Modafinil side effects, Provigil
January 20 2016 by
Ray Sahelian, M.D.

Modafinil (commercial trade names Provigil (US, UK), Vigil (Germany), Modalert (India), Modiodal (France, Mexico), Modavigil (Australia), Alertec (Canada), is a drug prescribed to treat narcolepsy. Modafinil is a psychostimulant.made by the pharmaceutical company Cephalon Inc. It improves wakefulness and vigilance, but its pharmacological profile is different from the amphetamines, methylphenidate (Ritalin) or cocaine. Modafinil is less likely to cause jitteriness or anxiety than traditional stimulants. Subjectively, it feels smoother and cleaner than the amphetamines.

2015
Modafinil is a safe “smart drug”, according to researchers at Harvard and Oxford universities. They conclud that the drug, which is prescribed for narcolepsy but is increasingly taken without prescription by healthy people, can improve decision- making, problem-solving and possibly even make people think more creatively. They claim the drug appeared safe to take in the short term, with few side effects and no addictive qualities but long term consequences are not well known.

Alternative
Br J Clin Pharmacol. 2013. Cognitive effects of two nutraceuticals Ginseng and Bacopa benchmarked against modafinil: a review and comparison of effect sizes. Over recent years there has been increasing research into both pharmaceutical and nutraceutical cognition enhancers. Here we aimed to calculate the effect sizes of positive cognitive effect of the pharmaceutical modafinil in order to benchmark the effect of two widely used nutraceuticals Ginseng and Bacopa (which have consistent acute and chronic cognitive effects, respectively). A search strategy was implemented to capture clinical studies into the neurocognitive effects of modafinil, Ginseng and Bacopa. Studies undertaken on healthy human subjects using a double-blind, placebo-controlled design were included. For each study where appropriate data were included, effect sizes (Cohen's d) were calculated for measures showing significant positive and negative effects of treatment over placebo. The highest effect sizes for cognitive outcomes were 0.77 for modafinil (visuospatial memory accuracy), 0.86 for Ginseng (simple reaction time) and 0.95 for Bacopa (delayed word recall). These data confirm that neurocognitive enhancement from well characterized nutraceuticals can produce cognition enhancing effects of similar magnitude to those from pharmaceutical interventions.

Modafinil and sleep deprivation
The non-amphetamine, wake-promoting drug, modafinil counters the adverse effects of sleep deprivation on working memory. In a randomized, double-blind study, Dr. Robert Joseph Thomas, of Beth Israel Deaconess Medical Center, Boston, and Dr. Kenneth K. Kwong of Massachusetts General Hospital, Charlestown examined the effect of modafinil on working memory and brain activation in the executive network following overnight sleep deprivation. Functional magnetic resonance imaging was used to assess the functional neurobiology of executive function in eight sleep-deprived medication-free men (ages 21 to 35 years) treated with 200 mg of modafinil or placebo. They underwent a verbal working-memory task with 3 levels of difficulty. Subjects in the sleep-deprived condition, had approximately 28 hours of continuous wakefulness, and in the rested condition, had 8 hours of scheduled sleep opportunity. The team assessed brain activation patterns and regional signal intensity based on the blood-oxygen level-dependent signal. Modafinil countered the ill effects of sleep deprivation on working memory, but only when the task difficulty was moderate.
   Dr. Sahelian says: There are a number of natural supplements that could be helpful in sleep deprivation and as a good natural alternative to modafinil. These include Mind Power Rx brain booster, Eyesight Rx, acetylcarnitine, DMAE, and other nutritional supplements.

Modafinil and depression - for mood elevation
A Randomized, Double-Blind, Crossover Trial of Modafinil on Mood.
J Clin Psychopharmacol. 2007.
Modafinil, a medication for the excessive sleepiness associated with narcolepsy, has been hypothesized to improve not just alertness but mood as well. The purpose of this study was to determine how treatment with modafinil affects mood in healthy volunteers. Normal healthy volunteers (n = 12, 10 men and 2 women; 30-44 years) underwent a 3-day, counterbalanced, randomized, crossover, inpatient trial of modafinil (400 mg daily) versus placebo with 4-day washout period between 2 treatments. Mood was assessed daily using both the Positive and Negative Affect Schedule and a general mood scale, which consisted of 10 bipolar adjective ratings based on a severity scale ranging from 1 to 10. Modafinil increased general mood and Negative Affect scales relative to placebo and had a significant effect on Positive Affect scales. These results suggest that modafinil may have general mood-elevating effects accompanied by increased negative affect (anxiety).
   Dr Sahelian says: it is possible that a medication (such as an amphetamine) may help depression or improve mood in the short term, but then later cause a crash with severe depression or other side effects.

Modafinil side effects, danger, addiction, how safe is it?
The most common modafinil side effects are headache, nausea, nervousness, and rhinitis. Additional adverse reactions include diarrhea, back pain, anxiety, insomnia, dizziness, and dyspepsia. Additional modafinil side effects may be discovered as more people use this drug for prolonged periods. Could heart problems occur?

J Clin Psychopharmacol. 2016. Addiction to Armodafinil and Modafinil Presenting With Paranoia.

Indian J Pharmacol. 2015. Fixed drug eruptions with modafinil. Provigil is a psychostimulant drug, which has been approved by the US Food and Drug Administration for the treatment of narcolepsy associated excessive daytime sleepiness, sleep disorder related to shift work, and obstructive sleep apnea syndrome. However, presently it is being used as a lifestyle medicine; in India, it has been misused as an "over the counter" drug. MOdafinil is known to have several skin side effects. Fixed drug eruption is a distinctive drug induced reaction pattern characterized by recurrence of eruption at the same site of the skin or mucous membrane with repeated systemic administration.

Questions
I am taking modafinil. I have narcolepsy and am searching everyday for something that keeps me awake. My mind is awake all the time, but does tyrosine make you have more energy as a whole or just wired.
   A. Tyrosine usually makes one more wired. Many people tell us Eyesight Rx and or Mind Power Rx help the mind stay alert and focused and provide good energy. Perhaps they can be a substitute for modafinil in some people.