9 Most Common Provigil Side Effects and Possible Dangers

Provigil (Modafinil, Modalert) falls into the class of Eugeroic drugs, used to stimulate the mind and increase wakefulness.

It is prescribed clinically in the treatment of sleep disorders with millions of users worldwide.

Provigil is also taken as a nootropic supplement by individuals who want to “hack” their brain to become more productive and achieve greater cognitive abilities.

While this nootropic is considered safer and better tolerated than traditional stimulants which can become addictive of cause withdrawal symptoms, there are some side effects to be aware of.

In most cases, Provigil side effects will be mild and will only last for a short period of time though there have been a few more serious adverse events reported.

There are also some drug interactions to be aware of and anyone with a pre-existing health condition should check with their doctor before using 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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How Provigil Works

Provigil is a wakefulness and alertness enhancing drug used to treat excessive daytime fatigue, narcolepsy, sleep apnea, and shift work disorder.

Many user reviews say that when taking this drug, it completely eliminates the need for sleep and makes them more focused and energetic.

As an off-label smart drug, it has gained favor among entrepreneurs, students and other people working in highly competitive industries to help them get ahead.

It is typically purchased as generic Modafinil from online pharmacies or as Adrafinil which is a legal prescription-free alternative that actually converts into Modafinil in the liver.

Clinical trials have demonstrated that Provigil has a positive effect on mental performance in areas such as memory, analytical reasoning, information retention, and concentration.

This pharmaceutical works by stimulating the central nervous system, though not with the same mechanism of action of typical stimulants like Adderall or even caffeine. Provigil increase the release of catecholamines such as Norepinephrine and Dopamine in the brain. These neurotransmitters are both involved in our energy levels as well as attention-assigning functions in the brain.

Provigil also raises levels of the neuropeptide Orexin by strongly activating Orexin-secreting neurons. The Orexin in turn stimulates the release of the neurotransmitter Histamine in the hypothalamus. This increase in Histamine leads to higher levels of wakefulness and perceptual awareness.

The hypothalamus is the system in your brain that regulates sleep cycles and fatigue. By increasing histaminergic activity, Provigil essentially blocks the feeling of fatigue and enables you to stay productive for more hours in a day.

Uses of Provigil

Modafinil was first tested for use in humans as a treatment for the sleep disorder narcolepsy. In many different double-blind placebo-controlled clinical trials done over the years, Modafinil has been determined to be a successful treatment for narcolepsy. It has been seen to significantly decrease excessive daytime sleepiness and increase wakefulness over a placebo.

Provigil has also been be tested for and approved as a treatment for the excessive sleepiness associated with shift-work sleep disorder (SWSD). Some people develop this condition when they are forced to work night shifts at their job. When taking Modafinil, people with SWSD have been observed to have better work performance over their baseline and over placebo.

Modafinil has also been approved as an adjunct treatment for obstructive sleep apnea/hypopnea syndrome (OSAHS). In some people, the traditional treatment for this condition (using a CPAP machine at night) still leaves them with excessive sleepiness during the day, and Provigil has been seen to decrease this sleepiness successfully.

Modafinil has been classified by the FDA in the United States as a Schedule IV prescription-only drug. Provigil’s officially approved on-label uses are for the sleep disorders described above.

However, there are many more off-label uses that Modafinil has been taken for. It is estimated that as many as 90% of all prescriptions written are taken for off-label uses. Some off-label uses relate back to Provigil’s approved use, like when it is taken to reduce fatigue associated with certain diseases, including multiple sclerosis, depression, fibromyalgia, and Parkinson’s disease.

One very common use relates to Provigil’s stimulating, concentration boosting effects: it is often used for improving the symptoms of attention-deficit hyperactivity disorder (ADHD). In many different studies, Provigil has been determined to reduce ADHD symptoms as measured by a number of tests including the DSM-IV ADHD Behavior Checklist, the Teacher and Parent ADHD Rating Scale-IV, and the Clinical Global Impressions-Improvement scale.

Provigil is also very commonly used off-label as a cognitive enhancing smart drug, or nootropic. A large variety of people from college students to business people use this drug to improve their concentration, focus, motivation, and memory.

There have been a few studies done using Provigil as a cognitive enhancer. One study found that relative to a placebo, Modafinil reduced fatigue levels, enhanced vigilance, decreased reaction time, and improved motivation. Another study saw that compared to a placebo, Provigil patients had improved performance on a spatial planning task, a stop-signal reaction time test, and memory tests of visual pattern recognition and digit span.

Provigil Side Effects

Provigil is considered to be one of the strongest nootropics available and with great strength there usually comes some chance of side effects.

While Provigil is regarded as safe by the medical community, there have been reports of some negative reactions to this drug.

Most of the side effects commonly encountered when using this wakefulness promoter are benign and only cause some temporary discomfort. The most frequently reported side effects include headaches and nausea.

Less frequently reported effects can consist of nervousness, loss of appetite, anxiety, lightheadedness, dry mouth, and insomnia especially when taken late in the day.

In very rare cases, Provigil has been associated with chest pain, hypertension, tachycardia, paresthesia, pharyngitis, and eating disorders.

Side effects may be particularly noticeable when you are first starting to take Provigil and typically disappear or subside after a few days. These side effects can also be diminished or potentially prevented by staying well hydrated and using a multivitamin supplement.

Other individuals say that exercising or using a dopamine-boosting supplement towards the end of its half-life helps to lessen the negative effects of this stimulant.

Nine of the most commonly reported mild Provigil side effects are discussed below, with any known ways to help avoid or mitigate them.

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1. Headaches

Headaches are the most commonly reported Provigil side effect. It has been estimated in a few reviews that as many as half of all Provigil users experience headaches at some point when taking the drug.

The exact cause of these headaches is still unknown, as it has not been studied directly, but it stands to reason that elevated Histamine levels could be at play. The pathophysiology behind it is still being studied, but it has been observed that elevated Histamine levels can cause cluster headaches.

Another theory that some users have is that because of the intense concentration and focus that Provigil can cause, you may forget to drink proper levels of water throughout the day, leading to dehydration and subsequent headaches. Setting alarms throughout the day to remind yourself to stay hydrated could help.

For some people, the headaches are present only when they begin taking the drug, and subside after a few weeks as their bodies adjust. However, if your headaches persist, and you want to/need to keep taking Provigil, then you may want to consider using an over-the-counter pain reliever NSAID, such as ibuprofen.

Users have reported that this can significantly reduce Provigil headaches. However some people may not want to have to take these drugs on a long-term basis due to concerns of elevated hepatotoxic enzymes, and this a personal choice you must make.

2. Digestive Upsets

Nausea is often the second most reported Provgil side effect, typically second only to headaches. Some people also report having heartburn, indigestion, stomachache, and even in some cases vomiting. Other users have reported that Provigil does not cause them issues when they initially take it, but that they later have diarrhea.

The exact cause of these symptoms can vary from person to person. For some people it just comes down to their physiology and not being able to handle the drug properly. Sometimes a lower dosage may help, but this isn’t the case for everyone.

One theory suggests that dehydration may be the cause of some digestive issues. Users report that large amounts of water should be consumed while taking Modafinil, over and above normal water consumption levels even for well hydrated people.

It has also been suggested that due to its stimulating effects that Modafinil may cause increased rates of digestion, leading to indigestion and diarrhea; similar effects have been reported from people who take amphetamine based stimulants.

Keeping well hydrated is one of the key suggestions for avoiding or minimizing many digestive upsets with Provigil. Users have suggested that a divided dose can help relieve some digestion issues.

One of the key suggestions is to take a lower dosage for a while and see if effects subside. What is considered a “normal” dosage for most people is simply too much for others, and a lower dosage can help.

3. Nervousness/Anxiety

Some people have reported feeling anxiety and/or nervousness when taking Provigil. Users report that they can simply have a “fluttery” feeling in their chest or stomach or have symptoms as severe as a full panic attack.

While people who have existing anxiety issues may be slightly more likely to experience this, there are many user reports from people who do not have existing anxiety conditions also report this side effect occurring.

It has been suggested that these effects may be due to the fact the Provigil may affect the neurotransmitter GABA in the brain. In animal research, Modafinil has been seen to decrease levels of GABA. It stands to reason that this effect would be seen in humans as well.

GABA is the primary inhibitory neurotransmitter known to counteract the excitatory neurotransmitter Glutamate; decreased levels of GABA have been observed in people with anxiety disorders in research studies.

Some suggestions for improving the anxious feelings including taking a lower dosage for a while and seeing if the symptoms improve. It has also been recommended by users to avoid taking caffeine with Provigil if you have this side effect. Taking the supplement L-Theanine has also been suggested by some users.

4. Loss of Appetite and Weight

Some users have reported having a significantly decreased appetite when taking Provigil. They report that they simply do not feel hungry while taking the drug. Others report that they become so focused on their work or studies that they simply forget to eat.

This loss of appetite can in turn lead to weight loss. While weight loss may be considered a benefit to some, it is not to others. Some people will even use Modafinil as a weight loss drug, but they typically take it as a diet aid, along with exercise and a calorie deficit. Losing weight through simply not eating is not a safe and healthy way to sustainably lose weight, and should be avoided.

The cause of the appetite loss associated with Provigil may be due to increases in the neurotransmitter Dopamine. Modafinil has been seen to increase Dopamine levels in the brain. When Dopamine levels are elevated, satiety is often high as well, and people don’t feel the need to seek out food. It is thought that Histamine may also play a role, as this neurotransmitter is involved in the regulation of appetite and metabolism.

Ways to help combat this loss of appetite are to schedule small frequent meals throughout the day. Setting alarms for yourself throughout the day to take breaks to eat and drink can be very helpful for eating properly and keeping hydrated.

5. Dizziness/Lightheadedness

Another common side effect that some people get while on Provigil is dizziness, lightheadedness, or vertigo. Some users report that they can feel very dizzy shortly after taking Provigil, and that the effect diminishes throughout the day and goes away, while others report continuing to feel dizzy for hours.

The exact cause of this side effect is not known. It is possibly due to changes in blood pressure; while it is rare, Modafinil has been observed to cause low blood pressures in some patients. The most common theory is that it is related to dehydration. As described before, it is very important to stay very well hydrated when taking Provigil, as it can be easy to become dehydrated and have a variety of side effects related to it.

6. Back Pain

Some users have reported having back, neck, and shoulder pain when taking Provigil. Tension in the neck and shoulders has been reported, as well as lower back pain.

This side effects does not appear to be a physiological response to the drug itself, although that has not been tested and cannot be ruled out. The most accepted theory has to do with the immense concentration and focus that Modafinil can cause in users.

Many users report that when they take a dose of Provigil that they can easily sit down and work non-stop for hours with high levels of focus and motivation. While this can be great for getting lots of work done, it can have physical effects on the body.

Sitting for long periods of time can cause muscles to become cramped and sore, especially if you are sitting with poor posture, or in a seat that is not ergonomic. On the other side, if you take Modafinil and then are very active, it is possible that the stimulating effects of the drug allows you to push harder and longer than you normally do, and possibly strain yourself.

Making sure you have proper lumbar support in your desk chair may help if you are sitting for long periods of time. Trying to take short breaks where you get up and move can help with this type of strain on the neck and back.

7. Rhinitis

When taking Provigil, a small number of people have reported developing rhinitis. This is irritation and inflammation of the mucous membranes of the nose, causing stuffy nose, runny nose, and/or post-nasal drip (mucus accumulation at the back of the nose or throat that drips down the throat, causing sore throat and/or throat clearing).

The exact cause of this side effect has not been studied, however there is a theory that it could be due to the elevated levels of Histamine that Modafinil causes. Histamine, in addition to regulating appetite and wakefulness, also plays a role in mediating the body’s allergen response. People with allergic rhinitis (seasonal or pet allergies) are familiar with the effects of elevated histamine levels and subsequent allergic reaction nasal issues.

If you have rhinitis caused by Provigil, then you can try taking a lower dosage for a while and see if this side effects subsists. Some people have reported using antihistamine allergy drugs to reduce rhinitis symptoms.

For other people though, this either does not truly help, or seems to dull the effects of Provigil. It may take some testing to figure out what works best for you in reducing this side effect and maximizing Progvigil’s benefits.

8. Cardiovascular Issues

Traditional amphetamine and methylphenidate based stimulant drugs are known for having a relatively high incidence of cardiovascular side effects. Many users have reported feeling heart palpitations and a racing heartbeat at times, and there have been serious cases of blood pressure changes occurring.

Initially it was thought that Provigil didn’t cause any negative cardiovascular effects because it causes its stimulating effects in the body in a different method than traditional stimulants. It has been determined thought that while much less common, some cardiovascular side effects can be experienced when taking Modafinil.

Provigil has been seen to increase blood pressure and heartrate, and it is thought to do this through altering autonomic function.

If you have any cardiovascular issues when taking Provigil – heart palpitations, fast heartbeat, chest pain – then speak with your doctor as soon as possible. They may recommend a lower dosage, or possibly a different dosage schedule.

9. Insomnia

Insomnia is a common side effect of Provigil. Many people have reported having problems falling asleep and staying asleep while taking this medication.

For many people, this side effect is normally just caused by poor timing of their dosage. Modafinil has a very long half-life of between 12-15 hours. This means that it can still be active in the body at amounts that can cause can effect for many hours after it was ingested.

Taking your dosage early in the morning is important for avoiding sleep disturbances. It has been recommended that Modafinil be taken first thing in the morning after waking up. Some users with sleep disorders have even said that they will wake up earlier than they need to to take their dosage (before 7 am) and then fall back asleep for up to a few hours as it kicks in.

When you first begin taking Provigil, insomnia can be a common side effect, regardless of when you take it. Many users have said that as their bodies adjusted to the drug the insomnia subsided and they no longer had issues. If you have just started taking Provgil, or are taking a new higher dosage, then give your body time to adjust.

If you still are experiencing insomnia after an initial adjustment period and when taking your dosage early in the morning, then speak with your doctor about lowering your dosage and other options.

Serious Provigil Side Effects

One of the most serious Provigil side effects that can occur is dermatological in nature and may be recognizable first as a simple skin rash. These conditions include Stevens-Johnson syndrome, Toxic Epidermal Necrolysis (TEN), and Drug Rash with Eosinophilia and Systemic Symptoms (DRESS).

These side effects are considered very rare. There has been strong scientific evidence that indicates that some people may have a genetic predisposition that makes them more susceptible to developing these skin rash conditions when they take some medications that are processed in the body a certain way – including Provigil.

These conditions typically are only seen after multiple months of prolonged use of this drug, but in some cases it is known to develop faster. If you notice any distinct changes to your skin while using this drug, it is important that you stop taking it immediately and speak to a medical professional.

Stevens-Johnson syndrome is the most common of these conditions to develop, and symptoms include a fever, body aches and pains, sore throat, rhinitis, and a red or purple rash typically near the mouth, nose, eyes, and/or genitals that spreads and eventually blisters.

While these instances are highly rare in the general population, in these certain individuals with the predisposition it is slightly more likely to be brought on by Provigil use. You may be able to lessen the risk of this condition by using Provigil only on an occasional basis as opposed to every day.

Provigil Safety, Dosages, and Contraindications

Provigil is approved as a prescription drug for adults. Use in children is often limited to severe narcolepsy cases. Pregnant women and breastfeeding mothers should not be using this drug due to a lack of conclusive research trials.

If you are on any other medication, it is best to consult your doctor to find out if Provigil is right for you. The following is a non-exhaustive list of some of the medications that are known to interact with Provigil:

• cyclosporine
• midazolam
• triazolam
• phenytoin
• diazepam
• clomipramine
• omeprazole
• propranolol
• SSRIs
• MAOIs
• Warfarin

It is also not advised to take oral steroidal birth control pills and other hormone-based contraceptives such as IUDs, patches or implants when using Provigil. One of the side effects of Provigil is that it can lessen the effectiveness of birth control while taking both together, and for up to one month after you stop using this drug.

The most commonly recommended dosage for Provigil is 200 mg per day for sleep disorders. It is recommended to take the drug first thing in the morning for people with narcolepsy and obstructive sleep apnea/hypopnea syndrome.

People with shift-work sleep disorder are typically advised to take a dosage of 200 mg between 30-60 minutes before a night shift, although sometimes an additional 100 mg dosage is taken during the shift. This higher dosage is not necessary for some people, but they do find they function better if they split their 200 mg dosage into two administrations during their shift.

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