Modafinil

It belongs to Amphetamines class. It is a powerful CNS stimulant. Modafinil is a wakefulness-promoting agent primarily used to treat sleep disorders such as narcolepsy, obstructive sleep apnea, and shift work sleep disorder. It acts as a central nervous system stimulant, enhancing cognitive function, alertness, and focus. Unlike traditional stimulants, modafinil is known for its lower risk of dependency and fewer side effects.

Indications

Modafinil is prescribed for: -Narcolepsy: To reduce excessive daytime sleepiness. -Obstructive Sleep Apnea (OSA): As an adjunct therapy to continuous positive airway pressure (CPAP) to improve wakefulness. -Shift Work Sleep Disorder (SWSD): To mitigate sleepiness in individuals with irregular work schedules.

Dosage

-Narcolepsy and OSA: 200 mg once daily in the morning. Some patients may require up to 400 mg daily. SWSD: 200 mg taken approximately one hour before the start of the work shift. -Dosage adjustments may be necessary for patients with hepatic impairment or elderly patients.

Contra-Indications

Left ventricular hypertrophy, mitral valve prolapse, Myocardial ischemia, Acute ST-elevation myocardial infraction, Disease of liver, psychotic disorder, Renal disease, unstable angina pectoris, hypertension. Hypersensitivity to modafinil.

Special Precautions

-Cardiovascular Evaluation: Patients with a history of heart disease should undergo evaluation before starting treatment. -Psychiatric Symptoms: Monitor for signs of psychiatric disorders, such as mania, delusions, or hallucinations. -Dependence and Abuse: Although the potential is lower, there is a risk of dependence and abuse. -Pregnancy and Lactation: Use during pregnancy only if the potential benefit justifies the potential risk. It is not recommended for breastfeeding mothers.

Side Effects

Headache, chills, fever, rhinitis, pharyngitis, backache, dyspepsia, anorexia, nausea, vomiting, diarrhoea, dyspnoea, anxiety, nervousness, depression, dizziness, insomnia, amentia, inpaired cognition, moodchanges, dyskinesia, hypertonia, paresthesia, tremors, amblyopia, cardiac arrhythmias, hypertension, hypotension, vasodilatation of blood vessels, hyperglycemia, polydypsia, xerostomia, dry skin, urinary retention, abnormal liver function tests.

Drug Interactions

-Cytochrome P450 Enzymes: Modafinil can induce CYP3A4 and inhibit CYP2C19, affecting the metabolism of various drugs, such as oral contraceptives, anticoagulants, and certain antidepressants. -Other CNS Stimulants: Concurrent use can increase the risk of adverse CNS effects. -Monoamine Oxidase Inhibitors (MAOIs): Should be avoided due to potential hypertensive crisis.