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Přípravek Vigil je obchodní název pro lék, Modafinil.
Je to lék, který podporuje bdělost, a je schválen ve Spojených státech Food and Drug Administration (FDA) jako safe alternative to typical stimulants.
It is also helpful with the treatment of many sleep related disorders. Mezi ně patří narkolepsie, porucha spánku pracovní směny, and daytime fatigue that is associated with sleep apnea.
Přípravek Vigil je někdy předepsán pro účely off-label in the treatment of ADHD, certain mood disorders, and as a cognitive enhancer or smart drug.
I když je tu rozsáhlý výzkum interakce modafinilu s četnými neurotransmiterové systémy, přesný mechanismus účinku léku zůstávají částečně nejasné.
To bylo řečeno, Máme dobrou znalost jak Provigil funguje obecně.
Bdělosti
Duševní bystrost
Zaměření- Stimuluje bdělost v mozku
- Podporuje duševní čilosti & zpracování
- Zvyšuje zaměření, motivace & energie
Modafinil historie
Příbuzná témata
- Co je Modafinil? (Provigil)
- Jak Provigil funguje?
- Účinky a výhody
- Uživatelské recenze
- Typické zkušenosti
- Doporučené dávky
- Jak se přípravek
- Provigil využití
- Použití pro ADHD
- Účinky na hubnutí
- Negativní vedlejší účinky
- Zneužití varování & nebezpečí
- Srovnání s Adrafinil
- Srovnání s Armodafinil
- Srovnání k Adderall
- Kde koupit
- Obecný Modafinil značky
- Je Modafinil právní?
- Jak se dostat Modafinil
- Přehled zdrojů Online
Modafinil byl poprvé objeven v 1976 by the French chemist and neurophysiologist professor Michel Jouvet for the French pharmaceutical company Lafon Laboratories. Lafon was later bought out by Cephalon Inc, who to this day produces the most widely-sold name brand version of Modafinil, Provigil.
Pro účely tohoto článku, Modafinil and Provigil are used synonymously, although generic version of Modafinil exist.
The discovery of Modafinil came about from the previous development of another related compound, Adrafinil. Adrafinil is one of a group of benzhydryl sulfinyl compounds that was first developed in 1974.
During testing to try and determine Adrafinil’s mechanism of action in the body, Modafinil byl objeven. Bylo zjištěno, že po požití, Adrafinil is transported to and then broken down in the liver. The primary metabolites of Adrafinil are the inactive modafinilic acid, aktivní střevního.
Modafinil was found to be the primary active compound of Adrafinil and the source of its effects in the body. Adrafinil and Modafinil have an incredibly similar molecular structure, s jediným rozdílem je, že Modafinil diastereomery že Adrafinil má na terminálu amid.
Adrafinil was first used and tested for many of the same uses that Modafinil was eventually tested for. Once Modafinil was able to be synthesized on its own without Adrafinil production of Adrafinil decreased. Eventually Modafinil surpassed its predecessor, and is exclusively used in medical contexts now.
How does Provigil Work in the Body?
Adrafinil, and consequently Modafinil, is classified as a eugeroic, nebo podporovat bdělost sloučenina. Researchers have found Modafinil to have stimulant-like effects comparable to the amphetamine type stimulants on the market.
Je to, however it is not in fact related to traditional stimulants, and has been seen to cause effects in different ways. Přesný mechanismus účinku Modafinil je stále neznámý.
Across various research studies it has been seen that Modafinil has effects on a large number of neurotransmitters and their transporters, včetně dopamin, Serotoninový, Epinefrin (Adrenalinu), Noradrenalinu (Noradrenalin), Histamin, a Orexins (Hypocretins).
Provigil helps to elevate levels of hypothalamic Histamine. Histamine acts as a modulator of various other neurotransmitters in the brain and has a primary role in promoting wakefulness, učení a paměť, úzkost, lokomoce, and eating and drinking.
Provigil has the ability to inhibit many of the actions of the Dopamine transporter. To vede ke zvýšení extracelulární, a tedy, synaptic concentrations of Dopamine.
Dalším cílem studie byla locus inhibitory akce Provigil. This is in hopes of identifying the effects of the drug on Dopamine in both the nucleus accumbens and striatum. Rovněž, the effects of Norepinephrine in the hypothalamus and ventrolateral preoptic nucleus, as well as Serotonin in the frontal cortex and amygdala are an area of interest.
One of the considered mechanisms of action involved Orexin, which is a brain peptide and also known as Hypocretin. Orexin neurony lze nalézt v hypothalamu, ale také projekty, které mají několik různých částí mozku, včetně mnoha oblastí, které mohou regulaci bdění v těle.
Activating these neurons will help to increase the Dopamine and Norepinephrine levels in those areas, and increases Histamine levels in the histaminergic tuberomammillary neurons. Studies involving rats have shown that Provigil increases the Histamine release levels in the brain, což může být možný mechanismus působení v člověka stejně.
Orexin receptory 1 a 2 jsou dva orexin receptory v těle. Animals that have defective Orexin systems give off signs and symptoms that are similar to that of narcolepsy, a léčba, které Přípravek Vigil je schválen FDA.
Provigil appears to activate these Orexin neurons in the animal models, a they are expected to promote and increase wakefulness.
Provigil a narkolepsie
Jak bylo diskutováno, Modafinil has many different mechanisms that cause it to be a wakefulness promoting agent. Because of these observed effects in animal studies, the first human trials involved using Modafinil as a treatment for narcolepsy.
Narcolepsy is a sleep disorder in which people cannot properly maintain a wakeful state, and in severe cases often fall asleep randomly multiple times per day. It is thought that one of the primary causes of narcolepsy is a decreased number of Orexin producing neurons in the brain. This deficit of Orexin can cause poor regulation of wakefulness.
Even in narcoleptics who do not fall asleep much during the day, excessive sleepiness is a common symptom many experience. This excessive daytime sleepiness occurs regardless of high quality sleep the previous night.
Multiple double-blind placebo-controlled clinical trials have been conducted that have definitively shown that Provigil significantly improves wakefulness and decreases sleepiness levels in narcoleptics ve srovnání s placebem. Scores on the Maintenance of Wakefulness test and the Epworth Sleepiness Scale have been seen to significantly improve when patients are given Modafinil in many different studies.
Modafinil has been proven to be such a successful treatment for narcolepsy that other new drugs have been tested against it to prove their efficacy. Studies have been conducted comparing Modafinil to sodium oxybate and pitolisant. Ve studiích, the active medications were seen to significantly improve sleepiness scores compared to a placebo, and to perform similarly to Modafinil, showing they could also be efficacious new treatments for narcolepsy.
Provigil has been approved as a prescription treatment for narcolepsy. It was approved for this purpose in France in 1994, and by the FDA in the USA in 1998. Since that time it has been officially approved to treat other sleep disorders that involve excessive sleepiness.
- Zvýšení energie, bdělost a motivace
- Zvyšuje duševní výkonnost a zaměření
- Podporuje paměť a poznávání
Provigil and Other Sleep Disorders
Circadian rhythm is the nearly 24 daily sleep/wake cycle that is dictated by our bodies biological clock. Humans are naturally diurnal and typically are awake during the day and sleep at night. Some people by necessity need to alter their normal sleep/wake schedule for their jobs.
Práce na směny poruchy spánku (SWSD) is a circadian rhythm disorder that can occur in some people that either on a continuous or intermittent basis work late night, přes noc, or extended shifts. Because they are awake during non-standard hours (tj.. awake at night) they can feel excessive sleepiness when awake, and also some sleep disturbances like insomnia when trying to sleep during non-standard hours (tj.. sleep during the day).
Multiple studies have been done using Modafinil to curb the excessive sleepiness experience by SWSD sufferers. One study compared the effects of a dose of Provigil or a placebo taken one hour before a night work shift. Ve srovnání s placebem, Provigil significantly improved scores on the patient administered Karolinska Sleepiness scale, and on the Psychomotor Vigilance scale. Patients who received Modafinil had significantly fewer and shorter attention lapses compared to placebo patients.
V jiné studii, patients were randomly assigned to receive a placebo or Modafinil 30-60 minut před noční směny; patient functioning and quality of life were assessed using the Functional Outcomes of Sleep Questionnaire at the start of the trial as a baseline, and at 4 a 12 týdny.
It was found that compared to the patients who received placebo, patients who received Modafinil showed significant improvement of scores on the Functional Outcomes of Sleep questionnaire in the productivity, aktivita, and vigilance categories.
Syndrom obstrukční spánkové apnoe/hypopnoe (OSAHS) is a medical condition that affects breathing during the night. Multiple times throughout the night, and even each hour, the airway is either partially or completely obstructed by the tongue, měkké patro, and /or the uvula, due to the muscles of the mouth relaxing involuntarily. Partial obstruction leads to shallow breathing (hypopnoe), and complete obstruction leads to the temporary stopping of breathing breathing (apnoe).
Due to experiencing many of these breathing episodes per night and having lower blood oxygen levels while sleeping, most people with this syndrome have very poor quality of sleep, and subsequently experience excessive daytime sleepiness.
The most common treatment for OSAHS is wearing either a mouth guard that keeps the tongue in place, or a continuous positive airway pressure (CPAP) stroj během spánku. For most people this helps to manage the condition, however excessive sleepiness is still sometimes felt by people receiving treatment, a v těchto případech, Modafinil has been used as an adjunct treatment to reduce this symptom.
One study compared Modafinil to a placebo in the efficacy of treating residual daytime sleepiness in patients with OSAHS who has been continuously using CPAP for at least two months prior to the start of the trial. Bylo zjištěno, že ve srovnání s placebem, Modafinli significantly improved daytime sleepiness. There was a significant change from baseline scores on the Epworth Sleepiness Scale as well as in multiple sleep latency times.
Modafinil has been classified as a Schedule IV prescription medication with the on-label uses of treating narcolepsy and shift-work sleep disorder, a jako doplněk léčby pro syndrom obstrukční spánkové apnoe/hypopnoe. Any other uses of Modafinil are considered off-label.
Off-Label použití modafinilu
While only officially approved for the previously discussed sleep disorders, Odhaduje se, že až 90% of all Modafinil prescriptions written are in fact for off-label uses.
One off-label use that Modafinil is sometimes prescribed for is disease-related fatigue. Fatigue is a symptom of many different diseases including multiple sclerosis, deprese, fibromyalgie, a Parkinsonova nemoc. Some research has been done using Modafinil for improving fatigue, specifically in people with depression and multiple sclerosis.
It has been found that compared to a placebo, Modafinil significantly improves disease-related fatigue. Nicméně, more research is still needed on many other specific diseases to determine if there are any condition related contraindications.
Na rozdíl od, Modafinil has been extensively studied for its ability to improve the symptoms of attention-deficit disorder (PŘIDAT) a pozornost deficit nepořádek hyperaktivity (ADHD).
Multiple double-blind placebo-controlled studies done on children, dospívajících, a dospělé, have all shown that compared to a placebo, Modafinil significantly increases scores on a variety of ADHD tests including the Teacher and Parent ADHD Rating Scale-IV, ADHD Rating Scale-IV School and Home Questionnaires, Conners stupnice hodnocení, and the Diagnostic and Statistical Manual of Mental Disorders IV ADHD Behavior Checklist.
A meta-analysis of studies done using Modafinil for ADHD was published in 2017. The compiled research showed that Modafinil was seen to have superior short-term efficacy compared to placebo in the reduction of ADHD symptoms, while also showing a safety and tolerability profile similar to placebo.
Modafinil has been shown to have an effect on ADHD symptoms, not only compared to a placebo, but also when tested against a conventional ADHD treatment. Jedna randomizovaná, dvojitě zaslepené, placebem kontrolované, three-phase crossover study tested Provigil against a placebo, as well as dextroamphetamine (Dexedrin).
There were three treatments: placebo, Provigil, dextroamfetamin. Patients were given one treatment for two weeks, then switched to another treatment for two weeks, and then given the final treatment for two weeks.
It was found that compared to the results seen with placebo, v two active medications significantly improved scores on the DSM IV ADHD Behavior Checklist for Adults, and trend significance was seen on the Controlled Oral Word Association Test. The researchers suggested that due to the similarity in improvement seen between dextroamphetamine and Modafinil, that Modafinil should be considered a viable alternative treatment for ADHD patients.
Provigil as a Cognitive Enhancer
One of the most popular off-label uses of Provigil is as a nootropic smart drug. Many different people from high powered executives to college students to computer programmers have reported using Modafinil as a cognitive enhancer.
User reviews say that Modafinil increases concentration, zaměření, produktivita, paměť, schopnost učit se, a bdělosti. Many people say that they use Modafinil to help them stay alert and focused on work tasks or studying for hours at a time. Enhanced concentration and productivity, along with improved memory make this a popular nootropic choice of university students looking for a competitive edge while studying and taking tests.
There has been some scientific research done that backs up some of the claims that recreational Provigil users have reported. One literature review of a selection of studies done testing the cognitive effects of Modafinil reported that there was a trend seen across the studies of Modafinil having positive effects on memory, konkrétně pracovní a epizodické paměti.
Another review found that Modafinil was seen to mainly affect cognition by improving executive function (rozhodování, řešení problémů, mental control, self-regulation) especially when planning for and executing complex or difficult tasks.
Jedna dvojitě zaslepené, placebem kontrolované, fully within-subjects trial compared the effects of placebo versus Modafinil in a battery of cognitive assessments including serial reaction time, logické uvažování, visual comparison, mental addition, a bdělost. Ve srovnání se skupinou užívající placebo, scores for the Modafinil group were improved for fatigue levels, motivace, reakční čas, a bdělost.
In another similar study, healthy volunteers were given either a placebo or Modafinil and then asked to complete a series of memory and attention tests. Ve srovnání s placebem, Modafinil significantly improved the scores on a digit span test, test paměti uznání vizuálního vzorku, prostorové plánování úkolu, and a stop-signal reaction time test. When asked how they felt on drug, volunteers reported feeling energetic, Výstraha, and attentive.
There was also seen a delayed latency to answer on certain tests, včetně územního plánování úloh, opožděné porovnávání vzorku testu, a rozhodovacích úloh. This slight delay enhanced the ability to inhibit prepotent responses, instead allowing for the natural reactionary response to be overridden by one that was more oriented to the goal at hand.
While this study was conducted in neurotypical volunteers, the researchers concluded that this reduction in impulsive responding could make Modafinil a beneficial treatment for people with ADHD.
Common Provigil Dosages
V Americe, Přípravek Vigil je schválen FDA, ale jen pro léčbu několika poruch. Jak již bylo zmíněno dříve, these disorders are shift work sleep disorder, Narkolepsie, a obstrukční spánkové apnoe.
V některých jiných zemích, it has also been approved for those that are hypersomnias (jako idiopatická hypersomnie).
FDA se obvykle doporučuje, aby předepsané dávkování pro některou z těchto poruch je jeden 200 mg dávkování každý den. Existují některé okolnosti, za kterých 100 do 400 mg denně rozděleno během jedné nebo dvou dávek se navrhuje, ale to je méně časté.
Pro podmínku, která není posun práce porucha spánku, Provigil se obvykle užívá v jedné dávce v ranních hodinách, nebo ve dvou denních dávek, jednou ráno a v poledne. For those with shift-work sleep disorder, the dosage is taken between 30-60 minutes before the start of a work shift at night.
It is not typically recommended to take Provigil after noon as it is a relatively long lasting drug with a Celkový poločas 12-15 hodin. Taking Provigil later in the day can carry a risk of other sleep disturbances and make it difficult to fall asleep at night.
There are no official dosage recommendations for off-label uses of Provigil. In situations where a prescription has been written for an off-label use such as fatigue or ADHD, then doctors most typically prescribe the standard 200 mg / den, to be taken in the morning.
People who take Modafinil as a nootropic smart drug typically follow dosing regimens similar to other uses, užívat 200 mg a day in the morning. Some users have reported that if they have a very long day of studying or work ahead of them then they will take an additional 100 mg around noon or slightly later if they are planning to stay awake late into the night.
Dávkách až 400 mg per day have been seen to be safe and well tolerated in research studies. Nicméně, dosages this large are not typically taken on a regular basis, as there have not been any significant increased benefits above a standard 200 mg dose observed, a the risk of potential side effects can increase with a higher dosage.
Modafinil vedlejší účinky
Zatímco to je obecně dobře snášena, there are some common mild side effects experience with Provigil use. Headaches and nausea are the most commonly reported side effects in research studies and user reviews.
Některé jiné mírné vedlejší účinky, které byly hlášeny patří:
- Úzkost
- Nervozita
- Bolest zad
- Dizziness/lightheadedness
- Zvracení
- Průjem
- Ztráta chuti k jídlu
- Pálení žáhy
- Zažívací potíže
- Sucho v ústech
- Dryness of the skin
- Stuffy or runny nose
Pro některé lidi, side effects are transient and will pass after their bodies adjust to the drug’s effects. Some side effects may be related to the dosage, and a lower dosage may help eliminate or lessen effects.
If your side effects subside, but you do not get the benefits of Modafinil at a lower dosage, then you can try slowly increasing the dosage back to a normal level, checking for side effects as you go. It is advised to speak with your doctor about any side effects you experience, so they can help determine the best dosage for your needs.
There is the possibility of rare, but serious side effects, such as the the skin and mucous membrane disorders Stevens-Johnson syndrome, toxická epidermální nekrolýza (DESET), a léková reakce s eosinofilií a systémovými příznaky (ŠATY). Cases of these conditions in people who have been taking Modafinil have not definitively shown that the drug was the cause, but it is important to be aware of the possibility.
While still considered quite rare, Stevens-Johnson syndrome is considered more likely to develop than the other two even more serious conditions. Symptoms of Stevens-Johnson syndrome include flu-like symptoms such as fever, nevolnost, bolest hlavy, bolesti těla, bolest v krku, and coughing, as well as a red or purple rash that spreads and may blister. Pokud zaznamenáte některý z těchto příznaků, then stop use of Modafinil and speak to your doctor immediately or go to an emergency room if necessary.
Vzhledem k tomu, existuje riziko vzniku přecitlivělosti nebo kožní reakce a další neuropsychiatrické poruchy, Evropská agentura pro léčivé přípravky bylo doporučeno, že nové předpisy pro pacienty lze používat pouze k léčbě spavosti spojené s narkolepsií.
Tam by mohlo být vážné vedlejší účinky, které by se mohly objevit v prvních dvanácti týdnech používání. Z tohoto důvodu, pokyny nevyžaduje žádné pacienty, kteří jsou již léčeni z Provigil přestat brát drogy.
Jak je popsáno výše, Provigil has been tested in all age groups and shown to be an effective treatment option for those that suffer from ADHD. Nicméně, v 2006 the FDA deemed Provigil unfit for use by children for the purpose of ADHD.
Důvodem je byl zamítnut bylo proto, že tam byly dva případy závažné kožní vyrážky, což možná související s Stevens - Johnson syndrom nebo Erythema multiforme mezi součtem 933 pacienty, kteří dostávali drogy.
Lékař, který provedl tyto diagnózy později odvolal a uvedl, že on měl misdiagnosed podmínka. Nicméně, FDA pro léčbu ADHD nebyl ještě přehodnocena Provigil.
Pokud máte zájem dozvědět se více o Provigil funguje, doporučuje se číst uživatelské recenze a zkušenosti protokolů slyšel od ostatních, kteří ho úspěšně.
Buying Provigil Without a Prescription
There are some doctors that are willing to write an off-label prescription for Provigil for conditions such as ADHD, especially in cases where traditional medications such as Adderall, Ritalin, and Dexedrine have not been entirely successful, nebo způsobit vážné vedlejší účinky. Theses prescriptions are entirely legal, however many doctors do not want to write them, for fear of increased scrutiny from medical boards.
Navíc, i s předpisem, many insurance companies will not cover off-label uses of drugs. Many people are not able to afford the
Getting a prescription to use Modafinil as a nootropic drug is nearly impossible though, as the use of drugs in healthy people to improve cognition or other bodily functions does not fall under FDA standards.
Many people who want to try Provigil will then turn to the “šedý trh” to purchase Modafinil without a prescription. There are many online pharmacies based in countries such as China and India where the sale of Modafinil is not as regulated, and it is not classified as a prescription only medication.
There are a number of issue with these online pharmacies though. Nejdřív ze všeho, there is no guarantee that you will actually receive your shipment. While you may not have any issues buying the product, when it reaches customs in your country, the laws of your place of residence are enforced.
Your package may simply be seized. If your country allows importation of drugs with a prescription, then you will have issues when you cannot produce a prescription. Bez ohledu na, you may not receive your purchases.
Navíc, if you do in fact receive your shipment of Modafinil, there is no way to tell if the product you get is in fact Modafinil. Quality control is often lacking from these sorts of vendors, and the product you get may not be Modafinil, or could possibly not be pure.
Non předpis Provigil alternativy
Instead of taking a risk on the safety and efficacy of products from gray market online pharmacies, many people instead turn to alternative nootropics that do not require a prescription.
As discussed before, Adrafinil is the direct prodrug of Modafinil. Když byl spotřebován, Adrafinil is metabolized in the liver into Modafinil. Protože to není perfektní konverze, you will need to take a higher dosage of Adrafinil than Modafinil to get similar effects.
While less potent, slower-acting, and not as long-lasting as Modafinil, many users report that the effects of Adrafinil are comparable to those of Modafinil. This drug is unscheduled and unregulated and does not require a prescription in the United States and many other countries around the world.
Many people use Adrafinil as a legal non-prescription alternative to Modafinil for nootropic purposes. Because of the conversion process in the liver, there is a risk of an increase of hepatotoxic enzymes if Adrafinil is taken regularly, so many people instead choose to use it on a as needed basis.
The Racetams are a class of compounds that are related to the original nootropic, Piracetam. Piracetam was first developed in the 1960s by a Romanian scientist working for UCB Pharmaceuticals in Belgium. It was the first nootropic ever developed, and prompted the scientist to create the term for this new class of compounds.
Racetams have effects on the cholinergic neurotransmission channels in the brain and central nervous system. These on Acetylcholine are believed to have effects on general cognition as well as memory. Racetams are also thought to increase oxygen and glucose transport in the brain, which may promote mental fluidity and alertness.
The derivatives of Piracetam are more potent than the original compound, and some have specific effects associated with them in addition to the increases to memory and concentration that all Racetams boast. Some of the most popular Racetams include Aniracetam, Oxiracetam, Pramiracetam, a Phenylpiracetam.
If you are unable to get a prescription for Provigil, instead of going through the gray market to buy Modafinil online that could potentially be suspect, consider using a Provigil alternative such as Adrafinil or one of the Racetams.
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Doprava zdarma
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- Markéta malá, Wilton L, Stanislav Slošiar. Bezpečnostní profil modafinilu napříč řadou předepisování indikace, včetně použití off-label, v nastavení primární péče v Anglii: výsledky studie sledování Změněný předpis – události. Drogovou Saf. 2013
- Esposito R, Cilli F, Pieramico V, Ferretti A, Macchia A, Tommasi M, Saggino A, Ciavardelli D, Manu A, Navarra R, Cieri F, Stuppia L, Tartaro A, Sensi SL. Akutní účinky modafinilu na mozek odpočívá státní sítě u mladých zdravých subjektů. PLoS One. 2013
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- Frakey LL, Salloway S, Buelow M, Malloy P. Randomizované, dvojitě zaslepené, placebem kontrolované studii modafinilu pro léčbu apatie u jedinců s mírnou až středně Alzheimerovy choroby. J Clin Psychiatry. 2012
- Arnold VK, Feifel D, Earl CQ, Jang R, Adler LA. 9týden, Náhodný výběr, dvojitě zaslepené, placebem kontrolované, paralelních skupin, studii k hodnocení účinnosti a bezpečnosti modafinilu jako léčba pro dospělé s ADHD. Disord pozornost J. 2014
Článek naposledy aktualizován: 12. dubna, 2018 od Nootriment