Provigil Dosages as a Smart Drug & for Medical Conditions

Provigil (or Modafinil) is a much sought-after drug that can increase mental vigilance, attention, acuity and performance across a battery of cognitive tests.

Smart drug users sometimes compare it to the fantasy drug NZT-48 featured in the movie Limitless which gave the user an ever-increasing amount of cognitive ability, enabling him to create a life about which most people only fantasize.

One Provigil dosage can turn you into a super-driven version of yourself that is focused, bright and not satisfied until their to-do list is completed. Taking as little as 100 mg or 200 mg of a Provigil dose per day is said to offer life-changing benefits.

Although Provigil is definitely not NZT-48, it has been a popular choice for executives, students, entrepreneurs and others looking to improve their motivation, output and productivity levels.

It is not a drug designed to replace good sleeping habits, but instead to help you during those times when you need to remain alert and awake mentally without fatigue.

Completing a large work project on a tight deadline, or studying for long hours before examinations are good examples of situations for which Provigil has been used successfully.

The downsides to Provigil include potential side effects, high cost and limited availability. What is the right Provigil dosage to use so that you can maximize your productive potential when taking this drug?

Modafinil

Ergogenic Drug

Alertness

Mental Acuity

Focus

How It Works:

• Stimulates wakefulness in the brain
• Promotes mental acuity & processing
• Enhances focus, motivation & energy

Dosage:

Between 100 - 200 mg per day

Safety:

Some Reported Side Effects

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Provigil History and Overview

Modafinil was first developed in the mid-1970s by a scientist in France working for the pharmaceutical company Lafon Laboratories. This company was later bought out by the company Cephalon Inc, who still to this day make the most common and popular name-brand version of Modafinil, Provigil. For the purposes of this article, Provigil and Modafinil are considered interchangeable, however it should be noted that there are many different generic brands of Modafinil available today.

Modafinil was in fact discovered due to testing on another related compound, Adrafinil. The two compounds are very similar in their molecular structure, with the only difference being that Adrafinil has a hydroxyl group on its terminal amide that Modafinil does not have. The reason for this great level of similarity between the two compounds is that Modafinil is in fact a metabolite of the breakdown of Adrafinil.

After it is consumed, in the body Adrafinil is naturally metabolized in the liver. It is broken down into Modafinil, which is its primary active component, and modafinilic acid, which is inactive. During research tests to determine Adrafinil’s mechanism of action in the body, Modafinil was discovered.

A good bit of previous research had already been done on Adrafinil by the time Modafinil was discovered, and research continued for a time afterwards as well. The two compounds are classified as eugeroics, or wakefulness-promoting agents, due to the stimulant-like effects they have. In initial animal trials, it was seen that Adrafinil (and later Modafinil in similar trials) had stimulating effects, causing increased locomotor activity and alertness, as well as hyperactivity at higher doses.

The exact mechanism of action of Modafinil is still unknown. It has been observed across multiple research trials to have an effect on a variety of neurotransmitters in the central nervous system and the brain, including Dopamine, Serotonin, Epinephrine (Adrenaline), Norepinephrine (Noradrenaline), Histamine, and Hypocretin (also known as Orexin).

Provigil has been seen to affect these different neurotransmitters by either increasing their output or inhibiting their re-uptake. It may also increase sensitivity in receptors to these neurotransmitters, causing them to become more effective.

It is thought that the primary cause of Modafinil’s effects may be caused by its relationship with Histamine and Hypocretin. The release of these two neurotransmitters is associated with heightened states of arousal and alertness, with Hypocretin specifically being related to the regulation of sleep and arousal states.

Provigil and Narcolepsy

Due to the stimulating, wakefulness promoting effects seen in animal trials, Adrafinil and Modafinil were first tested in clinical trials for improving the sleep disorder narcolepsy in humans. Adrafinil was first approved for this purpose in 1986. However, once Modafinil was able to be synthesized directly on its own, it began to replace Adrafinil in usage.

Provigil has been an approved prescription medication for the treatment of narcolepsy in France since 1994, and was approved by the FDA for use in the United States in 1998. There has been a large number of double-blind placebo-controlled studies done to determine the efficacy of this drug for treating this sleep disorder.

Narcolepsy is a sleep disorder that affects an individual’s ability to maintain wakefulness. Research has shown that a primary cause of narcolepsy is believed to be related to the loss of Hypocretin neurons in the brain, leading to significantly lowered levels of this neurotransmitter.

People with narcolepsy typically experience excessive daytime sleepiness that is unrelated to the quality of nighttime sleep, and can even fall randomly asleep throughout the day, sometimes multiple times per day. As a wakefulness promoting drug, Modafinil has been seen in multiple research studies to significantly reduce excessive daytime sleepiness (as measured by the self-administered Epworth Sleepiness Scale), reduce the number of sleeping episodes during the day, and increase the mean latency time to sleep (as measured by the Maintenance of Wakefulness Test).

Modafinil has been shown to be such a successful treatment for narcolepsy that it has even been used as a standard against which potential new narcolepsy drugs are tested. The drugs sodium oxybate and pitolisant have both had their efficacy tested against Modafinil before being approved as treatments for narcolepsy.

Provigil Use for Other Sleep Disorders

Since it was originally approved for use in humans for narcolepsy, the approved uses of Provigil have expanded to include two other sleep disorders that involve excessive sleepiness, namely shift-work sleep disorder and obstructive sleep apnea/hypopnea syndrome.

Shift-work sleep disorder (sometimes just called shift work disorder) is a sleep disorder that sometimes occurs in people who work overnight work shifts either on a continual basis, or more commonly when on a rotating or intermittent basis.

Circadian rhythm is the internal biological clock that runs on an approximate 24 hour cycle that determines normal sleep and wake cycles. Humans are naturally diurnal, and are typically awake during the daytime, and sleep during the nighttime.

Typically due to their work schedule, some people have to instead be awake at night, and sleep during the day. This can sometimes lead to shift work sleep disorder, where people experience excessive sleepiness when they are awake, and sometimes they also have insomnia when trying to sleep.

Provigil has been extensively studied for this condition, and it has been shown to significantly reduce excessive sleepiness, increase alertness, and reduce the frequency and duration of attention lapses while working compared to a placebo.

Obstructive sleep apnea/hypopnea syndrome (OSAHS) is a potentially serious sleep disorder where breathing stops and starts repeatedly throughout the night due to blockage of the airway. The muscles of the mouth involuntarily relax which allows the tongue and soft palate of the mouth to either partially obstruct the airway, leading to poor, shallow breathing (known as hypopnea); or completely block the airway, which leads to the temporary stopping of breathing (known as apnea).

People with this sleep disorder often have it develop over time, with symptoms worsening over the years. Most people with OSAHS experience poor sleep quality at night due to multiple episodes of poor or no breathing, sometimes even waking up choking or gasping. Extended periods of poor nighttime sleep, with no or few times of deep restful sleep, often leads to excessive daytime sleepiness.

The treatment for OSAHS is typically a device worn in the mouth at night to keep the tongue in place, or a continous positive airway pressure (CPAP) machine worn at night that keeps the airway open. Modafinil is therefore used as an adjunct treatment to help improve the common symptom of excessive sleepiness.

As also seen in studies on narcolepsy and shift-work sleep disorder, studies using Provigil to improve this symptom of OSAHS have proven successful. Patients given Modafinil report back significantly better scores on the Epworth Sleepiness Scale compared to patients given a placebo.

Provigil is classified by the FDA as a Schedule IV prescription only drug in the United States, and is prescribed on-label to treat narcolepsy, obstructive sleep apnea, and shift-work sleep disorder. It is similarly classified as a prescription medication in many other countries around the world, including Canada, the United Kingdom, Australia, Finland, Sweden, Germany, and Italy. Any uses beyond these approved uses is considered off-label.

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• Increases energy, wakefulness and motivation
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Popular Off-Label Uses of Provigil

While Provigil is only officially approved for the sleep disorders discussed above, it is believed that it is in fact used much more frequently for a variety of off-label uses. Some doctors will prescribe Provigil off-label for disease-related fatigue and ADHD. Using Provigil in a nootropic context is also very common.

Fatigue is a symptom that is related to many different diseases including depression, multiple sclerosis, chronic fatigue syndrome, fibromyalgia, and Parkinson’s disease. There has been some research done that has shown that Modafinil is able to reduce fatigue and sleepiness in patients with depression and multiple sclerosis significantly over a placebo.

Researchers have suggested that Provigil should be considered as an adjunct treatment for disease-related fatigue, especially in patients who may only be partial-responders to treatment for their specific disease.

It is estimated that up to 90% of all prescriptions written for Modafinil in the US are for off-label uses, and it is thought most of those prescriptions are for improving symptoms of attention-deficit disorder (ADD) and attention-deficit hyperactivity disorder (ADHD). Over the years there have been a multitude of studies done on children, adolescents, and adults with ADHD showing that Modafinil significantly improves symptoms compared to a placebo.

Multiple studies have followed the same general procedure of randomly assigning patients to a control group that receives a placebo or a test group that receives Modafinil; all subjects are then measured for performance on a variety of tests. Some studies are crossover studies that have then had patients switch after a period of time and be given the opposite treatment than they originally received (i.e. placebo patients are given Modafinil, and vice versa).

All research studies on using Provigil for ADHD have shown that compared to a placebo, the drug significantly improves performance on a variety of tests, including the Diagnostic and Statistical Manual of Mental Disorders IV ADHD Behavior Checklist, the Teacher and Parent ADHD Rating Scale-IV, and the Clinical Global Impressions-Improvement scale.

Some studies have also been done comparing Provigil to traditional medications used for treating ADHD. One study compared Modafinil to a placebo, as well as to dextroamphetamine (Dexedrine). Improvement in scores reaching trend level of significance was seen with both active medications on one test that was administered, the Controlled Oral Word Association Test, when compared to scores from the placebo group.

Results showed that scores on the DSM-IV ADHD Checklist were significantly improved in both the Provigil and dextroamphetamine test groups compared to scores seen in the placebo group. The researchers suggested that due to its ability to show improvements similar to the conventional medication that Modafinil should be considered as a viable alternative for ADHD treatment.

There are some doctors that will in fact write prescriptions for Provigil for their patients with ADHD, especially in cases where traditional amphetamine-based stimulant drugs have not been fully successful, or have caused serious negative effects. These off-label prescriptions are entirely legal, but are up to the discretion of individual doctors, and most doctors may not be willing to write such a prescription.

Another of the most common uses of Provigil today is related to the effects seen in people with ADHD. Smart drug users report using the drug to fight off fatigue, increase memory ability, enhance focus, boost mood, improve motivation, and decrease jet lag.

There have been some review studies done compiling the results seen in multiple other studies using Provigil for cognitive enhancement. These reviews found some general trends across the research available, showing that Modafinil may increase some aspects of memory, most specifically related to episodic memory which deals with memory of events, as well as working memory, a type of short-term memory related to linguistic processing and decision-making behavior.

Provigil Dosages

Provigil comes in tablet form in either 100mg or 200mg doses. The dosage needed to gain the beneficial effects will depend on your own individual neurochemistry.

It is important to note that most users experience the same, or even, better results at lower doses, while taking higher doses has been reported to sometimes cause discomfort, shakiness and other unwanted side effects without increasing the beneficial effects.

Provigil has been reported to build tolerance within the user, so finding the lowest possible dose required to achieve the desired effect is important in order to not desensitize your system to the drug.

Ideally, the dosage you use should be determined by consultation with a doctor or a pharmacist who knows your medical history.

However, there is a high degree of usage for Provigil or generic forms of Modafinil by individuals who do not have a prescription. These individuals need to be especially careful when it comes to deciding on their dosages since they often use the drug without any physician supervision.

We can use guidelines from the world of medical practice to determine what safe dosage ranges for Provigil are. In medical contexts, for the treatment of narcolepsy and obstructive sleep apnea, most doctors will prescribe 200mg doses, typically one per day in the morning. Sometimes the dosage is split into one in the morning and one near noon.

Dosages of 400 mg per day have been studied and are still considered well tolerated. However, there does not seem to be any added benefits above the 200 mg per day dosage, and there is the increased potential risk of side effects when taking a high dose.

For shift-work sleep disorder which occurs in individuals who often have to work night shifts as well as day shifts, dosages tend to vary. Most physicians prescribe single 100mg, 150mg or 200mg dose at the time the individual awakes each day. Most users say that take their dose about an hour before they start their work shift for the most benefit throughout their work time.

Among individuals who take Provigil as a cognitive enhancer, most users report that taking a 100mg dose in the morning provides them with the beneficial effects to carry them through the majority of the day. Others will use 200 mg to give them an extra boost on intense days at the office or school.

Since it can be expensive, getting the most out of a smaller Modafinil dosage is the best practice for saving money. The half-life for Provigil is about 12 hours, so if you take your dose at 8 a.m., the effects will continue until approximately 8 p.m.

If you intend to continue working or studying late into the night, a second dose in the late afternoon or early evening would be appropriate.

Many users report they can, occasionally, stay comfortably awake and alert for a 48-hour period, then sleep for 8-10 hours and feel well-rested. This is one benefit which sets Provigil apart from other psychostimulants.

The key is to do this only occasionally, if needed. Sleep deficit can prove to be a real problem for anyone going extended periods of time without giving their body and brain the downtime it needs to process, consolidate, assimilate and organize information and memories properly.

Provigil doses should never exceed 400mg within a 24-hour period. Because tolerance can build, a good plan for cycling Provigil with your other nootropic supplements is recommended.

Provigil Side Effects

Provigil has range of side effects which go from moderate to more serious in nature. Working with your doctor closely to monitor for these is important.

When taken at appropriate doctor prescribed dosages, Provigil is generally well tolerated by most adults. As with any medication though, there is always the potential for side effects and adverse reactions due to difference in personal sensitivities.

The most commonly reported side effects in research studies and user reports are headaches (the number one most commonly reported side effect), nausea, anxiety, and nervousness. Other mild side effects that have been reported, but less frequently include back pain, loss of appetite, indigestion, heartburn, diarrhea, vomiting, muscle stiffness, and rhinitis (inflammation of the nasal mucosa, causing stuffy and/or runny nose).

Because it is a wakefulness-promoting drug, insomnia and sleep disruption have been reported in some cases. This is almost exclusively seen in people who take two dosages a day, or take their single dosage later in the day (after noon). Most users who are taking a single dose in the morning report no sleep problems at all.

Sometimes the most common solution to decrease or eliminate mild side effects is simply to reduce your Provigil dosage. Higher dosages do not always yield better results, and that is the case with Provigil. Typically a dosage around 200 mg per day is sufficient to provide effects without the risk of side effects seen with higher dosages.

More rare, but serious, side effects include unusual skin rashes which often require hospitalization. These can include Stevens-Johnson syndrome, toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS).

None of these conditions have been observed in research study conditions on Provigil. It has not been thoroughly studied whether Provigil was in fact the cause of any reported cases, or rather was just being taken at the same time. Caution should still be taken though; if you experience a fever, flu-like symptoms, or a red, spreading rash than speak to your doctor immediately and stop taking Provigil until told you are allowed again.

One often ignored factor about Provigil is that is reported to have neuroprotective properties which may prevent damage to your brain in certain cases. This makes it quite different from stimulants like Adderall or Ritalin which tax systems in your brain and can cause damage if overused.

Non-Prescription Provigil Alternatives

Provigil is a prescription medication which can produce cognitive benefits in the user. It is designed to create a state of natural wakefulness. Dosing is usually between 100mg-200mg, taken once or twice during the course of the day.

Because Provigil requires a prescription and can cost up to $1500 each month, many nootropic users opt to use other nootropic alternative drugs and supplements. the non-prescription alternative, Adrafinil, instead.

As previously discussed, Adrafinil is the pro-drug of Modafinil that is metabolized into this active component in the liver. Modafinil is a more potent compound, as not all of the Adrafinil consumed is converted into this active component; therefore a much higher dosage of Adrafinil is needed to have the same effect as Modafinil.

Because of this, back in the 1980s Modafinil became the preferred drug, and usage and production of Adrafinil decreased. It is still possible to buy Adrafinil now though, and people who cannot get a prescription for Provigil sometimes use this related compound as an alternative.

Adrafinil is available without a prescription and, if purchased in bulk powder form, typically costs only about .30 cents per dose. One of the drawbacks to Adrafinil relates to how it is processed in the body. When it is metabolized in the liver, there is the possibility of the accumulation of liver-toxic enzymes. This risk is believed to increase with frequent use, so users tend to reserve Adrafinil dosages for only those special occasions when they need the extra motivation and productivity.

Another nootropic alternative to Provigil is any of the class of Racetams cognitive enhancers. This family of compounds are all derived from the parent compound Piracetam that was first discovered in the 1960s. Since that time, more potent derivatives have been developed including Aniracetam, Oxiracetam, Pramiracetam, and Phenylpiracetam.

These compounds all mostly have effects on memory and concentration, but the derivatives tend to have different specialty effects specific to themselves. Like Adrafinil, these are unregulated, unscheduled non-prescription compounds that some people use as a legal alternative to Provigil.

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