Modafinil is a prescription medication designed to help people overcome bouts of daytime sleepiness and mental fatigue. The medication can be helpful for people with medical conditions that cause them to feel tired and foggy throughout the day.
For others, modafinil can be a dangerous drug that leads to addiction. Those who develop addictions may feel helpless and hopeless. But there are treatment options available that can help people to overcome their addictions and embrace healthier lives.
Modafinil is primarily used to help people with narcolepsy. This condition causes an array of symptoms, including daytime sleepiness. People with narcolepsy can experience periodic episodes in which they feel suddenly overcome by the need to sleep, and that sense is so powerful that they are helpless to do anything but comply.
A sudden episode of sleepiness can be catastrophic if it takes hold while someone is driving or operating machinery. These episodes can also deeply affect a person’s ability to raise children, hold down a job, or engage with friends.
The Narcolepsy Network reports that only 25 percent of people who have narcolepsy have a proper diagnosis of the condition from a doctor and are getting care from that doctor. Those who do receive care might be given a prescription for modafinil.
Researchers believe, according to the National Institute of Neurological Disorders and Stroke, that narcolepsy is an autoimmune disorder. Cells that should protect the body attack the body instead, and in narcolepsy, cells that produce a brain chemical called hypocretin are the targets. When enough cells are destroyed, the body can no longer regulate sleep/wake cycles properly.
Medication therapy for narcolepsy is designed to help spark electrical activity within the brain, so those feelings of exhaustion are easier to ignore, if they come on at all. The National Organization for Rare Disorders reports that modafinil is the drug prescribed most often for people who are dealing with daytime sleepiness. For those with narcolepsy, the medication may help to keep symptoms of exhaustion at bay so they can stay awake throughout the day, no matter what might happen. For them, this can be a remarkable transformation, and it is well worth the risks and side effects that come with taking this medication.
People diagnosed with narcolepsy work with a doctor to control symptoms and achieve better health. Before they take the medication, they talk with a doctor about their health history. They may have blood tests to determine their current state of health. And they have instructions from a doctor about how to use the medication they are given.
In an article published in the journal Nature and Science of Sleep, researchers write that most people with narcolepsy are given a starting dose of 200 mg (milligrams) of modafinil, and they may slowly increase to taking 400 mg per day. In rare cases, doctors may prescribe up to 600 mg per day of the drug.
Throughout the therapy process, people talk with their doctors about their symptoms and how the medication is working for them. This partnership helps them to stay safe while using this powerful drug.
It may seem strange to consider that people who do not have narcolepsy might take a medication like modafinil. After all, people who don’t have this condition simply don’t have incapacitating episodes of sleepiness that put their health at risk unless they make poor lifestyle choices. Unlike people with narcolepsy, healthy people can take steps to ensure they feel as alert as they need to during the day.
Even so, many people consider modafinil a vital tool to help them cope with the demands of a modern, hectic life.
In addition to helping people overcome daytime sleepiness, modafinil has been associated with an enhanced ability to concentrate, even on mundane tasks. Some people, as Harvard Business Review puts it, consider modafinil to be a “smart drug” that helps them to tackle long hours spent on tedious work tasks. These people believe the drug makes them better at what they do, and they may see no reason at all to stop taking the drug.
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Some research supports this view. For example, in a study published in the journal European Neuropsychopharmacology, researchers found that modafinil helps to enhance attention, and that people who take it can learn new concepts quicker than they might if they hadn’t taken the drug. People who choose to take this drug recreationally might point to studies like this as evidence that the drug works, and that there should be no cause for concern if they keep taking the drug for long periods.
Many people do make a choice to take drugs that enhance performance. For example, in a study conducted by Nature, researchers found that one person in five had taken performance-enhancing, stimulant-type drugs without a prescription. Of those who made this choice, 44 percent used modafinil.
People often assume that modafinil isn’t addictive, as it isn’t technically considered a stimulant. For many years, researchers had no real idea of how the drug worked within the brain, and there were no studies that conclusively proved that the drug worked on known addiction pathways. That has changed. Now, researchers know quite a bit more about how modafinil works, and the new knowledge is troubling.
In a study published in the journal Environmental Health and Toxicology, researchers report that modafinil has an impact on the dopamine system within the brain. Dopamine is the chemical brain cells release when exposed to something positive or uplifting. Drugs that boost dopamine levels, like heroin, have long been associated with addiction. With repeated use, the brain becomes accustomed to high dopamine levels, and those chemical changes drive compulsive drug use. If modafinil works on these same receptors, it could have the same known addiction profile.
The development of an addiction can be subtle. Someone taking the first dose may not know that the pathway to addiction has been triggered. But with each subsequent dose, brain cells are changing. Natural processes that release brain chemicals are being altered, and those alterations can cause deep-set cravings for drugs that are hard to ignore. People may find they need to take more of the drug to feel the same effect, and that increased dosing can lead to real dangers.
In this study, only 17 percent of people with these symptoms needed treatment in a hospital. But those taking larger doses, which is common with addiction, may have a higher risk of complications. Those can be remarkably dangerous.
Researchers writing in the Journal of Clinical Sleep Medicine report that people taking up to 1,200 mg of modafinil per day for up to 21 days did not experience life-threatening complications. They did experience many of the symptoms listed above along with other unpleasant symptoms such as diarrhea and chest pain.
Symptoms like this should prompt people to stop their use of the drug. But when an addiction is in place, stopping that use can be remarkably difficult.
People with an addiction may not discuss the problem openly, but there are signs and symptoms families can watch for. According to Mayo Clinic, those signs include:
Families may notice that someone taking modafinil may seem nervous or agitated, and then remarkably calm moments later. That could indicate that the person felt a deep craving for the drug and then achieved release by taking the drug.
Families may also notice sudden withdrawals of money from bank accounts. In severe cases, family possessions may suddenly disappear. Keeping up with an addiction can mean spending immense amounts of money on drugs, and people may prioritize the use of drugs over everything else. That may mean theft.
People trying to hide an addiction may also require a great deal of privacy. They may sneak away from family gatherings, take days away from work, or skip out on meetings with friends. In time, they may prioritize drug use above all else, including the things they once loved to do. They may retreat into a world in which drugs are the only things that matter.
It’s important to note that addictions can be different in every person. Some people with addictions are very adept at hiding their issues from the people who love them. But in time, the damage an addiction causes can be so significant that it becomes impossible to ignore.
Some forms of addiction can be treated with medication therapy. Unfortunately, according to the National Institute on Drug Abuse, there is no such therapy available for drugs like modafinil. That means people with an addiction to this drug cannot take a pill to make their symptoms go away. But there are many things they can do to achieve control once more.
Forming a connection with a reputable counselor can be a vital first step. A counselor can help people to understand how the addiction took hold, and a counselor can help people build up skills they can put to use when the craving for drugs reappears. There are many different forms of addiction counseling, and one that is right for one person may not be right for another, but therapists can help to tailor the treatment to ensure that their clients get the most benefit.
Support group work can also be helpful for some people with an addiction. In a support group, people can connect to and learn from other people who have overcome an addiction.
Meetings can help people talk about the dark details of an addiction that they may not be comfortable discussing with anyone else. Meetings also can help people learn about the coping skills others use. Since most meetings are free, they can provide a low-cost form of maintenance therapy for addiction for the rest of people’s lives.
(June 2015). Narcolepsy Fast Facts. Narcolepsy Network. Retrieved November 2018 from https://narcolepsynetwork.org/about-narcolepsy/narcolepsy-fast-facts/
(July 2018). Narcolepsy Fact Sheet. National Institute of Neurological Disorders and Stroke. Retrieved November 2018 from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Narcolepsy-Fact-Sheet
Narcolepsy. National Organization for Rare Disorders. Retrieved November 2018 from https://rarediseases.org/rare-diseases/narcolepsy/
(March 2017). New Developments in the Management of Narcolepsy. Nature and Science of Sleep. Retrieved November 2018 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5344488/
(May 2016). Like it or Not, Smart Drugs Are Coming to the Office. Harvard Business Review. Retrieved November 2018 from https://hbr.org/2016/05/like-it-or-not-smart-drugs-are-coming-to-the-office
(November 2015). Modafinil for Cognitive Neuroenhancement in Healthy, Non-Sleep-Deprived Subjects: A Systematic Review. European Neuropsychopharmacology. Retrieved November 2018 from https://www.sciencedirect.com/science/article/pii/S0924977X15002497
(April 2008). Poll Results: Look Who's Doping. Nature. Retrieved November 2018 from https://www.nature.com/news/2008/080409/full/452674a.html
(February 2012). Practical Use and Risk of Modafinil, a Novel Waking Drug. Environmental Health and Toxicology. Retrieved November 2018 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3286657/
(March 2008). Toxicity from Modafinil Ingestion. Journal of Clinical Toxicology. Retrieved November 2018 from https://www.tandfonline.com/doi/abs/10.1080/15563650802175595
(January 2009). Unsuccessful Suicide Attempt of a 15-Year-Old Adolescent with Ingestion of 5,000 mg of Modafinil. Journal of Clinical Sleep Medicine. Retrieved November 2018 from http://jcsm.aasm.org/Articles/05_04_372.pdf
(October 2018). Modafinil (Oral Route). Mayo Clinic. Retrieved November 2018 from https://www.mayoclinic.org/drugs-supplements/modafinil-oral-route/precautions/drg-20064870
(January 2018). How Can Prescription Drug Addiction Be Treated? National Institute on Drug Abuse. Retrieved November 2018 from https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/how-can-prescription-drug-addiction-be-treated