Modafinil, sold under the brand name Provigil among others, is a medication to treat sleepiness due to narcolepsy, shift work sleep disorder, and obstructive sleep apnea. While it has seen off-label use as a purported cognitive enhancer to improve wakefulness in animal and human studies, the research on its effectiveness for this use is not conclusive. Modafinil is taken by mouth.
Modafinil is generally well-tolerated, with possible side effects including headache, trouble sleeping, and nausea. Rare serious dermatological reactions may occur in people with genetic predispositions and more commonly in pediatric patients, and, discontinuation is recommended at the earliest signs of rash or similar reactions. Serious rare side effects may include allergic reactions such as anaphylaxis and Stevens–Johnson syndrome, as well as hallucinations in people with a history of psychosis. It is unclear if use during pregnancy is safe. The amount of medication used may need to be adjusted in those with kidney or liver problems. It is not recommended in those with an arrhythmia, significant hypertension, or left ventricular hypertrophy. Modafinil appears to work by acting on dopamine and modulating the areas of the brain involved with the sleep cycle.
Originally developed in the 1970s by French neuroscientist Michel Jouvet and Lafon Laboratories, Modafinil has been prescribed in France since 1994, and was approved for medical use in the United States in 1998. In the United States it is classified as a schedule IV controlled substance, although its classification has been called into question. In the United Kingdom it is a prescription only medication. It is available as a generic medication. In 2017, modafinil was the 328th most commonly prescribed medication in the United States, with more than 900,000 prescriptions.