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 used “off-label” for wakefulness, for instance; students needing to stay up all night in preparation for exams, or at the workplace if an energy boost is desired that is long-lasting, even though the next day. More information on this topic is below.
NOTE: All pediatric use of Provigil is banned by the FDA. In Europe, prescribing the drug to anyone under the age of 18 is restricted.
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.
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.
Perhaps in an attempt to continue to promote non-FDA approved use, Provigil is also referred to in certain literature as a “cognitive enhancer” or a “smart drug.” Provigil has been added to a group of stimulants called nootropic drugs. Ritalin is one example of this drug class, which is promoted “off-label” as a cognitive-enhancement drug.
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.
The drug has never been FDA-approved for prescribing to children.
Provigil Side Effects
Some Provigil side effects are severe and can be life-threatening requiring immediate medical intervention regardless of age. The drug can produce a wide range of reactions.
The 5 most commonly reported side effects* of Provigil:
*The Cognitive Vitality Advisory Board advises that no long-term studies have been done regarding modafinil side effects on dementia or cognitive decline.5
Other Provigil side effects 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 the 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
- Shortness of breath
- Decreased appetite
- Uncharacteristic aggression, energy, talkativeness
- Swelling in the legs, face, eyes, throat, tongue, or other areas
- Allergic reactions such as hives, itching skin, redness
- Drug-induced psychosis: this can be confused with other forms of psychosis
- Dark-colored urine
- Unusual bruising or bleeding
- Congested or stuffy nose
- 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; however, one study showed a correlation between discontinuation of Provigil and the emergence of certain life-threatening symptoms.1 One sign of Provigil dependence is the emergence of withdrawal symptoms when stopping Provigil.
Severe Provigil Withdrawal Symptoms:
- 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. Alternative to Meds Center can provide Provigil withdrawal help on request.
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:
- Emotional blunting, inability to feel pleasure
- Angioedema (swelling beneath the skin or the mucous membranes)
- Anaphylaxis (swelling of the throat, face, tongue, eyes, lips, larynx, difficulty breathing, hoarseness, difficulty swallowing)
- Agitation and rage episodes
- Psychosis, hallucinations, agitation, mania
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. Treatment for tapering off Provigil can be completed at Alternative to Meds Center once any and all life-threatening factors have been addressed 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 undisclosed Provigil addiction. Proper Provigil discontinuation treatment may not be able to be administered appropriately because the immediate causative agent remains unknown.