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Provigil as Treatment for Excessive Daytime Sleepiness

Medication May Treat Fatigue from Sleep Disorders, Multiple Sclerosis

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Updated February 19, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Provigil as Treatment for Excessive Daytime Sleepiness
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Provigil, sold under the generic name modafinil, is a prescription medication used to promote wakefulness. Provigil is often prescribed to treat the excessive sleepiness caused by many sleep disorders, including narcolepsy, sleep apnea, and circadian rhythm disorders such as advanced sleep phase syndrome, delayed sleep phase syndrome, and shift work sleep disorder.

It is also prescribed to treat the fatigue common in multiple sclerosis.

How Does Provigil Work?

It is not known precisely how Provigil works.

Who Should Not Use Provigil?

As with a related medication, nuvigil, there are many conditions that must prompt you to be cautious if considering use of Provigil.

If you have a heart condition such as left ventricular hypertrophy, mitral valve disease, unstable angina (chest pain), or a recent heart attack, you should exercise caution. Moreover, you should be cautious if you have a history of psychiatric illness such as depression, mania, psychosis, or substance abuse. Those with severe liver or kidney disease and the elderly may also need to be careful using this medication.

What Are Common Side Effects?

There are some common side effects that may occur with the use of Provigil, just as with any medication. It is unlikely that you would experience most of these side effects -- and you may not have any of them -- but some that commonly occur include:

  • Headache
  • Nausea
  • Nervousness; anxiety
  • Nasal inflammation
  • Diarrhea
  • Insomnia
  • Dizziness
  • Upset stomach
  • Loss of appetite
  • Dry mouth
  • Throat inflammation
  • High blood pressure
  • Chest pain
  • Rapid or irregular heart rate
  • Blood vessel dilation
  • Elevated liver enzymes
  • Abnormal sensations (paresthesias)
  • Depression
  • Constipation
  • Sleepiness

What Are Potential Serious Reactions?

As with the use of any drug, there is the potential for serious reactions. These side effects occur less commonly:

  • Anaphylaxis (severe allergic reaction including difficulty breathing)
  • Angioedema (swelling)
  • Multi-organ hypersensitivity reaction
  • Stevens-Johnson syndrome (a serious skin reaction)
  • Toxic epidermal necrolysis (a serious skin reaction)
  • Rash
  • Fainting
  • High blood pressure
  • Abnormal heart rhythms
  • Mania
  • Psychosis
  • Suicidal thoughts
  • Dependency or abuse

Things to Keep in Mind

There are certain individuals who should not use Provigil or who should use it with caution, as described above. Pregnant women and those breastfeeding should not use Provigil as its safety is unknown and adverse fetal effects have been demonstrated in animal studies. Everyone who takes Provigil should undergo blood pressure monitoring.

If you experience any difficulties, you should be in close contact with your primary health provider.

Sources:

"Provigil." Epocrates Rx Pro. Version 3.4, 2010. Epocrates, Inc. San Mateo, California.

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