Modafinil Is Wall Street’s New Drug of Choice

When drugs are used illegally, reporting on their adverse effects is generally shoddier than for on-label prescription usage, for a variety of reasons. In my personal experience, Provigil is an extremely effective and powerful tool, and like any power tool, should be treated with the proper respect or you're likely to get hurt. See my other comment a few threads below for more information and context, but I wanted to reply quickly to this (admittedly excellent) resource because it didn't seem to have a whole lot to say about the potential dangers, and as I've personally experienced them (and still find Modafanil to be a drug worth taking on occasion) I thought I'd try and make sure that others like me can learn from my mistakes without the need for their permanent consequences. The long and short - If you choose to use Modafanil, drink plenty of water, try not to use it as a sleep replacement (48-72 hours without sleep) more than once or twice a month, and fortify and replenish your body with quality food before, during, and after. If you are reckless, the lack of sleep combined with a histamine agonist can have effects that are roughly the opposite of benadryl, including an increased propensity for immune response (including allergies), that depending on your misfortune may become a permanent part of your life.

There goes my night. That site is like a black hole.

Yes, those couple of hours right after it snows can be quite beautiful in a big city. If you want to cure yourself of your nostalgia you can just imagine the couple of hours after that. When the snow starts melting and everything turns into grey/black mush. I guess this is what it must feel like to stop taking Modafinil.

The lack of distinctive seasons was far and away the #1 reason I got out of California. Maybe you're not wrong about wanting to move back. :)

Diagnosed narcoleptic here with an MSLT score of about ~2min.

I've been taking Modafinil @ 200-400mg/day off and on since 2003, with probably a total of 4 years of usage in that time span, together with Xyrem for about a year in 2004 and punctuated by ritalin for a year or so around 2008-09. I personally only take it when I have to and try to avoid taking it on days on which I think I can manage without it.

Yes, it can be habit forming, but only psychologically and only weekly. I can totally see it being habit forming when "taken together with" a demanding worklife. If you aren't working lots of hours where you need to stay focused the entire time, there is little motivation to take modafinil. It's not any "fun" and the "high" you get is not from the drug itself, but the ego boost from getting a lot of shit done. People don't get "addicted" to the drug but to the feeling of productivity.

On top of that, it has little to no side effects. It might have exacerbated my bruxism slightly but that's about it.

However there is one risk with it and that is sleep deprivation. My number one advice to anyone that takes it is to never take it after about 11am in the morning (or less than 12 hours before the time you intend to sleep). If you follow that one rule, I can't foresee people having any issues with it long term. The problem with taking it less than 12 hours before bedtime is that it has a half-life of about 6-8 hours meaning that it's mostly worn off by 12 hours and sleep "no longer feels optional at that point. This approach lets your feel awake, alert, productive and focused during your daylight hours when you plan to be working.

If however someone does break that rule, it's easy to lapse into a messed up sleep cycle and that itself can lead to someone feeling more and more tired the longer it goes on leading to trying to fix the problem with more modafinil.

The side effects cited from Internal Medicine (“hypersensitivity reactions and neuropsychiatric adverse effects”) aren't a product of modafinil per se, but a constant accumulated lack of sleep. Add to that the fact that the symptoms of sleep deprivation are pretty much indistinguishable from schizophrenia and you have an explanation from those side effects.

I doubt that abuse of this drug would do anything to impact my ability to get this medicine even if such abuse was widespread. It's not a trivial thing for someone to fake a diagnoses with narcolepsy, like you can do with ADD/ADHD or anxiety disorders. A bona fide diagnosis requires a polysomnogram and MSLT if you don't show any serious signs of apnea. If one were to try to fake it, they probably need advice from an actual narcoleptic like myself to know what to say and do to fake one or both of those tests.

Plus, modafinil isn't even the most restricted narcolepsy drug. Xyrem is, which is basically pharmaceutical grade GHB. That drug only comes from one pharmacy in the country and is overnighted in massive boxes so that it can't be trivially stolen. The boxes are huge for two tiny bottles. TBH the only thing that prevents narcoleptics from getting access to a drug they need like xyrem (a necessity if you have cataplexy) are drug costs. If you don't have group insurance or if narcolepsy/cataplexy are pre-existing conditions for your insurance, then Xyrem will set you back around $50k to $80k a year last time I checked. I don't know street prices for drugs, but I imagine that they are 100-200x more expensive than a legitimate prescription. The reason for the cost is the fact that it's an orphan drug, meaning that the costs of bringing it to market are spread across a very small potential target market. Even that's kind of absurd since it's sleep benefits were known from back in the 80s when GNC sold it OTC well before any clinical trials. FWIW Faking cataplexy is largely impossible if your doctor performs the blood test available to diagnose it.

"a pill that can have some serious side-effects"

Such as?

Sanity check fail: 10mg is an implausibly small dose, so small you'd have to grind the pills and measure tiny quantities of powder. Are you sure you're not thinking of a different drug, or off an order of magnitude?

1. Modafinil also suppresses appetite.

2. It's easy to argue against the extremes. But nothing about using modafinil precludes sleeping 8 hours a day. The effects usually last anywhere between 12 to 16 hours. So, for example, you can take it with breakfast and go to bed normally in the evening.

Well the no free lunch theory is I think wrong, we are vastly better off with modern medicines. We are already getting free lunches of longer and heather lives.

My experience, obviously not scientific, with modafinil is mild mania, grumpiness/quick to anger (What I think is the tiredness coming through), increase concentration and attentiveness to a task. My intelligence goes down. Mixed with alcohol it can cause blackouts (It has a long half life so this can be a day or so later). Hard to sleep on. Euphoric enough to take recreationally.

Listening to other people they have different effects.

For me I'm not sure it's a effective drug. Because it's said long term you can build up tolerance I've always only done it one pill per week for small projects, so maybe doing it on a regular schedule it might stop some of the above negatives.

I've had a fair bit of experience (though not every day for months on end). From what I've read many people have a similar time, though some may end up with better results.

If you're tired, you can use it as an alertness aid. If before, you would have fallen asleep at your desk from exhaustion, you will instead be able to continue to work (but still be fairly tired). Modafinil will allow you to continue on from the point of exhaustion and be able to function in some reduced capacity (50-60%). You will experience some periods of higher function (almost like waking up and being a bit tired, and then your mind clears a bit), basically you will alternate between tired and fine for a few hours, each period about an hour in duration. Taking modafinil in this manner isn’t especially recommended, but if you just spent all day / night putting out fires and you need to come in the next day to ensure everything is still running smoothly (but hard work isn’t expected), modafinil will do great here. Alternatively, I would recommend using it at the beginning of a normal day after a full night’s rest. This will result in some periods of clear headedness, and generally make it incredibly easy to focus on a task. I wouldn’t say I’m as ‘quick’ on modafinil, but I can certainly refactor code and slowly improve it for hours without feeling bored or getting distracted. I find that it makes me super calm as well. It definitely hampers creativity / big picture thinking, I wouldn’t do system design on modafinil, or even design for a subcomponent, I wouldn’t be at my best and might miss details or produce a subpar design. Basically, if you are just implementing a chunk of code, and have already figured out the details, modafinil will result in a good experience, you’ll make steady progress, your work will be of high quality, and the day will go by fairly quickly.

aaron695 mentioned dose – 2-3 pills a week is fine. Alternating entire weeks on and off is fine. I would only take at most one pill a day, but some people take two and are fine. Tolerance builds up about as quickly as it does for Adderall IR. Definitely don’t go drinking on the drug, but if you typically have a drink with dinner you’ll be fine - just don’t expect to feel any of the effects from the alcohol. I’ve felt the beginnings of depression on other nootropics (specifically piracetam - I generally have a poor diet though, so that may have been my fault) – but haven’t had a problem with modafinil after an extended period of time. It will be difficult to sleep if you take it too late in the day, definitely dose in the morning.

Essentially it’s a stronger, better version of caffeine (increased alertness, focus, can be used to increase performance with acute use, but with regular use tolerance builds and productivity decreases).

The brain didn't evolve to address the struggles of today. My ancestors weren't trying to stay mentally engaged to a computer screen for eight hours at a time.

Depression for me. I've used it multiple times in law school and afterwards. I stopped because for a couple days afterwards I would get seriously depressed.

It's quite possible the brain isn't optimised for the current availability of nutrients. Judging by the number of overweight people walking around it seems likely that evolution has selected for efficiency rather than performance. Given that our gene pool hasn't changed much in 250,000 years a little chemical nudge in the right direction is probably the way to go.

>if this were the optimal brain wiring, we'd be there already

Evolution isn't an "optimal" process. It is very random. And very slow.

[I meant for this to be a short post, but it's grown entirely too long. TL;DR - Modafanil is in many ways a wonder drug, but it is absolutely not free of side effects. You need to know (and monitor) your own body, and not ignore physiological imbalance, even if it seems trivial. Drink a lot of water, eat lots of nutritious food while taking it, and for the love of god, do not stay up more than 2 or 3 nights in a row without sleep. It's not worth it. Read on below if you want context]

I wanted to provide a personal story to counter a lot of the enthusiasm and carelessness around modafanil. I'm a software engineer, and I've dabbled on and off with modafanil for a little less than a decade now, including several one-week runs of hardcore usage, without sleep, during contracting gigs in my early-mid twenties.

I'll start by saying that I still think modafanil can be extremely useful as a tool, and that, until I recently ran out, I would still take 100-200mg of modafanil if it were no more than once a week (with an effort to make it not more than twice a month), so I still feel the risks and unknowns can be worth the tradeoff. But make no mistake - modafanil is an effective medication, and like all effective medications, it has side effects, (light) mental habituation, and potentially life threatening side effects if used improperly.

At the end of one particularly rough 9 days or so of straight usage during a major release for a contract, averaging 3 hours of sleep once every two to three nights (and the rest solidly awake), I settled with the team at a 24-hour diner right before release, and had an all-potato breakfast. My stomach had been steadily gaining in acidity over the week, but I had ignored it. A couple of hours later, I threw up and accidentally inhaled a small amount of the most corrosive stomach acid I've ever felt. When I coughed it out I tasted blood, and shortly after found it harder to breath. The bleeding was so profuse that I found it necessary to handstand over a hotel bathroom sink to let it all drain out without choking me. Luckily the person who had dropped me off was nearby - I phoned him and he took me straight to the hospital. I never had experienced that level of lung trauma before, and I've had a lot of hospitalization events related to some pretty severe asthma in my life, and it was this moment more than any other in my life that I seriously considered that I might die. In the end, I made it out with a light lung infection, and was treated at the hospital for an allergic reaction. I've never been able to eat potatoes since without experiencing an allergic reaction.

I can't seem to find a citation for this right now, but I remember reading at one point that modafanil is an agonist in the histamine receptor family. I am not a neurologist, and I know that the histamine receptor family can have very contradictory effects due to them being a modulator of the release levels of neurotransmitters dopaminergic and serotonergic pathways, and is also more publicly famous as being the target of the antagonist, Benadryl. I generally think about the vigilance instilled by Provigil as the same kind of vigilance you may have experienced during the beginning stages of an infection. The immune system revs up, you get warmer, you don't want to move around as much (as opposed to amphetamine based stimulants that seem to give you physical energy you want to burn off), and you slip into a more introspective and determinedly focused state. But vigilance comes at a price, and if you keep burning carelessly through your internal resources without replenishing them, eventually you'll start burning the wick (you) too. Something will fail. Sometimes catastrophically.

There are however, extremely cheap lunches, which the savvy will take advantage of. From my personal experience, this is one such case.

Slightly OT:

I am surprised to hear this sentiment on HN as often as I do. It seems to imply a somewhat Luddite-like fear of technological advancement, versus the generally positive interest I would expect from hackers. Am I off base?

I'm not talking about modafinil specifically (no opinion there) but more generally.

In this case, you end up paying for the tolerance that builds up extremely quickly when you take Modafinil multiple times.

I completely disagree.

1. The effect is extremely noticeable, as noticeable as a headache is (whatever the opposite of a headache would be).

2. I did read a study which found evidence that a particular genotype affects whether someone finds modafinil effective. I happen to have that genotype correlated with modafinil effectiveness.

As opposed to vitriolic opinions?

Don't worry. To me, it sounds like the author was tripping on his own silly mind.

If you were going to run a site that made money from selling "illegal" drugs to people over the internet, would you want to poison your customers? Aside from losing money in the long term, you're going to draw quite the ire when it's discovered you supplied the lethal dose.

This is the largest fallacy in the "we must regulate" side of drugs.

That is very odd. I have never heard of somebody having euphoria from Modafinil in any of the medical literature or on any of the nootropic/drug forums.

http://www.gwern.net/Modafinil list off 10 different citations for the line "But what does medicine say? It seems to report no euphoria, tolerance, or withdrawal/dependency."