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What is Modafinil?

What is Modafinil?

Modafinal is a ‘wakefulness-promoting agent’; a drug that has a stimulating effect on the body, keeping the brain alert and making it easier for users to remain awake. 

It is often prescribed to treat and manage both temporary and long term conditions that cause or contribute towards excessive daytime sleepiness. By Encouraging the brain to remain alert during the day, modafinil is shown to be effective at regulating the body’s sleep/wake cycle to facilitate healthier sleep patterns in individuals. 

History of Modafinil

In 1977, neurophysiologist Dr Michel Jouvet was exploring the effects of another wakefulness-promoting agent, adrafinil, on patients diagnosed with narcolepsy. During his research, he discovered that adrafinil was being metabolized and converted into another substance – what we now know as modafinil – in the body. 

Jouvet’s findings were shared with French drug company L. Lafon, and further research into modafinil was conducted by the organization. Following promising outcomes and signs of potential, modafinil was registered in France in 1992. 

Is Modafinil a Stimulant?

Due to modafinil’s stimulant-like effects, it is often grouped together with psychostimulants such as dexamphetamine. However, in the absence of amphetamines, modafinil does not meet the criteria for being a stimulant. 

Amphetamines are used to increase the speed at which the brain communicates with the body. When messages are delivered more efficiently, the body is able to respond quicker, resulting in an individual being more alert and active. While modafinil produces a similar effect – and is used for similar purposes – it is actually a eugeroic, rather than a stimulant, due to its different pharmacological profile. 

A eugeroic is a class of drugs that promote alertness and wakefulness. The term comes from the combination of two Greek words: ‘eu’, meaning ‘good’, and ‘gregor’, meaning ‘wakening’. So a eugeroic is a drug used for ‘good wakening’. 

As modafinil is not an amphetamine-based stimulant – yet produces a similar effect – it has emerged as a strong area of interest for researchers. It has opened up doors to treating and managing conditions that have traditionally responded well to stimulants in a safer way. While amphetamines are considered to be dangerous, producing undesirable side effects such as anxiety and jitteriness, and known to be highly addictive, research to date suggests that modafinil has fewer downsides. 

Modafinil Uses: Sleep Disorders

Throughout modafinil’s research history, when participants have been asked ‘how does modafinil make you feel’, most have reported that the drug makes them feel awake, alert, and focused. For this reason, modafinil is primarily used to treat a broad spectrum of health conditions that can cause excessive daytime sleepiness. 

Some of these conditions include:

  • Narcolepsy

Narcolepsy is a condition which causes sufferers to experience sudden and excessive daytime sleepiness. Research suggests that modafinil could help to reduce the symptoms of narcolepsy in around two thirds of those diagnosed. 

  • Shift work sleep disorder

Long term shift work is known to cause lasting disruption to the body’s sleep/wake cycle. By helping the body to remain awake and alert during daytime hours, modafinil may be prescribed to help former shift workers rebuild their routine. 

  • Jet lag

Time differences between countries can cause travelers to sleep at inconvenient hours. Some doctors may prescribe modafinil on a short-term basis to help regular travelers settle into appropriate routines for the country they are currently in. 

  • Stress-induced sleep loss

Periods of stress and anxiety can greatly affect an individual’s ability to sleep at night. Modafinil’s ability to keep the body active and alert during the day helps to increase feelings of tiredness in the evening, making it easier to fall and stay asleep.

  • Cancer-related fatigue

Chemotherapy and other cancer treatments can cause severe, debilitating fatigue in patients. Studies have found that modafinil can be a highly effective solution, with the drug demonstrating ‘significant’ results on tiredness, mood, and general ability. 

  • Sleep difficulties in critically ill patients

Critically ill patients in intensive care units may be prescribed modafinil to fight fatigue, excessive daytime somnolence, and depression that can hinder recovery. Studies have concluded that modafinil could play a major role in the ICU. 

  • Sleep apnea

Obstructive sleep apnea is a condition which causes breathing to stop and start throughout the night. It can contribute to insomnia, and cause hypersomnia, or excessive daytime sleepiness. Modafinil is often used to alleviate tired feelings. 

Modafinil Uses: Impulse Disorders

While modafinil is approved for the treatment of sleep-related disorders, researchers believe that the drug has the potential to achieve much more. Currently, a strong area of interest lies in impulsive conditions. Experts report that modafinil ‘has been shown to reduce impulsiveness in a variety of disorders’, and could help with…

  • Attention deficit hyperactivity disorder

Using modafinil for ADHD could reduce instances of impulsivity in children who struggle to maintain focus, and who exhibit problematic behaviors as a result of this impulsivity. While more research needs to be conducted, early results are positive. 

  • Weight loss

Research has shown that weight loss may be a side effect of modafinil, sparking interest in the drug as a possible treatment for obesity. Studies have found that average daily caloric intake for modafinil users is reduced by up to 38%. 

  • Addiction

Modafinil’s ability to help individuals remain focused could help to reduce temptation and impulsivity in those struggling with multiple types of addiction, including alcohol addiction, food addiction, and substance abuse. 

Modafinil Uses: Smart Drug

In recent years, there has been increasing interest in modafinil as a ‘nootropic’; a type of drug that can be used to temporarily enhance cognitive ability in users. 

The use of nootropics is growing rapidly amongst both students and workers who require more time to study, carry out essential tasks, or meet deadlines. Smart drugs are intended to keep users awake and alert for longer, and help focus attention on a particular task or mission. Doctors, long distance truck drivers, and call center staff are amongst the growing number of occupations where smart drugs are used. 

Modafinil’s low risk of addiction and few side effects have earned it the nickname ‘the world’s first safe smart drug’. Research into modafinil as a nootropic shows that, while it doesn’t have much – if any – effect on memory, it does appear to have a significant and positive impact on planning and decision making. Researchers have noted that modafinil seems to work on ‘higher brain functions that rely on contribution from multiple simple cognitive processes’ such as longer tasks. 

How Does Modafinil Work?

The precise modafinil mechanism of action still isn’t fully understood. However, it is widely accepted that the drug’s ability to bind to DAT proteins, which transport a chemical called dopamine around the body, is likely the primary mechanism. 

Dopamine is a neurotransmitter that works within the body’s nervous system. Its role is to deliver messages between different cells. In many cases, this involves sending messages between the cells in the brain and cells in the body, such as messages which instruct the body to be active, and messages which tell it to relax and rest. 

When an individual experiences low levels of dopamine, it becomes more challenging for these messages to be communicated quickly and clearly. Messages can easily become lost or jumbled, which means that despite the brain knowing what needs to happen, the body fails to respond or act in the correct way. 

The usual physiological process is for the body to clear out any dopamine that has not been absorbed, but this can create low levels of the chemical, particularly in those who produce dopamine at a slower rate. This can happen for a number of reasons, including damage to the brain, or problems with the nerve cell receptors. 

When modafinil enters the body, it binds itself to the DAT proteins that are responsible for carrying dopamine around the body. The presence of modafinil prevents the body from clearing out any dopamine that has not been absorbed, helping to maintain higher levels and helping the brain communicate with the body.

There is another substance – armodafinil – which has a very similar mechanism of action. The two are considered to be ‘dopamine reuptake inhibitors’, preventing dopamine from being cleared from the body. The difference between the two is that while modafinil contains two mirror image molecules, R-(-)-modafinil and S-(+)-modafinil, armodafinil contains only the ‘R’ molecule. Despite this, they work very similarly, and some forms of brand name modafinil contain armodafinil.

While less well researched, modafinil’s action on the dopamine system is, in turn, understood to have some degree of impact on the body’s GABA system. Experts believe that modafinil could be responsible for increasing the release of serotonin in the body, which makes it an interesting topic of discussion for antidepressant researchers. Some believe that modafinil could offer relief from the symptoms of depression for those that have not seen results from serotonin reuptake inhibitors. 

Legal Status

Since modafinil was registered in France in 1992, most countries have legalized the drug, and today it is prescribed all over the world for the treatment of sleep disorders. In the United States, modafinil was approved by the Food & Drug Administration in 1998 for the treatment of narcolepsy, and in 2003 its approved use was extended to include the treatment of sleep apnea and shift work disorder. To date, modafinil has not been fully approved for other types of medical uses. 

Is modafinil a controlled substance in the US? Yes. The official modafinil drug class categorizes modafinil as a ‘Schedule IV Controlled Substance’. This means that, legally, modafinil should only be purchased with a valid prescription from a medical professional. However, as with other class IV substances like Xanax and Ambien, there is a gray area surrounding the purchase of modafinil. Especially because, as a nootropic, there is an argument for modafinil as a research drug. Therefore, various brands of modafinil are widely available online. Some users prefer to buy online as they are often able to secure their medication cheaper, and more quickly. 

Dosage

Modafinil dosage will usually begin at 100mg per day, with the option to increase gradually to 200mg to achieve the desired effect. Some very severe conditions may require that the patient begins with a daily 200mg dose, and increases over time as required to manage the symptoms of their condition. Modafinil usually comes in 100mg or 200mg film-coated tablets, which simply need to be swallowed with water. For best results, the tablets should be taken at roughly the same time each day.

Patients are sometimes advised to take modafinil tablets with food to reduce the risk of side effects. When doing so, it’s important to be aware that the time taken to feel the full effects of the drug can be longer. While a person taking modafinil on an empty stomach will usually feel the effects between 2-4 hours after administration, those taking modafinil with food will typically have a delay of around one hour. 

How long does modafinil last? Modafinil half life is around 15 hours for adults, and around 7 hours for children. This is why it is advised to take modafinil daily, and ideally at the same time, to ensure that the effects can continue to be experienced. 

If modafinil has been prescribed to treat or manage a specific medical condition, it is important to always follow the exact dosage as recommended by the healthcare professional. Taking more than prescribed, or taking more than 200mg per day without seeking professional advice, could result in overdose. Symptoms of modafinil overdose include irritability, confusion, restlessness, hallucinations, and chest pain. 

Interactions & Side Effects

For those taking other medications, there are a number of modafinil interactions to be aware of. Modafinil has been shown to increase the effects of medicines such as diazepam, propranolol, phenytoin, S-mephenytoin, tricyclic, and some types of SSRI antidepressants. It has also been shown to decrease the efficacy of some other medicines, particularly hormonal birth control such as the contraceptive pill. It is important to ensure non-hormonal birth control methods are implemented when taking modafinil as a backup should the drug interact with hormonal methods. 

While modafinil is generally considered to be safe, like all medicines it can cause minor side effects in users. Some of the most commonly reported side effects for this medication include headaches, nausea, stomach upset, runny nose, and dizziness. Most side effects should begin to ease as the body adjusts to the drug. However, more severe side effects, or minor side effects that do not subside, should always be checked by a medical professional. Always dial 911 for breathing difficulties. 

It is not recommended that pregnant women – or those actively trying to conceive – take modafinil. Research shows that modafinil could affect how a fetus develops in the womb. Potential outcomes could include heart defects, orofacial clefts, and hypospadias. While these birth defects are rare, they can – and do – happen. 

Where to Buy Modafinil

Modafinil can be purchased from pharmacies, either in-store, or online through companies like Next Pharmaceuticals. When buying modafinil, it’s important to understand that there are a number of different brands, each with a different name. 

Each modafinil brand will include the active ingredient modafinil or, in some cases, armodafinil. Essentially, the tablets are exactly the same, but have different names. 

However, it is important to select a high quality, reputable brand to ensure that you’re making a safe and responsible choice. Some good quality brands include:

Modalert

  • Modalert is made by Sun Pharma, and features the active ingredient modafinil. It usually comes in a stronger 200mg tablet, to be taken once per day, or as prescribed. Modalert can be purchased in 30, 60, 90, 120, 180, or 300 quantities. 

Artvigil

  • Artvigil is made by HAB Pharma, and unlike most modafinil brands it contains the active ingredient armodafinil which is chemically similar to modafinil. Artvigil is available as a 150mg tablet, to be swallowed once per day, or as prescribed. 

Modvigil

  • Modvigil is made by HAB Pharma, and is the modafinil-based equivalent of Artvigil. It comes as a 200mg tablet, to be taken once per day or as prescribed. Modvigil can be purchased in quantities of 30, 60, 90, 120, 180, and 300 tablets as required. 

Waklert

  • Waklert is made by Sun Pharma. Unlike Sun Pharma’s Modalert which contains modafinil, Waklert features the active ingredient armodafinil. It comes in a slightly weaker 150mg tablet, to be taken once per day, or as prescribed by a doctor. 

Modafinil Alternatives

Modafinil is widely considered to be one of the safest and most effective treatments for sleep disorders. It also boasts a great deal of promise as a form of management for impulse disorders, and could be key to creating a safer nootropics landscape. 

However, modafinil isn’t right for everyone. Some people may be unable to take modafinil due to other medication they have been prescribed. And some may experience side effects when taking modafinil that makes the medicine undesirable. 

While there is nothing quite as effective as modafinil, there are a number of other drugs that could help to better regulate the sleep/wake cycle. Etizolam is a good alternative for those struggling to sleep during the night. While it has a different mechanism of action to modafinil, it can help to promote a good night’s rest. 

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