Is Provigil Addictive?
Addiction Risk Seen in Wakefulness Drug Provigil
WebMD News Archive
March 17, 2009 - Provigil promotes wakefulness without getting you hooked.
But now it seems that addiction may very well be a Provigil risk.
Provigil (generic name, modafinil) is FDA approved for promoting wakefulness
in people with narcolepsy, sleep apnea, and shift work sleep disorder. Because
of its relatively benign safety profile, it's often prescribed "off
label" for people complaining of fatigue.
Some prominent scientists have suggested that responsible, healthy adults
should be allowed to use safer stimulant drugs such as Provigil and even
Ritalin to boost intellectual creativity.
But now researchers led by Nora D. Volkow, MD, director of the National
Institute on Drug Abuse (NIDA), report evidence that Provigil might be more
addictive than thought.
"There is an increasing use of this medication, and people have promoted
the off-label use of stimulants and Provigil as cognitive enhancers with the
belief that these drugs are safe," Volkow tells WebMD. "But these drugs
have side effects, and their use without proper medical oversight could lead to
abuse and addiction."
In their pilot study, Volkow's team recruited 10 healthy men who underwent
two sets of PET brain scans after taking either Provigil (200 milligrams or 400
milligrams) or an inactive placebo pill.
The brain scans showed that Provigil blocks dopamine transporters, the
molecules that remove dopamine from brain synapses. This increases the amount
of dopamine in the brain -- the brain's "reward" mechanism.
Addictive drugs such as cocaine and methamphetamine trigger the same
mechanism, although they do it much faster and more powerfully than Provigil
"The changes we are observing in dopamine concentrations with modafinil
are equivalent to those we have reported for [Ritalin] in the human brain,"
Volkow says. "So not only does [Provigil] increase dopamine in the human
brain, but does it by similar mechanisms to Ritalin and cocaine, by directly
blocking the dopamine transporter. It is not working by some distinct,
Volkow notes that Provigil has no effect on mice lacking dopamine
transporters. This indicates that while the drug may have other effects in the
brain, its dopamine-enhancing effect is crucial.