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Modafinil Alternatives

This entry was posted in Antidepressant on by .
Medically Reviewed

Last Updated on November 18, 2021 by Diane Ridaeus

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

How wonderful if medical professionals had the expertise and time to provide modafinil alternatives to avoid side effects or other undesirable liabilities of prescription medications.

A physician may have prescribed modafinil ( brand name Provigil® ) without discussing natural solutions besides drugs to address narcolepsy or other concerns. Alternative to Meds Center specializes in effective solutions that promote daytime wakefulness without potentially toxic side effects.

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Alternative to Meds has been the expert on antidepressant alternatives for over 15 years. We have published evidence regarding our success. Underlying issues can in many cases be addressed in very effective, yet non-drug-based ways. We frequently find that a prescribing physician could have overlooked treatable conditions, and sometimes the original factors that precipitated the unwanted symptoms can be reduced or completely resolved naturally, using a holistic treatment template.
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Alternatives to Modafinil — Weighing the Benefit to Risk Ratios

modafinil alternativesModafinil is a rapidly absorbed stimulant-type drug used to promote wakefulness for daytime sleepiness as in narcolepsy, or when a person has been unable to get sufficient sleep. Drug manufacturers say they do not know how it works exactly, even after clinical trials on cats.13 

Airline pilots might take it to stay alert while flying, or shift workers suffering from sleep disturbances who must stay awake on the job. For occasional use, such professionals might consider this a relatively safe and inconsequential solution.

Some people use modafinil as a so-called “smart drug” — much popularized in the media for college kids pulling an all-nighter before tests, for example.10  Surprisingly, the actual cognitive-enhancing effects can be largely attributed to the placebo effect, citing expected benefits as better than the control group taking the drug, according to a study published in the 2019 Frontiers in Psychiatry Journal.9 The rate of non-prescribed use of stimulants by college students has been reported as reaching up to 35% in a study published in the Journal of Academic Psychiatry, and a significant portion of these students are those with low grade-point averages.6  With effects described as similar to caffeine for alertness, in the short term, stimulants can result in heightened mental clarity. But like any dopaminergic (stimulating) drug, the effects wear off until the next dose and do not come without side effects. Common side effects after short-term use include headache, nervousness, tachycardia, and insomnia.7  Long-term or regular use causes much additional concern, described in more detail in the section entitled “modafinil side effects” found below.8,13 Students interviewed after taking modafinil regularly reported the drug eventually left them feeling as if they were living in a sort of twilight zone, neither fully awake nor fully asleep. The drug had altered their sleep patterns significantly. These lingering effects had counterproductive outcomes overall. As a long-term solution for getting better grades on little to no sleep, this drug ranks a solid F.1

Alternatives to Modafinil include:

  • holistic modafinil alternativesStudents:  Find and practice good study habits, and exam preparation instead of stimulants for an all-night cramming session.  Develop strategies to manage volume and deadlines proactively.11 
  • Insomnia:  Practice good sleep habits. When possible, keep to a regular sleep/wake schedule. Black-out curtains, removing electronics from the bedroom, use of eye masks, earplugs, white noise, or soft music are some examples.12
  • Supplements that can induce restfulness such as melatonin16,  Vitamin B complex,17  magnesium,28 herbal teas such as chamomile18 or lavender19, 5HTP20, valerian extract14,  available at health food outlets and even supermarkets.*
  • Avoid stimulants, alcohol, caffeine drinks, especially less than 6 hours before bedtime.21
  • CBT or other personal counseling to address sources of stress and rumination has been found even more effective than improving sleep hygiene. CBT provides an effective alternative to pharmacology. 12,15,22
  • Diet modification can improve sleep quality: Include foods high in tryptophan, zinc, astaxanthin, and melatonin such as cherries, pomegranates, salmon, trout, oysters, poultry, asparagus, broccoli, and many others.23
  • Narcolepsy has been linked to a deficiency in hypocretin, which mice studies show is reversible through the therapeutic use of branch-chained amino acids, which are found in lentils, chickpeas, chicken, beef, fish, eggs, and many other food sources.24,25

*Leathwood et al’s 1982 study showed the efficacy of valerian extract for sleep induction.14

Looking for modafinil alternatives does not have to mean searching for some other type of drug. In general, the better alternative to wakefulness drugs would look more like practicing better sleep hygiene, improved sleeping conditions, correcting diet, and other non-drug-based ways to improve the quality of one’s sleep. 

Modafinil and Narcolepsy

Someone suffering from narcolepsy is in dire need of actually correcting the problem as falling asleep at unexpected times during normal waking hours can be a risk to self and others, and can be a source of anxiety due to the unpredictable nature of the condition. Those who suffer from narcolepsy or other medical conditions would require a full medical assessment in order to set about discovering and correcting the underlying cause(s) of the condition. But the goal would remain the same, to vanquish symptoms without harsh drugs if at all possible. The lack of a certain brain chemical called hypocretin is thought to be what causes some cases of narcolepsy.5

A narcolepsy-related deficiency in hypocretin has been shown somewhat responsive to nutritional and other non-pharmacological therapy in mice and monkey studies using branched-chain amino acids that are found in such foods as chicken, beef, fish, eggs, and many others. Replacing hypocretin via intranasal sprays and other means, that as of 2021, are being worked on but have yet to be brought to market.24-27 

Modafinil Tolerance — Dependence

Any type of drug carries the risk of developing tolerance to the drug. Tolerance to a drug means it doesn’t create the desired effects as it once did, and so the need arises to use more, or more often to get the desired effects. Tolerance can lead to drug dependence.4

Drug dependence means that when you stop using a drug, withdrawals occur and you feel like you need to take more of it to feel normal.4 Dependence and tolerance often occur after repeated regular use of a drug. When the body and brain become accustomed to the drug in the system, the body/brain will adjust its chemistry to compensate. Developed dependence dilutes the effects of the drug so that one has to either increase the frequency or increase the dose to get the same effects. Also, because the drug is a stimulant, trying to sleep a normal 8 hours may become a bit of a logistics nightmare after long-term or regular use. The drug, as any stimulant can, disrupts normal sleep patterns.

It can take some serious strategizing and changing many things to return to normal. But if “normal” was feeling sleepy all the time, or at sporadic times, that is really the crux of the problem that needs fixing. One would benefit from resolving the underlying causes of that unwanted symptom without relying solely on drugs if possible. That is our focus at Alternative to Meds Center.

Modafinil Side Effects

modafinil side effectsBesides developing tolerance, another common modafinil side effect is tachycardia, or racing heartbeat when the body is at rest. Consider the anxiety of trying to have a normal conversation with someone when your heart (out of the blue, not if you are falling in love) begins to nearly audibly pound like it’s going to explode out of your chest. Even worse, think of that happening when you are trying to fall asleep! Stimulant drugs and their after-effects can feel quite similar to the dreaded panic attack, and they can happen at the least opportune time.

There are other (thankfully) rare side effects that can also throw a complete wrench into things. For example, Stevens-Johnson Syndrome, a drug-induced severe rash/fever/skin reaction that can be life-threatening and may require treatment in an ICU at the hospital.2 Modafinil can cause other rare reactions as well, such as peeling skin, sores, hives, eruptions that cover the whole body, including genitals, etc. Rather than risk developing dependence and taking a chance on other potentially harmful or off-putting side effects, one may decide to seek out natural solutions to sleepiness, lack of energy, lack of focus, etc., that don’t carry such potential liabilities.

More Modafinil Alternatives Information at Alternative to Meds Center

natural modafinil solutions sedona azAlternative to Meds Center specializes in helping people to get to the root of their symptoms such as fatigue, insomnia, depression, anxiety, etc., and resolving them at the source. A wealth of alternative treatments are offered including IV and NAD therapy, nebulized glutathione, physical activity and exercise training, acupuncture, massage therapy, equine therapy, lab testing and correction of diet, neurotoxin removal, neurotransmitter rehabilitation, and many others you can see on our services overview page. The fundamental nature of the programs we deliver is that they are non-drug-based, ( apart from tapering protocols when needed ) and center on testing to discover what can be improved using orthomolecular or other holistic ways of treating the problem.

We would like to speak more with you about the details of the programs we offer. Inpatient style, in our pristine facility, our clients are serviced by over 40 caring and expertly trained staff for your comfort and safety. Contact us today for information on the many modafinil alternatives we offer at the Alternative to Meds Inpatient Center.


1. Cox, D, Is Modafinil safe in the long-term? The Guardian Online 2013 May 31 [cited 2020 Dec 16]

2. NHS, UK, Stevens-Johnson Syndrome. National Health Services, UK publication online 2018 Oct 4 [cited 2020 Dec 16]

3. Thorne T, “Modafinil Tolerance | 7 Quick Tips to Avoid It” online from Modafinil.com [cited 2020 Dec 16]

4. NIH authors “Tolerance, Dependence, Addiction: What’s the Difference?” Jan 12, 2017 [cited 2020 Dec 16]

5. NIH authors, “Narcolepsy Fact Sheet.” NIH Publication No. 17 -1637 [cited 2020 Dec 16]

6.  Pedrelli P, Nyer M, Yeung A, Zulauf C, Wilens T. College Students: Mental Health Problems and Treatment Considerations. Acad Psychiatry. 2015;39(5):503-511. doi:10.1007/s40596-014-0205-9 [cited 2021 Nov 8]

7.  Nicholson PJ, Wilson N. Smart drugs: implications for general practiceBr J Gen Pract. 2017;67(656):100-101. doi:10.3399/bjgp17X689437 [cited 2021 Nov 8]

8.  Franke AG, Lieb K. Pharmakologisches Neuroenhancement und “Hirndoping” : Chancen und Risiken [Pharmacological neuroenhancement and brain doping : Chances and risks]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2010 Aug;53(8):853-9. German. doi: 10.1007/s00103-010-1105-0. PMID: 20700786. [cited 2021 Nov 8]

9.  Winkler A, Hermann C. Placebo- and Nocebo-Effects in Cognitive Neuroenhancement: When Expectation Shapes Perception. Front Psychiatry. 2019 Jul 12;10:498. doi: 10.3389/fpsyt.2019.00498. PMID: 31354552; PMCID: PMC6640161.[cited 2021 Nov 8]

10.  Partridge BJ, Bell SK, Lucke JC, Yeates S, Hall WD. Smart drugs “as common as coffee”: media hype about neuroenhancement. PLoS One. 2011;6(11):e28416. doi: 10.1371/journal.pone.0028416. Epub 2011 Nov 30. PMID: 22140584; PMCID: PMC3227668. [cited 2021 Nov 8]

11.  Fowler A, Whitehurst K, Al Omran Y, et al. How to study effectivelyInt J Surg Oncol (N Y). 2017;2(6):e31. doi:10.1097/IJ9.0000000000000031 [cited 2021 Nov 8]

12.  Chung KF, Lee CT, Yeung WF, Chan MS, Chung EW, Lin WL. Sleep hygiene education as a treatment of insomnia: a systematic review and meta-analysis. Fam Pract. 2018 Jul 23;35(4):365-375. doi: 10.1093/fampra/cmx122. PMID: 29194467. [cited 2021 Nov 8]

13.  FDA label Provigil (modafinil) Tablets [August 17 2007] [cited 2021 Nov 8]

14. Leathwood PD, Chauffard F, Heck E, Munoz-Box R. Aqueous extract of valerian root (Valeriana officinalis L.) improves sleep quality in man. Pharmacol Biochem Behav. 1982 Jul;17(1):65-71. doi: 10.1016/0091-3057(82)90264-7. PMID: 7122669. [cited 2021 Nov 8]

15.  Haynes J, Talbert M, Fox S, Close E. Cognitive Behavioral Therapy in the Treatment of Insomnia. South Med J. 2018 Feb;111(2):75-80. doi: 10.14423/SMJ.0000000000000769. PMID: 29394420. [cited 2021 Nov 8]

16.  Costello RB, Lentino CV, Boyd CC, et al. The effectiveness of melatonin for promoting healthy sleep: a rapid evidence assessment of the literatureNutr J. 2014;13:106. Published 2014 Nov 7. doi:10.1186/1475-2891-13-106 [cited 2021 Nov 8]

17.  Lichstein KL, Payne KL, Soeffing JP, et al. Vitamins and sleep: an exploratory study. Sleep Med. 2007;9(1):27-32. doi:10.1016/j.sleep.2006.12.009 [cited 2021 Nov 8]

18.  Chang SM, Chen CH. Effects of an intervention with drinking chamomile tea on sleep quality and depression in sleep disturbed postnatal women: a randomized controlled trial. J Adv Nurs. 2016 Feb;72(2):306-15. doi: 10.1111/jan.12836. Epub 2015 Oct 20. PMID: 26483209. [cited 2021 Nov 8]

19.  Chen SL, Chen CH. Effects of Lavender Tea on Fatigue, Depression, and Maternal-Infant Attachment in Sleep-Disturbed Postnatal Women. Worldviews Evid Based Nurs. 2015 Dec;12(6):370-9. doi: 10.1111/wvn.12122. Epub 2015 Nov 2. PMID: 26523950.

20.  Maffei ME. 5-Hydroxytryptophan (5-HTP): Natural Occurrence, Analysis, Biosynthesis, Biotechnology, Physiology and ToxicologyInt J Mol Sci. 2020;22(1):181. Published 2020 Dec 26. doi:10.3390/ijms22010181 [cited 2021 Nov 8]

21.  Drake C, Roehrs T, Shambroom J, Roth T. Caffeine effects on sleep taken 0, 3, or 6 hours before going to bedJ Clin Sleep Med. 2013;9(11):1195-1200. Published 2013 Nov 15. doi:10.5664/jcsm.3170 [cited 2021 Nov 8]

22.  Anderson KN. Insomnia and cognitive behavioural therapy-how to assess your patient and why it should be a standard part of care. J Thorac Dis. 2018;10(Suppl 1):S94-S102. doi:10.21037/jtd.2018.01.35 [cited 2021 Nov 8]

23.  Binks H, Vincent G, et al., “Effects of Diet on Sleep: A Narrative Review.”  Nutrients. 2020;12(4):936. Published 2020 Mar 27. doi:10.3390/nu12040936 [cited 2021 Nov 8]

24.  Andlauer O, Moore H 4th, Hong SC, Dauvilliers Y, Kanbayashi T, Nishino S, Han F, Silber MH, Rico T, Einen M, Kornum BR, Jennum P, Knudsen S, Nevsimalova S, Poli F, Plazzi G, Mignot E. Predictors of hypocretin (orexin) deficiency in narcolepsy without cataplexy. Sleep. 2012 Sep 1;35(9):1247-55F. doi: 10.5665/sleep.2080. PMID: 22942503; PMCID: PMC3413802. [cited 2021 Nov 8]

25.  Elliott JE, De Luche SE, Churchill MJ, Moore C, Cohen AS, Meshul CK, Lim MM. Dietary therapy restores glutamatergic input to orexin/hypocretin neurons after traumatic brain injury in mice. Sleep. 2018 Mar 1;41(3):zsx212. doi: 10.1093/sleep/zsx212. PMID: 29315422; PMCID: PMC6454530. [cited 2021 Nov 8]

26. Takenoshita S, Sakai N, Chiba Y, Matsumura M, Yamaguchi M, Nishino S. An overview of hypocretin based therapy in narcolepsy. Expert Opin Investig Drugs. 2018 Apr;27(4):389-406. doi: 10.1080/13543784.2018.1459561. Epub 2018 Apr 9. PMID: 29623725. [cited 2021 Nov 8]   

27.  Deadwyler SA, Porrino L, Siegel JM, Hampson RE. Systemic and nasal delivery of orexin-A (Hypocretin-1) reduces the effects of sleep deprivation on cognitive performance in nonhuman primates. J Neurosci. 2007;27(52):14239-14247. doi:10.1523/JNEUROSCI.3878-07.2007 [cited 2021 Nov 8]

28.  Djokic G, Vojvodić P, Korcok D, et al. The Effects of Magnesium – Melatonin – Vit B Complex Supplementation in Treatment of Insomnia. Open Access Maced J Med Sci. 2019;7(18):3101-3105. Published 2019 Aug 30. doi:10.3889/oamjms.2019.771 [cited 2021 Nov 18]


Originally Published Mar 25, 2020 by Diane Ridaeus


This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

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.

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Modafinil Alternatives
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Nothing on this Website is intended to be taken as medical advice. The information provided on the website is intended to encourage, not replace, direct patient-health professional relationships. Always consult with your doctor before altering your medications. Adding nutritional supplements may alter the effect of medication. Any medication changes should be done only after proper evaluation and under medical supervision.

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