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Nuvigil is a smart drug that has seen its profile grow exponentially over the past few years.
Everyone from doctors to psychiatrists to parents to students to entrepreneurs and financial industry titans have been praising Nuvigil and the health benefits it offers.
Nuvigil can put your brain into overdrive, helping you to stay alert and focused at work and school without causing anywhere near the same risk of side effects as ADHD drugs like Adderall and Ritalin.
Despite this fact, Nuvigil is not currently approved in the USA for the treatment of ADHD and any prescription written for this purpose would be considered an off-label use. It is only officially approved to treat a few serious sleep disorders that involve excessive sleepiness.
Why has the FDA been reluctant to approve a potential ADHD drug that is so well regarded in the medical community? Is Nuvigil safe and are there any side effects that you should worry about?
Energy
Cognition
Motivation- Wakefulness-boosting stimulant
- Enhances motivation and focus
- Shown to boost mental performance
Nuvigil Drug Information
Related Topics
- What is Armodafinil?
- What is Nuvigil?
- Armodafinil vs. Modafinil
- User Review
- Typical Nuvigil Experiences
- How it Works
- Nuvigil for ADHD
- Effects on Depression & Anxiety
- Dosage Recommendations
- How to Take
- Reported Side Effects
- Withdrawal & Tolerance
- Prescription Information
- Buying Nuvigil
- Generic Nuvigil Brands
- Is Armodafinil Legal?
- Is Nuvigil Safe?
- Comparison to Adderall
Nuvigil is the brand name for the wakefulness promoting drug Armodafinil.
It is the newest rendering of the analeptic drug Modafinil (brand names: Provigil, Alertec, Modavigil).
The notable difference between the Armodafinil and Modafinil is that while Modafinil is comprised of both the R and the S enantiomers of the active ingredient, Nuvigil is an enantiopure drug containing only the R enatntiomer. The name Armodafinil comes from R-Modafinil, the compound it contains.
In research it has been determined that the R-Modafinil enantiomer is more pharmacologically stable and active, and also longer-lasting than the S-enantiomer. Because of this refinement to the chemical composition of Modafinil, Nuvigil has been successfully marketed as a purer form of Modafinil which may offer the user cleaner, more controlled effects.
Leaving off the inactive (or less active) S isomer potentially could eliminate some of the more common side effects which users experienced with Modafinil, causing manufacturers to state that Nuvigil is safer than its predecessor.
Below are some of the important difference between the two drugs:
- Nuvigil, being a more potent drug, requires smaller doses than Modafinil.
- The half-life of Nuvigil is about 15-hours as compared to Modafinil’s half-life of 12-hours.
- The patient literature states Nuvigil is potentially habit forming, while Modafinil is considered non-addictive.
- Anecdotal reports from users whose doctors switched them over to Nuvigil indicate there are some differences in effects for certain people.
- Psychostimulants can interact differently with individual’s brain chemistry, meaning that the effects of Nuvigil might not be the same as those of Modafinil in some people.
Provigil vs Nuvigil
Modafinil was first discovered by a French scientist in 1976 working for Lafon Laboratories. The discovery of this compound came about because of testing to determine the mechanism of action of another related compound, Adrafinil.
In 1974, scientists at Lafon developed a series of benzhydryl sulfinyl compounds, including Adrafinil. Testing to determine how it works in the body led to the discovery of Modafinil. Adrafinil is metabolized in the liver into its component parts, of which Modafinil has been determined to be the primary active compound which causes Adrafinil’s effects in the body.
Adrafinil and Modafinil (and consequently Armodafinil) are classified as eugeroics, or wakefulness promoting compounds. The exact mechanism of action of these compounds is still unknown, however some of these effects they have on various neurotransmitters such as Dopamine, Norepinephrine, Orexin, and Histamine has been observed in research studies.
Modafinil is known to strongly activate Orexin neurons and Orexin secreting neurons in the brain. Orexin is a neuropeptide that is involved in the regulation of wakefulness, arousal, and appetite. The Orexin in turn stimulates the release of the neurotransmitter Histamine in the hypothalamus. Histamine is involved in the regulation of the same functions as Orexin.
It is hypothesized that Armodafinil acts in a similar way on Orexin and Histamine function in the brain as Modafinil does. Also similarly to Modafinil, Armodafinil has been observed to be a Dopamine transport and reuptake inhibitor, allowing for higher circulating Dopamine levels. Dopamine may play a role in the increased motivation seen when taking Armodafinil.
Lafon Laboratories was bought by Cephalon Inc in 2001. In 2011, Cephalon was acquired by Teva Pharmaceutical Industries. To this day, Cephalon, as a subsidiary of Teva, makes the most well known brand name version of Modafinil, Provigil.
When the patent on Provigil was due to expire, the company decided to try and maintain their market position by creating a new, purer form of Modafinil. This led to the creation of the enantiopure Armodafinil, which was branded as Nuvigil. To this day, Cephalon makes Provigil and Nuvigil as the most popular brand name versions of Modafinil and Armodafinil.
Generic Nuvigil and Provigil are also available from many different vendors, often sold as simply Armodafinil and Modafinil, although other trade names do exist.
- Increases energy, wakefulness and motivation
- Boosts mental performance and focus
- Supports memory and cognition
Uses of Armodafinil
Like its predecessor Modafinil, Armodafinil is categorized as a Schedule IV prescription drug by the FDA in the United States. It is classified as prescription drug in many other countries in the world, including the United Kingdom, Australia, and Canada.
Armodafinil has been approved for use for the same conditions as Modafinil: as a treatment for narcolepsy and shift work sleep disorder (SWSD), and as an adjunct treatment for obstructive sleep apnea/hypopnea syndrome (OSAHS).
In different double-blind placebo-controlled research studies, when compared to a placebo, Armodafinil has been observed to be significantly better at improving wakefulness and decreasing excessive daytime sleepiness in narcoleptics and people with OSAHS, or the excessive sleepiness experienced at night by patients with SWSD.
In a study on narcolepsy, it was found that there was a significant increase in mean sleep latency scores as measured by the Maintenance of Wakefulness test. In a study with SWSD patients, Armodafinil significantly improved scores on the Epworth Sleepiness Scale, as well as improve sleep latency times as measured by the Multiple Sleep Latency test.
Scores on the Maintenance of Wakefulness test, the Clinical Global Impression of Change scale, and the Epworth Sleepiness Scale all improved when Armodafinil was used as an adjunct treatment for the excessive sleepiness still experienced in people with OSAHS that were being treated with nCPAP (nasal continuous positive airway pressure) for their condition.
Any use that is not for one of these sleep disorders is considered an off-label use. It has been estimated that as many as 90% of all prescriptions written for Modafinil are used off-label. It is believed that many prescriptions for Armodafinil are used in a similar way.
One off-label use of Armodafinil is to help improve the symptoms of attention-deficit hyperactivity disorder (ADHD). Not many studies have been done using Armodafinil for this purpose, but there is a large amount of literature on Modafinil, and it is believed that these results may be able to be extrapolated to Armodafinil.
Modafinil has been seen in many different double-blind placebo-controlled research studies to significantly improve ADHD symptoms compared to placebo, as measured on a variety of different tests, including the DSM-IV ADHD Behavior Checklist, the Teacher and Parent ADHD Rating Scale-IV, the Clinical Global Impressions-Improvement scale, and Conners Rating Scales.
One of the most common off-label uses of Nuvigil is using it as a cognitive enhancing smart drug. Users report that Armodafinil acts in much the same way as Modafinil, and improves concentration, focus, motivation, and memory. People say they use it before a large work presentation or an exam at school to help them be productive and work uninterrupted for hours at a time.
There haven’t been many studies devoted to studying Nuvigil’s nootropic benefits alone, but in research on other topics, positive cognitive effects have been observed. In one study using Nuvigil for narcolepsy, statistically significant improvements were measured in tests of memory, attention, and fatigue. In another study on people with SWSD, significant improvements were seen on Cognitive Drug Research tests of attention and memory.
Dosage and Overdose Potential
Nuvigil is most commonly prescribed at 150mg per day, taken in a single dose. Its half-life is about 15 hours, so a second dose is usually not necessary unless the user intends to remain awake and vigilant for an extended period of time.
During the clinical trials for Nuvigil, there were no instances of overdose reported; however, there are anecdotal reports of overdose which may be helpful.
In one case, a female with fibromyalgia had been taking Modafinil (Provigil) for excessive daytime sleepiness. Modafinil helped her to feel awake and alert, but the medication also caused her to experience headache and nausea.
In an effort to relieve these side effects, her physician switched her over to Nuvigil. She reports that once she began taking Nuvigil, it caused her to feel “heavier, slower and tired.”
In an effort to stay awake, she increased her dose of the medication throughout the day, finally taking a total of ten 150-mg tablets of Nuvigil.
At that time, she began experiencing overdose symptoms:
“I felt like my heart was racing, hands shaking. I tried not to talk to co-workers because I could not think of what I wanted to say. I had a heavy slow lethargic feeling, and slight headache. I found it difficult to stay on task. My back and neck are sore and my joints are sensitive. I feel tired and awake at the same time.”
There is no known antidote for Nuvigil overdose. Suspected overdoses should be closely monitored by a physician. Taking 10 pills of Nuvigil is definitely not considered safe and is something your physician will likely caution against.
In most cases, one pill is sufficient to produce desired results.
Most doctors will advise against using any amount in excess of one pill at a time. If you take more than this amount, you greatly increase the risk of side effects and lower the therapeutic safety profile of the drug.
Tolerance Potential
Psychostimulants inevitably have potential for building tolerance within the user’s system. Nuvigil is no exception.
Tolerance occurs when the brain processes which are usually affected by the drug are no longer highly sensitized to it.
Normally, this occurs over a period of continuous use, though with Nuvigil there are a few reports of quick tolerance results (2-5 doses) in some individuals. This, again, is likely due to the individual’s personal sensitivity and is probably uncommon.
To keep your brain sensitized to tolerance inducing drugs like Nuvigil, cycling is recommended. The safest way to take Nuvigil is to only use it on an occasional basis such as once a week when facing an especially long day at the office.
If taking Nuvigil for nootropic or lifestyle purposes, most users cycle the drug regularly (for example: two weeks on, 1 week off followed by 1 week on, two weeks off). Cycling keeps your brain guessing and not growing accustomed to any single drug’s active ingredients.
Withdrawal
Those using Nuvigil over a period of time, or those taking high doses, may develop a need for taking the drug.
This is a bit different than typical drug addiction, in that Nuvigil user’s are not craving or seeking out the drug, but their body must try to readjust to being without it. This can cause withdrawal symptoms.
The symptom users most commonly experienced withdrawal symptom is sleepiness, especially if stopping the drug suddenly. Other withdrawal symptoms may include temporary memory deficits and fatigue. Working with your doctor through this period is important.
Nuvigil Side Effects
When taken at appropriate dosages as recommended by a doctor, Nuvigil is generally well tolerated in adults. Most people experience no or some minor side effects. The most commonly reported minor side effects from research studies and user reviews online include:
- headaches
- nausea
- dizziness
- insomnia
- anxiety
- diarrhea
- dry mouth
- depression
- indigestion
- loss of appetite
- upper abdominal pain
As with many strong medications, there is typically an adjustment period when first taking Nuvigil. Some people have reported having minor side effects for the first few weeks of taking this drug. These side effects typically subside and cease after an individual’s physiology adjusts to the drug’s effects.
If side effects persist for longer, then it is possible that the dosage is not right. Some people have a higher sensitivity to the effects of certain medications, and what is a typically recommended dosage for most people may be too much for them.
Speak with your doctor about trying out a lower dosage to see if this helps alleviate side effects. If you still get the benefits of Nuvigil at the lower dosage then you may be fine to just continue at this new dosage. If you are not seeing the benefits you need, then slowly increase your dosage over a week or more, keeping note of any side effects that may occur.
Insomnia is a common side effect of Nuvigil that is caused by the stimulating nature of this compound. Armodafinil has a long half-life of approximately 13 hours and can still have effects many hours after it is taken, so if taken too late in the day it can cause sleep disturbances. To avoid issues when sleeping at night, take your dose in the morning, before noon to allow for the effects to wear off before bed.
Stevens-Johnson syndrome, toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms are very rare, but serious skin and mucous membrane conditions that may develop in some people when taking Nuvigil. There is evidence that some people with a genetic susceptibility may develop these conditions when taking certain drugs that are metabolized in the body a certain way, including Armodafinil.
Stop taking Armodafinil immediately and contact your doctor or go to an emergency if you develop flu-life symptoms, fever, and a rash that spread and blisters, located mainly near the mouth, nose, eyes, and genitals.
Contraindications
Nuvigil is contraindicated with a number of over-the-counter and prescription medications. Medications that may interact negatively with Armodafinil includes, but is not limited to:
- steroidal/hormonal contraceptives
- midazolam
- triazolam
- cyclosporine
- phenytoin
- omeprazole
- clomipramine
- propranolol
- diazepam
- Warfarin
- SSRIs
- MAOIs
- oxycodone
- acetaminophen
- ibuprofen
- Cold and flu medication containing guaifenesin, hydrocodone, chlorpheniramine, pseudoephedrine, and/or phenylephrine
This list is not complete, and other interactions can occur. Your doctor should speak with you about any medications you are taking before prescribing Nuvigil. If you are considering any new over-the-counter medications or supplements then speak with your doctor before starting them to determine if any interactions exist.
Nuvigil Safety in Review
Nuvigil (Armodafinil) is a drug designed to promote wakefulness and mental vigilance in the user without producing agitation or anxiety. It is sold legally in the USA, UK and in Canada. Nuvigil is considered to be much safer than other psychostimulants, but there are side effects that have been observed.
It is not clearly understood how Nuvigil works in the brain, but studies indicate it works on multiple brain processes involved in the sleep response system. Normal dosage of Nuvigil is 50mg – 200mg taken once daily.
Overdose can occur but there are no known fatalities due to Nuvigil overdose. Tolerance can occur over time, indicating a need for cycling Nuvigil or taking it only on occasion.
Use over a long period of time can result in withdrawal symptoms if stopped suddenly. Nuvigil should be taken under the supervision of a doctor who can monitor you for any of these safety concerns.
Is Nuvigil safe? Ultimately, this drug is considered to be safe when used properly, but if it is misused it does have to potential to cause negative side effects. If you are concerned about side effects, ask your doctor about using Modafinil or Adrafinil as an alternative.
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Article last updated on: April 12th, 2018 by Nootriment