Modafinil for Alertness: Risks and Benefits

For those who find it increasingly difficult to stay awake — despite an appropriate amount of sleep — medication may be introduced for treatment and relief. While such an approach can help to improve the outlook for the individual, no medication is without risk and the individual should be fully informed before starting any type of regime.

One such medication is modafinil, which is the generic drug for the brand name Provigil. This medication is prescribed for individuals wishing to improve wakefulness when excessive sleepiness is present. It is a common medication given for individuals suffering from narcolepsy or other sleep disorders. Modafinil works well in such situations as it is a wakefulness-promoting agent.

It is not totally clear as to why modafinil helps individuals to be more awake, although it is assumed that the drug alters the natural chemicals in the brain known as the neurotransmitters. It has been shown to effectively stimulate alertness and can improve functioning of the frontal lobe of the brain. The medication’s ability to stimulate and improve functioning was different than standard stimulants.

This medication has been known to cause dependency and even addiction in certain users and therefore individuals must assess dependence risks versus benefits of the medication before taking it long term. Likewise, even if the medication will only be used in the short term, gaining more information is a good idea.

In some situations, modafinil has been used to treat ADHD and early studies showed significant promise. In one clinical trial, however, one child — out of 933 — developed a life threatening skin rash, known as “Stevens Johnsons Syndrome.” While it is argued that the rash was not a result of the medication, the FDA refused to approve the use of the medication in the treatment of ADHD.

Doctors are not held to the standards of the FDA, however, in their prescribing practices. While the FDA forbids manufacturers to advertise their product in the treatment of any condition that has not been approved, doctors can prescribe the medication if they believe it is the right fit in the situation. This “off label” prescribing provides more leverage for the doctor and greater options for the patient.

Interestingly, modafinil has also been prescribed for the treatment of cocaine addiction, although it has not been approved for such uses and studies are still relatively small on the impact the medication can have for those addicted to cocaine.

Modafinil does affect the brain’s reward center, which highlights its potential for dependency and abuse. One NIAAA study stressed that additional research should be conducted as it is still unclear as to the potency and risk involved in taking modafinil long term.

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