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Comment by ido | Hacker News Reader

A lot (most? all?) of these drugs are habit forming and have serious side effects.

Modafinil has fewer side effects and is less habit forming than drugs such as caffeine, nicotine, and alcohol. In fact, modafinil is safer than caffeine:

Basti and Jouvet (1988) describe a suicide attempt using 4500 mg of modafinil; the suicidee survived with no long-term effects but temporary nervousness, nausea, and insomnia.

That's 45 doses of modafinil and she was fine afterwards. 45 times the typical dose of caffeine would be lethal. Sure, you can argue from ignorance about potential long-term effects, but that argument works for anything that wasn't invented before you were born. Based on the evidence we have now, modafinil appears quite safe.

Edit: You are the first reply that didn't start with "because." You broke the pattern! >:(

What does being habit forming and having serious side effects have to do with media lethal dose? Just because you can take a lot of something without it killing you doesn't imply it's safe to take daily for extended periods of time.

Would you agree that the following is most likely true? p(long_term_safety|overdose_non_lethal) > p(long_term_safety|overdose_lethal)

That is, if an acute overdose of modafinil is not lethal, then it is more likely that the drug is safe for long term use. An equivalent acute overdose of caffeine would cause ventricular fibrillation and death. Yet few people are concerned about caffeine's long-term safety.

Also, notice the side effects of modafinil overdose: nausea, nervousness, and insomnia. Side effects of caffeine overdose include hallucinations, psychosis, and rapid muscle breakdown leading to kidney failure.

Although modafinil's mechanism of action isn't well-understood, evidence points to it having a neuroprotective effect. See http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2654794/ . So if anything, it's probably beneficial in the long-term.

While I happen to agree with you, I think that andrewf was pointing out that while modafinil is known not to be an acute toxin, that says little as to whether it is a chronic toxin, since its mechanism is poorly understood and may have undesirable long-term side effects.

A good example might be fructose, which you'd have to try very hard indeed to overdose on, but seems to be a long-term chronic toxin with many unpleasant effects, the high LD50 and the advisability of taking it at all being quite unrelated, indeed opposing.

Yes, there are many counterexamples, but most compounds that are safe in large acute doses are safe in small long-term doses. Given this evidence, the studies showing neuroprotective effects, and the fact that modafinil has been around since the 80's, I assign high probability to its long-term safety.

Sure, but p(getting murdered|having recently bought ice cream) > p(getting murdered|having recently bought a christmas tree), also ;)

Could you provide a citation about how modafinil has fewer side effects then, particularly, (black) coffee?

What I've found in the literature says that longer term studies on the effects of modafinil are needed http://www.ccjm.org/content/74/8/561.full.pdf (2007)

While the WSJ ran an article, http://online.wsj.com/article/SB1000142405274870327860457462... , pretty much saying that black coffee is at worst a wash health wise (though I do note that they said caffeine has a pro-obesity effect and Modafinil an antagonistic effect (it's wiki article says as much)).

My point is that, from what I know, coffee isn't that bad. What information do you have that counters my notion or that modafinil is worth the unknown risks? Preferably with citations, please and thanks. I'm very curious about this topic for obvious reasons.

It's also not at all clear whether their long-term effect will be positive for any particular person, or how to predict it. A large portion are basically milder versions of amphetamines, without nearly as many of the really bad side effects. But they fundamentally do the same thing, upping short-term energy and concentration. One common issue is that people fall into on/off work patterns: you're taking the enhancer and working like mad, or, when you're not, you're totally checked out. There are a lot of kinds of intellectual work for which oscillating between 110% and 0% effort isn't really optimal, though.

I think it's somewhat telling that the best success seems to be at high-pressure environments with fairly prescribed tasks, like law school.

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