Provigil

Provigil is the brand name for modafinil, a wakefulness-promoting agent used to treat excessive daytime sleepiness associated with certain sleep disorders. Modafinil was developed in the 1970s by the French company Lafon and was later marketed as Provigil by Cephalon in 1998. It is a racemic compound with a mechanism that is not fully understood, but it is believed to influence multiple neural systems, including dopamine pathways and the orexin system, to promote wakefulness. Modafinil has a relatively lower abuse potential than traditional stimulants and is classified as a Schedule IV controlled substance in several countries, including the United States.

Medical uses for Provigil include the treatment of excessive daytime sleepiness in adults with narcolepsy, obstructive sleep apnea/hypopnea syndrome, and shift work sleep disorder. It may be prescribed off-label for fatigue associated with other conditions, but it is not approved as a general cognitive enhancer.

Pharmacology and administration: Modafinil is taken by mouth, typically 100 to 200 mg once daily, depending on the condition and patient response. The onset of action occurs within hours, with a half-life generally around 12 to 15 hours. Absorption can be influenced by meals, and concomitant use with other medications can affect drug levels through enzyme induction or inhibition.

Adverse effects and safety: Common side effects include headaches, nausea, dry mouth, dizziness, and nervousness. Serious reactions are rare but can include severe skin reactions. Modafinil can interact with other drugs by affecting hepatic enzymes, and it may reduce the effectiveness of hormonal contraceptives. It is not recommended during pregnancy unless clearly needed; breastfeeding considerations should be discussed with a clinician.