What is it?
Modafinil is a drug that is marketed as an agent to improve alertness and wakefulness. It is indicated for people who suffer from excessive sleepiness due to conditions such as narcolepsy (Sleep walking), obstructive sleep apnea or work shift sleep disorder.
It is marketed under the trade name of Provigil in United states. It is classified as a scheduled drug by the US FDA and is restricted in its availability. However, in many other countries, Modafinil is a prescription drug but is not restricted in its availability.
One of the most common off-label use of the drug is as cognition enhancer. When administered, the drug is supposed to increase awareness and hence it is sometimes marketed as a nootropic agent.
How does it work?
The precise mechanism by which the drug acts is still largely unknown. However, recent studies have shown that the drug acts to increase the levels of a chemical substance (neurotransmitter) called Dopamine in the brain.
Dopamine is a neurotransmitter that is associated with increased alertness and enhancing the mood. It is also associated with the pleasure pathways of the brain. Modafinil causes an increase in the presence of Dopamine by blocking its uptake back in to the neurons. However, there are possibly many other mechanisms of action that can be attributed to the drug. The mechanisms leading to the improved memory and cognition are not completely clear as of yet.
What are the benefits of Modafinil?
Modafinil is an excellent drug for treating disorders such as excessive sleepiness. The drug belongs to a category of drugs called Euggeroic drugs that promote wakefulness. Medically, the drug has been used to treat many sleep disorders causing excessive daytime drowsiness and sleepiness.
Modafinil has also found some potential off-label benefits apart from promoting wakefulness. It has been successfully used in patients suffering from Multiple Sclerosis (MS) to reduce the neurological fatigue associate with the disease.
Apart from MS, it has also been successfully used to treat fatigue in a number of conditions including cerebral palsy, fibromyalgia and chronic fatigue syndrome.
As Modafinil promotes wakefulness, the militaries of many countries are interested investing the drug as an alternative to potentially dangerous and addictive Amphetamines. Many military outfits including French, British and US have been using the drug in certain missions requiring increased wakefulness and alertness.
It has also been used by astronauts in certain long term missions to combat fatigue and improve the sleep cycles.
The usual dosage of the drug is 200 mg once a day taken in the morning with breakfast. Although higher doses of up to 400 mg have been well tolerated but, they offer no additional benefit over and above the 200 mg per day dose.
What are the side effects of the drug?
Although Modafinil is well tolerated, certain side effects have reported. There are some serious adverse reactions reported in some individuals on Modafinil. These include:
l Serious rash
l Multi organ hypersensitivity reactions
l Persistent sleepiness
l Cardiovascular events
Some psychiatric side effects following the use of the drug have also been reported. These include mania, confusion, hallucination and in some cases even suicidal tendencies. These effects are more common in people having a history os depression or psychoses.
Modafinil has also been shown to interact with hormonal contraceptives reducing their effectiveness. The effects can last unto a month after stopping the dosage of modafinil.
Although the addiction potential of Modafinil is very low, it is still restricted in availability s per the US FDA. One of the reasons being the similarities it shares with other stimulant drugs such as Amphetamines. It is also associated to elevating the mood and hence has a potential to be misused. As such, Modainil abuse does exist and people have been found to use the drug for recreation purposes. Psychological dependence is only found in some cases where there is a daily overdose of the drug.
Long term use of Modafinil
Although the long term safety and effectiveness studies on Modafinil are not available currently, it is generally reported to be a safe drug if taken at a proper dosage.
A number of large scale clinical studies have found that there is no tolerance developed to the drug even after three years of daily usage.
Overdosing on Modafinil is not life threatening, but may cause some unwanted side effects.
A number of clinical trials conducted in m,any countries have revealed that Modafinis does offer significant benefits in maintaining wakefulness and reducing fatigue. Modafinil has been found to be very useful in treating many conditions such as:
l Neurodegenerative disorders such as MS and Parkinson’s disease and Schizophrenia
l Hypersomnia: The drug is used to treat people who have the condition and is also reported to induce a healthy sleeping cycle following the use
l Cognitive enhancement: Extensive research in Modafinil’s ability to improve cognition and memory has revealed that the drug improves some working memory but the results are largely inconclusive about improvement in attention span improvement and spatial memory
Although modafinil is a good drug in treating sleep disorders, the effect in improving cognition is still debated heavily. It is a good agent for people suffering form excessive sleep during the day time but the jury is still out regarding other claims including improving memory.
A number of user reviews of the drug indicate that there is significant enhancement in working memory and cognition. The abuse potential is minimal and hence the drug shows promise. Only time will tell whether there are any long term effects of the drug.