Modafinil's abuse potential

Modafinil's abuse potential

Modafinil (Provigil^®) is a wake-promoting medication used to treat narcolepsy and other sleep disorders. Recently, the drug has be used off-label to enhance cognition in psychiatric patients and even in healthy patients seeking a memory boost. Modafinil has been touted as having a low abuse potential; however, a new study questions that assumption. Most stimulant medications, such as methylphenidate and amphetamine, increase brain dopamine levels. Modafinil was thought to exert its effect in the brain on pathways other than dopamine, but now there is evidence that dopamine is involved. Researchers from the National Institute on Drug Abuse looked at 10 healthy male volunteers to measure the effects of modafinil at therapeutic dosing of 200 mg and 400 mg given orally. PET scans were used to measure the effect of modafinil on extracellular dopamine and dopamine transporters. Modafinil increased extracellular dopamine and showed evidence of occupancy of dopamine transporters, effects similar to drugs with the potential for abuse. The authors conclude that, considering the increasing use of modafinil, there needs to be heightened awareness for potential abuse of and dependence on modafinil in vulnerable populations (JAMA 2009;301:1148-1154).