1. Modafinil (CAS No. 68693-11-8) is a medicine which
stimulatescentral nervoussystemandisusedcommonly in
conditions which lead to excessive daytime sleepiness.
These conditions may include shift work sleep disorder
usually encountered in shift workers working outside the
normal schedule, narcolepsy related fatigue experienced
duringdaytime andobstructive sleepapneaincombination
with continuous positive airway pressure (CPAP).
The primary mechanism of action of modafinil is not very
clear but it is known to be inhibiting the dopamine
reuptake,hence increasingitsconcentrationinbloodwhich
isa stimulantitself and well known as ‘happy hormone’. It
has alsobeenobservedthatitincreasesthe concentrations
of nor-epinephrine and serotonin in the prefrontal cortex
and hypothalamus which can be due to indirect effect of
increaseddopamine. All these hormones and neurotransmitters are considered as stimulant, thereby
making modafinil as wakefulness promoting agent.
Modafinil isreadilyabsorbedorally,and it is available as 100mg and 200mg oral tablets. For adults, it is
recommended to take 200mg orally once a day in the morning for the treatment of narcolepsy or
obstructive sleep apnea and one hour before the start of the work shift for treatment of shift work
disorder.Modafinilisnotapprovedtobe usedinpediatricpopulation because its efficacy and safety in
this age group has not been established yet.
Modafinil isgenerallywell-toleratedmedicine with extremely rare serious adverse events. Commonly
experienced adverse events are very mild including headache, nausea and decreased appetite which
have been observed in less than 10% of the users. Few other adverse effects may include anxiety,
insomnia,dizziness,diarrhea, and rhinitis. Although it is a safe drug but if any patient experiences any
rare serious rash including Stevens-Johnson syndrome, it should be discontinued at the same time.
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