Last Updated on April 3, 2023 by
Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD
Below is an overview of research available on the subject of modafinil addiction, as well as FDA-approved and off-label uses in the workplace and other settings. Additional information is given on the known adverse effects of modafinil and the extended-release version, armodafinil.1-3
When a person regularly takes a drug that alters how the brain functions, including modafinil, Provigil, and its other brand name versions, they are at risk of modafinil addiction or dependence, and the potential for adverse effects. Though the exact mechanism of addiction to Modafinil is not known, researchers have studied how drugs influence the neuroplasticity of brain tissue. This remains true whether one’s physician has prescribed the drug or whether one lives in a country where modafinil is available without a prescription.4,13-16
College students have been subjected to questionable hype about so-called “smart drugs” like modafinil, promoting them for staying up all night cramming for exams or catching up with backlogged writing assignments. Some have nick-named these “smart drugs” making them seem like a perfect choice for students seeking cognitive enhancement. Clinical research, however, shows they can be addictive and can ruin cognitive ability, memory, and physical and mental health.1,6-8
We can see a parallel in the tsunami of ADHD stimulant drugs that took hold of the entire educational system. Where these drugs were promoted to increase learning potential, according to Currie et al, over the long term, there is
“little evidence of positive effects on academic outcomes or schooling attainment. In fact, we find deterioration in important academic outcomes including grade repetition and math scores.” ~ Janet Currie, Mark Stabile, Lauren Jones, authors 10
Clinical research shows that stimulant drugs won’t magically raise IQ or make a person smarter. And that they can harm over the long term. But if you are sleep-deprived, a stimulant such as modafinil helps a person to stay awake and alert despite a lack of sleep. This is because modafinil, like other stimulants, has the ability to manipulate our natural neurochemistry. The use of stimulant drugs in the field of education has been an experiment of nightmarish proportions. According to the research of Barkley and Cunningham, published in The Journal of Clinical Pediatrics, the use of stimulant drugs in classrooms fails to improve the academic performance of the majority of children put on ADHD stimulant medication.9 As a society, we might ask why the educational system has allowed itself to be influenced, and some would say manipulated, by pharmaceutical manufacturers for so long. If a person continues taking a stimulant drug every day for an extended period of time, there are some definite downsides aside from deteriorating efficacy. Eventually, the body/brain/nervous system can become impaired and possibly even injured. You can find more about these topics in the section about adverse effects, below.
Modafinil is prescribed for a condition called “narcolepsy,” or excessive daytime sleepiness. Obviously, falling asleep at work could present critical problems on the job, including safety. For example, an airline pilot can’t fall asleep at the controls without risking hundreds of lives, and in a similar fashion, a truck driver can’t doze off at the wheel. A jet-lagged traveler may find their daytime meeting impossible due to fatigue. So stimulants may be resorted to for occasional use.
However, a 2019 clinical study of adolescents with narcolepsy at Toronto Sick Children’s Hospital reported that the majority of participants suffered the adverse effects of, and dependence on modafinil or other medication-based treatment.11 Most felt the medication did not fully relieve their symptoms of narcolepsy. However, the holistic treatments that included scheduled sleep times, exercise, and psychosocial support were preferred by the majority of students. The exact mechanism of action of modafinil is unknown, and there is research ongoing to discover whether dopamine, serotonin, norepinephrine, GABA, or other natural hormones and molecules are affected.18
Until a curative is found, narcolepsy will continue to be considered an incurable, life-long disorder. Thankfully, researchers like Nishino and Okuro continue to explore new treatment avenues and possible cures for this debilitating condition.12 Additionally, the emerging field of regenerative biology is also exploring stem cell applications to trigger the regeneration of orexin-producing neurons, which could potentially reverse the condition of narcolepsy.13,17
Other holistic therapies that are available presently, aim to at least reduce the symptoms of daytime sleepiness without addictive medications, such as testing for and addressing any nutritional deficiencies as well as addressing other lifestyle factors that could be contributing to the condition. Alternative to Meds Center has been working with clients to help resolve such problems for many years, with overwhelming success.
Good quality sleep is one of the most important factors allowing for mental clarity, alertness, and energy. You are invited to contact us directly to find out more about effective drug-free strategies for improvements in daytime wakefulness, improved mental clarity, increased energy, and better quality sleep without having to resort to pharmaceutical prescription drugs.
Of concern, the potential for modafinil adverse effects can cause havoc, and even life-threatening reactions such as Stevens-Johnson Syndrome, and others.1-3,5,18 Even before habitual use develops dependence or addiction, adverse reactions can be significant, and as reported by the FDA include:
Of course, where one has become dependent on a drug to stay awake, most likely sleep issues will need to be resolved to be able to come off the drug successfully. Modafinil tapering can be made easier by utilizing modafinil alternatives (drug-free) for wakefulness. But, most importantly, we focus on discovering and correcting anything found to be a possible contributor to daytime sleepiness, insomnia, sleep disruption, low energy, sleep apnea, and other issues of concern.
Therefore, allergies, diet, accumulated neurotoxin removal, lifestyle, and many other subjects may be productively treated using non-drug-based methods. The transition from drug-dependent to drug-free can be made tolerable and eased using the correct choices for safe cessation and treatment protocols. Testing and other assessments are used to evaluate the best treatments for each individual upon entry to the program. Insurance coverage is available from most well-known insurance providers.
Please contact us at Alternative to Meds Center for a thorough overview of the protocols, testing processes, and treatments used in our health-focused, evidence-based modafinil addiction treatment programs.
1. Mariani JJ, Hart CL. Psychosis associated with modafinil and shift work. Am J Psychiatry. 2005 Oct;162(10):1983. doi: 10.1176/appi.ajp.162.10.1983. PMID: 16199854. [cited 2023 April 3]
2. Darwish M, Kirby M, Hellriegel ET, Robertson P Jr. Armodafinil and modafinil have substantially different pharmacokinetic profiles despite having the same terminal half-lives: analysis of data from three randomized, single-dose, pharmacokinetic studies. Clin Drug Investig. 2009;29(9):613-23. doi: 10.2165/11315280-000000000-00000. PMID: 19663523. [cited 2023 April 3]
3. Govt of Canada Recalls and Safety Alerts Bulletin “New warnings regarding ALERTEC (modafinil) and serious rash, allergic reactions, mental health problems – For Health Professionals.” Health Canada 2007 Dec 21 [cited 2023 April 3]
4. Hockenhull J, Wood DM, Dargan PI. The Availability of Modafinil and Methylphenidate Purchased from the Internet in the United Kingdom Without a Prescription. Subst Use Misuse. 2020;55(1):56-65. doi: 10.1080/10826084.2019.1654516. Epub 2019 Aug 20. PMID: 31431114. [cited 2023 April 3]
5. FDA label PROVIGIL (modafinil) [approval 1998] [cited 2023 April 3]
6. Elliott GR, Elliott MD. Pharmacological cognitive enhancers: comment on Smith and Farah (2011). Psychol Bull. 2011 Sep;137(5):749-50. doi: 10.1037/a0024119. PMID: 21859176. [cited 2023 April 3]
7. Sussman S, Pentz MA, Spruijt-Metz D, Miller T. Misuse of “study drugs:” prevalence, consequences, and implications for policy. Subst Abuse Treat Prev Policy. 2006 Jun 9;1:15. doi: 10.1186/1747-597X-1-15. PMID: 16764722; PMCID: PMC1524735. [cited 2023 April 3]
8. Heinz A, Kipke R, Heimann H, Wiesing U. Cognitive neuroenhancement: false assumptions in the ethical debate. J Med Ethics. 2012 Jun;38(6):372-5. doi: 10.1136/medethics-2011-100041. Epub 2012 Jan 6. PMID: 22228818. [cited 2023 April 3]
9. Barkley RA, Cunningham CE. Do stimulant drugs improve the academic performance of hyperkinetic children? A review of outcome studies. Clin Pediatr (Phila). 1978 Jan;17(1):85-92. doi: 10.1177/000992287801700112. PMID: 22418. [cited 2023 April 3]
10. Currie J, Stabile M, Jones L. Do stimulant medications improve educational and behavioral outcomes for children with ADHD?. J Health Econ. 2014;37:58-69. doi:10.1016/j.jhealeco.2014.05.002 [cited 2023 April 3]
11. Xiao L, Chen A, Parmar A, Frankel L, Toulany A, Murray BJ, Narang I. Narcolepsy Treatment: Voices of Adolescents. Behav Sleep Med. 2021 Apr 20:1-9. doi: 10.1080/15402002.2021.1916496. Epub ahead of print. PMID: 33877929. [cited 2023 April 3]
12. Nishino S, Okuro M. Emerging treatments for narcolepsy and its related disorders. Expert Opin Emerg Drugs. 2010 Mar;15(1):139-58. doi: 10.1517/14728210903559852. PMID: 20166851.[cited 2023 April 3]
13. Steward MM, Sridhar A, Meyer JS. Neural regeneration. Curr Top Microbiol Immunol. 2013;367:163-91. doi: 10.1007/82_2012_302. PMID: 23292211. [cited 2023 April 3]
14. Wuo-Silva R, Fukushiro DF, Borçoi AR, Fernandes HA, Procópio-Souza R, Hollais AW, Santos R, Ribeiro LT, Corrêa JM, Talhati F, Saito LP, Aramini TC, Kameda SR, Bittencourt LR, Tufik S, Frussa-Filho R. Addictive potential of modafinil and cross-sensitization with cocaine: a pre-clinical study. Addict Biol. 2011 Oct;16(4):565-79. doi: 10.1111/j.1369-1600.2011.00341.x. Epub 2011 Jul 25. PMID: 21790900. [cited 2023 April 3]
15. Nyberg F. Structural plasticity of the brain to psychostimulant use. Neuropharmacology. 2014 Dec;87:115-24. doi: 10.1016/j.neuropharm.2014.07.004. Epub 2014 Jul 11. PMID: 25018041. [cited 2023 April 3]
16. Krishnan, R., & Chary, K. V. (2015). A rare case modafinil dependence. Journal of pharmacology & pharmacotherapeutics, 6(1), 49–50. https://doi.org/10.4103/0976-500X.149149 [cited 2023 April 3]
17. Slowik JM, Collen JF, Yow AG. Narcolepsy. [Updated 2022 Jun 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459236/ [cited 2023 April 3]
18. Modafinil – an overview of various scientific and medical publications published by Science Direct [cited 2023 April 3]
Originally Published by Diane Ridaeus Published May 13, 2020
Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente. He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.
Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.
Can you imagine being free from medications, addictive drugs, and alcohol? This is our goal and we are proving it is possible every day!
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