Modafinil 200mg Tablet: Smart Drug For Decision Fatigue Or Workaholic Crutch

What is Modafinil?

Modafinil 200mg Tablet is a prescription central nervous system stimulant that helps people stay awake, enhance concentration, and combat fatigue. It is commonly used to treat narcolepsy and shift work sleep disorder but doctors may also prescribe it off-label for many reasons, such as to treat ADHD, for airline pilots, or to treat excessive fatigue associated with medical conditions like cancer or multiple sclerosis (MS).

Researchers aren’t exactly sure how modafinil works, but they believe it stimulates the production of monoamines (a class of neurotransmitters), which includes dopamine, noradrenaline, and serotonin. Although modafinil is a highly effective prescription medication, it has the same effect on dopamine centers of the brain as cocaine, methamphetamine, and amphetamines do.1 Like other stimulants, it also causes psychoactive and euphoric effects, which influence a person’s moods, thoughts, emotions, and perceptions.

Not surprisingly, due to its ability to stimulate the brain, enhance focus and concentration, reduce appetite, and greatly reduce the need for sleep, it is commonly abused non-medically without a prescription.

In the United States, it is sold under the brand name Provigil. The medication is produced in tablet form (100mg or 200 mg tablets) and is intended to be taken once daily. Generally, it is well-tolerated by most people and clinical evidence shows Provigil may cause mild withdrawal symptoms in some patients, although physical dependence from modafinil use or abuse is very rare.

Although other similar stimulants like Adderall are regarded as being significantly more dangerous when it comes to their potential for abuse, modafinil (Provigil) is a Schedule IV drug in the United States, which means it does have the potential to be abused and it may cause physical or psychological dependence in some individuals.

Is Modafinil Addictive?

Some research suggests that modafinil (Provigil) may have some potential for addiction and abuse. One study from the Journal of the American Medical Association found that modafinil’s method of action is similar to that of very addictive drugs like meth and cocaine.1 This suggests that people with a history of substance abuse problems may be more prone to modafinil abuse as well.

Research has also proven that it dependence is possible, although rare.2 The case study’s findings provide evidence that Provigil can produce mild tolerance, which means some people may abuse it to achieve the same effects they felt at lower doses. As a result, they might develop feelings of psychological or physical dependence.

Also, more and more high school and college students, working professionals, and others are beginning to abuse modafinil as a cognitive enhancer. Unfortunately, it has gained a reputation as another smart drug with the ability to improve cognitive performance. However, although Provigil will increase concentration, much like a few cups of coffee can, it is not a wonder drug. In fact, when it’s abused in large doses, it can actually have the opposite effect and may make a person more distractible.

About Modafinil Abuse and Addiction

Modafinil is commonly abused as a study drug by students, professionals, and others who are looking to fight fatigue and stay awake longer as well as enhance their focus and concentration. Although Provigil is a milder prescription stimulant than Adderall or others, it may still have the potential to cause psychological dependence if it’s abused.

The 2018 National Survey on Drug Abuse reports that prescription stimulant abuse is a big problem in the U.S. In 2018 alone, about 5.1 million Americans misused prescription stimulants like Provigil in the past year.

What Are the Side Effects of Modafinil Abuse?

Modafinil can sometimes cause unwanted side effects. If a student or young person is using Provigil without a prescription, he or she may experience some of the following side effects:

  • Difficulty sleeping
  • Loss of appetite
  • Excessive thirst/dry mouth
  • Gastrointestinal problems
  • Muscle tightness or pain
  • Skin peeling
  • Blisters
  • Chest pain
  • Difficulty breathing or swallowing
  • Irregular heartbeat
  • Dizziness
  • Nausea
  • Headache 

What Are the Signs and Symptoms of Modafinil Abuse?

Modafinil addiction is extremely rare, but if someone is taking Provigil without a prescription and using it as a cognitive enhancer, he or she may also display some of the other typical signs of drug abuse, such as:

  • Frequently trying to obtain a prescription for Provigil
  • Lying about taking Provigil
  • Worrying about getting the next dose of Provigil
  • Experiencing uncomfortable withdrawal symptoms 
  • Developing a tolerance
  • Continuing to abuse modafinil despite the harmful physical, emotional, and social consequences

What Are the Withdrawal Symptoms of Modafinil?

Many people do not report experiencing any withdrawal symptoms after discontinuing the use of modafinil. However, some people may experience Provigil withdrawal symptoms like:

  • Poor concentration
  • Tiredness or fatigue
  • Low energy
  • Depression
  • Shortness of breath
  • Sleepiness 

If a person experiences any modafinil withdrawal symptoms they are typically very mild. However, if the symptoms are more severe and you’re finding it difficult to quit on your own, a medical detox program can provide safe stabilization and medical treatment to help you through it.

Can You Just Stop Taking Modafinil?

If you have been misusing modafinil as a cognitive enhancer and you want to stop, it’s best to do so gradually to give your body time to adjust to the absence of the medication. Much like other prescription drugs, you should talk to your doctor before modifying your dosage or getting off modafinil entirely.

However, if you’ve become accustomed to using Provigil without a prescription and you want to stop, withdrawal symptoms may occur. In this case, you may need medical assistance to safely quit. A medical detox program can provide medication-assisted treatment and clinical counseling to help you manage any physical or psychological side effects of quitting your modafinil habit.

Depending on the severity of your Provigil abuse, your substance abuse history, and your treatment needs as determined by your doctor, you may also want to continue treatment after detox by enrolling in a residential rehab program, intensive outpatient program (IOP), or a sober living program. These types of addiction treatment programs can help you address the root causes of your addictive behavior, help you cope with cravings, and make positive life changes.

How Long Does it Take for Modafinil to Get Out Of Your System?

Most modafinil users don’t experience withdrawal symptoms and there is no predetermined timeline for those that may experience it. However, with its long half-life of about 12 to 15 hours, the effects of modafinil usually disappear after about 16-22 hours. Therefore, modafinil can remain in your body for up to four days after the initial dose.

Although modafinil can be detected via a drug or urine drug test, corporate employers are very unlikely to test for it. However, professional gaming or e-sports participants and students may be more likely to be drug tested for specific prescription stimulant drugs like Provigil since it is more likely to be abused among these populations.

How Can I Get Off Modafinil?

If you are psychologically dependent on modafinil, it may be difficult to stop using it. In these instances, you may need professional help to get off Provigil. A medical detox program can help you overcome your prescription stimulant abuse and prepare for ongoing treatment in rehab.

During rehab, clinical counselors and addiction treatment specialists will help you make behavioral changes and sustain long-term sobriety by using evidence-based addiction treatment approaches such as:

  • Individual therapy
  • Group therapy
  • Cognitive behavioral therapy
  • Contingency management
  • 12-Step facilitation therapy
  • Family behavior therapy
  • Rational emotive behavioral therapy
  • Specialized therapies like art therapy, music therapy, or pet therapy

A drug rehab program may not always be necessary for someone struggling with modafinil abuse, but depending on the severity of the psychological addiction and his or her drug abuse history, it could be helpful.

Inpatient Drug Rehab vs. Outpatient Drug Rehab for Modafinil Abuse

During residential rehab clients:
Live at the drug rehab center while they complete treatmentAbide by the rules and regulations set forth by staff Attend one-on-one therapy, group family, and family therapy sessionsParticipate in recovery-centered group activities on-site and off-siteMay have visitors but generally have limited access to people and places outside the rehab center

During outpatient rehab clients:
Live at home or a sober living home while they complete treatmentAbide by the rules and regulations set forth by staffAttend in-person or online group sessions several times each weekMaintain personal responsibilities at work, school, or at homeComplete recovery-related assignments and activities in group sessions and independently

The cost of residential rehab programs and outpatient rehab programs can vary depending on their location, amenities, and services offered. However, most addiction treatment providers accept insurance, which can greatly reduce the cost of addiction treatment. Depending on your health insurance policy and coverage, a portion of the cost of your treatment may be covered. Alternatively, you can pay for addiction treatment using other payment options such as:

  • Employee Assistance Programs (EAP)
  • Financed healthcare loans
  • Sliding scale payment plan
  • Credit cards
  • HSA funds

What Are Continued Care Options for Modafinil Abuse?

After completing detox or rehab for modafinil, you may choose to continue receiving sobriety support through various programs like sober living or aftercare.

Sober Living Programs

Sober living programs are designed to support men and women in recovery by providing a safe, sober place to live. Sober living homes are traditionally gender-specific homes and some offer LGBTQ housing or pet-friendly housing as well.

Many sober living homes provide additional recovery support services to help residents thrive and adjust to life after addiction treatment. These recovery support services may include:

  • Drug and alcohol testing
  • Certified peer recovery support programs
  • Phased recovery programming
  • Employment assistance
  • Volunteer placement
  • Educational planning
  • Access to IOP and clinical care services via a third-party company or provider

Health insurance providers don’t cover the cost of sober living programs, but many provide affordable housing options for people in recovery. Some may even offer scholarships or financial assistance.

Aftercare Programs

Certain life events can cause high amounts of stress, which can increase a person’s risk of relapse. Examples might include losing a loved one, relocating to a new city, or finalizing a divorce. As such,

aftercare programs can provide much-needed support.

Aftercare programs provide ongoing support and accountability for rehab alumni by providing weekly “check-in” meetings. Group members are challenged to grow on an individual level as they support one another in their sobriety. Additionally, discussions about recovery-related topics also provide opportunities to enhance current strategies to manage cravings, stress, and deal with high-risk situations in recovery.

Narcolepsy Treatment: Modafinil vs. Armodafinil

Narcolepsy is a chronic (long-lasting) sleep disorder that can seriously disrupt daily life. People with this medical condition suffer from excessive daytime sleepiness and sudden attacks of sleep. Affected individuals struggle with staying awake for long periods regardless of the circumstances. 

While there is no cure for narcolepsy, the condition can be treated. Lifestyle changes and medications can help manage the symptoms of excessive sleepiness. Two wakefulness-promoting agents commonly used to treat narcolepsy are modafinil (brand name Modvigil) and armodafinil (brand name, Waklert). These medications help people with narcolepsy feel more alert and stay awake. 

Please continue reading to learn more about armodafinil and modafinil, including how they are similar, how they are different, and which one—armodafinil/modafinil—may be right for you.

Modafinil and armodafinil – What are these medications?

Armodafinil and modafinil are both wakefulness-promoting agents that have stimulant-like effects. Armodafinil is the R-isomer of racemic modafinil. Meaning, they have the same chemical structures but with a slightly different arrangement of structures. Similar to how the thumb on your left hand is on the left, and the thumb on your right hand is on the right. Both modafinil/armodafinil are Schedule IV drugs that have a low potential for abuse and dependence.  Both medications are available by prescription only. 

The exact mechanisms of how armodafinil and modafinil work is unknown. It is believed that these medications affect sleep-promoting neurons in the brain. Scientists think they work by boosting dopamine levels in the parts of the brain that controls sleep and wakefulness. Dopamine is a naturally occurring brain chemical in the central nervous system that is involved in the sleep-wake cycle. Higher levels of dopamine during armodafinil/modafinil treatment can lead to improved wakefulness.  

What are armodafinil and modafinil used to treat? 

Armodafinil and modafinil are approved by the U.S. Food and Drug Administration (FDA) to treat the following conditions:

Narcolepsy (excessive sleepiness)

This chronic sleep disorder is characterized by overwhelming and excessive daytime sleepiness with sudden attacks of sleepiness regardless of circumstances.

Shift work sleep disorder (SWSD)

This is a sleep disorder of the circadian rhythm (day-night cycle). It affects people who work the night shift and stay awake during normal sleeping hours. Symptoms can include excessive sleepiness, insomnia (difficulty sleeping), or both.

Obstructive sleep apnea (OSA)

This is a sleep-related breathing disorder in which affected individuals repeatedly start and stop breathing during sleep.

All these sleep disorders—narcolepsy, shift work sleep disorder, and obstructive sleep apnea—are characterized by excessive sleepiness and feeling unrested. Both armodafinil and modafinil improve wakefulness in people who struggle with excessive daytime sleepiness and fatigue.

In addition to the above, armodafinil and modafinil are used off-label to treat cancer-related fatigue, fatigue related to multiple sclerosis, and in people with disorders like ADHD (attention deficit hyperactivity disorder) and depression. 

How are armodafinil and modafinil different?

Armodafinil (R-modafinil) and modafinil are similar in many ways. Both are stimulant-like prescription drugs and are a type of sleep disorder medicine (wakefulness-promoting agent). They are available as oral tablets. Brand name and generic versions are available for both. They are prescribed to people over the age of 17 for narcolepsy, shift work disorder, and obstructive sleep apnea. They can be used long-term, as directed by a physician, to control symptoms of daytime sleepiness. 

However, there are subtle differences between armodafinil and modafinil. As noted, armodafinil is the R-enantiomer of modafinil (you can think of it as a mirror image). So, the chemical structure is different. Armodafinil (Nuvigil) is a newer drug, approved in 2007, compared to modafinil (Provigil) which was FDA approved in 1998. The recommended dose of modafinil is 200 mg once a day, and armodafinil is 150 mg once a day. 

The potential adverse effects and drug interactions of both drugs are similar. Common adverse effects of both medicines include headache, insomnia, dizziness, nausea, dry mouth, nervousness, weight loss, and diarrhea. 

The incidences of side effects may be more common with one medication or the other, armodafinil versus modafinil. Serious but rare side effects are allergic reactions to either medications. Symptoms of an allergic reaction include shortness of breath, hives, swelling of face, tongue, and throat – This is a life-threatening medical emergency, you need to seek medical attention immediately. If you are allergic to modafinil, more than likely, you are allergic to armodafinil, and vice versa.   

Is Nuvigil stronger than Provigil?

Both medications are FDA-approved and have similar wakefulness effects. However, a critical difference between armodafinil and modafinil is the pharmacodynamic effects. It is believed that armodafinil has a longer half-life. Meaning, pharmacokinetic studies show that it stays in the body longer.  Studies have shown that there are higher plasma concentrations (armodafinil levels) in the body later in the day. Armodafinil can therefore produce longer-lasting effects and better wakefulness than modafinil. 

Studies comparing armodafinil to modafinil have also shown that a 150 mg single dose of armodafinil produces effects comparable to a 200 mg single dose of modafinil. Therefore, armodafinil may be the stronger medication on a milligram to milligram basis. In other words, armodafinil administration may be more effective than modafinil administration in treating daytime sleepiness in people with sleep disorders. 

With that said, there are currently no studies on modafinil/armodafinil that clearly say one drug is definitively more effective than the other. However, randomized clinical trials and meta-analyses have found that armodafinil and modafinil have comparable efficacy and safety profiles in treating sleep disorders. Both medicines significantly improve excessive sleepiness and sleep latency (the amount of time taken to fall asleep). Patients with narcolepsy, shift work disorder, and obstructive sleep apnea tolerate both medications well.

A deciding factor between armodafinil versus modafinil may be the cost of treatment. Generic armodafinil is more expensive than generic modafinil. However, generic armodafinil may be slightly less expensive than brand name Provigil. It is best to consult a doctor to decide between the two medications for the treatment of sleep disorders or address any other concerns that you may have. 

How effective is modafinil for narcolepsy?

More than one clinical trial has shown that modafinil and armodafinil significantly improved sleepiness in healthy subjects with acute sleep loss in a nocturnal period, i.e., short-term sleep deprivation. 

Modafinil has been clinically proven to be effective in treating sleepiness associated with narcolepsy. It can also help people with shift work disorder and obstructive sleep apnea. Provigil (modafinil) starts working 30-60 minutes after you take the medication, a bit longer if you take it with food. Notably, modafinil has fewer side effects and is better tolerated than traditional stimulant drugs such as Adderall and Vyvanse. 

Keep in mind that modafinil or armodafinil may not completely treat your symptoms. You may have some excessive residual sleepiness. 

Can you sleep on armodafinil?

Armodafinil is an effective treatment for excessive sleepiness and daytime sleepiness. It can help you stay awake and alert for 12-15 hours at a time. You should take your medication as directed by your physician. If you are using this medicine to treat narcolepsy or obstructive sleep apnea, you will probably be advised to take it in the morning. If you are taking it for shift work disorder, you should take it one hour before your shift starts to prevent excessive sleepiness while at work.. Since they both are wakefulness-promoting agents, taking modafinil and armodafinil before bed will cause trouble falling asleep. 

Keep in mind that while armodafinil can help you stay awake, it is not a substitute for getting enough sleep. You should continue to practice good sleep habits. You should also continue to use any breathing devices like a CPAP machine prescribed by your doctor for obstructive sleep apnea. 

Does armodafinil cause euphoria?

Armodafinil is not known to cause euphoria (feeling high). It is a Schedule IV substance with a low potential for abuse and dependence. However, armodafinil does have psychoactive effects and can affect your mood since it affects the dopamine level in your brain.

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