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A to Z of MS Modafinil (Provigil)

Product name

Provigil

Modafinil is a drug that promotes wakefulness and is licensed for treating people who experience excessive sleepiness due to narcolepsy. Research has suggested that it may be an effective treatment for the management of multiple sclerosis fatigue in some people where sleepiness is a factor in their fatigue. However following the findings of a safety review, the European Medicines Agency recommended that the use of modafinil should now only be associated with narcolepsy.

How modafinil works

It is thought that modafinil works by selective activation of a particular part of the brain called the hypothalamus. This area is thought to control normal sleep and wakefulness patterns. Unlike central nervous system stimulants, modafinil does not result in any rebound hypersomnia (or 'crash') as it wears off.

How is modafinil given?

Modafinil is taken orally as tablets.

Side effects and contraindications

Modafinil is generally well tolerated with mild side effects, which can include headache, nausea and asthenia (weakness, loss of strength). Modafinil reduces the effect of contraceptive drugs.

Reference

Rammohan KW, et al.
Efficacy and safety of modafinil (Provigil) for the treatment of fatigue in multiple sclerosis: a two centre phase 2 study.
Journal of Neurology, Neurosurgery and Psychiatry 2002;72(2):179-183.
abstract

Littleton ET, et al.
Modafinil for multiple sclerosis fatigue: does it work?
Clinical Neurology and Neurosurgery 2010;112(1):29-31.
abstract

MHRA.
Modafinil (Provigil): information to support safer use; now restricted to narcolepsy.
read online