Modalert (modafinil) is a central nervous system stimulant used to help people who experience excessive sleepiness stay awake and alert.

It is often used to help with chronic sleepiness due to:

• Narcolepsy
• Sleep apnea
• Neurodegenerative disorders
• Delayed sleep phase syndrome
• Chronic fatigue of unknown origin

Modalert is typically used to promote wakefulness during the day followed by a usual night of sleep. While it can be used to stay awake and relatively alert for considerably longer periods, this should be done only in extenuating circumstances. The effects of sleep deprivation can be very serious, even if disguised with a stimulant.

Some examples of extenuating circumstances:

• Occasional Jet lag
• Working odd or unusually long shifts, or changing shifts
• Performing complex tasks or operating dangerous equipment with insufficient sleep
• Military/combat situations when sleep is not an option

When working as intended, the medication removes the side effects associated with drowsiness, making patients more alert, better able to focus and concentrate, and, in some individuals, markedly improving short-term memory. Some individuals use Modalert as a cognitive enhancement aid, for studying or to otherwise boost cognitive performance for important events, though this is not an approved use in most places.

For most patients Modalert produces effects somewhere between those of caffeine and amphetamines, but without producing the jittery, fidgety feelings associated with those stimulants. Likewise it produces milder physical effects, such as rapid heart beat or increased blood pressure, though these can still be a concern when preexisting conditions are present.

For some patients Modalert does produce a mild euphoria which can be addicting. Addiction is not a major concern with this product, however, compared to other stimulants such as caffeine, nicotine, or amphetamines.

Dosage & Administration

Modalert comes in tablets, which should be taken about an hour prior to needed wakefulness. Effects last 8 to 15 hours, depending on individual response. Tablets can be split if needed for smaller doses.

The medication can be used as-needed, whether that need is daily or once a year:

• For medical conditions which produce fatigue, take 200 mg in the morning.
• For extenuating circumstances, take 200 mg about an hour prior to required wakefulness.
• If needed to maintain wakefulness, an additional 100 to 200 mg may be taken every 4 to 8 hours.
• Do not exceed 400 mg per day without explicit doctor approval.

Individuals with chronic sleepiness often take Modalert daily for several consecutive months. Most patients do not develop tolerance to the medication and there are no concerns about withdrawal effects.

Patients who take Modalert report feeling:

• More alert
• Greater self-confidence
• Improved sense of well-being
• Improved short-term memory
• Improved ability to concentrate
• Improved ability to perform complex tasks
• Improved ability to stay awake if desired
• Reduced "brain fog" or sleep inertia

Not all patients experience all the above effects, or experience them in the same strength, though most notice a considerable difference in at least several areas.

Modalert is sometimes used as a performance-enhancer. Patients involved in activities which may test for substances should be aware that Modalert may be tested for/detected. If the medication was prescribed by a doctor, showing proof of a prescription should resolve the issue.

Precautions Before Use

Patients with a history of heart, liver or kidney disease should not use Modalert without first speaking with a doctor about potential risks.

Most patients experience only mild side effects, if any at all, with nausea and vertigo being most common. Other relatively common effects include:

• Headache
• Difficulty staying asleep
• Diarrhea or constipation
• Loss of appetite
• Taste changes
• Dry mouth or thirst
• Flushing or sweating
• Stiff muscles

There is a very small risk the medication will produce a potentially life-threatening reaction which can effect the skin and liver. Warning signs include:

• Any kind of unexplained rash or hives
• Sores in the mouth
• Peeling or blistering skin
• Difficulty swallowing or breathing
• Yellowing of skin or eyes (jaundice)
• Dark urine
• High fever

Modalert is known to interact with a wide variety of other medications; speak with a doctor or pharmacist before using this product with other drugs, including over-the-counter varieties.