As we have written elsewhere, Modafinil is an analeptic drug designed to promote wakefulness and fight against fatigue. However, apart from it also being used as a so called ‘smart-drug’ by students, what other potential uses of Modafinil for fatigue, or other purposes, are there? When reading this article please remember that Modafinil is also marketed internationally as: Provigil, Alertec, Modavigil and Modalert.
Modafinil and multiple sclerosis
There was a time when anyone suffering from multiple sclerosis would not have been encouraged by the medical profession to attempt to exert themselves or do anything but rest. Fortunately times are more enlightened these days and the medical profession now encourages multiple sclerosis patients to be as active as they can be. Whilst multiple sclerosis (MS) is a serious condition, especially in its early stages it is also an unpredictable one; with one week a patient being particularly disabled and the next not as badly so. However, the fatigue associated with MS, whether the disabilities arising from it are in a bad or not so bad phase, can be debilitating in itself. To this end patients that are taking Modafinil to combat these feelings of fatigue has been clinically tested. The tests have illustrated that at lower doses, such as Modafinil 200mg, taken once a day, it can make a significant and positive impact on feelings of fatigue, exhaustion and general apathy/malaise of MS patients – compared to a control group being given a placebo.
Modafinil and depression
Bearing in mind that in the study above MS patients reported lower feelings of apathy and general fatigue – a low dosage of Modafinil 200mg has also been investigated as a treatment for depression. For the majority of people reporting and being diagnosed as being in a state of depression, only one anti-depressant medication will be prescribed. However, if someone is diagnosed as having a major depressive disorder (MDD); extra/secondary medication can also be prescribed, the most commonly used one recommended by the American Psychiatry Association being Lithium. One such MDD is Atypical Depression (AD), which is a chronic mood disorder or dysthymia. AD is typified by the patient being able to display good mood behavior in response to an event deemed positive to themselves – but at other times they will often over-eat and over-sleep, when not able to be induced into a ‘good mood’. Needless to say, this tendency to over-sleeping lends itself to investigating how well patients might respond to treatment with Modafinil – alongside their other anti-depressant(s). Clinical trials have established that Modafinil is effective in the short-term treatment of hyper-somnolence, the over-sleeping disorder which is commonly found to be a symptom of AD.
Modafinil and Attention Deficit Hyperactivity Disorder (ADHD)
You might well be surprised that ADHA patients are taking Modafinil, an analeptic drug. You would assume that a sedative might be thought to be more appropriate rather than a stimulant. Modafinil works by acting as a stimulant releasing the monoamines; catecholamine norepinephrine and dopamine from the user’s synaptic terminals. In doing this it will almost certainly also change the levels of gamma amino-butyric and glutamate that activate the hypothalamus – the part of the brain that reacts to excitement! Normally ADHD patients are required to take their medication regularly throughout the day to control their condition. Some studies have been undertaken to see if ADHA patients can be taking Modafinil as a ‘once a day’ treatment, due to its ‘half-life’ of 15 hours. After an average 5 week course of Modafinil 200mg, using standard ADHD assessment tests, mixed results have been obtained. Although the attention span of those in the tests did show some improvement, as might be expected considering the many peopel are taking Modafinil as a ‘smart drug’; reports of side-effects such as the delayed onset of sleep and lightheadedness in the ADHD patients means that further studies are now needed.
Modafinil to counter drug-induced sleep
The sleep inducing effects of other drugs might be countered by people that are taking Modafinil. With the exception of an adjunct to anti-depressant drugs, there are no other drug-induced patients that are taking Modafinil. Otherwise, if a person has been prescribed sedatives/narcotics then taking an analeptic like Modafinil or Provigil would be counter-intuitive.