Provigil: Uses, Dosage, Effects & Addiction Risks

Provigil (modafinil) is a central nervous system (CNS) stimulant that treats sleep disorders by increasing energy and wakefulness. Although it is a Schedule IV drug with low risk for addiction and dependence, it is possible to become addicted to the drug. Learn the risks.
Evidence Based
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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 disorders include:

  • Narcolepsy — a chronic sleep disorder characterized by increased daytime sleepiness and sudden attacks of sleep.
  • Shift work sleep disorder (SWSD) a sleep disorder caused by working shifts that do not align with the body’s circadian rhythms.
  • 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 daytime sleepiness.

Modafinil is a eugeroic drug, and its name comes from Latin, meaning “good arousal.” Further, 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 SWSD, take 200 mg one hour before beginning a work shift.

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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
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Common Side Effects

Side effects of Provigil (modafinil) include:

  • Nausea
  • Headache
  • Stuffy nose
  • Diarrhea
  • Nervousness
  • Back pain
  • Anxiety
  • Dizziness
  • 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.
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Addiction Symptoms

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 SWSD. 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:

  • Insomnia
  • Restlessness and excitation
  • Confusion or disorientation
  • Nausea
  • Hallucinations
  • Diarrhea
  • 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.

Benefits

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.


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Resources

Cleveland Clinic. “Shift Work Sleep Disorder.” Cleveland Clinic, Apr. 2017, https://my.clevelandclinic.org/health/diseases/12146-shift-work-sleep-disorder

Drug Enforcement Administration. “Drug Scheduling.” DEA, https://www.dea.gov/drug-scheduling

Food and Drug Administration. “PROVIGIL (modafinil) Tablets [C-IV].” FDA, Aug. 2007, https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/020717s020s013s018lbl.pdf

Food and Drug Administration. “NUVIGIL (armodafinil) tablets, for oral use, C-IV.” FDA, Apr. 2015, https://www.accessdata.fda.gov/drugsatfda_docs/label/2015/021875s021lbledt.pdf

Food and Drug Administration. “PROVIGIL (modafinil) Tablets [C-IV].” FDA, Aug. 2007, https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/020717s020s013s018lbl.pdf

King, Dongsoo. “Practical Use and Risk of Modafinil, a Novel Waking Drug.” Environmental Health and Toxicology, Feb. 2012, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3286657/pdf/eht-27-e2012007.pdf

Krishnan, R., Chary, KV. “A rare case of modafinil dependence.” Journal of Pharmacology & Pharmacotherapeutics, Jan-Mar. 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4319252/

Mayo Clinic. “Narcolepsy.” Mayo Clinic, Jan. 2019, https://www.mayoclinic.org/diseases-conditions/narcolepsy/symptoms-causes/syc-20375497

Mayo Clinic. “Obstructive sleep apnea.” Mayo Clinic, Jun. 2019, https://www.mayoclinic.org/diseases-conditions/obstructive-sleep-apnea/symptoms-causes/syc-20352090

MedlinePlus. “Modafinil.” MedlinePlus, Feb. 2016, https://medlineplus.gov/druginfo/meds/a602016.html

National Institute on Drug Abuse. “Prescription Stimulants.” NIDA, Jun. 2018, https://www.drugabuse.gov/publications/drugfacts/prescription-stimulants

Substance Abuse and Mental Health Services Administration. “2018 National Survey on Drug Use and Health Annual National Report.” SAMHSA, Aug. 2019, https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHNationalFindingsReport2018/NSDUHNationalFindingsReport2018.pdf

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Updated on: July 17, 2020
Author
Addiction Group Staff
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Medically Reviewed
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Annamarie Coy,
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