Provigil: Uses, Dosage, Effects & Addiction Risks

What Is Provigil (Modafinil)?

Modafinil is a prescription medication classified as a eugeroic, a type of wakefulness-promoting agent. 

Under the brand name Provigil, modafinil is a central nervous system stimulant that treats sleep disorders by improving wakefulness. It can also be used to treat excessive fatigue.

What Can Modafinil Treat?

Unlike some traditional stimulant drugs, modafinil is generally associated with fewer adverse side effects. Due to this, it is often used as a prescription drug for medical conditions like:

• 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 not to 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 and resulting in excessive sleepiness during the day

What Are the Risks of Modafinil?

Modafinil generally has fewer euphoric and psychoactive effects than traditional stimulants like amphetamines.

Possible effects of the drug include: 

• Mood changes
• Thinking alterations
• Perception changes
• Euphoric effects
• Psychoactive effects

The Drug Enforcement Administration (DEA) classifies modafinil as a Schedule IV drug. It has a low potential for substance abuse and a low risk of dependence. However, it can still lead to uncomfortable and potentially severe side effects.

Additionally, modafinil has been shown to produce similar psychoactive side effects to other scheduled central nervous system (CNS) stimulants, such as Adderall and Ritalin. Modafinil is often used off-label by people with ADHD, as the effects of modafinil are similar to Adderall and Ritalin. 

Common Side Effects

Side effects of Provigil (modafinil) include:

• Nausea
• Headache
• Stuffy nose
• Diarrhea
• Nervousness
• Back pain
• Anxiety
• Dizziness
• Upset stomach

Severe Side Effects of Modafinil

More serious side effects can occur while using modafinil. If any of these occur, contact your doctor or seek medical attention immediately:

• Anxiety
• Depression
• Mania
• Hallucinations
• Suicidal ideation
• Chest pain
• Heart palpitations

Allergic Reactions to Modafinil

Serious allergic reactions to modafinil have been reported, affecting 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
• Sores or ulcers
• Red lesions

It is also possible to develop anaphylaxis, a dangerous allergic reaction that can be life-threatening if not treated immediately. Symptoms include:

• Skin rash or itching
• Hives or welts on the skin
• Difficulty breathing and swallowing
• Hoarseness or difficulty speaking
• Swelling of the face, hands, or mouth

Who Is at Risk When Taking Provigil?

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 disorder
• Cardiac diseases
• Cardiovascular disease
• Heart attacks
• Hypertension
• Liver problems
• Psychiatric disorders
• Psychotic disorders
• Renal dysfunction
• Seizures
• Addiction or substance use disorders (SUD)

Do not use Provigil if you've had an allergic reaction or skin rash while taking armodafinil (Nuvigil). It is also unknown whether modafinil passes through breast milk, so seek medical advice from a healthcare professional if you plan on or are currently breastfeeding.

What Happens When You Get Addicted to Modafinil?

Although Modafinil has a low risk of addiction and dependence, it’s still possible to become addicted. Take note of the following symptoms for an addiction, overdose, or withdrawal reaction to modafinil.

Modafinil Dependence

People who abuse modafinil for an extended period of time may develop a dependence on it. However, developing a physical or psychological dependence on modafinil is rare.

When you’ve become dependent on a substance, you’ll have strong urges or cravings to continue using the drug, regardless of its adverse side effects.

You can also develop a tolerance for the drug with prolonged use. When this happens, you’ll need more frequent or higher doses of modafinil to achieve the same effect.

Modafinil Addiction Symptoms

If you become addicted to Provigil, you might be unable to stop using it despite knowing its harmful side effects.

Addiction symptoms include:

• Sleeping problems
• Loss of appetite
• Dry mouth
• Chest pain
• Irregular heartbeat
• Gastrointestinal problems
• Muscle tightness or pain
• Skin peeling or blisters
• Difficulty breathing or swallowing
• Dizziness
• Nausea
• Headache 

Modafinil Overdose Symptoms

It’s possible to overdose on modafinil, and most overdoses occur in combination with other drugs and alcohol.

Symptoms of an overdose include:

• Insomnia
• Restlessness and excitation
• Confusion or disorientation
• Nausea
• Hallucinations
• Diarrhea
• Changes in heart rate (tachycardia - faster heart rate than normal, bradycardia - slower heart rate than normal)
• Chest pain
• High blood pressure

In the most severe cases, death can occur due to an overdose.

Modafinil Withdrawal Symptoms

If you suddenly stop using the drug, you may experience withdrawal symptoms if you’ve developed a dependence on it. 

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, he experienced the following side effects: 

• Anxiety
• Erratic sleep
• Lethargy
• Tremors

Because of these side effects, talking to a doctor before stopping modafinil use is important.

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How to Stop Taking Modafinil

Overcoming an addiction can be difficult, especially because of withdrawal symptoms. Because of this, it’s important to seek treatment.

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). 

Addiction Treatment Programs

Effective methods for treating stimulant addiction include cognitive-behavioral therapy (CBT) and contingency management. 

CBT is a program centered around learning how to identify problematic behaviors in addiction and correct them. In this program, participants 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, including:

• 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

Another treatment option is contingency management (CM), which provides tangible rewards to reinforce positive behaviors. CM stimulates the reward pathway similar to drug use, making it effective at encouraging patients to continue treatment and promote abstinence.

Provigil Drug Interactions

Provigil is known to have interactions with a large number of medications, including diazepam and phenytoin. These interactions can change how the drug works, potentially increasing the risk of harmful side effects or worsening already existing ones.

Provigil can also decrease the effectiveness of birth control methods. It is especially important to tell your doctor if you use a hormonal contraceptive, including:

• Birth control pills
• Vaginal rings
• Intrauterine devices (IUDs)
• Patches
• Shots
• Implants

For a complete list of drug interactions, consult your doctor and ask for a medication guide.

How Modafinil Works

Modafinil's mechanism of action is not fully understood but appears to involve several neurotransmitters, including dopamine reuptake inhibition. 

Dopamine is involved in the brain's reward system, accumulating extracellular dopamine and enhancing intercellular signaling. These effects all contribute to modafinil’s addiction and abuse potential.

Provigil is shown to be reinforcing, as demonstrated in a study on monkeys who give themselves the drug. However, the relevance of these findings to human use should be approached with caution, as individual responses to medications can vary significantly.

How to Take Modafinil Safely

Modafinil is prescribed as tablets that are taken orally. To treat narcolepsy and obstructive sleep apnea, take 200 milligrams (mg) every morning. To treat SWD, take 200 mg 1 hour before beginning a work shift.

Taking modafinil safely is important due to the risks associated with prescription stimulants. A study from 2018 found that about 5.1 million people (12 and older) have misused prescription stimulants in the past year, around 1.9% of the U.S. population.

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Summary

Provigil (modafinil) is a central nervous system (CNS) stimulant that treats sleeping disorders like narcolepsy or shift work sleep disorder (SWD). However, like other stimulant drugs, Provigil can lead to uncomfortable or severe side effects when misused. 

Modafinil is considered a Schedule IV controlled substance, meaning it has a low potential for abuse and addiction. However, it’s still possible to develop an addiction or dependence after prolonged use.

Modafinil abuse can lead to overdose and withdrawal. Fortunately, there are treatment options to help you recover from addiction, including cognitive-behavioral therapy (CBT) and contingency management (CM).

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