chemical model of modafinil

Is This Wakefulness Wonder Drug for You?

Adults with excessive daytime sleepiness resulting from sleep apnea, narcolepsy and shift-work sleep disorder have an FDA-approved treatment to help them stay awake. Modafinil (Provigil or Nuvigil) is a stimulant medication that works on the central nervous system to improve “wakefulness.” It has also shown some promise in treating fatigue associated with disease states including multiple sclerosis, Parkinson’s disease and depression. Some studies have reported that modafinil helps with cognitive performance, especially working memory. It may also improve mood.

Modafinil has a different chemistry than amphetamine-type stimulants and does not appear to have properties that pose significant dangers for addiction or abuse. However, the drug is used “recreationally” to enhance physical and/or cognitive performance by those in occupations or situations demanding/desiring long periods of alertness. An article in New Scientist magazine titled, “Get ready for 24-hour living,” describes modafinil as a lifestyle drug that can override the body’s need for sleep. In the U.S. it is classified as a non-narcotic Schedule IV controlled substance to curtail potential abuses.

There is only one study of treatment of CFS with modafinil published in the peer-reviewed literature. Its 14 CFS subjects did not report reduced fatigue or perform better on cognitive tasks, although the authors recognize this may be due to the small sample size and insufficient study power.

Like most medications, modafinil has reported common side effects, including headache, nausea, nervousness, stuffy nose, diarrhea, back pain, anxiety, trouble sleeping, dizziness and upset stomach. Even so, it is considered to be a relatively safe drug. People using modafinil with success indicate that it doesn’t produce the same “jittery” or “racing” feeling that caffeine and other stimulants often do.

Drug-maker Cephalon sells modafinil under the trade names Provigil and Nuvigil (a longer-acting form of Provigil). It is not approved for use in children under the age of 18 and carries several precautions and contraindications that should be considered by the prescribing health care professional and his or her patient. The medication is also quite pricey ($1.50+ per pill) and unlikely to be covered by insurance for uses other than those related to narcolepsy, obstructive sleep apnea and/or shift-work sleep disorder.

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