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What is Modafinil?
Modafinil is a prescription eugeroic, or wakefulness agent. It’s used to help people with sleep disorders — like sleep apnea, narcolepsy and shift work sleep disorder — stay awake. It’s manufactured by Cephalon Labs [1, 2].
In addition to increased alertness, people who have taken modafinil have also noted that it improves their focus, concentration, productivity and executive functioning. This has been noted in scientific studies, as well .
Modafinil Side Effects and Safety
The U.S. National Library of Medicine details several different potential side effects of modafinil :
- difficulty falling asleep or staying asleep
- loss of appetite
- unusual tastes
- dry mouth
- excessive thirst
- tight muscles or difficulty moving
- back pain
- uncontrollable shaking of a part of your body
- burning, tingling, or numbness of the skin
- difficulty seeing or eye pain”
In addition, they explain that there are also several severe side effects that warrant urgent medical attention:
- peeling skin
- mouth sores
- difficulty breathing or swallowing
- swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- chest pain
- fast, pounding, or irregular heartbeat
- frenzied, abnormally excited mood
- hallucinating (seeing things or hearing voices that do not exist)
- thinking about killing or harming yourself”
Among people who have taken modafinil before, the most commonly reported side effects include insomnia, headache and loss of appetite. The insomnia can be alleviated somewhat by taking modafinil first thing in the morning so that the drug has time to metabolize and break down during the day — so there aren’t still large quantities of active modafinil in the system when it’s time to go to bed.
Modafinil may also be linked to a rare and serious condition called Stevens Johnson Syndrome. Currently, one case report has linked armodafinil (a structurally similar compound) to a confirmed case of Stevens Johnson Syndrome .
You shouldn’t take modafinil if you’re pregnant, breastfeeding, or under the age of 18 unless it’s been prescribed by a doctor, and you should avoid other stimulants, high-dose caffeine, and alcohol while taking modafinil.
Finally, the U.S. National Library of Medicine shares the medications that modafinil may have a possible interaction with. This is not an exhaustive list, so it’s important to discuss modafinil and your other medications with your doctor before you start taking it. Here are the medications they say may interact with modafinil:
“anticoagulants (‘blood thinners') such as warfarin (Coumadin); certain antidepressants such as amitriptyline, amoxapine, clomipramine (Anafranil), desipramine (Norpramin), doxepin (Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); certain antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); cyclosporine (Neoral, Sandimmune); diazepam (Valium); certain medications for seizures such as carbamazepine (Tegretol), phenobarbital, and phenytoin (Dilantin); monoamine oxidase (MAO) inhibitors, including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate); propranolol (Inderal); selective serotonin reuptake inhibitors (SSRIs) such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft); rifampin (Rifadin, Rimactane); and triazolam (Halcion)”
Modafinil for ADD
While ADD is a commonly used term, it’s actually not an official diagnosis. ADHD is the official diagnosis, and the subtype typically known as ADD (absent hyperactivity) is known as inattentive-type ADHD. This form is characterized by forgetfulness and lack of focus, but without the typical hyperactivity or impulsiveness that typically accompanies ADHD.
Surprisingly, modafinil has a fairly robust history of use for ADHD. In fact, Cephalon Labs had developed an enteric-coated form called Sparlon — which was in clinical trials as of 2006.
Clinical trials revealed that Sparlon had powerful positive effects on cognition in children with ADHD. Sparlon was more effective than placebo, and equally as powerful as commonly used stimulants for ADHD like Ritalin and Adderall [7, 8].
Unfortunately, modafinil was also associated with the rare, potentially fatal side effect Stevens Johnson Syndrome. One child in the clinical trials experienced a skin rash similar in nature to the rash seen in Stevens Johnson Syndrome, which led the Food and Drug Administration to deny approval to Sparlon in 2006 [6, 9].
Since then, a case of Stevens Johnson Syndrome has been noted in the literature as a possible result of armodafinil, which is very similar to modafinil — so these concerns clearly weren’t without warrant .
Regardless, many adults may still be interested in the possibility of reducing their ADD symptoms with modafinil. For the most part, it presents a lower risk of severe side effects than the more powerful stimulant drugs often prescribed for ADD, like Ritalin and Adderall.
However, it is unlikely that modafinil will ever become approved for ADHD — especially in children — because of its history and connection to Stevens Johnson Syndrome.
An Effective Treatment for Atypical ADD
Because of the promising research on ADHD and modafinil, many adults with ADD have tried to manage or treat their symptoms using modafinil. In fact, many physicians advocate for this use too: ADHD management remains one of most common off-label prescriptions given for modafinil.
Additionally, modafinil may be less habit-forming than other ADHD treatment alternatives — making it safer and less risky. One individual with ADD who uses modafinil to help manage it has said that modafinil provides all of the benefits of amphetamine stimulants, while still keeping him feeling sober.
However — as with any medication — results are mixed and vary widely from person to person.
Some people say that modafinil worked excellently in helping them to manage their ADD symptoms, while others say they felt it had no effect at all. Several people with ADD have reported that modafinil gives them just the right amount of focus and concentration to get through the day productively.
Regardless, commonly reported side effects from people who have tried modafinil specifically to manage their ADD include irritability and increased blood pressure.
Modafinil and ADD | Verdict
Modafinil is a wakefulness agent for sleep disorders that offers a number of other potential benefits. For this reason, it’s given as an off-label prescription for a number of conditions — including ADD.
ADD is actually a type of ADHD, known as inattentive-type ADHD. While people with inattentive-type ADHD struggle with focus, they don’t show hyperactive tendencies. Modafinil is a promising alternative to powerful stimulants that are often prescribed for ADD because it is effective, less habit-forming and has fewer side effects.
However, it’s not totally without side effects. Some people with ADD who’ve used modafinil report that it increases their blood pressure or causes irritability. It may also be associated with a rare, fatal condition known as Stevens Johnson Syndrome.
Regardless, there are many reports that modafinil has been life-changing for ADD management, with no side effects of note.
- Minzenberg MJ, Carter CS. Modafinil: a review of neurochemical actions and effects on cognition. Neuropsychopharmacology. 2008;33(7):1477-1502. doi:10.1038/sj.npp.1301534
- Billiard M, Broughton R. Modafinil: its discovery, the early European and North American experience in the treatment of narcolepsy and idiopathic hypersomnia, and its subsequent use in other medical conditions. Sleep Med. 2018;49:69-72. doi:10.1016/j.sleep.2018.05.027
- Battleday RM, Brem AK. Modafinil for cognitive neuroenhancement in healthy non-sleep-deprived subjects: A systematic review. Eur Neuropsychopharmacol. 2015;25(11):1865-1881. doi:10.1016/j.euroneuro.2015.07.028
- Peñaloza RA, Sarkar U, Claman DM, Omachi TA. 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
- U.S. National Library of Medicine. Modafinil. MedLine Plus website. Updated February 2, 2016. https://medlineplus.gov/druginfo/meds/a602016.html
- Holfinger S, Roy A, Schmidt M. Stevens-Johnson Syndrome After Armodafinil Use. J Clin Sleep Med. 2018;14(5):885-887. Published 2018 May 15. doi:10.5664/jcsm.7132
- Turner D. A review of the use of modafinil for attention-deficit hyperactivity disorder. Expert Rev Neurother. 2006;6(4):455-468. doi:10.1586/14737220.127.116.115
- Biederman J, Swanson JM, Wigal SB, et al. A comparison of once-daily and divided doses of modafinil in children with attention-deficit/hyperactivity disorder: a randomized, double-blind, and placebo-controlled study. J Clin Psychiatry. 2006;67(5):727-735. doi:10.4088/jcp.v67n0506
- PharmaTimes. Cephalon drops Sparlon after FDA says ‘no.’ PharmaTimes Online website. August 10, 2006. https://www.pharmatimes.com/news/cephalon_drops_sparlon_after_fda_says_no_996067