modafinil modafinil modafinil, sold under the brand name provigil among others, is a central nervous system (cns) stimulant medication used 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. modafinilclinical datatrade namesprovigil, alertec, modavigil, othersother namescrl-40476; diphenylmethyl-sulfinylacetamideahfs/drugs.commonographmedlineplusa602016license data us fda: modafinil pregnancycategory au: d dependenceliabilityrelatively lowaddictionliabilityvery low to lowroutes ofadministrationby mouthdrug classcns stimulantatc coden06ba07 (who) legal statuslegal status au: s4 (prescription only) ca: ℞-only uk: pom (prescription only) us: schedule iv pharmacokinetic databioavailabilitynot determined due to its aqueous insolubilityprotein binding62.3%metabolismliver (primarily via amide hydrolysis; cyp1a2, cyp2b6, cyp2c9, cyp2c19, cyp3a4, cyp3a5 involved elimination half-life15 hours (armodafinil),4 hours (esmodafinil)excretionurine (80%)identifiers iupac name 2-(diphenylmethanesulfinyl)acetamide cas number68693-11-8 ypubchem cid4236iuphar/bps7555drugbankdb00745 ychemspider4088 yuniir3uk8x3u3dkeggd01832 ychebichebi:31859 ychemblchembl1373 ycomptox dashboard (epa)dtxsid0023329 echa infocard100.168.719 chemical and physical dataformulac15h15no2smolar mass273.35 g·mol−13d model (jsmol)interactive image smiles o=s(c(c1ccccc1)c2ccccc2)cc(=o)n inchi inchi=1s/c15h15no2s/c16-14(17)11-19(18)15(12-7-3-1-4-8-12)13-9-5-2-6-10-13/h1-10,15h,11h2,(h2,16,17) ykey:yfghcgitmmyxaq-uhfffaoysa-n y (verify) modafinil’s side effects include headaches, anxiety, excessive adrenal gland overproduction, and nausea. serious side effects in high doses include delusions, unfounded beliefs, paranoia, irrational thought, and transient depression, possibly due to its effects on dopamine receptors in the brain, as well as allergic reactions. the amount of medication used should be adjusted in those with kidney problems, as this medication has markedly increased side effects during renal insufficiency. 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. its legal status varies by jurisdiction; in the united states it is classified as a schedule iv controlled substance, whereas in the united kingdom it is a prescription only medication. in some countries no controls apply. it is available as a generic medication. in 2020, modafinil was the 302nd most commonly prescribed medication in the united states, with just over 1,000,000 prescriptions. usage medical modafinil is not considered to be a classical psychostimulant, but rather is classified as a eugeroic (wakefulness-promoting drug). sleep disorders modafinil is used primarily for treatment of narcolepsy, shift work sleep disorder, and excessive daytime sleepiness associated with obstructive sleep apnea. for obstructive sleep apnea, it is recommended that patients use continuous positive airway pressure (cpap) appropriately before they consider starting modafinil to help with daytime sleepiness. because of the risk for development of skin or hypersensitivity reactions and serious adverse psychiatric reactions, the european medicines agency recommended that new patient prescriptions should be only to treat sleepiness associated with narcolepsy. fatigue the uk national institute for health and care excellence (nice) and ms ngos suggest modafinil to help with multiple sclerosis (ms) fatigue. occupational