THE ULTIMATE ‘SMART DRUG’ : 

Modafinil, globally known by its brand name Provigil,  is a ‘wakeful promoting agent’ that improves excessive daytime sleepiness associated with narcolepsy or Shift work sleep disorder – caused by an imbalance of wakefulness-promoting and sleep-suppressing peptides. Popularly known as a ‘Smart Drug’ for its effective mechanism of enhancing cognitive functions, attention span, and memory, hence medical professionals prescribe it to people with decreasing concentration abilities. 

MECHANISM: 

• This stimulant activates Glutamatergic circuits and simultaneously inhibits GABA.
•  It reuptakes dopamine by binding itself to the reuptake pump, eventually leading to the enhancement of extracellular dopamine. 
• The drug targets the brain and changes substances in areas that control sleep and wakefulness directly through the network of neurotransmitters.
• Additionally, it enhances the adrenaline receptors and increases the effect of serotonin, both substances that excite the nervous system.
• Since this drug has less dopamine-releasing properties, making it less prone to abuse.

POTENTIAL MODAFINIL SIDE-EFFECTS: 

If you are new to the medications, you might face some common side effects: 

• Headache
• Diarrhea
• Heartburn
• Loss of appetite
• Excessive thrust

There can be severe side effects as well, so get immediate medical help if you  notice any : 

• Rash
• Difficulty breathing 
• Hallucination
• Chest pain

DRUG DELIVERY METHOD:

• Tablet consumption by mouth.
• Can be consumed with or without food, as per convenience.
• For Narcolepsy – advised intake of one tablet in the morning 200-300mg. 
• For Shift Work Sleep Disorder – one tablet an hour before shift.
• Avoid consuming 400mg or more powerful doses without medical advise, it can lead to sleep deprivation at night. 
• Take medicine at the same time every day.
• Talk to your doctor regarding your condition for accurate dosage.

USAGE PRECAUTIONS:

• If your work shift changes every day, inform your doctor.
• If you’ve a history of using sleeping pills, consult before consumption.
• Don’t increase or decrease your dosage without consulting your doctor, it is based on your medical condition and response to treatment.
• Don’t extend the medication course without medical supervision as it can lead to habit-forming.
• If you are allergic to Armodafinil or related salts, talk to your physician.
• Patients with a history of heart disease require special supervision.
• In case of pregnancy or breastfeeding, medical advice is needed.

MODAFINIL USES IN THE USA : 

• Considered a schedule IV controlled substance, Modafinil tablets are very commonly used in the USA and are a trusted narcolepsy medicine.
• Generally for treating sleep-wake interaction in night shift army professionals, pilots, and firefighters.
• Due to its lower abuse potential, doctors also prescribe it for several psychiatric conditions.
• In some cases, it is also given to patients post-anesthesia sedation to recover quickly.

DRUG INTERACTION: 

• Research done on real people has found that Modafinil interacts with drugs like – aripiprazole which is an antipsychotic), amphetamine, aspirin, and diphenhydramine. Talk to your doctor if you’re on any of these medications.
• Check for CYP3A4 as an active or inactive ingredient in your medications as Modafinil tablets tend to affect the pharmacodynamics of this salt.
• Modafinil is proven to have reduced the effect of contraceptive pills or are hormonal steroids like birth control, patches, etc. Consult your healthcare provider for a reliable backup.
• It can also lead to the removal of drugs like axitinib, bosutinib, daridorexant, and elacestrant.
• Avoid taking other medications containing Armodafinil as it can lead to overdose.
• In dietary habits – consult your doctor if you’ve excessive intake of caffeine in any form or eating or drinking grapefruit.

CASE STUDY : 

• • Commonly known as the helicopter simulation study, where 6 pilots aged 29-46 were exposed to 40hrs or 2 days 1 night of continuous wakefulness.
  • They were given three 200mg doses each, throughout the study.

• Result: After completing their shift, four out of six pilots reported that they experienced enhanced attention and wakefulness and also improved alertness. 

CONCLUSION: 

Cognitive functions govern our day-to-day activities and thoughts which include learning new things, remembering, attention span, and reasoning which ultimately leads to effective problem-solving. Enhancing these functions will eventually help your brain work better, which is possible with Modafinil as it stimulates wakefulness and makes you more active.

With its minimum dopamine-releasing property, it is less prone to be addictive and abused, making it a safer option as well. Consult your doctor regarding your condition before taking the medicine and follow the guidelines.