Modafinil (Provigil) for ADHD

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Modafinil’s Pharmacology Profile

  • Half-life:  15 hours
  • Peak Concentration:  2 to 3 hours after dosing
  • Metabolism:  Primarily by the liver
Adderall Addiction Treatment in Seattle, WA | Adult Mental Health Services

Provigil for Adults with ADHD

What is Modafinil?

The prevalence of adult attention-deficit/hyperactivity disorder (ADHD) in patients with substance use disorder (SUD) is high.

According to a recent systematic review [1], the prevalence rate was 23.3% (95% CI 17.7%, 30.1%), although prevalence varies depending on the psychoactive substances involved and the diagnostic instrument.

Given the close bidirectional relationship between both disorders, it seems highly improbable that the elevated co-morbidity between adult ADHD and SUD is due to chance alone. Some authors have even suggested that SUD and ADHD could be different aspects of the same overarching condition [2] or that the same endophenotype (i.e. impulsivity) may underlie both disorders [3].

Reserach has found that modafinil has positive effects on

  • Working memory
  • Recognition memory
  • Sustained attention
  • Prefrontal-dependent cognitive functioning in Adult ADHD and Major Depressive Disorder

Managing inattention, excessive sleepiness, fatigue and cognitive dysfunction associated with ADHD and Clinical Depression.

According to the aforementioned systematic review, approximately one-fifth of patients at SUD treatment centers may also require drug therapy for ADHD, the
primary treatment for adult ADHD [4]

According to the aforementioned systematic review, approximately one-fifth of patients at SUD treatment centers may also require drug therapy for ADHD, the
primary treatment for adult ADHD [4]

In contrast to stimulants, modafinil has demostrated no effects on sleep architecture, including REM rebound.  Modafinil does not produce withdrawal symptoms or tolerance with chronic use.

There is no evidence that modafinal can produce a hihgh that would lead people toward addictive behavior.

Modafinil, a low potency inhibitor of the DAT and norepinephrine transporter (NET), is a
Federal Drug Administration-approved compound that was developed to increase
wakefulness in the treatment of narcolepsy

The wake-promoting drug modafinil is frequently used off-label to improve cognition in psychiatric and academic populations alike. The domain-specific attentional benefits of modafinil have yet to be quantified objectively in healthy human volunteers using tasks validated for comparison across species.

Further, given that modafinil is a low-affinity inhibitor for the dopamine and norepinephrine transporters (DAT/NET respectively) it is unclear if any effects are attributable to a non-specific increase in arousal, a feature of many catecholamine reuptake inhibitors (e.g., cocaine, amphetamine). These experiments were designed to test for domainspecific enhancement of attention and cognitive control by modafinil (200 and 400 mg) in healthy volunteers using the 5-choice continuous performance task (5CCPT) and Wisconsin Card Sort Task (WCST).

An additional cross-species assessment of arousal and hyperactivity was performed
in this group and in mice (3.2, 10, or 32 mg/kg) using species-specific versions of the behavioral
pattern monitor (BPM).

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Research for Provigil as Treatment for ADHD

Modafinil improves attentional performance in healthy, non-sleep deprived humans at doses not inducing hyperarousal across species.

Effects of modafinil on non-verbal cognition, task enjoyment and creative thinking in healthy volunteers

The Unique Psychostimulant Profile of (±)-Modafinil: Investigation of Behavioral and Neurochemical Effects in Mice

A Placebo-Controlled Trial of Modafinil for Nicotine Dependence

Modafinil Increases the Latency of Response in the Hayling Sentence Completion Test in Healthy Volunteers: A Randomised Controlled Trial

Efficacy of Modafinil on Fatigue and Excessive Daytime Sleepiness Associated with Neurological Disorders: A Systematic Review and Meta-Analysis

A double blind, placebo controlled trial of modafinil for the treatment of cocaine dependence without co-morbid alcohol dependence

Modafinil and sleep architecture in an inpatient-outpatient treatment study of cocaine dependence

Apathy syndrome treated successfully with modafinil

A Systematic Review of Modafinil:  Potential Clinical Uses and Mechanisms of Action

Modafinil:  Not just for sleep disorders?

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