Modafinil is a commonly discussed stimulant. Many websites and groups herald it as a better version of caffeine, and for a reason…
The stimulant has strong wakefulness properties. It induces stronger focus and alertness, which makes it a productivity booster.
However, the strong effects of the stimulant mean strong side-effects, especially if used by patients. So if you do plan on using Modafinil, you should do so with caution!
Modafinil in the USA
The stimulant is FDA-Approved for treatment. It is used to treat the following disorders:
- Obstructive sleep apnea
- Sleep work shift disorders
- Narcolepsy
Modafinil also has off-label uses. We’ll discuss how Modafinil works, its FDA-approved and off-label uses, and how to best improve therapy outcomes using it.
FDA Approved Treatments
Modafinil is legally used as a first line treatment for the following:
- Sleep Work Shift Disorders
- Narcolepsy. Modafinil is used for daytime fatigue caused by narcolepsy, though it does not improve cataplexy symptoms
Modafinil is legally an adjunctive treatment for:
- Obstructive Sleep Apnea. Applied with CPAP (continuous positive airway pressure)
Off Label Uses
Modafinil is sometimes used to for the following disorders:
- Cocaine addiction. Some evidence shows that cocaine dependence is treatable with Modafinil
- Multiple sclerosis fatigues
- Cancer-related fatigues. Treatment here is based on mixed evidence, some showing efficacy
- Acute bipolar and unipolar depressive episode
- ADHD. There is efficacy evidence in pediatric treatment. However, adult ADHD patients have shown little benefit of Modafinil use
With that, Modafinil is often used to enhance cognitive properties. But, the risks discussed in medical literature are uncertain and imprecise.
Types of Patients Modafinil is Administered to:
Modafinil is available to patients as either 100mg or 200mg tablets and is administered orally. The dose is taken once per day, usually at 200mg.
The Modafinil drug classification is a substance class IV.
Adult Dosage
Recommend modafinil tablet dosage is 200mg, administered orally for obstructive sleep apnea or narcolepsy
To treat shift work disorders, 200mg of modafinil per day is administered – normally one hour before work shifts begin.
For Specific Populations
Pediatric Treatment
Safety and effectiveness of modafinil isn’t established. Modafinil isn’t FDA-approved for pediatric populations in any form.
Side effects of pediatric use include SJS (Stevens-Johnson syndrome), EMM (Erythema Multiform Major), and skin rashes.
Geriatric Treatment
For the elderly, lower doses and close monitoring of patients is recommended.
Lactating Women
It is unknown if modafinil affects breast milk. Modafinil should be used with caution, especially if a newborn is breastfed exclusively.
Pregnancy
The FDA classifies modafinil as a pregnancy category C medication. No evidence shows or excludes harm to human fetuses.
With that, there is some evidence of increased intrauterine growth and abortion in certain animal studies.
Renal Impairments
Modafinil should be carefully used with severe renal impairment patients, where no renal dosing recommendations exist.
Hepatic Impairments
Modafinil doses should be reduced by ½ of the normal doses indicated to normal patients. For severe impairment patients, a 100mg maximum dosage should be administered.
Author: Dr. Ravi Bhasker, MD, graduated from the University Of Kansas School Of Medicine in 1974. He works in Socorro, NM and specializes in Family Medicine.
