleeping.
However, studies depict that Modafinil does not effectively treat fatigue although it can be used to optimize performance while fatigued. From another study (2015), Modafinil for use in multiple sclerosis-associated fatigues gives the resulting evidence as weak and inconclusive [6]. However, some individuals give mixed reactions about Modafinil for fatigue as seen from the Modafinil rating summary [7].
What About Modafinil for Weight Loss?
Notably, one of the most common negative effects reported among Modafinil users is weight loss. Although it is not a fat-burner in an individual body, it should be perceived that it supports diet and lifestyle modifications.
Modafinil can help overcome the issues of food cravings while dieting and potentially helps cultivate the lifestyle and diet habits that contribute to a healthy weight. It increases metabolism since the body stores the extra energy in the form of fat. It’s a handy tool for boosting the weight loss process and helping those using it stick to the plan – in regards to the energy needed to shift worker.
Since the mechanism of appetite inhibition in an individual body is unknown, it’s believed that the Modafinil effect on orexin and histamine plays a crucial role. This drug helps in boosting the neuropeptide orexin concentration in the central nervous system and brain. Notably, orexin focuses on the regulation of the wakefulness and appetite and also aids in releasing histamine – a neurotransmitter that enhances the proper regulation of the state of the sleep-wake cycle, appetite and arousal. Modafinil helps to raise the level of these compounds to inhibit the appetite – and in the process, an individual begins to shed the weight.
This doesn’t mean you should only take Modafinil for weight loss. Combine it with changes to diet and lifestyle; routinely exercising and smaller food portions are an excellent place to start. Modafinil is then used to optimize these changes.
Set realistic goals, change daily routines around food and exercise, and use Modafinil as an addition to pushing the body towards a healthy weight.
Is Modafinil Prescribed for Energy?
Modafinil is only an off-label prescription for energy and other related end needs. Brain-enhancing drugs may increase the release of brain chemicals like dopamine and norepinephrine, which can improve memory, mental acuity, and energy, learning, and motivation in the short term.
Modafinil is a unique dopamine uptake inhibitor. Its mechanism of action raises the level of dopamine concentrations in the brain by binding to the dopamine active transporter (DAT) & preventing the dopamine reuptake. Dopamine is a chemical neurotransmitter that the brain nerves use to effectively communicate with each other hence improving concentration and other cognitive brainpower effects. It also increases the activity of other essential neurotransmitters such as orexin, histamine (which promotes wakefulness), & norepinephrine (an important neurotransmitter that increases mental energy).
By boosting the levels of norepinephrine and dopamine, it effectively facilitates reasoning when it comes to problem-solving, enhances mental performance, energy, and promotes wakefulness and focus [8].
Several people use this drug in hopes of boosting their attention, memory or energy levels. Most healthy people take Modafinil as a “smart drug” to boost energy and enhance focus. It excites the mind so much with impressive brain benefits. Modafinil helps a certain group of people using it feel alert, focused and better able to concentrate on tasks.
Other Symptoms in Which Modafinil May Be Helpful
Doctors began to consider the effects of Modafinil and extensively prescribed it off-label for other sleep disorder related conditions. Extensive research shows that Modafinil has wider applications in helping various people with certain health conditions leading to the off-label prescription for conditions including major depressive disorder, Alzheimer’s disease, cognitive impairment in schizophrenia, methamphetamine abuse, and age-related memory decline, apathy in the elderly, jet-lag, fatigue and other related conditions.
This wider category of certain health conditions is due to Modafinil’s ability to restore wakefulness (its first reason as a prescription), improve concentration, and focus among other benefits.
Apart from its prescribed uses, Modafinil is impressively dubbed as the “king” of the study drugs. Students take this “smart drug” to improve their study energy, focus, vigilance, thinking, mental acuity, & concentration to excel during exams or win a competition. Also, as it’s the #1 “smart drug”, it’s used by professionals – including CEOs, military personnel, astronauts, workers, etc. and the increasing popularity of people from all walks of life, who use it just to boost productivity, promote wakefulness, and cognition.
Instructions and Safe Dosages of Using Modafinil
Modafinil’s recommended standard dose is 200 mg taken once per day. However, there exist lower doses of 50 mg and 100 mg.
Can I get a modafinil prescription? For certain sleep disorder conditions, it is taken as per the prescription. However, off-label use for energy, ADHD/ADD, fatigue, cognitive enhancement or productivity tasks is highly recommended not to administer modafinil without consulting with a doctor.
It’s paramount to know how the drug functions. Off-label, some people increase modafinil effects for studying, productivity and other uses by increasing the dose to 400 mg once daily. 400 mg is the maximum recommended dose strength. This, however, depends on how you take it and for what purpose. It’s an everyday use for certain sleep disorder conditions. Individuals using it for cognition and productivity take it only as needed.
Let’s read more information in our Modafinil dosage guide.
Before initiating modafinil, find a doctor. It’s a must to assess your health, consider possible disease or drug interactions, and negative effects and reactions that might arise while using this drug. Modafinil is safe for healthy individuals, but it does not mean that it should be taken without a recommendation from a doctor. Since everyone’s health is different, modafinil can work for you while it does not work in some individuals due to their health conditions and response to this medication.
Possible Side Effects and Warnings
Some modafinil negative effects can last for a few days, hours, or minutes and fade away with continual use of medication. Its side effects are normally classified into the following groups:
Some of the common negative effects include:
- dizziness;
- headaches;
- nausea;
- insomnia.
In rare cases, users may experience
- depression;
- anxiety;
- hallucinations.
Taking modafinil may also trigger allergic reactions to an individual (based on response to medication and health condition) such as severe rashes. Modafinil dosage should only be changed after having consulted with a medical specialist to ensure that it is safe for you.
Also, to a limited number of people, modafinil is likely to cause dizziness or blurred vision. Don’t drive or operate heavy machinery after taking this drug. It’s highly recommended not to stop the nootropic medication suddenly – it can contribute to withdrawal symptoms. Also, as part of a safe dosage, modafinil has not been studied enough for use in pregnant women. Consulting with a medical specialist before breastfeeding is also highly recommended.
Always follow the instructions given in the leaflet and do not mix modafinil with other drugs, since mixing drugs can cause minor or major interactions which might be harmful to your health. Make sure to keep a mandatory list of all the medicines/products you use (including nonprescription/prescription drugs and herbal products) and share it with your medical specialist.
Certain drug interactions include:
- CYP2C19 & CYP3A4/5 substrates;
- warfarin;
- street drugs (such as MDMA/”ecstasy”, methamphetamine);
- monoamine oxidase inhibitors;
- birth control medications and others [10].
Also, be aware of some health conditions including heart issues like chest pain, liver & kidney, high blood pressure, mental/mood disorders (such as mania, depression, psychosis, etc.) – they may cause health problems including moderate or major health conditions due to side effects. Using grapefruits/juice or mixing with alcohol can cause some unprecedented side effects [11].
In Summary
Scientists dubbed Modafinil as the world’s #1 safe “smart drug”. It is believed to effectively promote wakefulness, increase cognitive brain function including productivity effects. It helps alleviate certain health conditions in numerous ways outside its prescribed use. Modafinil has a wider potential in treating various health conditions related to sleep disorders, depression, fatigue, memory loss, cognitive dysfunction, and others.
References:
- Modafinil: its discovery, the early European and North American experience in the treatment of narcolepsy and idiopathic hypersomnia, and its subsequent use in other medical conditions. Michel Billiard, Roger Broughton. Published: September 2018. Sciencedirect.com.
- Molecular genetics of attention-deficit/hyperactivity disorder. Faraone SV, Perlis RH, Doyle AE, Smoller JW, Goralnick JJ, Holmgren MA, Sklar P. Published: Jun 2005. Ncbi.nlm.nih.gov.
- A review of the use of modafinil for attention-deficit hyperactivity disorder. Turner D. Published: April 2006. Ncbi.nlm.nih.gov.
- Treatment-resistant depression: therapeutic trends, challenges, and future directions. Khalid Saad Al-Harbi. Published: May 1, 2012. Ncbi.nlm.nih.gov.
- Modafinil reduces depression’s severity when taken with antidepressants. Published: November 27, 2013. Sciencedaily.com.
- Modafinil. Retrieved: April 9, 2020. Wikipedia.org.
- User Reviews for Modafinil to treat Chronic Fatigue Syndrome. Retrieved: April 9, 2020. Drugs.com.
- Modafinil | Uses. Retrieved: April 9, 2020. Drugs.com.
- Modafinil Side Effects by Likelihood and Severity. Retrieved: April 9, 2020. Webmd.com.
- PROVIGIL® (modafinil) Tablets [C-IV] (PDF). Retrieved: April 9, 2020. Accessdata.fda.gov.
- Mixing Modafinil With Alcohol. Retrieved: April 9, 2020. Therecoveryvillage.com.