What Meds

Psychiatric Medications


Modafinil
Brand Name: Provigil

Overview
Provigil is the brand name for modafinil, a CNS (central nervous system) stimulant. The exact mechanism of action is unknown, but CNS stimulants increase alertness and wakefulness. In large doses, CNS stimulants can also cause insomnia, nervousness and tension, and hyperactivity.

Why is this drug prescribed?
Provigil is FDA-approved for:

Relatively recently, Provigil has been used to treat ADHD in children, but there are conflicting studies. Some studies indicate that Provigil is helpful, while others find that it has no effect on symptoms of ADHD. Studies consistently indicate that Provigil is well tolerated and side effects from this drug are minimal.

Otherwise, Provigil is used to treat narcolepsy. Narcolepsy is a disorder of sleep associated with excessive daytime sleepiness, involuntary sleeping and/or sudden limpness during the day. Sometimes narcoleptics have difficulty sleeping at night. Provigil treats the symptoms of narcolepsy, but is not a cure. The usual adult dosage is 200mg once a day, usually in the morning.

How much of this drug is typically used?
Tablet: 100mg, 200mg

Warnings and Precautions
Studies of Provigil have been confined to adults; no information about the specific effects of Provigil in children is available. As with most medications, its effects on children, especially side effects, are likely to be stronger in children.

Provigil can interfere with hormonal birth-control medicines such as birth-control pills or implants. Alternate methods of birth control, such as condoms, should be used during Provigil therapy and for one month after Provigil therapy.

Provigil should be taken in the lowest effective dose, as it can be addictive when taken for a long time or in large doses.

For Pregnant or Nursing Mothers: Provigil has not been studied in pregnant women, but animal studies indicate that it may cause birth defects and an increased chance of miscarriage. It is not known whether Provigil passes into breast milk, but many medications do pass into breast milk, and breastfeeding mothers are advised to use caution and discuss alternative medications with a doctor.

Contraindications
Provigil should Not be used for people with the following medical conditions:

Precautions
Provigil may be used with caution in people with the following conditions:

Adverse Reactions
Provigil may cause the following reactions:

The remaining side effects are uncommon:

Rarely:

Interactions with Drugs and Other Substances
Drugs or substances that may interact with Provigil include:

Research Studies and Use in Child Psychiatry
ADHD: A recent review of three randomized placebo-controlled studied found that modafinil improved symptoms and behaviors in patients with inattentive and combined subtypes of ADHD. Thus, although not FDA-indicated, it is sometimes used third-line as a treatment for ADHD.

Modafinil is also used to augment depression treatment, specifically targeting sleepiness and fatigue in depressed patients, though this has not yet been studied in children.

Sources

Stanford Medicine Resources:

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