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What is Modafinil used for?
Modafinil is primarily approved for the treatment of narcolepsy (a malfunction of the sleep/wake regulating system in the brain and characterized by uncontrollable bouts of daytime sleep), obstructive sleep apnea (a sleep disorder characterized by pauses in breathing during sleep) and shift work sleep disorders.
It is widely used to suppress the need for sleep and combating general fatigue. It is popular with people suffering from Chronic Fatigue Syndrome and also depression, since it reduces tiredness and boosts mood.
Is Modafinil beneficial for anything else?
Experimentally, Modafinil is being used in the treatment of:
- Alzheimer’s disease
- Age-related memory decline
- Attention-deficit disorder
- Myotonic dystrophy
- Multiple sclerosis-induced fatigue
- Post-anaesthesia grogginess
- Cognitive impairment in schizophrenia
- Spasticity associated with cerebral palsy
- Idiopathic hypersomnia
How effective is Modafinil?
Studies directly comparing the affects of Modafinil and d-amphetamine on sleep have shown that d-amphetamine causes a dose dependant impairment of sleep, where as Modafinil does not.
One trial in particular, carried out in 1989 by Saletu, Frey and others and examining Modafinil and d-amphetamine, described amphetamine as “vigilance increasing” but Modafinil as “vigilance promoting.” The difference being that Modafinil will not prevent you from sleeping if you want to, but it will help you remain awake with far greater alertness.
Modafinil was put through its paces during a 60 hour sleep depravation trial carried out by Lagarde, Batejat and others in 1995. During the trial, a group of volunteers were given either Modafinil or a placebo and assessed for vigilance using a series of questionnaires and tests. Modafinil users were found to sustain a satisfactory level of vigilance with an absence of sleep episodes, while the placebo group gradually declined and slipped into bouts of ‘micro sleep’ (a brief loss of attention – of which the subject is often unaware - when they’re tired but trying to stay awake).
A three year French study by Bastuji and Jouvet examining Modafinil’s effect on the treatment of profound sleep conditions hypersomnia and narcolepsy, found that it reduced drowsiness in 83 per cent of hypersomniac patients and 71 per cent of narcoleptics.
A number of other studies have affirmed this finding and Modafinil’s effectiveness in the treatment of both narcolepsy and hypersomnia, and the weakness and fatigue condition catoplexy.
What is the dosage?
Modafinil comes as a tablet to take by mouth. It is usually taken once a day – shortly after waking – with or without food. If you are taking Modafinil to treat shift work sleep disorder, you should take it one hour before the beginning of your shift. Take Modafinil at the same time every day – do not change the time of day without talking to your doctor.
A single dose of 200mg is the usual initial dosage, which may be increased up to 400mg a day if necessary. You may need to divide the total dose over two or more smaller doses for ultimate effectiveness throughout the day. If you are over 65 years of age, it is recommended you start therapy at 100mg daily.
If you forget to take a dose of Modafinil, take the next dose at the usual time. Never take a double dose.
Are there any side effects or contraindications with modafinil?
So long as you follow your doctor’s instructions, taking Modafinil should produce no undesirable effects. If you do experience episodes of nervousness, excitation, aggressive tendencies, insomnia, anorexia, headaches, dry mouth, palpitations or gastrointestinal discomfort, make sure you are following the instructions for taking Modafinil correctly.
If you are pregnant or breast-feeding, you should not take Modafinil. If you suffer from hypertensivity, your blood pressure and heart rate should be monitored. If you have a history of left ventricular hypertrophy or ischaemic ECG changes, chest pain, arrhythmia or other clinically significant manifestation of prolapse of the mitral valve associated with the use of CNS stimulants you should not take Modafinil.
If you are taking oral contraceptives, while being treated with Modafinil, you should take a product containing 50mg or more of ethinyl oestradiol to ensure their efficacy is not compromised.
Modafinil is not recommended for children.