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Provigil is the Cocaine of the Twenty-First Century

provigil.jpg Provigil (AKA modafinil) has been called a wonder drug: it can keep you awake and alert for hours without side-effects, and it's even recommended as "the professor's little helper" by neuroscience researchers writing in the prestigious journal Nature. Provigil, approved by the US food and drug administration for the treatment of narcolepsy, is often prescribed "off label" for ailments like severe jet lag, ADHD, and even problems with sleep cycles. But this drug, which is supposed to be a non-addictive stimulant because it doesn't get you high, turns out to be potentially as euphoria-inducing and addictive as cocaine.

In March 2006, researcher Stefan Kruszewski wrote in The American Journal of Psychiatry:

Modanifil is reinforcing, as evidenced by its self-administration in monkeys previously trained to self-administer cocaine.
And back in 2002, an article published in Behavioral Pharmacology states:
Modafinil and cocaine dose-dependently increased heart rate and blood pressure. The results of the present study suggest that modafinil has minimal abuse potential, but should be viewed cautiously because of the relatively small sample size. Future studies should further characterize the abuse potential of modafinil using other behavioral arrangements, such as drug discrimination or drug self-administration. A full characterization of the abuse potential of modafinil will become important as the use of this drug increases.
Other reports suggest that Provigil isn't addictive at all, and would in fact work well as a cure for methamphetamine addiction. Here's a snippet from a 2006 article from Current Psychiatry Reports:
In early trials, several candidate medications—bupropion, modafinil, and, to a lesser extent, baclofen—have shown promise in treating aspects of methamphetamine dependence, including aiding memory function necessary to more effectively participate in and benefit from behavioral therapies.
With more and more people getting prescriptions for Provigil, and the drug fast catching up with Viagra for most spammy ads online, shouldn't someone be investigating just how addictive it is?

2:28 PM on Tue Mar 25 2008
By Annalee Newitz
6,464 views
38 comments

Comments

  • Naw. As long as it makes money, the less investigation the better.

  • More investigation = making it illegal?

  • More investigation could get it reclassified with the narcotics, making control infinitely more stringent.

  • But I like sleep. Sleep is where I'm a viking.

  • I'm sorry, but it sound suspiciously like you want the FDA to do its job. Bad Annalee! BAD!

  • Want!

  • "I have to get up at five o'clock in the morning and SPARKLE, Neely, SPARKLE!"

  • Considering every wonder drug through the years (starting with heroin -- cures your morphine problem!) has been claimed to be non-addictive, and then of course it turns out to be hellaciously so... yeah.

    But the FDA doesn't do their job any more, so they're probably just chuckling, all "silly little blogger Annalee" and rolling around in their piles of pharmco cash.

  • Image of Gopherit Gopherit at 04:08 PM on 03/25/08 *

    @Garrison Dean: Brilliant.

  • @Annalee Newitz:

    As far as the FDA? Yes. That is exactly how it will work. Well, that, at least with a little help from our friendly neighborhood lobbyist.

    Chances are, this kind of thing won't get kicked off the market unless it kills a few people.

    Anyone taking any bets?

  • spammers also go nuts over Allegra and Claritin, neither of which require interventions. unless i'm mistake, the ADD scripts are off-label. i took it during a period of excessive sleepiness and never noticed any significant changes in focus or energy (unfortunately!) it just made me a little droon-y and humorless, and getting off it was totally fine....but speaking of sci-fi and detox, how about that Shivers-inspired stuff that demi moore is doing? that's legal(????)

  • oh right... "off label." will read first paragraph before comments from now on!!!

  • What's wrong with drugs being addictive?

    It's only when governments control and restrict the drug supply that issues arise.

    cf. Prohibition

  • They trained monkeys to TAKE cocaine? Seriously? O_o

  • I wish I could fake ADHD, they get all the best drugs.

  • The first study doesn't demonstrate addiction. addiction is selecting the drug over food and water.. that is what addicted animals do...

    Provigil isn't addictive or habit forming.

    In fact it is less addictive or habit forming then its closest over the counter equivalent..

    Caffeine. (it is better than caffeine, it doesn't produce a rush, but rather an increased alertness or vigilance if you will)

  • This post is really very far off base. There are people with legitimate medical problems who need this medication, and you are essentially classifying them as cocaine-addicts.

    First, it's also important to realize that most of the press this drug has gotten recently is due to off-label usage. Meaning, you're reading about it because people are taking it improperly, not because of any claims the manufacturer is making (to my knowledge, anyway).

    Secondly, the clinical definition of "addictive" is different from what you seem to believe. Many drugs -- Provigil most likely included -- cause physical dependence to some degree (hence instructions that tell you to taper your dosage). However, drugs that are truly addictive also include a psychological component. No one in their right mind would ever crave Provigil, because it doesn't get you high. I'm not sure where you're getting the idea that it's "euphoria-inducing", as that description is not supported in any of the articles you quoted.

    Sorry to be overly cranky on this, but this post seems irresponsibly alarmist. I know we all love to hate big pharma (because they deserve it), but come on.

  • @designmartini: Actually, you'll notice that I included two journal articles that essentially said there was no danger from Provigil. One said it the likelihood of addiction was extremely low, and the other said it was such a beneficial drug that it should be used to treat addictions to other drugs. So I think I took a pretty balanced perspective, and represented both sides.

  • @designmartini: Also I personally know people who crave Provigil.

    Look I don't have a moral problem with this. I crave coffee and other drugs that are kind of bad for me. Do I think those cravables should be illegal, or that my desire for them should make me a social outcast? Nope.

  • @designmartini I agree completely. My fiance is borderline narcoleptic and needs to take Provigil when he's about to fall asleep in the middle of doing important things like working with machinery in his lab or driving. It really makes me angry to read alarmist articles like this that make everyone who use the drug seem like abusers. He doesn't take it to "give him an edge" or "get high" -- he takes it so that he can function normally. Yes there are people who are abusing this and other drugs. But we should not blame the drug or indirectly blame people who are taking it for legitimate reasons. I think calling it the cocaine of the 21st century is needlessly alarmist and very inaccurate. Just my $0.02.

  • Wouldn't using previously addicted monkeys kind of compromise the test sample?
    They've already developed a behavior which they could regress into.

    I don't know about monkey brains but once someone develops one harmful addiction, they tend to be able to jump right over to another one even if it's not a particularly bad one.

  • @Annalee Newitz: And I crave meat.

    Psychologically addictive and physiologically addictive do tend to be drastically different things due to what they entail.
    Most drugs with high classification in federal law tend to do the latter.

  • Provigil is a helluva drug.

  • I wanna new drug.

    One that won't make me helpless, wonderin' what to do.
    One that makes me feel like I feel when I'm with you.
    ...when I'm alone with you, baybay.

    -JC

  • I had a stroke a in late 2k5. One of the effects of the brain damage was a severe decrease in my ability to maintain attention and alertness. They first tried two different ADHD drugs on me but both would cause me to puke within a half hour of taking them. The third try was something new called provigil. It has been a godsend. I am much more functional on the days that I take it than on the days that I have not taken it. It is tightly regulated as it is because people like to use it as a recreational drug. The insurance companies watch carefully how often you refill a prescription and won't approve refills more frequent than once a month. Doctors are also only allowed to prescribe a certain dosage a month.

    There are days when it seems to wear off sooner than others. The doctor said that isn't unusual but due to the regulations they can't do a higher dosage that he recommends that patients occasionally skip days so they can save up pills to take on those days where it runs out.

    While the medicine is beneficial and I can see why people would take it to help when alertness is needed I don't think it is addictive. No more so than caffeine anyway. The effect of the pills really are similar to taking a caffeine pill only without the crash or irritability.

    I was also told by my doctor that the government has been regularly giving provigil to the troops in Iraq to insure alertness on lengthy missions.

  • Image of braak braak at 05:52 AM on 03/26/08 *

    I don't know if a drug should be made illegal just because fucking monkeys can't control themselves.

  • @Annalee Newitz: Nice use of the "Crave" instead of "Addicted"

  • @Annalee Newitz: Yes, the post included links to two peer-reviewed articles, but the gist of the post and the headline in particular implies that Provigil is a high-powered stimulant in the class of cocaine or meth. Your words, not the articles, claim it "turns out to be potentially as euphoria-inducing and addictive as cocaine"

    No where, in either article, does it say it triggers a high akin to that of hardcore narcotics.

    Which brings up your back pedaling from "shouldn't some investigating be done" to "I don't want to ban cravables." Do you really want our government, notorious for putting politicians in science positions, determining what drugs you can handle? As someone who has to deal with a job that interrupts circadian rhythms, drugs like this are essential because they promote wakefulness, allowing proper sleep when I go to bed, despite irregular hours. When you simply can't get enough sleep, is drinking a pot of coffee a day any better than taking a few pills?

    @KraZe: Good points about the test monkeys, but considering this article is from a peer reviewed journal, I'd hope the answer isn't that simple.

  • First there was that piece on labmonkey assraping to see how HIV got transmitted [io9.com] and now getting them hooked on coke?
    This might be a moot point, but monkeys have it bad.

  • @Annalee Newitz: I think Illuminatus restated my point very well. My main objection with this post was not the articles you included, but the text framing them. The "euphoria-inducing" is particularly inaccurate and offensive. People who take this med for narcolepsy aren't taking it to get high, and shouldn't be classified with coke-heads and meth addicts.

    Also, I think what you mean by "craving" and the term in the context of addition is very different. Check out Google's list of definitions for "addiction" ([www.google.com]); I would guess that these are a far cry from what your friends are claiming to experience.

    Again, I don't mean to jump all over this, because lots of other news sources have included similarly alarmist stories over the past year or so, but I trust io9 to be a little smarter than that. :)

  • I suffer from narcolepsy and this drug is the only thing preventing me from suffering from sleep deprivation.

    for me, it is most definitely *NOT* addictive, and I mean that. if my wife doesn't remind me to take it, I forget. There is no high, there is no rush, there is no positive effect at all, except for not feeling like you've been awake for 10 days straight, and even that doesn't kick in for 45 minutes.

    however, one thing I did notice is that when I take my prescribed amount of provigil, I am able to concentrate on a single thing for up to 12 hours. This is an amazing super-human ability, in my eyes, because ever since I was 13 concentration has been something I've never been able to do (due to narcolepsy). My wife and family all tell me that they can concentrate for as long as they want normally, so it seems that provigil isn't much of a superdrug after all.

    And provigil doesn't prevent me from sleeping. On the odd occaision where I actually am tired from doing something extremely strenuous in the morning, I can choose to take a nap in the afternoon, and wake up with the provigil still in full effect. For me, provigil makes me like every lucky motherfucker in the world that doesn't have narcolepsy.

    Provigil is a fucking GODSEND for those of us who suffer from narcolepsy.

  • Slate did their own human trial:

    [www.slate.com]

    And I want that Restless Leg Syndrome drug that turns people into sex and gamling fiends!

    Hooray for crazy side-effects!

  • There is a successor drug FDA approved from Cephalon, NUVIGIL, which is the single-isomer formulation of modafinil. Just thought y'all might want to know.

  • FWIW, Provigil makes me cranky and sweaty. On the plus side, orgasms are way more intense. Also, the "coffee miracle" that ensures morning regularity is amplified to 11.

  • Taking the good with the bad - I did a smoking cessation study with this drug. It made me frighteningly psychotic - BEFORE I stopped the cigarettes. When the study was over (I had dropped out because of this side effect), they sent me an update on the results and found that "no significant side effects were reported". yeah, right.

  • Provigil makes me calm, because my crankiness is caused by a feeling of complete and total exhaustion when I don't take it.

    Clearly provigil is great for some people (me, and the other two narcoleptics I know who take it) and bad for some people (you lucky bastards that don't have narcolepsy).

    You'll have to rip this drug from my cold dead hands before I'll go back to being exhausted 24/7, no matter how much sleep i get.

  • I'm drinking coffee and eating chocolate cheesecake as I read this article. =)

  • the reason methamphetamine is illegal is because it can not be patented, anyone can make it. now with these new amphetamine like drugs the drug companies can finally justify the legal use of these substances.-blurey

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