302 Modafinil
Drawbacks.Modafinil can produce euphoria in humans. Headache, dry
mouth, sore throat, appetite loss, nausea, diarrhea, uneasiness, depression,
insomnia, fever, infection, and weakness have been reported by modafinil
users. Among cardiac patients, unwanted actions may include heart palpita-
tions, chest pain, and breathing difficulty. High doses have caused tremors,
faster pulse rate, high blood pressure, peevishness, confusion, and aggression.
Although the compound is a stimulant, it has a risk of adversely affecting
skills needed for operating dangerous machinery such as automobiles.
A modafinil dose lasts a shorter time in young females than in young males.
Abuse factors.Modafinil’s chemical properties reduce or even eliminate its
effects if injected or smoked, reducing its convenience for abuse. Studies in-
dicate the drug has less abuse potential than many other stimulants, but mon-
keys will self-administer modafinil, a traditional sign of addictive potential in
a substance. Scientists running one monkey experiment noted, however, that
only massive doses would interest the animals; even an amount of modafinil
200 times the size of a dextroamphetamine dose was not enough to get them
to self-administer the two drugs at the same rate. In a rat test the rodents
acted like modafinil has some effects reminiscent ofcocaine. In one scientific
study persons with a history of drug abuse found modafinil’s actions plea-
surable and similar to those ofmethylphenidate. People using modafinil daily
for 9 weeks showed no dependence; and a study of 140 patients who used
the drug for varying amounts of time, ranging from 1 month to almost 10
years, revealed no dependence. Tests of humans taking modafinil daily for 40
weeks indicated no development of tolerance.
Drug interactions.Modafinil can make birth control pills and implants less
effective. A laboratory test indicated that the drug may reduce blood levels of
cyclosporine, an immunosuppressant used to help organ transplant patients.
Modafinil may raise blood levels ofdiazepam, tricyclic antidepressants, the
anti–blood clot medicine warfarin, and the epilepsy medicine phenytoin.
Cancer.Laboratory tests have not found indications that modafinil causes
cancer.
Pregnancy.Fetal injury emerged in pregnant rats receiving 10 times the
normal maximum human dose of modafinil, but pregnant rabbits receiving
the same dosage did not show fetal damage attributable to the substance. At
lower doses rat offspring appeared normal, and milk from nursing rats re-
ceiving the drug did not seem to harm the pups. Effects on human pregnancy
and milk are uncertain.
Additional scientific information may be found in:Akerstedt, T., and G. Ficca. “Alertness-Enhancing Drugs as a Countermeasure to Fa-
tigue in Irregular Work Hours.”Chronobiology International14 (1997): 145–58.
Baranski, J.V., and R.A. Pigeau. “Self-Monitoring Cognitive Performance during Sleep
Deprivation: Effects of Modafinil, D-Amphetamine and Placebo.”Journal of Sleep
Research6 (1997): 84–91.
Lyons, T.J., and J. French. “Modafinil: The Unique Properties of a New Stimulant.”
Aviation, Space, and Environmental Medicine62 (1991): 432–35.
“Modafinil for Narcolepsy.”Medical Letter on Drugs and Therapeutics41 (1999): 30–31.
Rugino, T.A., and T.C. Copley. “Effects of Modafinil in Children with Attention-
Deficit/Hyperactivity Disorder: An Open-Label Study.”Journal of the American
Academy of Child and Adolescent Psychiatry40 (2001): 230–35.