Modafinil, also known by its chemical name diphenylmethylsulfinylacetamide, falls within the category of psychostimulants. It is part of a class of compounds known as nootropics, which are utilized in the treatment of conditions like narcolepsy, restlessness, sleep apnea, and various sleep-related disorders. This drug is also employed to address issues related to concentration, memory, and cognitive perception. While it is categorized as a dietary supplement, Modafinil is prohibited in several countries and is deemed a form of sports doping. Mechanism of Action The precise mechanism by which Modafinil interacts with neurotransmitter neurons in the brain remains somewhat elusive. It is presumed that the active component heightens the release of monoamines, including catecholamines, dopamine, and norepinephrine, from synaptic clefts. Simultaneously, it elevates histamine levels in the hypothalamus, a process akin to the action of amphetamine-based stimulants. It is important to note that Modafinil is non-addictive and carries a reduced potential for misuse when compared to traditional stimulants, all while maintaining its efficacy in countering drowsiness. Approved Uses Modafinil is incorporated into treatment regimens as an adjunct to antidepressants, serving multiple therapeutic purposes. The approved indications for its use encompass:

• Mitigating the urge to sleep excessively.
• Combatting overall fatigue.
• Addressing pathological daytime sleepiness, such as hypersomnia.
• Managing attention deficit hyperactivity disorder.
• Enhancing short-term memory function.
• Alleviating the effects of sleep deprivation.
• Treating neurolepsy.
• Enhancing reaction time and precision (widely employed by military personnel, astronauts, and pilots).
• Correcting disruptions in circadian rhythms and enhancing sleep quality.

Treatment for Cocaine Addiction Modafinil shows promise as an experimental treatment for cocaine addiction due to its opposite mechanisms of action in the brain. A double-blind study examining the effectiveness of these two components discovered that addicts increased their consecutive days without cocaine use. However, it had no impact on the rate of change in the number of days without use. Despite these findings, a patent was not granted for this application. Weight Loss Even individuals within a healthy weight range may turn to this drug to curb their appetite and shed pounds. Month-long studies have shown that users of the drug can reduce body weight and calorie intake by 18% when taking 200 mg and by 38% when taking 400 mg per day, compared to a placebo. Scientists attribute this appetite-suppressing effect to an amphetamine-like mechanism, although it doesn’t elevate heart rate. Conversely, one company has obtained a patent for a drug designed to promote weight gain. Treatment of Mental Disorders Modafinil is occasionally employed off-label for the treatment of mental disorders. It aids in restoring cognitive functions in individuals who have undergone chemotherapy, mitigates memory impairments, alleviates depression in cases of bipolar affective disorder (although it can occasionally trigger a manic phase), and reduces symptoms of neurological fatigue in multiple sclerosis. In pediatrics, the medication is sparingly used to treat attention deficit disorder in children and adolescents aged 6-17 years, although it’s banned in several countries due to dermatological toxicity, and no patent has been secured for this purpose. Directions for Use and Dosage The standard tablet dosage is 4 mg/kg of body weight, which roughly translates to 100-200 mg per day. This dose is effective for targeted suppression of sleepiness or for enhancing alertness in the morning or at night. For the treatment of narcolepsy or sleep apnea (periods of breath-holding during sleep), a daily dose of 200-400 mg is recommended, typically taken in the morning and at noon. To enhance physical performance, a range of 100-400 mg per day may be used. For the management of hypersomnia (excessive daytime sleepiness), a single daily dose of 200 mg in the morning is advisable. When addressing drowsiness associated with shift work, a 200 mg tablet should be taken one hour prior to the start of the shift. In the realm of athletics, dosages of 50-100 mg per tablet are common, with gradual dose increases. The drug is typically consumed 2-3 hours before sporting events and is particularly suitable for aerobic exercises, endurance activities, as well as events like shot put, pole vault, or long jump. However, it’s worth noting that for bodybuilders, the use of this drug is not warranted as it does not significantly impact muscle gain or fat loss. Drug interactions  Before starting therapy, the patient should notify the doctor about the medications he is taking because the combination of Modafinil with other drugs may have unpredictable effects. It reduces the effectiveness of birth control pills, which leads to the development of unwanted pregnancy, so during therapy, it is better to use barrier methods of contraception. The drug, in combination with yohimbine (included in potency-enhancing drugs), increases the heart rate and increases blood pressure to dangerous levels. Combination with alcohol is prohibited.