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Modafinil is an analeptic used to treat drowsiness associated with narcolepsy. Modafinil is also approved by the US Food and Drug Administration (FDA) for the treatment of sleep disorders associated with shift shifts.

Modafinil is a psychostimulant that speeds up the vital functions of the body.

Modafinil is used to treat excessive sleepiness caused by narcolepsy (a condition that causes excessive daytime sleepiness) or shift work sleep disorder (drowsiness during scheduled waking hours and difficulty falling or staying asleep during scheduled sleep hours in people who work at night or on rotating shifts).

Modafinil is also used along with breathing devices or other treatments to prevent excessive sleepiness caused by obstructive sleep apnea/hypopnea syndrome (OSAHS; a sleep disorder in which the patient briefly stops breathing or breathes shallowly many times during sleep and therefore does not get enough amount of restful sleep). Modafinil belongs to a class of medications called wakefulness agents. It works by changing the amount of certain natural substances in the area of ​​the brain that controls sleep and wakefulness.

It was developed in the late 1980s by the American drug manufacturer Cephalon to treat narcolepsy, a condition in which people suddenly fall asleep during the daytime. Narcolepsy affects approximately 0.02–0.03% of the population.

Modafinil

Modafinil is sold as a prescription drug in Finland and is indicated for the treatment of narcolepsy in adults. The recommended starting dose is 200 mg/day. Single doses should not exceed 400 mg.

Modafinil is an analeptic used to treat drowsiness associated with narcolepsy. Modafinil is also approved by the US Food and Drug Administration (FDA) for the treatment of shift work sleep disorder (SWSD) and sleepiness associated with obstructive sleep apnea.

The European Medicines Agency, however, recommends limiting new prescriptions of medicines containing modafinil to cases of narcolepsy due to the risk of neuropsychiatric, dermal and allergic side effects.

At the same time, since these side effects are most often observed in the first two weeks of using the drug, its use according to previous prescriptions is not limited. The off-label use of modafinil is also popular as a relatively safe psychostimulant. In Russia, in 2012, modafinil was included in the list of psychotropic substances.

Indications and dosing regimen

Indications and dosing regimen

In addition to these indications, modafinil is also approved by government regulators in some countries for the treatment of cases of idiopathic hypersomnia (abnormal daytime sleepiness, the cause of which is not clearly diagnosed).

For the treatment of hypersomnia associated with narcolepsy and obstructive sleep apnea, a single dose of the drug in the morning at a dose of 200 mg is recommended, although there is data from clinical trials, according to which double use (morning and noon) of 200 mg is more effective. A single dose of 400 mg does not lead to a significant increase in efficacy compared to a dosage of 200 mg.

In the treatment of drowsiness associated with a shift in work shifts, a single dose of 200 mg of the drug is recommended 1 hour before the start of the shift, a good effect is also achieved with a single dose of 300 mg.

In all cases, the daily dosage should not exceed 400 mg; taking the drug in the afternoon is not recommended, since modafinil is slowly excreted from the body (half-life 12-15 hours) and may interfere with normal night sleep. In general, dosage recommendations range from 100 to 400 mg per day, in 1-2 doses.

Misuse

Modafinil is widely used off-label to suppress the need for sleep. It is also used without a doctor’s prescription to combat general fatigue not related to lack of sleep, such as in the treatment of attention deficit hyperactivity disorder (ADHD) and as an adjunct to antidepressants (particularly in individuals with significant residual fatigue).

There are differing opinions as to whether the cognitive effects that modafinil shows in healthy individuals who do not suffer from sleep deprivation may be sufficient for modafinil to be considered a cognitive enhancer.

Researchers agree that modafinil improves some aspects of short-term memory, such as digit recall, computation, and pattern recognition, but results related to spatial memory, executive functions, and attention are inconsistent. Some of the positive effects of modafinil may only be experienced by “low performing” people or those with low IQs. One study showed that modafinil restored learning to normal levels in methamphetamine addicts, but showed no effect in healthy people.

Misuse

Other uses

Modafinil is widely used without a prescription to suppress the need for sleep, while it improves short-term memory after sleep deprivation. In addition to self-use by people in order to enhance their capabilities, modafinil is widely used by doctors for a variety of purposes.
In the United States and many other countries, drugs are registered for only one use, but can be prescribed by doctors for various purposes, taking into account the individual needs of the patient.

This use, called off-label, is very widely practiced. Modafinil is used to treat depression and fatigue in depression, fibromyalgia, chronic fatigue syndrome, myotonic dystrophy, opiate-induced drowsiness, cerebral palsy, and Parkinson’s disease.

It improves subjective mood and friendliness, at least for shift workers. Used for jet lag due to jet lag. Modafinil may also be an effective and well-tolerated treatment for patients with seasonal affective disorder. It is also prescribed by some doctors for the “owl” syndrome.
There is evidence that modafinil, when used on its own, is effective for some subgroups of people with depersonalization-derealization syndrome.

The subgroups of people it most frequently affects are people with a lack of attention, low excitability of the nervous system, and increased drowsiness. However, no clinical studies have been conducted. Dr. Evan Torch calls the combination of SSRIs and modafinil “a hidden gem that can really help cure depersonalization disorder.”

Other uses
Course with Modafinil for women