Many of us say that we’re tired all the time, but some people actually suffer from disorders that physically prevents them from staying awake. Imagine all the disasters this could lead to. Falling asleep in a dangerous environment or in the middle of a dangerous activity could result in a life-or-death situation.
Fortunately, there are medicines available that target this symptom; one example is modafinil, better known by its trade name Provigil. This drug was created in 1970s by French neuroscientist Michel Jouvet, and by the early 2000s, it has been legalised for medical use in many countries. Even though it does not provide a permanent cure for the main disorder, it is the most widely-prescribed drug for those suffering from excessive sleepiness.
The exact mechanism as to how Provigil works is still being studied, but it basically works by increasing the level of dopamine in the brain. However, it differs from typical stimulant drugs that excite the brain, in that it does not give users the feeling of a “high”. Instead, it falls under the handful of drugs that are classified under the eugeroics class, otherwise known as wakefulness-promoting drugs.
When taken in the right dosage, the medication is reported to have mild side effects in a small fraction of users. Rare cases of serious reactions to Provigil are mostly caused by severe allergic reactions to the drug. And because they do not produce a euphoric effect, the risk of addiction is low as well, although withdrawal symptoms might occur in long-time users who stop abruptly.
As such, the drug is classified by the Drug Enforcement Administration (DEA) as a schedule IV substance, together with other medicines that have been deemed to have a lower potential for abuse like Xanax and Valium. This means that in the US, Provigil is considered a controlled substance and can only be dispensed with a doctor’s prescription.
Medical Uses
Provigil is prescribed in the US mainly to treat three disorders that result in excessive daytime sleepiness, namely: narcolepsy, shift work sleep disorder and obstructive sleep apnea.
Narcolepsy is a neurological disorder where a person experiences bouts of extreme drowsiness throughout the day, and in some cases accompanied by a loss of muscle control. It is believed to affect about 1 in 2,000 people, yet a lot about this disease is still not understood and many people remain undiagnosed or misdiagnosed.
Researchers are still figuring out what causes narcolepsy, and the treatments available as of now only focus on relieving symptoms. Xyrem is one of them, to prevent muscle weakness and sleeping problems; Provigil is another, to tackle daytime sleepiness.
Excessive daytime sleepiness is also one of the symptoms of shift work disorder, where a person is forced to have unnatural sleeping times which messes up the body’s circadian rhythm. This makes the body unable to fall asleep and stay awake at the right times which can lead to an array of other health problems, including not being able to continue carrying out their work properly.
The best treatment for shift work disorder is to make sure the patient gets enough sleep, which is difficult but can be achieved through good planning, napping, and so on. Artificially controlling their exposure to light is another way to help the body adapt to its new sleep schedule and improve the circadian rhythm. Lastly, drugs like Provigil can be used to promote sleep or awakeness as needed.
Excessive daytime sleepiness can also occur in patients suffering from obstructive sleep apnea. This is when the body’s airway is obstructed when sleeping, resulting in breathing problems throughout the night. This could lead to a myriad of symptoms ranging from a dry mouth to high blood pressure, or drowsiness in the day due to the lowered sleep quality.
There are quite a few treatment methods for obstructive sleep apnea before drugs come into play, depending on the cause. In some cases, symptoms can disappear with lifestyle changes like losing weight, quitting smoking and drinking, or changing sleep positions. There are also different devices that patients can put in their nose or mouth at night to help open the airway while they sleep.
If these are not effective, another possible option is to undergo surgery to remove whatever is causing the blockage. While seeking for the most suitable treatment method, Provigil can be used to combat daytime drowsiness.
“Smart Drug” and “Go Pill”
While Provigil can only be dispensed in the US with a prescription, it is still very popular for its use as a general mind booster. Many healthy people are turning to drugs or supplements that can improve cognitive ability, and Provigil is one such drug amongst other stimulants and nootropics.
As a matter of fact, modafinil is actually used by the US military as a “go pill” for its awakening effects, working hand in hand with the “no-go pills” that are meant to help soldiers sleep and recover. Using them on the field is presumed to help them to stay alert and awake even with the lack of sufficient rest.