ADD Medication and Treatment Reviews

Modafinil

Brand name: Provigil

What is Modafinil?

Modafinil is a wakefulness-promoting prescription drug that reduces the extreme sleepiness that accompanies sleep disorders including narcolepsy, obstructive sleep apnea, and shift work disorder (SWD). It is sometimes used off-label to treat symptoms of ADHD in adults 18 years of age and older. This use is not approved by the FDA, but some research has shown improvement in ADHD symptoms when compared to a placebo. According to the FDA, modafinil is a federally controlled substance (C-IV) because it can be abused or lead to dependence. The safety and effectiveness for children has not been established.

Armodafanil (Nuvigil) is a drug similar to modafinil that could potentially have similar effects, but its impact on ADHD in adults has not yet been studied.

How to Use Modafinil

Before starting or refilling a modafinil prescription, read the medication guide included with your pills, as it may be updated with new information.

This guide should not replace a conversation with your doctor, who has a holistic view of your medical history, other diagnoses, and other prescriptions. If you have questions, ask your doctor or pharmacist before you begin taking the medication.

Dosage for Modafinil

As with all medications, follow your modafinil prescription instructions exactly. If a patient experiences upset stomach as a side effect, this medication can be taken with food.

Tablets are available in 100mg and 200mg dosages.

The recommended dosage is 200mg, taken orally, once daily in the morning (or just prior to beginning work for people with SWD). A reduced dose is recommended for elderly patients and patients with severe hepatic impairment.

Do not drink alcohol while taking this medication, as the use of modafinil with alcohol has not been studied.

Side Effects Associated with Modafinil

The most common side effects of modafinil are as follows: headache, back pain, nausea, nervousness, stuffy nose, diarrhea, feeling anxious, trouble sleeping, dizziness, and upset stomach.

Other serious side effects include: a serious rash or allergic reaction including Stevens-Johnson Syndrome; rapid swelling beneath the skin; new mental health problems such as depression, anxiety, aggression, hallucinations, and thoughts of suicide; and symptoms of a heart problem including chest pain, abnormal heartbeat, and trouble breathing. In rare cases, modafinil can create a multi-organ hypersensitivity reaction, which can be life-threatening. Stop taking modafinil and seek medical attention immediately if you experience any of these serious side effects.

Taking modafinil may impair your ability to drive, operate machinery, or perform other potentially dangerous tasks. If side effects are bothersome, or do not go away, talk to your doctor. Most people taking this medication do not experience any of these side effects.

Report to your doctor any heart-related problems or a family history of heart or blood pressure problems. Patients with structural cardiac abnormalities and other serious heart problems have experienced cardiac arrest while taking modafinil. Stimulants, like modafinil, can increase blood pressure and heart rate. Physicians should monitor these vital signs closely during treatment. Call your doctor immediately if you experience warning signs such as chest pain, shortness of breath, or fainting while taking modafinil.

Also disclose to your physician all mental health issues including any family history of psychosis, depression, or mania. Modafinil may create new or exacerbate existing mania, delusions, hallucinations, suicidal ideation, and aggression. Call your doctor immediately if you experience new or worsening mental health symptoms including depression or mania.

Elderly or debilitated patients with impaired hepatic or renal function should use caution and be observed closely when taking modafinil.

Stimulants like modafinil have a low potential for abuse and addiction. It is a “Schedule IV drug,” a designation that the Drug Enforcement Agency uses for drugs with a low potential for abuse. Other Schedule IV drugs include Xanax, Klonopin, and Valium. People with a history of drug abuse should use caution when using this medication. Taking the medication exactly as prescribed can reduce potential for abuse.

The above is not a complete list of potential side effects. If you notice any health changes not listed above, discuss them with your doctor or pharmacist.

Precautions Associated with Modafinil

Store modafinil in a secure place out of the reach of children, and at room temperature. Do not share your modafinil prescription with anyone, even another person with ADHD. Sharing prescription medication is illegal, and can cause harm.

You should not take modafinil if you have any of the following conditions: allergy or hypersensitivity to modafinil, armodafinil or any of the ingredients in modafinil medications.

If you’re thinking of becoming pregnant, discuss the use of Modafinil with your doctor. Animal studies indicate a potential risk of fetal harm. It is not known if modafinil is passed through breastmilk, so it is recommended that mothers do not nurse while taking it.

The safety of Modafinil for children under age 17 has not been established.

Interactions Associated with Modafinil

Before taking Modafinil, discuss all other active prescription medications with your doctor.

Use caution when taking modafinil concurrently with MAOIs. Certain illegal drugs such as methamphetamine and MDMA/ecstasy can interact with modafinil.

Modafinil can decrease the effectiveness of hormonal birth control including pills, shots, patches, vaginal rings, and intrauterine devices (IUDs) – while taking modafinil, and for one month after stopping modafinil. Talk to your doctor about the birth control choices that can reduce the risk of becoming pregnant while taking modafinil.

Modafinil can increase the speed at which certain medications are processed by your body, which could decrease their effectiveness.  Examples of medications that could be affected include: cyclosporine.

Modafinil can increase concentrations of certain medications in the body, including omeprazole, phenytoin and diazepam.

Caffeine can increase the side effects of modafinil.

Share a list of all vitamin or herbal supplements, and prescription and non-prescription medications you take with the pharmacist when you fill your prescription, and let all doctors and physicians know you are taking modafinil before having any surgery or laboratory tests. The above is not a complete list of all possible drug interactions.

Sources

http://www.provigil.com/PDFs/prescribing_info.pdf
https://www.fda.gov/downloads/drugs/drugsafety/ucm231722.pdf
https://www.ncbi.nlm.nih.gov/pubmed/16623645

3 Modafinil Related Links

  1. Reviewing for Adult.
    Have tried various brands of Modifinil after reading lots of open media about it.
    I found that the effects kick in within about 60-90minutes, and when i first started taking it i felt a surge of good mood, i felt happy and positive. I did not find huge improvements in terms of focus or reduction of ADD related symptoms, however there were minor improvements. I found in squashed my appetite completely for about 7hours. The key benefit i found was no drop in afternoon energy, i worked solidly all day ( no more focused, just no tiredness).
    The evenings i had taken it were obvious to my partner as i was more talkative and didnt settle as quickly as normal (16hours after ingestion) and probably took 45mins to go to sleep compared to the normal 5-10.
    The day after, if you do not take another the following day, I struggled a lot with focus, comprehension and drive. It would be almost to say by taking the medication you had borrowed the energy from the next day, and then have to go through it without.
    I limited myself to only taking Modifinil twice a week at that point, the days i needed to get more done. However that being said, after 4-6months of this pattern the effects of good mood etc are much less potent and i have therefore stopped taking it all together.

  2. I’m using Modafinil (legally prescribed and bought at a pharmacy in Germany) for 4 months already.
    They do come in 100 and 200mg pills. At first I kept “half” of a pill dosage daily excluding weekends to see, what it does.
    Now I’m on 100mg 5/7 days pattern.
    I don’t have any trouble sleeping (naturally one have to remember to take care of proper sleep preparation – no overeating nor late screen reading (eBook reader is fine, tablet – not so, not even with “blue light limiting” apps).
    I don’t see any food/eating problems (again – I cook myself and eat really healthy things I really like).
    Back pain (?) – I have it naturally – too little exercise daily so I’m not connecting it with Modafinil. If I remember to stretch and massage some points on my body there is no pain at all.
    Other things negative – none.

    How is it affecting me in the positive sense?
    I’m awake. Really awake. No need for a coffee (I’m more yerba and matcha enthusiast). Senses are kind of sharper (not placebo but also normally achievable if you know how to focus).
    So in general – it is working as it supposed to.
    Will it work for you? Under one condition – if you know how to do things without Modafinil it will help you further. If you are seeking some wonder drug, that will take you away from browsing internet, mindless hours at fb/yt etc. you are in deep trouble – it will actually make you to dive into wasting your time more aggressively as you would wish in your deepest fears.

    Modafinil is an enhancer – if you have good habits you will benefit from it. If your life is about wasting time you are going to do it on a new, higher level. So better avoid it.

  3. I have been taking 200mg Modafinil daily 5-7 days a week in the early morning for just over 12years. I have been prescribed it for day time sleepyness/narcolepsy as I was commuting and falling asleep while driving. And other issues with falling asleep. So in that sense it has litteraly been a life saver.

    But I have found it treats my ADD as equally well. It has helped me perform better in my career where I otherwise would have been distracted and gone off track and struggle to complete assignments. Provigil has had a profoundly positive impact on my quality of life and ability to provide for my family.

    I have experienced many of the positive side affects of the medication, improved memory, ability to focus, more driven. The negative side affects have been negligble.

    There was a time my Dr recommended that I change to Nuvugil in 2009, which I didn’t understand because modafinil was working well, but I tried it. On the surface it seemed similar, but over a period of several months depression snuck up on me, which I have never before experienced, and don’t have a history of. It literally took me months to figure out that my uncharacteristic negative attitude was actually depression and caused by changing my medication. This caused some radical life changing decisions to take place in regards to career and family. I was able to get things back on track after changing back to modafinil.

    I later realized that the timing of my Drs recommendation came at the end of the patent period for provigil. So generic options of modafinil where now available, reducing profits for the pharma. The company that held the patent on provigil came out with Nuvigil with a new patent. I speculate that the Dr was incentivised to have his provigil patients move to Nuvigil. Lesson learned.

    I have never tried medication for treatment of my ADD, but Modafinil for treatment of ADD has been very positive for me, to the point I am more concerned about treating my ADD with it. The benefits of treating my narcolepsy are a positive side affect. Don’t get me wrong, I need to treat my narcolepsy, it’s not good to fall asleep driving, or when you are in boardroom meetings.

    I do drink alcohol regularly, and at times heavily. I haven’t noticed any problems on interactions. I am 6’2 250lbs 42 yo and am in relatively good health. Been taking since I was 30.

    One negative thing that is more behavioral on my part is that I started early on taking zolpidem in the evenings to help me go to sleep. I now have a dependency on zolpidem that I need to resolve. Looking back, I feel I could have corrected my sleeping by other means and behaviorial choices. So just be careful you don’t go down that path.

    As Marcin stated above, it isn’t going to magicaly make you focus on the things you should be focused on, you need to make choices on what to focus on. But it sure helps clear up thoughts considerably and allow you to focus, be more creative, understand complex problems and contribute to teams. And otherwise actively participate in life around you and minimizing ADD distractions. It may even enhance the positive characteristics that come along with ADD.

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