Modafinil Abuse: Signs, Symptoms, and Treatment

Medically Reviewed

In 2003, Kelli White became the world’s fastest woman, thanks to a combination of performance-enhancing drugs that included the stimulant modafinil. Later that year, she won the 100- and 200-meter races at the World Track and Field Championships, becoming the third woman ever to do so.

But her reign ended there. White was stripped of her medals after a positive drug test revealed modafinil in her urine.

“I began using these substances not to give me an advantage but because I had become convinced I needed to use them to level the playing field with my competitors,” White said in a 2005 hearing with the U.S. House Government Reform Committee.

White was among many who have turned to modafinil, a narcolepsy treatment medication, to improve performance. Typically, people have turned to modafinil to increase wakefulness so that they can study harder, work longer, and achieve more. In fact, the use of “smart drugs” like modafinil, Adderall, and Ritalin have become de rigueur across college campuses and workplaces nationwide. Like White, what fuels this abuse is the desire to gain an edge in highly competitive environments.

At the same time, modafinil users are potentially subjecting themselves to adverse effects and potential overdose.

Read on to learn more about modafinil and its dangerous signs and symptoms, along with treatment options.

What is Modafinil?

Modafinil is a central nervous system (CNS) stimulant developed in the 1970s by a French neurophysiologist to treat narcolepsy and other sleep disorders. It wasn’t until 1998 that the U.S. Food and Drug Administration (FDA) approved modafinil as a narcolepsy treatment. The FDA also approved its use as a shift work sleep disorder and obstructive sleep apnea/hypopnea treatment in 2003. It is sold under the brand name of Provigil.

Despite its official recognition as a medically useful drug, the U.S. Drug Enforcement Administration (DEA) designated modafinil as a Schedule IV controlled substance right along with Xanax and Valium, which means it has a low potential for abuse and carries a low risk of dependence. In its ruling, the DEA stated that modafinil produced behavioral effects similar to other stimulants like cocaine.

Still, modafinil’s exact mechanism of action is unknown. What is known is that modafinil is a dopamine reuptake inhibitor, and users experience arousal when they take it, but not a “high” that is more common with other prescription stimulants like Adderall or Ritalin.

But in large enough doses, modafinil can yield an alarming number of side effects and overdose symptoms.

Signs and Effects of Modafinil Abuse

People who abuse modafinil will exhibit common signs of substance abuse. They may exhibit compulsive behaviors where obtaining the drug becomes the focus of their life. And they will use a substance amid adverse circumstances, such as a health or a legal problem.

Other signs of abuse are revealed through the side effects associated with a substance. Modafinil produces common and severe side effects. Some are not discernible to the eye, but others are. The serious side effects can yield more observable physical effects along with psychological symptoms.

Modafinil can produce side effects that include:

  • Nausea
  • Diarrhea
  • Constipation
  • Gas
  • Unusual tastes
  • Dry mouth
  • Excessive thirst
  • Uncontrollable shaking of a part of your body
  • Burning, tingling, or numbness of the skin
  • Difficulty seeing or eye pain
  • Flushing
  • Sweating
  • Appetite loss
  • Tight muscles or difficulty moving
  • Heartburn
  • Nosebleed
  • Back pain
  • Headache
  • Dizziness
  • Drowsiness
  • Confusion
  • Difficulty falling asleep or staying asleep

Serious side effects of modafinil are as follows:

  • Difficulty breathing or swallowing
  • Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • Rash
  • Blisters
  • Peeling skin
  • Mouth sores
  • Chest pain
  • Fast, pounding, or irregular heartbeat
  • Frenzied, abnormally excited mood
  • Hives
  • Itching
  • Hoarseness
  • Anxiety
  • Depression
  • Hallucinating (seeing things or hearing voices that do not exist)
  • Thinking about killing or harming yourself

Symptoms of Withdrawal

There are no major symptoms of withdrawal from modafinil use, according to Mental Health Daily. However, there are some signs of withdrawal that can manifest. The biggest factor that determines whether a user experiences withdrawal has to do with how long they have been taking modafinil. The longer a user takes the drug, the more dependent they can become.

Dosage also matters. According to Mental Health Daily, modafinil has not been found to have additional therapeutic effects beyond 200 mg per day. People who exceed this dosage level are likely to experience symptoms.

When modafinil use ceases, the following discontinuation effects can result:

  • Fatigue
  • Sleepiness
  • Concentration problems
  • Low energy
  • Shortness of breath
  • Depression

Modafinil Overdose Symptoms

Because modafinil does not produce any significant withdrawal symptoms or a discernible “high” like other stimulants, the assumption is that it is safe. This cannot be further from the truth.

Its overdose symptoms are serious and necessitate medical attention. Modafinil overdose can include these symptoms:

  • Diarrhea
  • Nausea
  • Difficulty falling asleep or staying asleep
  • Confusion
  • Restlessness
  • Agitation
  • Fast, slow, or pounding heartbeat
  • Chest pain
  • Hallucinations (seeing things or hearing voices that do not exist)
  • Nervousness
  • Uncontrollable shaking of a part of the body

How Professional Treatment Can Help

Even addictions to “mild” substances of abuse can lead to permanent damage, which can greatly hamper your life. This is why professional addiction treatment is critical. It can help break the modafinil addiction and help you chart a course toward a healthy life.

Treatment begins with medical detoxification. This is where the modafinil and other toxins are removed from your body under the supervision of a licensed medical team.

You can continue treatment through an intensive outpatient program (IOP), which provides counseling and therapy designed to help you get to the root of your addiction. The added benefit of an IOP is that you can access treatment but have the freedom and flexibility to continue with your daily life.

If you need additional support, a clinical team can arrange aftercare through an alumni program, which connects you to a supportive recovery community.

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