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What is Provigil (Modafinil)?
Provigil, the brand name for the drug modafinil, is a central nervous system (CNS) stimulant that treats sleep disorders by improving wakefulness. These medical conditions include:
- Narcolepsy — a chronic sleep disorder characterized by increased daytime sleepiness and sudden attacks of sleep.
- Shift work disorder (SWD) — a sleep disorder caused by working shifts that do not align with the body’s circadian rhythms, often causing someone to not get enough sleep.
- Obstructive sleep apnea — a potentially dangerous sleep disorder where the throat muscles block the airway during sleep, stopping breathing during the night; this results in excessive sleepiness during the day.
Modafinil is a prescription drug and is considered a eugeroic drug. Eugeroic drugs promote wakefulness with little to no adverse side effects commonly experienced with stimulant use.
A study from 2018 found that about 5.1 million people (12 and older) have misused prescription stimulants in the past year. This is about 1.9 percent of the U.S. population.National Survey on Drug Use and Health (NSDUH)
It is prescribed as tablets that are taken by mouth. To treat narcolepsy and obstructive sleep apnea, take 200 milligrams (mg) every morning. On the other hand, to treat SWD, take 200 mg one hour before beginning a work shift.
Modafinil is often used off-label by people with ADHD, as the effects of modafinil are similar to other stimulants such as Adderall and Ritalin.
Risks of Modafinil
Modafinil has similar effects as central nervous system (CNS) stimulants, such as amphetamine and methylphenidate. These drugs all produce euphoric and psychoactive effects, and alter mood, thinking, perception, and feelings.
The Drug Enforcement Administration classifies Modafinil as a Schedule IV drug. These drugs are defined as, “drugs with a low potential for abuse and low risk of dependence.”
Serious allergic reactions to modafinil have been reported, affecting both the skin and airways. Contact your doctor right away if you develop any of the following skin reactions:
- Peeling, blistering or loosening of the skin
- Severe acne or skin rashes
- Sore or ulcers
- Red lesions
It is also possible to develop anaphylaxis, a dangerous allergic reaction that can be life-threatening if not treated immediately. If any of these symptoms occur, contact emergency medical services immediately:
- Skin rash or itching
- Hives or welts on the skin
- Difficult breathing and swallowing
- Hoarseness or difficulty speaking
- Swelling of the face, hands or mouth
There was an application submitted to the FDA to market modafinil for pediatric attention deficit hyperactivity disorder (ADHD), but it was denied due to its dermatological toxicity and the occurrence of Stevens-Johnson syndrome in clinical trials.
Common Side Effects
Side effects of Provigil (modafinil) include:
- Stuffy nose
- Back pain
- Upset stomach
More serious side effects can occur while using modafinil. If any of these occur, contact your doctor or seek medical attention immediately:
- Mental (psychiatric) symptoms — symptoms include anxiety, depression, mania, hallucinations or thoughts of suicide.
- Heart problems — symptoms include chest pain and heart palpitations.
Before using Provigil, make sure that you share your complete medical history with your doctor. Especially if you or your family has a history of:
- Bipolar disorders
- Cardiac disease
- Cardiovascular disease
- Heart attacks
- Liver problems
- Psychiatric disorders
- Psychotic disorders
- Renal dysfunction
Do not use Provigil if you've had an allergic reaction or skin rash while taking armodafinil (Nuvigil). It is unknown whether modafinil passes through breast milk, so seek medical advice from a healthcare professional if you are currently or plan on breastfeeding.
Provigil is known to have interactions with a large number of medications, including diazepam, and phenytoin. For a complete list of drug interactions consult your doctor and ask for a medication guide.
It is especially important to tell your doctor if you use a hormonal contraceptive, including:
- Birth control pills
- Vaginal rings
- Intrauterine devices (IUDs)
Provigil can decrease the effectiveness of these birth control methods.
Although it is a Schedule IV drug with low risk for addiction and dependence, it is possible to become addicted to Provigil (modafinil). Addiction is characterized by a set of behaviors surrounding drug use. Someone who is addicted to Provigil might be unable to stop using it, may continue to do so despite knowing it is harmful, and may have cravings when not taking it.
Modafinil blocks the reuptake of dopamine into neurons, a neurotransmitter that plays an important role in the reward system of the brain. The drug allows dopamine to remain outside of the neurons and transmit signals between the cells. As a result, this effect on brain chemistry gives Provigil its addictive potential.
Provigil has been shown to be reinforcing, as demonstrated in a study performed on monkeys who give themselves the drug. Additionally, it has been shown to produce similar psychoactive side effects to other scheduled CNS stimulants, such as Adderall and Ritalin.
A study from 2015 detailed an individual who became addicted to Provigil after he was prescribed it to treat SWD. He felt normal only when taking the drug above the recommended dosage, a common sign of addiction and dependence. However, when he skipped doses, the side effects experienced included anxiety, erratic sleep, lethargy and tremors of the hands.
It is possible to overdose on modafinil, and most overdoses occur in combination with other drugs and alcohol. Symptoms of an overdose from the medication alone or in combination with other drugs include:
- Restlessness and excitation
- Confusion or disorientation
- Changes in heart rate (tachycardia or bradycardia
- Chest pain
- High blood pressure
In the most severe cases, death can occur as the result of an overdose.
When Provigil (modafinil) is used for an extended period of time, the body becomes accustomed to its presence. It may reach the point where you are dependent on the drug, and you cannot function normally without it. Symptoms of dependence include needing to increase the dose of a drug to feel the same effects experiencing withdrawal symptoms after stopping use.
If you stop using modafinil, you may experience negative side effects known as withdrawal symptoms. The most common withdrawal symptom from the medication is sleepiness in people who have narcolepsy. This is most likely to occur if you quit a drug “cold-turkey” or abruptly.
Addiction Treatment Options
The safest way to stop using a drug is under the care of a medical professional. Tapering is a method that decreases a drug dose over time to prevent shock to the body’s systems. This gradual process helps the brain and body adjust to the absence of a drug and prevents uncomfortable side effects.
Treatment options are available to help you or a loved one overcome addiction to Provigil (modafinil). Effective methods for treating stimulant addiction include cognitive-behavioral therapy (CBT) and contingency management.
Cognitive-behavioral therapy is a program centered around learning how to identify problematic behaviors in addiction and correct them. During this program, patients learn to think ahead about likely problems and how they may handle them. Examples of specific techniques are provided by the National Institute on Drug Abuse. They include:
- Exploring the positive and negative consequences of continued drug use
- Self-monitoring to recognize cravings early and identify situations that might put one at risk for use
- Developing strategies for coping with cravings to avoid high-risk situations
Contingency management (CM) is a treatment approach that gives tangible rewards to patients to reinforce positive behaviors. It is likely that the reward given during CM stimulates the reward pathway similar to drug use, making this a useful method. Thus, it is extremely effective in encouraging patients to continue treatment and promoting abstinence from drugs.
Overcoming addiction to Provigil (modafinil) is difficult to do alone. Find treatment today.
Is Provigil a narcotic?
No, provigil is a central nervous system stimulant, not a narcotic. Narcotics depress the central nervous system.
Is Provigil a controlled substance?
Yes, Provigil is a schedule IV federally controlled substance, meaning it has potential for abuse and addiction.
Is modafinil habit forming?
Yes, modafinil has addictive properties and can cause cravings.