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Modafinil is a prescription drug in Australia, primarily used to treat sleep disorders including narcolepsy, obstructive sleep apnea, and work shift sleep disorder.
Other names for Modafinil include Provigil, Modvigil, Modalert, and Alertec. Modavigil is the brand name version of Modafinil sold in Australia and New Zealand.
As a eugeroic substance, Modafinil encourages wakefulness. It is also used widely, off-label, as a cognition enhancer or smart drug.
Modafinil is also being studied for its effectiveness at treating attention deficit hyperactivity disorder (ADHD), neurological fatigue, depersonalization disorder and more.
In Australia Modafinil is a schedule IV controlled substance. Its usage is restricted and controlled, purportedly due to the possibility of addiction.
Usage of Modafinil in Australia, and in most other countries, also requires a prescription. However, there is a large online grey market for generic forms of this drug sold from countries such as India. Consumers should be aware that there are risks from purchasing unregulated drugs from non-approved sources like this.
Alertness
Mental Acuity
Focus- Stimulates wakefulness in the brain
- Promotes mental acuity & processing
- Enhances focus, motivation & energy
How Modafinil Works in the Body
Related Topics
- What is Modafinil? (Provigil)
- How Does Provigil Work?
- Effects and Benefits
- User Reviews
- Typical Experiences
- Recommended Dosages
- How to Take
- Provigil Uses
- Use for ADHD
- Effects on Weight Loss
- Negative Side Effects
- Abuse Warnings & Dangers
- Comparison to Adrafinil
- Comparison to Armodafinil
- Comparison to Adderall
- Where to Buy
- Generic Modafinil Brands
- Is Modafinil Legal?
- How to Get Modafinil
- Review of Online Sources
Modafinil was first developed at the French pharmaceutical company Lafon Laboratories (bought in 2001 by Cephalon Inc) in 1976. To this day, Cephalon makes the most popular brand name version of Modafinil, known as Provigil. Modafinil is closely related to the compound Adrafinil, which was developed in 1974.
Testing to determine Adrafinil’s mechanism of action found that its primary active component is Modafinil. Adrafinil is broken down in the liver into modafinilic acid and Modafinil after it is ingested. This makes Adrafinil a prodrug of Modafinil.
In animal testing, Adrafinil was seen to cause stimulating effects, including increased locomotor activity and alertness. As was to be expected, similar testing with Modafinil had the same results.
Adrafinil and Modafinil are classified as eugeroic compounds, meaning that they promote wakefulness and alertness. While they both have stimulant-like effects in the body, they are not related to traditional amphetamine or methylphenidate based stimulants.
The exact mechanism of action of Modafinil is unknown, but it has been seen to cause its stimulating effects in some different methods than traditional stimulants. In different studies done to determine how Modafinil works in the body, it has been seen to affect many different neurotransmitters and their transmission systems, including Dopamine, Histamine, Orexin (Hypocretin), Epinephrine, and Norepinephrine.
Like methylphenidate and amphetamines, Modafinil acts to block the transport of Dopamine. This leads to higher levels of Dopamine in the brain, which is believed to be related to increased motivation, enhanced memory, and improved mood.
Two compounds which may cause the bulk of Modafinil’s wakefulness effects are Orexin and Histamine. Orexin is a neuropeptide that regulates sleep and wake states, arousal, and appetite. Modafinil has been seen to strongly activate Orexin neurons and Orexin-secreting neurons in the brain. Orexin in turn stimulates the release of Histamine, a neurotransmitter that is also involved in wakefulness, arousal, and appetite regulation.
Modafinil for Narcolepsy
Because of its wakefulness promoting effects seen in animal studies and research on how it works in the body, the first human clinical trials used Modafinil to try and treat narcolepsy.
Narcolepsy is a sleep disorder that affects sleep and wake states, specifically the inability to maintain wakefulness. One cause of narcolepsy is thought to be a decrease in Orexin producing neurons in the brain. As discussed previously, Modafinil has been seen to stimulate Orexin production, and is thought to help stimulate any remaining neurons to produce more.
Narcoleptics have a hard time staying awake during the day, regardless of the quantity and quality of sleep the previous night. They experience excessive daytime sleepiness and depending on the severity of the case can fall asleep multiple times per day, typically without warning.
In multiple double-blind placebo-controlled research studies using Modafinil for narcolepsy, it has been seen that Modafinil significantly improves various measures of sleepiness and wakefulness compared to a placebo.
Scores have been seen to improve on the patient-administered Epworth Sleepiness Scale, the amount of time before falling asleep increases as measured by the Multiple Sleep Latency Test, and the quantity and duration of daytime sleep episodes was seen to decrease as measured by the Maintenance of Wakefulness Test.
Modafinil has been seen to be such a successful treatment for narcolepsy that it has been used as a measure of efficacy when testing novel narcolepsy drugs. One test compared sodium oxybate to Modafinil and a placebo. It was observed that both of the active medications improved scores on the Epworth Sleepiness Scale, the Maintenance of Wakefulness Test, and the Clinical Global Impression Scale.
The sodium oxybate was seen to be as effective as Modafinil, and an additive effect was seen when both drugs were taken together, suggesting it may be useful as an adjunct treatment with Modafinil in severe narcolepsy cases.
A similar study found similar results when testing pitolisant against Modafinil. In the study, pitolisant was seen to be superior to placebo in improving Epworth Sleepiness Scale scores, and similarly efficacious as Modafinil.
Modafinil for Other Sleep Disorders
Since it was first used for treating narcolepsy sleep disorder, Modafinil has been approved for use for two other sleep disorders that involve excessive sleepiness: shift-work sleep disorder and obstructive sleep apnea/hypopnea syndrome.
Humans’ natural circadian rhythm is to be diurnal, meaning they are awake during the day, and sleep at night. In some situation, people are forced to switch this normal schedule, and be awake at night, and sleep during the day. This most typically occurs when people work late night, overnight, or extended hours work shifts.
Shift-work sleep disorder is a circadian rhythm disorder than can sometimes occur in people in this situation. Their bodies are unable to adjust properly to their new schedule, and they experience excessive sleepiness when they are awake at night, and sometimes they have insomnia when they try and sleep during the day.
Obstructive sleep apnea/hypopnea syndrome is a potentially serious sleep disorder that affects breathing during the night. The muscles of the mouth and throat involuntarily relax during sleep, causing the tongue, soft palate, and uvula to block the airway. A partial blockage can lead to labored or shallow breathing, known as hypopnea, while a complete blockage can lead to the temporary cessation breathing, known as apnea.
People with this condition often experience many of these breathing episodes every night, leading to poor sleep quality and consequent excessive daytime sleepiness. Normal treatment for this condition is wearing a nasal continuous positive airway pressure (nCPAP) machine at night. In cases where this treatment still leaves the patient with residual daytime sleepiness, Modafinil is sometimes used as an adjunct treatment.
While the cause of the excessive sleepiness differs between the two conditions detailed above, as has been seen in narcolepsy patients, Modafinil is significantly better at reducing sleepiness and improving wakefulness in these patients than a placebo.
One study on people with shift work sleep disorder had people for 12 weeks take a dose of either Modafinil or placebo 30-60 minutes before a nighttime work shift began. At baseline, 4 weeks, and 12 weeks of treatment, patients completed the Functional Outcomes of Sleep Questionnaire, which measures the effect of excessive sleepiness on various aspects of life, including vigilance, activity level, general productivity, social outcome, and intimacy.
It was found that compared to placebo, Modafinil significantly improved scores on this questionnaire, indicating improved functioning and quality of life in these patients. Another similar study had patients complete the Psychomotor Vigilance Test while on their work shifts. It was seen that Modafinil decreased the frequency and duration of attention lapses, as measured by performance on the test.
In a study on obstructive sleep apnea, patients who had been using nCPAP for at least two months and were experiencing excessive daytime sleepiness where given either a placebo or Modafinil once daily for 4 weeks. It was seen that compared to placebo patients, Modafinil patients had significantly improved scores on the Epworth Sleepiness Scale, and significantly increased times on the Multiple Sleep Latency Test.
Modafinil is classified by the Department of Health Therapeutic Goods Administration as a Schedule IV Prescription only Medication in Australia. It requires an Australian registered doctor’s prescription to legally buy, own, and use this drug.
- Increases energy, wakefulness and motivation
- Boosts mental performance and focus
- Supports memory and cognition
Off-Label Uses for Modafinil in Australia
In Australia, in addition to the approved prescription uses, Modafinil is also used for a variety of off-label purposes.
Some of these include chronic fatigue syndrome (CFS), fibromyalgia, spastic cerebral palsy, myotonic dystrophy, Parkinson’s disease, sleepiness induced from opioids, multiple sclerosis, depression, primary biliary cirrhosis, excessive daytime somnolence and various neurodegenerative and psychiatric conditions.
As an off-label “smart drug”, Modafinil is sometimes purchased by students in Australia to help them study. It is considered to have cognitive enhancement properties and is also used to boost productivity in the workplace.
Modafinil for Fatigue:
In Australia, Modafinil is frequently used to decrease fatigue. It is commonly taken for narcolepsy and shift-work sleep disorder. This drug is also sometimes used to alleviate fatigue caused by jet lag.
It may also be used as an adjunct therapy for treating fatigue related to other health conditions. Diseases like type 2 diabetes, multiple sclerosis, CFS and others are caused largely by imbalances in mitochondrial energy.
Multiple sclerosis (MS) is commonly characterized by extreme fatigue. Cephalon conducted a clinical trial to discern the effects of Modafinil on MS-related fatigue.
Two dosage levels were tested in 72 patients with differing degrees of MS severity. An inactive placebo was also tested. After 9 weeks, all participants completed self-evaluations utilizing standardized scales.
Both groups that received Modafinil reported significant decreases in MS-related fatigue. No changes of significance were noted in the placebo group. Also, the group receiving the higher dosage reported only slightly better results than did the lower-dosage group.
Modafinil for Depression:
Modafinil has been studied for its use to relieve fatigue in people with depression, as well as either an adjunct treatment with antidepressants or as an alternative treatment for the disorder.
In one study using Modafinil for fatigue in people with major depressive disorder, it was seen that compared to placebo, scores on the Fatigue Severity Scale, the Epworth Sleepiness Scale, and the Clinical Global Impression of Change Scale were significantly improved from the baseline in patients given Modafinil.
One study from the University of Cambridge found that when taken together with traditional antidepressant treatment, Modafinil improved the severity of depression as well as remission rates significantly compared to taking antidepressants alone. Fatigue and excessive sleepiness are also symptoms associated with depression, and Modafinil was seen to have benefit in this area as well.
Another preliminary study used Modafinil as an adjunct therapy with antidepressants, as well as on its own in patients with major depression. Scores on depression ratings scales were improved in both the Modafinil with antidepressants group, as well as the Modafinil monotherapy group. The researchers concluded that Modafinil should be further studied as a potential alternative depression treatment, especially for patients who have been non-responders or partial responders to traditional treatments.
Modafinil for Weight Loss:
Some Australians also use Modafinil to help them reach and maintain healthy weight levels.
Studies involving both overweight and/or obese people, and those of healthy weight levels, show that Modafinil has an appetite suppressing effect.
Various studies have shown Modafinil to induce weight loss more so than placebos. In one study from 2008, participants decreased total caloric intake levels by 18% with 200 mg daily doses of Modafinil. Another group received 400 mg daily doses and decreased caloric intake by 38%.
The appetite reducing effects appear similar to those induced by amphetamines. One primary difference between the effects of Modafinil and amphetamines is a lower rate of stimulant-like side effects. Modafinil does not seem to increase the heart rate in the same way as amphetamine drugs.
In one case study, a patient weighing 280 pounds initially lost over 90 pounds in three years. His BMI went from 35.52 down to 29.59 – from being classified as obese to within the range considered healthy.
In 2000, Cephalon filed for patent rights on using a modafinil derivative as an appetite suppressant. However, it has not yet been approved for this purpose in Australia and is used off-label.
Modafinil for ADHD:
A number of individuals in Australia use Modafinil off-label to treat the symptoms of attention-deficit hyperactivity disorder (ADHD). Research has shown Modafinil may improve concentration and attention span in individuals with ADHD. Furthermore, this drug is generally better tolerated than some traditional amphetamine or methylphenidate based ADHD medications, such as Adderall or Ritalin.
Many double-blind placebo controlled research studies have been conducted in all age groups testing Modafinil’s efficacy for improving symptoms of ADHD. When compared against a placebo, Modafinil has been seen to significantly improves scores on a variety of tests, including the Teacher and Parent ADHD Rating Scale-IV, Connors’ Parent Rating Scale, Connors’ Teacher Rating Scale, the Clinical Global Impressions-Improvement scale, and the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) ADHD Behavior Checklist.
Modafinil has even been tested against a traditional ADHD medication, dextroamphetamine (Dexedrine) to determine its efficacy. In the study, it was found that both medications performed similarly, and that they both improved scores on the DSM-IV ADHD Behavior Checklist for Adults. significantly compared to placebo. The researchers suggested that due to how it performed compared to dextroamphetamine that Modafinil should be considered a viable alternative to conventional ADHD medications.
There are some doctors who will prescribe Modafinil to their patients with ADHD. It is legal for doctors to write prescriptions for off-label uses of drugs, but they are under no obligations to do so. However, doctors who are current on the research of using Modafinil for ADHD are sometimes willing to prescribe it.
Especially in patients where traditional stimulant based ADHD medications have not been successful at treating symptoms, or in situations where they have caused serious negative effects (typically cardiovascular related problems) then some doctors may prescribe Modafinil.
Modafinil as a Cognitive Enhancer:
The drug is said to promote increased energy, alertness, focus, and mental performance. In some research studies, administering Modafinil to sleep-deprived individuals resulted in an improvement in accuracy on tests administered. Similar results have also been seen in non-sleep deprived, healthy, neurotypical individuals.
One double-blind, placebo controlled, fully within-subjects study had patients complete a cognitive assessment at baseline, then take either a placebo or Modafinil and complete the cognitive assessment at 90 and 180 minutes after drug ingestion. Compared to the scores from the placebo group, patients in the Modafinil group had improved scores in reaction time, vigilance, fatigue levels, and motivation.
Another similar randomized double-blind, placebo-controlled between-subjects study gave patients a dose of placebo or Modafinil prior to completing a series of neuropsychological tests aimed to test memory and attention. It was seen that scores were significantly improved in the Modafinil group on a tests of digit span memory and visual pattern recognition memory, a spatial planning task, and stop-signal reaction time was improved.
In addition to the improvements in scores, there was a small delay in answering on some tests. This was seen to correlate with a reduction in impulsive and prepotent responses (habitual, reflexive responses that are counter to completing a given task). While this study was done on neurotypical individuals, the researchers suggested that this result shows that Modafinil could have benefits for individuals with ADHD.
Can You Buy Modafinil Without a Prescription in Australia?
Modafinil is only legally allowed to be bought and used with a doctor’s prescription. The only approved uses that Modafinil is prescribed for are narcolepsy, shift-work sleep disorder, and obstructive sleep apnea/hypopnea syndrome. In some cases, doctors may prescribe Modafinil for ADHD, but this is an off-label use, and not all doctors will write such prescriptions.
Modafinil is very rarely if ever prescribed for nootropic purposes, as most of the time medications are prescribed with the intent of treating or curing a condition, disorder, or disease. Drug prescriptions are not given to healthy people who are trying to improve their cognitive functioning.
Therefore, when taken for so-called “nootropic” effects, Modafinil is commonly purchased without a prescription from “gray market” online pharmacies. It is legal to sell and buy Modafinil over the counter in some countries such as India and Mexico. Some people will buy Modafinil online from countries where the sale is legal and then attempt to import it.
However, this is not recommended due to multiple different risks. First of all, there is the risk of receiving a misbranded product that has not undergone sufficient quality control. It is impossible to know that the product you receive is in fact pure Modafinil without having it analyzed by a laboratory.
While some online pharmacies do provide a Certificate of Analysis, this would need to be done on every single batch of product they sell, which is almost never done. Many online pharmacies do not even offer any analysis records, and the authenticity of the products they sell is even more suspect.
Another risk when you order Modafinil online this way is that packages may be seized at the border when importing to Australia. Customs officials will search and seize any shipments of prescription drugs they find, and your information could be registered with authorities.
Overall, it is recommended to not try and buy Modafinil without a prescription, and instead to research some alternative nootropics instead, such as one of the Racetams (discussed below).
Modafinil Safety and Side Effects
Before using Modafinil, discuss the risk of side effects with your doctor. For most people, the potential benefits outweigh the risk of adverse side effects.
While generally well tolerated, mild side effects have been reported with Modafinil use. The most commonly reported side effect of Modafinil is headaches. In one study sponsored by Teva Pharmaceuticals, one-third of all participants reported headaches. Some other sources have estimated that as many as half of the people who use Modafinil will experience headaches.
Some other commonly reported side effects of Modafinil include nausea, anxiety, and nervousness. The following list gives some of the other mild side effects have been reported less frequently, but are still not considered rare:
- Indigestion
- Heartburn
- Upset stomach
- Vomiting
- Diarrhea
- Back pain
- Dry skin
- Dry mouth
- Muscle stiffness
- Decreased appetite
- Weight loss
- Insomnia
In some cases, an adjustment period may be necessary when first taking Modafinil. Some people have reported having mild side effects for a few weeks that diminished as time went one.
One cause of side effects can be too high of a dosage. While a normal dosage may not produce side effects in most people, everybody’s physiology is different. Lowering the dosage may help to reduce or eliminate side effects. If the benefits decrease as well, then slowly increase the dosage back to a higher level, keeping note of any side effects that may occur.
Insomnia has been reported with Modafinil use. This is most commonly caused by taking a dose too late in the day. Modafinil has a relatively long half-life of between 12-15 hours. It is recommended to take dosages in the morning, or at the latest by noon. A dosage taken in the afternoon may have too much of a stimulating effect late in to the night and cause sleep disturbances.
There is a small chance of developing one a group of rare, but possibly life-threatening dermatological reactions with Modafinil use, including Stevens-Johnson syndrome, toxic epidermal necrolysis (TEN), or drug reaction with eosinophilia and systemic symptoms (DRESS). There is strong evidence suggesting that certain people may have a genetic predisposition to developing these conditions when they take certain medication, including Modafinil.
There have not been any reported cases of these conditions in any research studies conducted in adults, and only one case in a pediatric patient, where the diagnosis was later retracted. While the chances are very low of developing these conditions, it is important to be aware of the possibility. If you develop a fever, flu-like symptoms, and a rash that spreads and blisters, than stop taking Modafinil immediately and contact your doctor, or go to an emergency room.
Negative Interactions and Contraindications
Modafinil’s mechanisms of action is not yet well understood. It seems to work by selectively blocking the transport of dopamine and it may affect histamine levels in the brain. Due to this, there is a risk of drug interactions when combined with other medications. Speak to your doctor to learn of all possible interactions.
The following is a non-exhaustive list of some of the medications known to interact with Modafinil:
- Ibuprofen
- Acetaminophen
- Cold and flu medications containing guaifenesin, chlorpheniramine, hydrocodone, and/or phenylephrine
- Warfarin
- MAOIs
- SSRIs
- Tricyclic antidepressants
- Cyclosporine
- Steroidal/hormonal conctraceptives
Consumers in Australia who want to buy Modafinil must have a prescription to use this drug legally. While grey-market sources may exist from online pharmacies based in other countries, it is not recommended to purchase from these websites due to the risk of product seizure or contamination.
Legal Modafinil Nootropic Alternatives
For some people around the world, Adrafinil is one of the most common legal Modafinil alternatives. This prodrug causes similar effects in the body as Modafinil, and is an unscheduled, unclassified compound in places like the United States, Canada, and the UK.
Unfortunately, Adrafinil is classified the same as Modafinil in Australia and New Zealand, as a Schedule IV prescription only drug, so this eliminates it as a viable alternative to Modafinil.
Because of this, many people who want to experience nootropics will consider one of the Racetam class of compounds. The parent compound, Piracetam, was first developed in the 1960s by UBC pharmaceutical company in Belgium. Piracetam’s inventor coined the term nootropic (from Greek meaning “to turn the mind”) to describe this first compound of its class.
This group of compounds have been seen to positively affect Acetylcholine levels and transmission in the brain. This is believed to lead to better overall cognition and memory formation and recall. They also increase oxygen and glucose transport, allowing for greater mental fluidity and overall alertness.
While Piracetam is similarly classified as a Schedule IV drug, its derivatives are still unscheduled in Australia. These derivatives include Oxiracetam, Aniracetam, and Pramiracetam. These compounds are considered significantly more potent than their predecessor, and are typically chosen by seasoned nootropics users over Piracetam.
If you are interested in experiencing some of the nootropic effects of Modafinil without risking buying from online pharmacies, then consider using an alternative such as one of the Racetams.
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Article last updated on: April 11th, 2018 by Nootriment