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Provigil Addiction, Withdrawal | Modafinil Side Effects, Alternatives, Tapering

Last Updated on August 25, 2021 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr John Motl MD

Before attempting Provigil withdrawal, Alternative to Meds Center recommends becoming acquainted with some of the properties and side effects of starting or stopping this psycho-stimulant drug.

Provigil (modafinil) is a central nervous system stimulant with similar effects to cocaine and amphetamines.

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Marketed for shift workers, astronauts, and military personnel to stay awake, and to treat narcolepsy disorder, modafinil is a Class IV controlled substance in the US. Its use is banned in Olympic sports. Provigil, the brand name for the generic modafinil, has a troubled history concerning certain severe side effects and life-threatening reactions requiring withdrawal from the drug, and questions that arose when various efforts began to promote the drug for non-FDA-approved usages. Provigil is prescribed off-label for a large range of symptoms and conditions, which will be discussed in more detail below.

As much as possible, Alternative to Meds Center recommends thoroughly researching any drug before starting or stopping it. But a person taking a CNS stimulant may find they are experiencing adverse symptoms and may want to quit the drug. It is never advisable (except in the case of life-threatening drug reactions) to abruptly quit any psychoactive drug. Always seek competent medical guidance to stay safe during Provigil withdrawal. The most frequently asked questions section below may provide a good starting point for such research. More information is freely available concerning Provigil dependence, Provigil alternatives, withdrawal from Provigil, what you need to know before stopping Provigil, and other topics on request.

Provigil Withdrawal

At ATMC I was always supported. The staff was great at providing opportunities for me to work towards stability. What helped me here was always keeping a positive outlook and the constant encouragement and reminders to keep faith in myself.



What is Provigil (modafinil) Used For?

The FDA-approved uses for Provigil (modafinil) are to treat the following conditions:

Narcolepsy:  excessive sleepiness, especially that occurs spontaneously or unexpectedly during normal waking hours
SWD:  shift work sleep disorder
Sleep Apnea:  a sleep disorder involving intermittent airway stoppage and frequent snoring episodes, associated with oxygen deprivation and certain heart conditions

The drug is also prescribed (or otherwise obtained) for a wide range of “off-label” uses. An article published in the JAMA – Internal Medicine reported that across all years, 89% of patients had an off-label prescription for modafinil. The authors also showed a 10-fold increase in the number of prescriptions from approximately 50,000 in 2002 to over 500,000 in 2008. These are astounding figures. Modafinil was prescribed for depression, multiple sclerosis, Parkinson’s disease, chronic fatigue, ADHD, and other conditions. The 2013 research letter found about half of all modafinil prescriptions were accompanied by an antidepressant, and 15% were co-prescribed benzodiazepines.14

NOTE:  Provigil is not approved for children aged 17 and under. That would make any prescription to this age group off-label. In children with narcolepsy, side effects of Provigil included Tourette’s Syndrome, hostile behavior, sudden loss of muscle tone, weakness, hallucinations while falling asleep, low white blood count, and painful menstruation.10

Provigil (modafinil) Alternative Names and Slang

Stimulant drugs are popularized on the street and have also become increasingly common in workplace settings, in schools, and in military use to keep soldiers awake during long-duration missions. Slang terminology refers to these types of drugs as go-pills, uppers, or speed. Provigil has addictive potential according to published studies.11

Modafinil is the generic name and is sold and prescribed under numerous trade names, including Provigil, Modiodal, Movigal, Alertex, Intensit, Vigil, Wakelert, Modiwake, and many others in various countries.

CNS stimulants like Provigil are commonly referred to in certain literature as “cognitive enhancers” or “smart drugs.” Though the mechanics of action are different, Ritalin is another example of drugs that are promoted “off-label” as a cognitive-enhancement drug. In an interesting double-blind placebo-controlled study analyzing 2876 chess games, 4 groups of players were compared:  those taking a placebo, those taking Ritalin, those taking Provigil, and those taking caffeine. Placebo chess players played faster than all other groups, needing less time for considering their next moves than either those taking Ritalin, caffeine or Provigil.15

The drug may sound like a good idea but does come with risks. Due to the possibility of life-threatening side effects, adverse reactions need to be carefully watched. More on side effects is below.

Provigil Side Effects

Some Provigil side effects are severe and can be life-threatening requiring immediate medical intervention regardless of age. According to the drug label, Provigil can produce a wide range of reactions, similar in nature to other CNS stimulant drugs.1,10

Side effects* of Provigil:

  • Euphoria
  • Anxiety
  • Insomnia
  • Dizziness
  • Headache
  • Nausea, upset stomach
  • Back pain
  • Nervousness
  • Stuffy nose
  • Diarrhea

*The Cognitive Vitality Advisory Board advises that no long-term studies have been done regarding modafinil side effects on patients with dementia or cognitive decline.5

Severe Provigil side effects1,10 include:

  • Suicidal thoughts, thoughts of self-harm, suicide attempt
  • Stevens-Johnson Syndrome:  a potentially life-threatening condition caused by medication that first causes flu-like symptoms, followed by raised welts which blister, painfully burst, and form dark crusts. The face, mouth, eyes, throat, and entire body can be affected. The condition needs immediate emergency care either in a burn unit, or hospital with ICU.
  • Mood changes that occur abruptly or without an observable cause
  • Depression
  • Agitation
  • Irritability, hostility
  • Shortness of breath
  • Confusion
  • Decreased appetite
  • Mania: uncharacteristic aggression, energy, talkativeness
  • Swelling in the legs, face, eyes, throat, tongue, or other areas
  • Severe rashes, allergic reactions such as hives, itching skin, redness
  • Hallucinations
  • Drug-induced psychosis: this can be confused with other forms of psychosis
  • Fever
  • Dark-colored urine
  • Unusual bruising or bleeding
  • Tachycardia: racing heartbeat, pounding heartbeat
  • Heart palpitations (irregular heartbeat)
  • Respiratory depression, difficulty breathing
  • Chest pain
  • Emotional blunting, inability to feel pleasure, or other usual emotional response
  • Increased liver enzymes
  • Tingling or numbness in the hands or feet

Provigil Withdrawal Symptoms

Some individuals have reported an absence of any significant Provigil withdrawal symptoms on stopping Provigil. Clinical trials on the topic of withdrawal from Provigil are scarce.11 One sign of Provigil dependence is the emergence of withdrawal symptoms when stopping Provigil.

Severe Provigil Side Effects Requiring Withdrawal:

  • Stevens-Johnson Syndrome*:  a serious allergic reaction requiring immediate medical intervention in a burn unit or ICU
  • Multi-Organ Hypersensitivity:  a sometimes fatal condition/allergic reaction to various internal organs such as the liver, kidneys, blood vessels, etc.
  • TENS (Toxic Epidermal Necrolysis):  a potentially fatal skin condition characterized by swelling and sepsis and/or death
  • DRESS** (drug-induced rash with eosinophilia):  abnormally high white blood cell count and other systemic symptoms requiring emergency medical treatment.

*Important Notes on Provigil Withdrawal:  The FDA recommends to immediately stop the drug if signs of a rash appear and seek medical attention at once. **According to the FDA, a study reported that discontinuation of Provigil did not prevent a rash from becoming life-threatening, nor did it prevent life-long disfigurement or becoming disabled as a result.1

Where emergence of a rash or other severe or life-threatening adverse effects require withdrawal, such as Stevens-Johnson syndrome, hallucinations, psychotic episodes, etc., the process would be best managed for safety reasons, in an inpatient setting, where adequate monitoring and treatment are readily available.

Discontinuation symptoms can appear within some hours, days, or even weeks after the drug is stopped.

Provigil withdrawal symptoms can include the following according to FDA-required labeling information and clinical reports:1,10,11

  • Lethargy, sleepiness
  • Low mood, anhedonia, dysphoria 
  • Anxiety
  • Insomnia
  • Rise in body temperature

Discontinuing/Quitting Provigil (modafinil)

Quitting Provigil sometimes needs to be done without delay when taking the drug has induced a life-threatening reaction; however, this must only be done in a medical setting where the risk to life can be mitigated, as in an ICU. More commonly, gradual tapering off Provigil is recommended. Medication tapering can be completed at Alternative to Meds Center once any and all life-threatening factors have been addressed if needed in a hospital setting.

The drug is reportedly easily found and purchased online, where safety information is not adequately provided. This is important to note, where young people can become vulnerable targets, especially if they feel under pressure to perform well in school and are lacking guidance and direction towards better solutions.

In some situations, a person may intend to keep their use of Provigil undisclosed; thereby resulting in possible tragic health consequences and a developing Provigil addiction that is not addressed.

For many persons, it may not be so much the withdrawals from Provigil that need addressing, but the return of original symptoms, that could be resolved successfully with safer alternative treatments.

Provigil (modafinil) FAQs

Several questions regarding Provigil can be hard to find definitive answers for, but we have collated as much vital information as possible, to help anyone ensure their personal safety and health.

In the below section, we have attempted to provide information on some of the legal issues, mechanism of action, where to seek the best Provigil tapering help, and other frequently asked questions.

An individual may want to better understand and resolve such questions before ever starting to take a drug like Provigil.

Is Modafinil Legal?

Different countries have different legal positions on the purchase and distribution of modafinil according to the drugmaker’s website.16

US have classed modafinil as a Schedule IV controlled substance that only a DEA registered importer can bring into the country without a prescription. A US resident is limited to bringing in a maximum of 50 pills from a foreign country in person only, for personal use.

NOTE:  Schedule IV drugs are considered low risk for abuse and addiction, yet many find this drug highly addictive and it is often abused.

UK laws regulate the drug as only available by prescription and only to persons age 18 or older.

China laws ban the drug from any medical or prescription use, making the drug illegal to possess.

Japan laws classify the drug as a Schedule 1 (illegal, no medical use) psychotropic drug, which is illegal to import. Comparable Schedule 1 drugs are heroin, LSD, etc.

Russia has regulated modafinil as a Schedule II substance, meaning it has a high potential for abuse and addiction, similar to cocaine or morphine. Possession of just a few pills can result in a lengthy prison sentence.

Australia regulates modafinil as legal with prescription only for human or animal medical use.

Canada lists modafinil as an uncontrolled schedule F substance, meaning that the drug will be seized by border/customs officers if a person is attempting to import the drug.

Scandinavian countries also list the drug as prescription only, as is the case in all EU countries.

Mexico laws consider modafinil as an uncontrolled substance, meaning it can be dispensed and purchased without a prescription. Within the borders of Mexico, the drug is legal, but crossing borders with it would be subject to the laws of the country of entry.

Before traveling to any country or crossing borders with a prescription drug, it is highly advisable to check with customs laws before travel.

Is Modafinil A Stimulant?

Yes, although the drug is not classified as a stimulant per se, modafinil is used to help people suffering from narcolepsy to stay awake during normal waking hours. It is also used to stimulate and prevent drowsiness for shift workers, and to stimulate the alertness of soldiers or others who need to stay alert and awake for long periods of time. Modafinil and other prescribed stimulant drugs, like the stimulant drug Ritalin, have been included in a relatively new class of drugs called “nootropics.” Nootropic drugs have been promoted as cognitive enhancers, whose popularity has been seen to expand with executives, college students, and others who may want to improve mental sharpness while reducing the need for sleep.

Ritalin, modafinil, and other drugs in this class all act as stimulants, which can make the user feel temporarily brighter, euphoric, and reduce the need for sleep. However, there is a growing body of evidence showing that over time, a sleep-deprived, artificially boosted level of energy can result in significant injury and degradation to mental and physical health. This drug is recommended to be taken only for specific sleep disorders for health and safety reasons.1,2,10,12-14

There are Provigil alternatives that can also help with mood, sleep, and energy that do not involve prescription drugs. Alternative to Meds Center can supply more information on healthy Provigil alternatives on request.

Is Modafinil a Narcotic?

Yes, and no. A narcotic, by definition, is an illegal drug that affects mood or behavior and is sold for non-medical purposes. Since modafinil does affect mood and behavior, and is sold for non-medical purposes as well as medical purposes, and is sometimes sold legally and sometimes illegally, the context and geography relating to the user and the purpose of use would be the deciding factors.

The Library of Congress defines Provigil and modafinil not as narcotic drugs or even as “stimulants,” but as “wakefulness promoting agents.” 3

However, some believe that such polished or academic definitions may have the questionable effect of promoting these drugs without any focus on potential Provigil addiction or abuse. Such casual representation may mislead some into discounting the health liabilities associated with Provigil.16-18

Is Modafinil a Dopamine Agonist?

While modafinil is not a strong dopamine agonist in the same way as cocaine is, modafinil may act, at least in part, as a dopamine agonist, meaning it can act in a similar dopaminergic fashion. The drug has a rather complex and not entirely understood psychokinetic mechanism as regards dopaminergic and other types of CNS neurotransmitter/receptor action.4-8

The drug induces or activates histamine and certain proteins and enzymes and may influence some neurotransmitters, similar to but weaker in action than cocaine. The dopamine transport mechanisms being blocked (causing accumulation in the nerve synapses) can result in euphoria and other effects. The exact dopaminergic action of Provigil or modafinil is thought likely better explained by some other not yet understood mechanism, as only a negligible dopamine agonist effect has been established, which action is observed to be significantly weaker than that seen in other stimulants.

These various internal chemical interactions that the drug influences can combine, synergistically contributing to an elevated sense of energy and brightened mood and euphoria that is associated with this stimulant drug. More research is needed to further explore the exact psychokinetic action on the brain and highly complex central nervous system.5

How Long Does Modafinil Stay in Your System?

The half-life of modafinil is roughly 15 hours, according to the patient instruction pamphlet that is given out with a prescription to the drug in the UK.2

The half-life of any medication, including Provigil or modafinil, can be affected by individual genetics, which will affect the rate of metabolism, kidney or liver efficacy issues, and certain other health factors. The slower the rate of metabolism, the longer the half-life can become.

Does Modafinil Show Up on Drug Tests?

Here is some information on modafinil or other brand name versions and drug test results:

Modafinil breaks down into several types of metabolites. Some of these metabolites clear faster than others. These inactive metabolites can test positive on plasma, serum, or urine drug tests for up to 30 hours after ingesting Provigil. Routine drug testing, for instance, routine drug testing at a place of work, does not usually include testing for modafinil. Special testing panels and other methods of testing for the presence of modafinil can be utilized such as liquid chromatography, gas-based tests, or other specialized testing methods.

False positives for methamphetamines or other stimulant drugs are not likely to show up on a modafinil drug test because their structure differs significantly. However, Ritalin, Adderall and Concerta all have similar structures to methamphetamines, and therefore that is why these can test as a false positive to amphetamines because they are so similar. Because of the difference in structure, there cannot be a false positive for amphetamines on a modafinil test.

If you are an athlete, testing for doping agents is common and so a drug test might be used that was specifically designed to detect this substance.4

Nuvigil vs Provigil - How Are They Different?

Nuvigil is the brand name for the generic drug armodafinil, a variation of modafinil.17 There are similarities between Nuvigil and Provigil, i.e., both are prescribed to promote wakefulness. However, there are also some differences:

  • They have slightly different chemical structures.
  • Nuvigil pills start at 50mg increasing by 50mg up to 250mg maximum. Provigil pills come in only two strengths, either 100mg or 200mg.
  • Nuvigil tablets are round and white, Provigil tablets are elongated and white.
  • Beyond these slight differences, there is no great dissimilarity between the two drugs.

Treatment for Provigil Addiction, Abuse, and Dependence?

If a person has found the adverse effects of Provigil have outweighed the benefits, Alternative to Meds Center can help a person to safely recover. One strategically important part of recovery that is sometimes overlooked is the advantage of being able to discover and fully address the root causes of symptoms that led to taking prescription drugs in the first place. Toxic accumulations 18 in the body can create sleep disturbances – these neurotoxins can be tested for and removed to resolve the problem. Nebulized glutathione treatments complement the recovery of energy. Impaired muscle tone and low energy can be remedied by therapeutic massage and getting active, which can greatly help with withdrawal from stimulants.13

If the causes and contributing factors leading to lack of energy or sleep disturbances were never exhaustively searched for, and never fully addressed, these problems can likely return after stopping the prescription, leaving a person in roughly the same shape or perhaps worse off than before. Proper rebalancing chemistry in the body through targeted nutrition and supplementation can obtain significant health results. We focus on learning de-stressing techniques, and provide personal counseling and life coaching, as well as revitalizing IV + NAD therapy, and many other actions that help in regaining robust energy and good health that lasts much longer than a drug ever could. You are invited to become acquainted with everything we offer at Alternative to Meds on our services overview page.

Please contact us at Alternative to Meds Center for more detailed information on how our program can help with possible lingering after-effects of Provigil and managing Provigil withdrawal.

1. FDA label Provigil (modafinil) Appr. 1998 Revised 2015 Jan [cited 2021 Aug 24]

2. Provigil leaflet UK Health Services [cited 2020 Sep 23]

3. Kim D. Practical use and risk of modafinil, a novel waking drugEnviron Health Toxicol. 2012;27:e2012007. doi:10.5620/eht.2012.27.e2012007 [cited 2021 Aug 24]

4. Wesensten NJ. Effects of modafinil on cognitive performance and alertness during sleep deprivation. Curr Pharm Des. 2006;12(20):2457-71. doi: 10.2174/138161206777698819. PMID: 16842170. [cited 2021 Aug 24]

5. Battleday RM, Brem AK (2015) Modafinil for cognitive neuroenhancement in healthy non-sleep-deprived subjects: A systematic review. Eur Neuropsychopharmacol 25, 1865-1881. [cited 2021 Aug 24]

6. Sheng P, Hou L, Wang X et al. (2013) Efficacy of modafinil on fatigue and excessive daytime sleepiness associated with neurological disorders: a systematic review and meta-analysis. PLoS One 8, e81802. [cited 2021 Aug 24]

7. 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 2021 Aug 24]

8. Golden SA, Russo SJ. Mechanisms of psychostimulant-induced structural plasticity. Cold Spring Harb Perspect Med. 2012 Oct 1;2(10):a011957. doi: 10.1101/cshperspect.a011957. PMID: 22935995; PMCID: PMC3475397. [cited 2021 Aug 24]

9. Malhi GS, Byrow Y, Bassett D, Boyce P, Hopwood M, Lyndon W, Mulder R, Porter R, Singh A, Murray G. Stimulants for depression: On the up and up? Aust N Z J Psychiatry. 2016 Mar;50(3):203-7. doi: 10.1177/0004867416634208. PMID: 26906078. [cited 2021 Aug 24]

10. FDA Medication Guide Provigil (modafinil) Tablets Revised Jan 2015 [cited 2021 Aug 24]

11. Krishnan R, Chary KV. A rare case modafinil dependenceJ Pharmacol Pharmacother. 2015;6(1):49-50. doi:10.4103/0976-500X.149149 [cited 2021 Aug 24]

12. 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 2021 Aug 24]

13. He Q, Wu J, Wang X, Luo F, Yan K, Yu W, Mo Z, Jiang X. Exercise intervention can reduce the degree of drug dependence of patients with amphetamines/addiction by improving dopamine level and immunity and reducing negative emotions. Am J Transl Res. 2021 Mar 15;13(3):1779-1788. PMID: 33841702; PMCID: PMC8014419.

14. Penaloza R, et al., “Trends in On-label and Off -label Modafinil Use in a Nationally Representative Sample.” JAMA Intern Med. 2013;173(8):704-706. doi:10.1001/jamainternmed.2013.2807 [cited 2021 Aug 24]

15. Franke AG, Gränsmark P, Agricola A, Schühle K, Rommel T, Sebastian A, Balló HE, Gorbulev S, Gerdes C, Frank B, Ruckes C, Tüscher O, Lieb K. Methylphenidate, modafinil, and caffeine for cognitive enhancement in chess: A double-blind, randomised controlled trial. Eur Neuropsychopharmacol. 2017 Mar;27(3):248-260. doi: 10.1016/j.euroneuro.2017.01.006. Epub 2017 Jan 22. PMID: 28119083. [cited 2021 Aug 24]

16. Drugmaker’s website, “Modafinil in Europe 2021 – The A-Z Guide” [cited 2021 Aug 24]

17. Nuvigil FDA label approved 2007 [cited 2021 Aug 24]

18. Viaene M, Vermeir G, Godderis L. Sleep disturbances and occupational exposure to solvents. Sleep Med Rev. 2009 Jun;13(3):235-43. doi: 10.1016/j.smrv.2008.07.003. Epub 2009 Feb 7. PMID: 19201227. [cited 2021 Aug 24]

Originally Published Sep 13, 2018 by Diane Ridaeus

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

Dr. John Motl, M.D.

Dr. Motl is currently certified by the American Board of Psychiatry and Neurology in Psychiatry, and Board eligible in Neurology and licensed in the state of Arizona.  He holds a Bachelor of Science degree with a major in biology and minors in chemistry and philosophy. He graduated from Creighton University School of Medicine with a Doctor of Medicine.  Dr. Motl has studied Medical Acupuncture at the Colorado School of Traditional Chinese Medicine and at U.C.L.A.

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Provigil Addiction, Withdrawal | Modafinil Side Effects, Alternatives, Tapering
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