Talk:Modafinil/Archive 1

Heart Problems

I have found no medical literature that suggests that modafinil can interfere with the mitral valve prolapse, and it would seem to me upon reviewing the literature that modafinil doesn't have anything to do with the heart: it solely stimulates one area of the brain and has nothing to do with the heart at all. A series of questions to my physician backed this up, saying that there is no way that the Provigil could have caused my mitral valve prolapse, and that it would have no adverse effects on my heart: obviously, this is OR and there is always the chance that my physician could be wrong, but OR can be useful in showing us when we may have something incorrect and need to check for different or opposing sources.Phoenix Song (talk) 23:59, 17 February 2008 (UTC)

Another Source

I'm not quite sure where this would fit, but I think maybe there should be a section about how much Provigil is used, and by whom, or something like that. The following L.A. Times Story might be worthwhile to cite in that section. --Pordaria (talk) 15:30, 3 January 2008 (UTC)

Removed Chronic Fatigue Syndrome BBC reference

The linked to page didn't mention modafinil or it's off-label use at all, making it a bad reference. 84.12.25.190 (talk) 17:51, 11 December 2007 (UTC)

Dissociative Identity Disorder

I've heard rumours about this. Check out this forum: http://akers44.com/forums/index.php? daniel4242 1:45, 27 April 2007

Your link's dead meat, daniel. --129.49.7.125 (talk) 22:08, 1 October 2009 (UTC)

Rewrite

I have just done a major rewrite on this article, hopefully giving a more logical grouping of the information, as well as cleaning up the indications, adding counterindications and warnings, pharmacokinetic data, etc.

Some of this is from memory, though I added the PI sheet etc to the external links, and tried to verify the most important bits that I changed.

If there is anything you feel is not borne out by the sources, slap a {{fact}} tag on it, and drop me a message on my talk page, and I will source or remove it within a week at most (probably within a day or so). Please do not just revert the edit without discussing it first, despite the scope of the changes. Zuiram 02:38, 30 October 2006 (UTC)

Archive?

Are there any objections to moving a substantial part of the content on the talk page to an archive page? The page is getting crowded, and much of it is stale. Zuiram 02:44, 30 October 2006 (UTC)

Modafinil and coffee

I'm on Modafil from India (by Sun Pharma) and when I started, I had a very uncomfortable experience with this drug and coffee. I experienced high blood pressure, an increased heart rate and chest pains. I read on drug boards that this is not uncommon when combining this drug and a lot of coffee but it is nowhere in the product literature. I'm not sure if it belongs here as it probably only affects me and handful of other coffee abusers.

Also, in Canada, Modafinil is a Schedule F drug (a normal prescription drug) but it will still be seized by Customs since only regulated importers, health professionals (pharmacists and MDs), and government agencies can legally import any prescription drug even with a prescription. Not a big deal if it happens once or twice, but if a pattern forms then they can impose harsher penalties other than forfeiture.

Modafinil and coffee/caffeine interaction

I also had problems by initially continuing to drink coffee while using this drug. As someone who was "used to" drinking a large quantity of coffee over the course of the day to STAY AWAKE (1- 2 pots or 6-12 cups daily), I noted that Modafinil exaggerated the shakiness of caffeine and was unpleasant. I found that I no longer needed a large quantity of coffee and would recommend to anyone who has been prescribed this drug, that excessive caffeine consumption is no longer necessary. I was able to easily become a "normal" or "casual" coffee drinker at one cup daily, and found this had lessened the adverse reaction.

Yes, It would be nice if there were trials on this OTC drug interaction, or at minimum a warning that coffee and caffeine consumption is no longer necessary (as this is a wakeful promoting drug) and may interact in an unpleasant manner with Modafinil. I'm wondering if the headache side effect associated with this drug is actually the patient's discontinuation of coffee and resulting caffeine withdrawal?

My blood pressure is typically very low, so I have no known adverse effects in this area in my short term usage of Modofinil. A study in this area would also be beneficial. Healthcare patient63 (talk) 23:58, 8 February 2010 (UTC)

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Absorption and Tmax

I have added a few minor details, broadening the scope of the article. I would be interested if anyone knows the time for modafinil to take effect after ingestion. Richard Farmbrough.

Pretty much the standard 35-45min as with most ingested drugs. From the PDR monograph: "Absorption of PROVIGIL tablets is rapid, with peak plasma concentrations occurring at 2-4 hours. The bioavailability of PROVIGIL tablets is approximately equal to that of an aqueous suspension. The absolute oral bioavailability was not determined due to the aqueous insolubility (<1 mg/mL) of modafinil, which precluded intravenous administration. Food has no effect on overall PROVIGIL bioavailability; however, its absorption (t max ) may be delayed by approximately one hour if taken with food." (copyrighted, fair use, don't include in article) --Bk0 20:22, 21 Dec 2004 (UTC)

• • I have been using modafinil for about 2 months every week day and find it takes about 1 hour to take effect and probably 3 hours for peak effect. However this is a very subjective and hard to determine number.. i find its effect isnt so much waking you up and preventing you from wanting to sleep. You will usually wake up more as the day goes on regardless of taking this drug so its difficult to define. --danielg 16:20, 24 March 2006 (UTC)

Peak effect and peak concentration is not always the same thing. Zuiram 00:24, 30 October 2006 (UTC)

On a full stomach 100mg of modafinil can easily take 4 hours to have an adequate effect (perceived)... I'll stop yawning when it kicks in, generally 3~4 hours after dosing. Take by mouth every morning before meal (po qam ac) for faster results.

Military Use

Many sites refer to military use, some hard and fast documentation would be nice. Rich Farmbrough 13:46, 18 Aug 2004 (UTC)

This study is done by this canadian defence (defense) research firm. 63.201.228.94 05:10, 4 August 2005 (UTC)

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"Dosage varies from once 100 mg/day to twice 200 mg per day (the second about 4 hours after waking), and is more effective on naive users."

This seems more qualitive than objective. What exactly is meant by "naive users?" Do you mean patients? How does one define their level of naivete in this case? What exactly does a "naive" person indicate in this instance? Is there any source for this claim? MSTCrow 14:44, Nov 23, 2004 (UTC)

Naive with respect to stimulants, I.E. newly diagnosed. The data is from a published paper listed at www.modafinal.com IIRC. Rich Farmbrough 19:18, 21 Dec 2004 (UTC)

Yes, "naive" when used in medical papers means a patient not yet exposed to whatever the paper is talking about. In this case it means people who have never before used modafinil. --Bk0 20:12, 21 Dec 2004 (UTC)

Some papers and anecdotes indicate that the sensitivity can be sustained by coadministering an alpha-2 antagonist, such as reboxetine. Otherwise, its utility as an augmentor in antidepressant therapy is reduced to nil in a matter of weeks. Zuiram 00:24, 30 October 2006 (UTC)

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"The French government indicated that the Foreign Legion used modafinil during certain covert operations. " SOurce ? The FFL don't do "covert operation", and the EMAT (french head of army)always denied any use of modafinil. —Preceding unsigned comment added by 84.103.11.125 (talk) 13:20, 27 November 2008 (UTC)

NPOV?

Hmm -- I was reading through this:

The manufacturer claims that modafinil allows people who suffer from unusual fatigue to remain awake without side effects or impairment of job performance. However it does not live up to this in all cases, occasionally producing rashes and intestinal problems. The usual prescription is for a single dose to be taken shortly after waking; its effects last for most of the day without preventing normal sleep at night, though in narcolepsy twice-daily administration is required. Under no-sleep conditions, a dose is taken at 8 hour intervals.

and it seemed to me that it was inappropriate for a "Indications" section. Side-effects have been their own separate section in every other Wikipedia entry I have read; why should this one be any different? It seems like it was written by someone who had a bad experience with the drug. I'm not seasoned enough to rewrite it myself, but can someone take a look at this?24.34.92.252 07:22, 10 November 2005 (UTC)

i tend to agree with you - this article is clearly written by someone very biased against modafinil (or possibly certain prescriptions in general?). the emphasis is on the negative side-effects and possible flaws with the medication rather than the various uses, treatment durations, and other necessary general information. very disappointing. i will try and take a moment to make some edits when i have more time.

long term effects & relation to other amphetamines?

(many topics in one actually)

Are any specifics known about the long term usage of this drug? For instance, would a fighter pilot on a typical hightened dispatch (let's say, for argument's sake, 2 weeks) be subjected to alternate between Zolpidem and Modafinil (or Dexedrine) ?

- What are the effects on the judgement capabilities of the subjects (short term and long term) after 24 or 48 hours of sleep deprivation?

- How does this compare or differ from general Amphetamines or Dexedrine with regard to:

- libido effects

- recreational

- perhaps dosage and half time ?

Martixer

I'm not aware of any literature or studies regarding the topics you mention, so any information would be anecodotal and original research. However, modafinil is not an amphetamine and the effects are quite different from, eg, dextroamphetamine. Modafinil is not particularly euphoric or recreational, so the abuse potential is low. Also, regarding your first example, sedatives such as Zolpidem shouldn't be necessary to achieve sleep; unlike typical sympathomimetic stimulants, insomnia is not a common side effect of modafinil use. --Bk0 (Talk) 15:21, 11 January 2006 (UTC)

The effects on judgement capabilities after sleep deprivation are better than with amphetamines for all durations of time. The same goes for sleep deprivation without drugs. Cognitive performance is also better. The exception is, of course, when sleep deprivation has gone on for so long that tolerance to the drug prohibits further dose increases.

My experiences with the effects you mentioned are limited to dexedrine, but I can offer some educated guesses based on the material I've read. Libido should be largely unaffected, though there is a potential for slightly elevated libido and a slightly shorter orgasm-refractory period in men. Recreational use value of modafinil is essentially zero; you should not experience any actual euphoria. If you don't have anything specific you need to do, it's unlikely to give you anything. Frequency of dosing (based on halflife etc) should be comparable to dexedrine (d-amphetamine), while desoxyn (d-methamphetamine) will last longer.

Zuiram 05:40, 3 November 2006 (UTC)

Urine smell of sulphur?

Can someone who has actually tken modafinil comment on whether it causes a rotten egg smell in your urine? Thanks. --James S. 04:54, 16 January 2006 (UTC)

It's not a rotten egg smell, but there's certainly an odor. It's very distinct. It smells like the drug tastes.

Eh, can't say I have - otherwise I wouldn't go into any public toilets...

Yes, when combined with certain other drugs. have you been combining this with amphetamines or benzodiazepines? - D. Morelos

-- Yes, it smells like sulfur. Its a by product of its breakdown. Anyone who takes it must notice it.. its only extremely strong when taken in high doses.. about 1gram if you are using it to stay up all night. Its never not there though. On par with coffee urine I would estimate. – danielg

I haven't noticed any odors at 400mg/day. --moof 10:16, 5 July 2006 (UTC)

Who on earth uses 1 gram a day? No offense here, but 600mg a day should keep a dead person awake for 24 hours. :P Zuiram 00:24, 30 October 2006 (UTC)

Patrick: 200 mg all 8 hours is enough to keep a narcoleptic cow awake for at least 40 hours. This is the proper dosage! The evidence suggests that a overdosis of modafinil is dramatically enhancing the elimination of active modafinil through the P450-Enzyme System in the liver, hence modafinil wears off within some days! Modafinil most effective dosage is at 200 mg all 8 hours is IMHO. I am on modafinil since months with-out any side effects.

I have taken Adrafinil, which gets metabolized into modafinil in the body and this is normally considered the mechanism of adrafinil. I can say that my urine definitely has an odor to it. Its hard to place what is smells like, but I can easily smell it, especially if using a urinal. I take 2x 300 mg of adrafinil, which is the recommended dose.Rjkd12 14:32, 14 May 2007 (UTC)

I used Provigil at 200 mg for a time. It most definitely made my urine stink. The smell came after I started the Provigil, and left after I stopped taking it. The only other drug I was on was Lexapro (ok, and caffeine). The smell was somewhat asparagus-ish. The asparagus page is potentially revealing on this subject, stating that only a fraction of humanity can smell the sulfur breakdown products from asparagus. If modafinil is being broken down into similar sulfur compounds, then this could account for why many people don't report the smell.

I find it odd that I can't find a citable source on this side effect. I remember seeing it in many places when I was researching the drug. -- Cyrius|✎ 08:16, 24 May 2007 (UTC)

Actually I like the smell and odor of modafinil in the urin. Strange. Ahmedunited 15:29, 30 September 2007 (UTC)

Petition

Just disambiguated the reference to the FDA petition, as coming from a private individual (as aposed to any of the drug companies mentioned)

Evidence based on the fact that the adressee in the petition response: http://www.fda.gov/ohrms/dockets/dockets/05p0265/05p-0265-let0001-vol1.pdf [is James S.] ... appears to be unrelated to drug companies. --Zootalures 23:26, 13 March 2006 (UTC)

Yes, that's me. There was an earlier petition from a competing drug company in application for generic production, but it was withdrawn when the particle size patent was asserted. In the U.S. form of government, people are peers of companies. Full petition text. --James S. 04:18, 14 March 2006 (UTC)

News

Well, the patent is about to expire, and suddenly the world press is full of articles: by date; Here is the latest at present; some peer-reviewed work; now known also as "Sparlon,"for skin rashes and child ADHD; apparently this has been an "off-label" treatment for years; comparison with coffee for wakefulness; financial news; FDA panel reversal on ADHD.

I predict they will close my petition, or keep it open, but not grant it. However, I predict that within a few weeks of April 1st (the patent expiration date), that the company which had the withdrawn generics application will challenge the particle size patent, asking for injunctive relief, thereby circumventing the generics application process. This drug is not usually excluded from insurers' formularies. --James S. 20:58, 24 March 2006 (UTC)

Vigicer or vigicer?

Where does the name "Vigicer" come from? It is not in MEDLINE or the U.S. Patent and Trademark Office's TESS, live or dead. However, there is no shortages of google hits for it from "without a prescription" pharmacies. Is Vigicer the black/grey-market name?

Should it be capitalized? --James S. 21:11, 24 March 2006 (UTC)

It is the marketed name of the drug, so it would be Vigicer. It's a proper noun. — tomohawk 15:53, 17 May 2006 (UTC)

Histamine

Just corrected some spelling and stuff and added some additional European names. A lot of info on this page is quite 'US-centric' (no offence meant!) such as patents, legality etc - added some UK stuff.

The section on histamine suggested that modafinil works on H3 only, could not find any evidence for this so changed to statement about promoting histamine release. Berry 09:49, 26 April 2006 (UTC)

I think I was the one that added the bit about H3-receptors, and as I recall, the study in question mentioned H3-receptors specifically, not histamine generally. Also note that generalized histamine release would lead to the typical reactions to that, including the possibility of anaphylaxis. Zuiram 23:35, 7 May 2007 (UTC)

Modafinil is a reliable medicine against narcolepsy, sleep-apnoe-sydrome and good by shift-working. But you cannot expect wonder of this. you will not "pull out trees" with it. So the effect is more modest in this.--Fackel 20:20, 30 May 2006 (UTC)

C-fos

"by greatly elevating c-fos expression"

Thought this was unnecessarily scientific and there is no real info anywhere about what this gene is or does. Am life sciences student and myself have never heard of it! If anyone wants to put it back in, then please write something like 'by greatly elevating the expression of c-fos, a -------." Berry 21:00, 22 June 2006 (UTC)

• • I'm relatively new to Wikipedia discussions and I could not find where this should go but...**

How exactly is the modafinil chemical displaced racemic? I see no chiral carbon...

I didn't know this either, but it seems to be the sulphur atom in the sulfoxide group and not a carbon that is chiral. Berry 12:03, 26 July 2006 (UTC)

modafinil

does modafinil help curb your appetite? and do you think it could be a replacement for adderall users?--kim--71.87.196.11 15:00, 24 July 2006 (UTC)

Any stimulant will tend to reduce appetite, but I don't think modafinil is as potent in this regard as typical stimulants. As to using it for any particular purpose, go talk with your doctor. In the future, if asking for hints on WP, try to at least include some information about what you intend to use it for. Zuiram 00:24, 30 October 2006 (UTC)

I know this is anecdotal, but here you are: when I went on it (due to narcolepsy), I lost 20 pounds in about six weeks. I also fasted completely accidentally -- I wouldn't realize I'd missed a meal until I'd missed four or five. I always had a "Hmm, dinner's in an hour or so, right?" feeling then, but I never felt properly hungry. I went back to my doctor, he said "Oh yeah, decrease in appetite, that is a side effect now that you mention it." My weight loss has slowed down a lot since, because I'm making sure I eat two meals of three, but I am still losing weight because it allows me to have smaller portions and still feel perfectly full. 128.122.253.229 10:22, 5 November 2006 (UTC)

There are several papers on this topic, and it seems that modafinil is about as good as amphetamines at reducing appetite, but has fewer side effects. I'm not aware of any studies demonstrating long-term efficacy of modafinil for weight loss (and I am aware of studies showing that amphetamines do not show long-term efficacy), so if you're looking to lose weight, modafinil may not be for you.

I added a "Weight loss" section with plenty of articles backing up the information. It appears that modafinil does reduce appetite at least to some extent, and there's some evidence that it may be useful long-term. -Apagadomenina 01:02, 31 May 2007 (UTC)

Do any of the studies address whether the weight loss could be just from increased wakefulness & activity? --129.49.7.125 (talk) 22:21, 1 October 2009 (UTC)

Provigil also used to treat fatigue in fibromyaliga

It shows up in the fibromyalgia blogs for treating fibrofog and fatigue, so it seems like that should show up in the literature about it at some point. Might be worthwhile research lead. --Aunt Amanda 06:13, 24 October 2006 (UTC)

There should be no original research on Wikipedia, according to policy.

That said, there more than just anecdotal evidence that it helps with "brain fog" and fatigue. There is literature out there, but it's generally fairly technical. In my experience, brain fog is mostly influenced by norepinephrine, dopamine and glutamate, and modafinil elevates all of these, though I suspect desoxyn does a better job of it. As for fatigue, that depends on a number of factors. Many kinds of fatigue will respond to augmenting these same neurotransmitters, and also to raising testosterone levels. As a potentially interesting anecdote, I have found that buprenorphine does a fairly good job with both of these, though in my case they were caused by an adverse reaction to a neuroleptic medicine (levomepromazine) rather than fibromyalgia. It also restored my hormone levels to normal; before starting therapy, they were so off that the lab told my doc to investigate whether I was undergoing an unauthorized sex-change treatment. Cost me 30% muscle and bone mass. Zuiram 05:48, 3 November 2006 (UTC)

prolapse mitral valve?

I USED to have prolapse mitral valve, but it got better. From reading the article, it seems I can't use modafinil. Is this true, and could the article elaborate more on it? 204.117.11.226 17:54, 29 November 2006 (UTC)ClintJCL

Study drug?

Does anyone know why modafinil is not very commonly used as a study drug? You so often hear reports about ritalin, ect. being misused by students to stay awake, but I have never seen anything in the news about modafinil being used this way despite it being a Schedule IV (less than many other study drugs). And it does work for non-narcoleptic people, that's what the military studies are showing. Nor do the side effects look very common. I don't understand why everyone isn't using this drug. Is it hard to obtain? Do people not know of its existence? Although it was released in 2000. Can you cast any light on this?? It just seems very strange to me, surely this is exactly what one would look for in a study drug, yet I have never heard anything on the news about it being used that way. 128.122.253.212 01:31, 2 December 2006 (UTC)

What I'm going to say may sound preachy but I think it is a valid opinion and no offense is intended. I have read before that effective learining involves consolidating information learned while awake and attentive into different parts of the brain while asleep. This is confirmed by this section borrowed from a wikipedia article on memory: "Short-term memory is supported by transient patterns of neuronal communication, dependent on regions of the frontal lobe (especially dorsolateral prefrontal cortex) and the parietal lobe. Long-term memories, on the other hand, are maintained by more stable and permanent changes in neural connections widely spread throughtout the brain. The hippocampus is essential to the consolidation of information from short-term to long-term memory, although it does not seem to store information itself. Rather, it may be involved in changing neural connections for a period of three months, or more, after the initial learning. One of the main functions of sleep is thought to be to improve consolidation of information, as it can be shown that memory depends on getting sufficient sleep between training and test, and that the hippocampus replays activity from the current day while sleeping." Effective learning stragies involve adequeate periods of awake attentive learning and SLEEP. In my opinion, strategies that bypass millions of years of brain evolution ultimately fail. From my experience so far, Ritalin and Adderall consistently and reliably promote vigilance and attention in both ADD and non-ADD patients, however the effects of Provigil are less robust. Perhaps this is why it is not as sought after. In addition, the number of patients prescribed Ritalin and Adderall vastly exceeds the number of Provigil patients, thus it is more readily available.--Psychofarm 14:52, 2 December 2006 (UTC)

Hercules: Why are people not allowed to use Modafinil as a recreational drug? Who says that the production costs are so high and people get injured and addicted. Thats nonsens. Modafinil is just a simple synthesized drug. I have a dream that one day modafinil will be sold like Aspro/Aspirin... This orphan status is a hoax anyway, they just want to make money. That's all.

Polyphasic: From what I understand, Modafinil in the US is by prescription only. Adafinil on the other hand can be ordered online by anyone. Adafinil does cost around $40 per forty 300mgtablets while Modafinil costs about $150 for thirty tablets. By individual accounts, Adafinil seems safe when taking 1-2 tablets a day for 1-2 months, but longer than that, I haven't read or heard anything. I'm a college student so it's all good info for me. —Preceding unsigned comment added by 71.245.106.163 (talk) 08:56, 3 April 2008 (UTC)

Original 2006 anon: I don't know whether this is only since then, but modafinil has become one of the three paradigmatic 'study drugs' (along with Ritalin & Adderall); just look at a Google News search: http://news.google.com/news/search?aq=f&q=modafinil --129.49.7.125 (talk) 22:20, 1 October 2009 (UTC)

Subtly disguised advertising?

I have two issues with the following paragraph:

Cephalon hopes to soon release the longer-lasting Nuvigil (R-modafinil) as a "truly once-a-day" wakefulness medication. In 2006, the FDA sent Cephalon an "approvable letter" for Nuvigil, pending agreement on the final product labeling.

One, it doesn't match the tone of the text surrounding it, and sounds somewhat like an advertisement for "Nuvigil" -- no evidence is given for the terms "longer-lasting" and "truly once-a-day".

Two, it appears in the "off-label" section, and has nothing to do with that section.

--71.219.101.10 08:30, 19 April 2007 (UTC)

It appears to have been moved and backed up with facts since this post.

-Apagadomenina 00:54, 31 May 2007 (UTC)

Generics & effectiveness

I'm going to restore the statement regarding the effectiveness of generics. Yes, in theory, the basic ingredient is the same. However, (1) no one really knows if Modalert is pure modafinil, (2) according to Cephalon's research, modafinil loses efficiency if it's in the form of particles larger than 40 microns (see US patent 5618845). It's not known if particles in Modalert are small enough. --Itinerant1 22:47, 4 May 2007 (UTC)

---

Sounds good to me. There definitely has been a lot of talk in forums about the lack of effectiveness of some generics, especially with Modalert. I feel like the public should have access to that information.

-Apagadomenina 00:57, 31 May 2007 (UTC)

Causes urine, mucus, and sweat to smell foul

I'm sure that quite a few people have noticed that it makes their urine smell foul - but I'm starting to notice that my mucus and sweat have also been smelling with that sulphur (or rotten vegetable)-like smell. Anyone else to confirm that it makes other bodily liquids smell foul? I also wonder if it gets passed into sperm production in any way...

Yes I also can smell the Modafinil sulphur in the urine and sweat. But honestly, I like it. —Preceding unsigned comment added by 84.114.183.219 (talk) 02:28, August 25, 2007 (UTC)

Stay hydrated

I've taken modafinil (as Provigil) a handful of times before some long drives. I feel tired but do not have the overwhelming sleepiness that is so dangerous. One thing I've noticed: I have to stay hydrated or it really doesn't work at all (in other words, I drink plenty of water). If this information appears somewhere in the literature I think it would be important to include in the article. —The preceding unsigned comment was added by 71.162.83.31 (talk) 12:47:29, August 19, 2007 (UTC)

Performance Enhancer in Sports

Is there information on how modafinil is used as a performance enhancing drug, how it is tested, how long it remains in bloodstream etc...? —Preceding unsigned comment added by 195.110.84.99 (talk) 13:08, August 27, 2007 (UTC)

It is a banned drug and athletes have been banned for using it.

http://news.bbc.co.uk/sport1/hi/athletics/3210876.stm —Preceding unsigned comment added by 203.198.92.138 (talk) 09:37, 1 August 2008 (UTC)

How can I snythesise Modafinil at home for personal use ?

The synthesis of modafinil is acutally very easy and cheap. Its also easy to obtain the real modafinil formulas for the synthesis. But I dont know much about chemistry. Could a chemist please add a Youtube-Video that exlains how to do it yourself and make real modafinil at home.

Don't forget: the synthesis of Modafinil is cheaper than Aspirin at all. Ahmedunited 15:34, 30 September 2007 (UTC)

You can't. It's not a complicated synthesis but you still can't do it in a kitchen. You shouldn't attempt to make aspirin in a kitchen either, for that matter - you still need things that you can't buy as a "civilian", and it's quite dangerous to be working with flammable/noxious chemicals indoors. For that matter you should never take any home-made drug, since you wouldn't have any way to assay it - see MPTP for an example of what can happen in this situation. Senatorpjt (talk) —Preceding comment was added at 17:52, 20 June 2008 (UTC)

why are you even responding to this bullshit? a youtube video on how to make it in his mom's kitchen? what the fuck

Yeah. The synthesis looks pretty nontrivial to me: http://www.erowid.org/archive/rhodium/chemistry/adrafinil.modafinil.html --Gwern (contribs) 22:29 29 October 2009 (GMT)

No link saying that Modafinil potentiates MAOIs by a factor of 4

So I deleted it. —Preceding unsigned comment added by 75.73.198.70 (talk) 20:01, 23 October 2007 (UTC)

Legal status

I quote:

"United Kingdom (not listed in the Misuse of Drugs Act and is available by prescription without legal restrictions)".

Can we change this to:

"United Kingdom (not listed in the Misuse of Drugs Act and is available without legal restrictions, both on the internet and by prescription)"

...otherwise, it may appear that it's not legal unless obtained by prescription.

SNRI

I'm confused... according to the modafinil monograph it is not indicated to effect norepinepherine receptors... additionally this is the only mention of norepinepherine in the entire monograph. Why is it listed as being a norepinepherine reuptake inhibitor?99.236.56.120 (talk) 01:27, 21 February 2008 (UTC)

Implications in Parkinson's Disease

Some research exists that suggests a neuroprotective role of Modafinil in MPTP-induced experimental models of Parkinson's disease. I will provide the information to the page if the subject is of interest to readers and editors. —Preceding unsigned comment added by Synapticjunction (talk • contribs) 05:58, 8 March 2008 (UTC)

No, it is not of any interest. There are a lot of chemicals with neuroprotective action in rats. Paul Gene (talk) 10:48, 8 March 2008 (UTC)

With all due respect, the effect has been well-documented in the literature by respected researchers, and does not simply represent a "neuroprotective" effect generally, but rather an anti-Parkinsonian effect specifically. The most recent research was conducted by van Vlieta SA et al, 2008 (published in the prestigious neuroscience journal Brain Research), and demonstrated that modafinil prevents MPTP-specific neuronal damage (a common model for measuring anti-Parkinsonian effects) in the substantia nigra of marmoset monkeys using tyrosine hydroxylase immunoreactive staining. Given additional earlier research showing similar effects under different experimental conditions, I think it is premature to dismiss a presentation of such information in the present article, as it represents important knowledge in the medical community regarding the effects of modafinil in clinical and experimental research that ought to be shared with and relayed to the wikipedia reading community.Synapticjunction (talk) 18:35, 8 March 2008 (UTC)

Modafinil and DSPS (Delayed Sleep Phase Syndrome)

The article on Delayed Sleep Phase Syndrome mentions that Modafinil "...does not deal with underlying causes of DSPS, but it may improve a sleep-deprived patient's quality of life. ..."

Modafinil has not been approved by FDA for treatment of DSPS, hence we cannot add DSPS to the respective paragraph. But I believe the Modafinil article should mention that Modafinil might potentially be of help to people who suffer from DSPS. 92.117.247.185 (talk) 17:28, 4 August 2008 (UTC)

FDA Approved or Simply Indicated?

The first sentence says it is "approved by the FDA for the treatment of...shift work sleep disorder." Two sentences later is the line "Modafinil is also indicated, though not approved, in the treatment of...shift-work sleep disorder" MacScoop (talk) 20:27, 8 September 2008 (UTC)

Use as anti-jet-lag drug?

There seems to be some anecdotal evidence that Modafinil is useful for counteracting jet-lag, but I'm aware of no studies showing one way or another. What is wikipedia's policy on including anecdotal information about drug use? I'll be glad to try to add something if it's the correct thing to do. Jbradfor (talk) 21:16, 2 September 2009 (UTC)

I've added a reliably-sourced anecdote. :) --129.49.7.125 (talk) 22:07, 1 October 2009 (UTC)

Generics-related injunction

Not sure how to incorporate this: http://www.businessweek.com/investor/content/sep2009/pi20090928_251573_page_2.htm http://www.businessweek.com/investor/content/sep2009/pi20090928_251573_page_3.htm

"The FTC has gone to court seeking a permanent injunction that would allow generic entry prior to April 2012, on the grounds that Cephalon illegally paid several generic drug manufacturers compensation to secure their respective agreements not to compete for a "substantial period" prior to original expiration of a key patent in 2015. Specifically, Cephalon paid some generic companies more than $200 million in exchange for agreements not to flood the market with their cheaper chemical copies of modafinil prior to 2012. The FTC suit alleges that consumers were denied access to lower-priced generic versions of Provigil prior to patent expiration.
On July 28, both the company and investors breathed a collective sigh of relief when a new judge, was assigned the case. The judge issued an order consolidating all of the cases, telling all parties that he needed to be brought up to speed on the case. He then asked all plaintiffs to refile all their motions in concise form before restarting the discovery process. The judicial switch effectively delayed relief sought by the FTC and other plaintiffs, as it will likely take at least two years for any rulings to come down from the bench. The 10Q Detective concurs with analysts at investment banker Natixis Bleichroeder that the delay benefits Cephalon's switchover campaign."

--129.49.7.125 (talk) 22:03, 1 October 2009 (UTC)

wakefulness promoter

What exactly is meant by that? The papers I've read don't seem to cover it. Is it that if someone is sleep-deprived, modafinil will boost his performance; or is it that administered before sleep deprivation prevents the usual effects of sleep deprivation (or both)? --Gwern (contribs) 18:07 4 October 2009 (GMT)

JAMA article on modafinil

"Poised to Challenge Need for Sleep, "Wakefulness Enhancer" Rouses Concerns", Brian Vastag JAMA. 2004;291:167-170.

Don't really have the time to work it in myself, but it has some good bits like a description of Diane Sawyer taking modafinil on Good Morning America. Email me if you want a copy and will add it in. --Gwern (contribs) 01:50 2 December 2009 (GMT)

IUPAC name

http://pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=24847873&loc=ec_rcs says 3-Oxo-4,4-diphenylbutanamide. Rich Farmbrough, 20:44, 27 July 2010 (UTC).

Section removed

I have removed the chemical synthesis section because there were errors in the structure diagram. And without the diagram, the remaining text isn't very useful. Here it is if anyone wants to recreate a diagarm and use this text: Modafinil can be synthesized beginning with the reaction of benzhydrol with chloroacetic acid and thiourea. The resulting carboxylic acid is treated with thionyl chloride and ammonia to generate the amide. Finally, oxidation of the thioether to the sulfoxide with hydrogen peroxide produces modafinil. Lafon, L.; 1979, U.S. patent 4,177,290 -- Ed (Edgar181) 15:11, 29 July 2010 (UTC)

modafinil & emotion

"Modafinil differs from other arousal-enhancing agents in chemical structure, neurochemical profile, and behavioral effects. Most functional neuroimaging studies to date examined the effect of modafinil only on information processing underlying executive cognition, but cognitive enhancers in general have been shown to have pronounced effects on emotional behavior, too. We examined the effect of modafinil on neural circuits underlying affective processing and cognitive functions. Healthy volunteers were enrolled in this double-blinded placebo-controlled trial (100 mg/day for 7 days). They underwent BOLD fMRI while performing an emotion information-processing task that activates the amygdala and two prefrontally dependent cognitive tasks-a working memory (WM) task and a variable attentional control (VAC) task. A clinical assessment that included measurement of blood pressure, heart rate, the Hamilton anxiety scale, and the profile of mood state (POMS) questionnaire was also performed on each test day. BOLD fMRI revealed significantly decreased amygdala reactivity to fearful stimuli on modafinil compared with the placebo condition. During executive cognition tasks, a WM task and a VAC task, modafinil reduced BOLD signal in the prefrontal cortex and anterior cingulate. Although not statistically significant, there were trends for reduced anxiety, for decreased fatigue-inertia and increased vigor-activity, as well as decreased anger-hostility on modafinil. Modafinil in low doses has a unique physiologic profile compared with stimulant drugs: it enhances the efficiency of prefrontal cortical cognitive information processing, while dampening reactivity to threatening stimuli in the amygdala, a brain region implicated in anxiety."

http://thirdreviewer.com/2010/neuroscience/neuropsychopharm/modulatory-effects-of-modafinil-on-neural-circuits-regulating-emotion-and-cognition/ --Gwern (contribs) 04:23 30 August 2010 (GMT)

"BACKGROUND:: Emotional impairments are important determinants of functional outcome in psychosis, and current treatments are not particularly effective. Modafinil is a wake-promoting drug that has been shown to improve emotion discrimination in healthy individuals and attention and executive function in schizophrenia. We aimed to establish whether modafinil might have a role in the adjuvant treatment of emotional impairments in the first episode of psychosis, when therapeutic endeavor is arguably most vital. METHODS:: Forty patients with a first episode of psychosis participated in a randomized, double-blind, placebo-controlled crossover design study testing the effects of a single dose of 200 mg modafinil on neuropsychological performance. Emotional functions were evaluated with the emotional face recognition test, the affective go-no go task, and the reward and punishment learning test. Visual analogue scales were used throughout the study to assess subjective mood changes. RESULTS:: Modafinil significantly improved the recognition of sad facial expressions (z = 2.98, p = .003). In contrast, there was no effect of modafinil on subjective mood ratings, on tasks measuring emotional sensitivity to reward or punishment, or on interference of emotional valence on cognitive function, as measured by the affective go-no go task. CONCLUSIONS:: Modafinil improves the analysis of emotional face expressions. This might enhance social function in people with a first episode of psychosis."

"Effects of Modafinil on Emotional Processing in First Episode Psychosis" http://medicine.journalfeeds.com/psychiatry/biol-psychiatry/effects-of-modafinil-on-emotional-processing-in-first-episode-psychosis/20101127/ --Gwern (contribs) 01:43 29 November 2010 (GMT)

Legal status in Canada

The infobox incorrectly lists modafinil as having "Schedule F" status in Canada. There is no such classification as "Schedule F" in the Controlled Drugs and Substances Act, and modafinil does not appear to be specifically listed anywhere in the text of any of the schedules found on the official government website. I'm just not sure if the listing should be removed entirely from the infobox, or simply changed to "unscheduled." — Preceding unsigned comment added by 216.211.39.20 (talk) 16:44, 5 November 2016 (UTC)

It's Rx only. I'll check the exact schedule when I have time ;-) --D Anthony Patriarche (talk) 18:46, 3 May 2021 (UTC)

Psychiatric reactions

I'm tempted to remove Modafinil#Psychiatric reactions, but I'm not familiar enough with Wikipedia medical article standards. The only citation is this notice from the Australian government which mentions 5 cases of adverse psychiatric symptoms, 3 of which had symptoms prior to taking modafinil. That seems remarkably anecdotal and not at all worthy of inclusion to me. Daask (talk) 14:12, 25 January 2018 (UTC)

The whole medical section needs to be reworked; it has been literally shat on. here are sources, some of which might be OK. Some will not be. These need to be used carefully; and content put in "medical use" or "research" depending on whether the source says modafinil is actually used clinically or if it is just discussing clinical research, in which case it would go in the research section. Jytdog (talk) 14:32, 25 January 2018 (UTC)

I've cited this textbook in several articles, including amphetamine, dextroamphetamine, Adderall, and lisdexamfetamine, among others. The following is from its entry on modafinil.

Commonly Prescribed for
(bold for FDA approved)
• Reducing excessive sleepiness in patients with narcolepsy and shift work sleep disorder
• Reducing excessive sleepiness in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) (adjunct to standard treatment for underlying airway obstruction)
• Attention deficit hyperactivity disorder (ADHD)
• Fatigue and sleepiness in depression
• Fatigue in multiple sclerosis
• Bipolar depression

Seppi333 (Insert 2¢) 03:57, 26 January 2018 (UTC)

References

Should “misuse” be called a “side effect” in the lede?

Just as the clinical information in the article needs to be correct, so does the language used to convey the information.

The term “side effect” might be used colloquially to refer to any subsequent event that can be linked in some way, but it has a more precise and useful definition in a clinical context. “Misuse” is a very broad, vague word.

I don’t dispute that this drug carries with it the possibility of misuse -but that’s true of any drug. If it applies to 100% of drugs, how useful is it to state it about this, or any, particular drug? For that matter, is there anything at all that can’t be “misused”? Is “misuse” therefore a “side effect” of toothpaste? Or an aircraft?

The fact that “misuse” may follow an initial use doesn’t make it a “side effect” like constipation and headaches, or even that a drug may be prone to psychological dependence. Those are side effects. To call misuse a side effect is a misuse of language. Issues that might be called “misuse” are dealt with by other drug articles as “recreational”, “illegal”’ or “non-medical” use - that is, if it's a significant issue. The Thalidomide article has no such section because it's not used that way.

Which raises the question, how significant is the issue for modafinil? The article states “The addiction and dependence liabilities of modafinil are very low” and that cases of modafinil abuse are “very rare”. There is some minor concern about its status in sport, and as a “smart drug” (is that misuse or just use?). In short, not so significant as to deserve appearing in the lede.

I intend to revert on the grounds that a) to acknowledge “misuse” as a side effect is so general as to lose any useful meaning, b) non-medical, recreational, and illegal use are not “side effects”, and c) the purported misuse of this drug is not so significant as to warrant inclusion in the lede.

I also removed the sentence “In OSA continuous positive airway pressure is the preferred treatment” as it has nothing to do with this article. Captainllama (talk) 17:31, 7 June 2019 (UTC)

I agree with your logic. On the other hand, "adverse effects" would, I believe, encompass both side effects and dependency issues.--71.36.97.107 (talk) 02:48, 8 June 2019 (UTC)

Disagree with you on both of these:

• It is important to clarify that modafinil is not a first line treatment for OSA which that sentence does. In fact the ref that is used which is specifically about modafinil mentions this.
• Abuse / misuse potential are potential adverse effects and is supported by this source.https://www.drugs.com/monograph/modafinil.html

This is not at all correct "I don’t dispute that this drug carries with it the possibility of misuse -but that’s true of any drug" Very few medications have the possibility of "misuse/abuse" Doc James (talk · contribs · email) 16:30, 8 June 2019 (UTC)

The body of the article was based on some low quality primary sources. Have trimmed a bunch of it. Doc James (talk · contribs · email) 16:36, 8 June 2019 (UTC)

opening paragraph

Opening paragraph states:

"While it has seen off-label use as a purported cognitive enhancer, the research on its effectiveness for this use is not conclusive."

seems misleading or not neutral, only because reading the references, one is a link to google books with not much relevant information. And the other reference says explicitly:

"We found that whilst most studies employing basic testing paradigms show that modafinil intake enhances executive function, only half show improvements in attention and learning and memory, and a few even report impairments in divergent creative thinking. In contrast, when more complex assessments are used, modafinil appears to consistently engender enhancement of attention, executive functions, and learning."

So while it is true that studies are inconclusive, the subtext in the wiki intro is clearly, "laymen use it thinking it improves cognition, but there is no evidence for that." So the opening is misleading. Hopefully somebody can find references to support their opinion or work on the opening to make it accurate. I'll try and do that if nobody ends up responding. thanks Violarulez (talk) 20:27, 14 January 2021 (UTC)

Schizophrenia edit

Can somebody pleas edit the part that says that modafinil is not effective with schizophrenic patients! I'm schizophrenic and take modafinil and find it does absolute wonders. There should be articles on the internet that counter-act who ever posted this argument — Preceding unsigned comment added by 2603:7080:F83F:4F5A:9C42:4FD:25F6:B787 (talk) 00:17, 21 February 2021 (UTC)

The section does say "may slightly reduce negative symptoms", i.e. it modestly improves depression etc. The trouble with meta-analyses is that they miss or downplay the one patient in a hundred (or even 1 in 10) who experiences significant benefit, but these are the sources we have to rely on here. I will keep my eye open for RS's that may confirm that some patients obtain significant relief of negative symptoms or drug side-effects, which I would actually expect from my experience with its use in MDD. --D Anthony Patriarche (talk) 19:45, 3 May 2021 (UTC)

Interactions

Needs expert review and expansion. While drugs.com interactions page does show major interactions for the opioids listed (I've added the cite), it lists a total of 421 interactions of which 49 are major. The original text read "...as well as other drugs"; I deleted this as unhelpful & unverifiable. In fact, the "various other drugs" include interactions via pathways other than CYP3A4, so mentioning them in the same breath would be misleading, but leaving them out altogether gives undue weight to the opioid interaction. I suggest expanding the section to short-list more major interactions. Not sure I have the attention span to dig through them myself, or (more importantly) the current expertise to know which to choose & how to group them. Will leave it as is (edited) for now.

Note: the cite I added is intentionally redundant, should eventually revert to the all-inclusive refname AHSF2018; I thought the link to the detail page might be useful to editors, as I missed the hyperlink to the details page myself on first checking--on the top page it appeared the opioids weren't included! --D Anthony Patriarche (talk) 19:22, 3 May 2021 (UTC)

Formulation improvements?

Maybe these formulations could be improved:

While it has seen off-label use as a purported cognitive enhancer to improve wakefulness in animal and human studies, [...]

I believe "off-label use" typically refers to doctors prescribing a drug in cases not covered by the label; I wouldn't call it off-label use if a substance is tested in studies for a use not covered by its label.

It shares biochemical mechanisms with addictive stimulant drugs, and some studies have reported it to have similar mood-elevating properties, although to a lesser degree. It is not clear whether these effects are any more different than the ones from caffeine.

The phrase "any more different" sounds strange to me. Modafinil's effects are different from the ones of addictive stimulant drugs, and caffeine's effects are different from the ones of addictive stimulant drugs, and it is unclear whether the former difference is larger than the latter? AxelBoldt (talk) 00:25, 7 May 2022 (UTC)

Why saying "As a 'smart drug' it allegedly increases mental focus and helps evade sleep, properties which attract students,......", When it's kinda confirmed?Jacobs, Ira; Bell, Douglas G. (June 2004). "Effects of acute modafinil ingestion on exercise time to exhaustion". Medicine and Science in Sports and Exercise. pp. 1078–1082. doi:10.1249/01.mss.0000128146.12004.4f. Retrieved 13 October 2022. for more references, see https://modapills.co.uk/blog/modafinil-is-equal-to-smart more here listed in references section. 11:03, 13 October 2022 (UTC)

Spam removed. MER-C 19:27, 31 January 2023 (UTC)