Other 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.
Recent studies which have reviewed previous research papers on modafinil have found no strong evidence for its use in treating MS-related fatigue. Although some potential benefits of the drug were identified, these studies concluded that evidence on the effectiveness of modafinil in treating MS fatigue was weak and inconclusive.
Amantadine is another drug which is sometimes used to treat fatigue in MS.
How does modafinil work?
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 excessive tiredness (a 'crash' or rebound hypersomnia) as it wears off.
How do I take modafinil?
Modafinil is taken orally as tablets.
Side effects and contraindications
Modafinil is generally well tolerated with mild side effects, which can include headache, nausea, chest pain, loss of appetite and weakness. Modafinil reduces the effectiveness of contraceptive drugs so you will need to consider other birth control methods while taking the drug and for two months after stopping treatment.
- Journal of Neurology, Neurosurgery and Psychiatry 2002;72(2):179-183. Summary Efficacy and safety of modafinil (Provigil) for the treatment of fatigue in multiple sclerosis: a two centre phase 2 study.
- Clinical Neurology and Neurosurgery 2010;112(1):29-31. Summary Modafinil for multiple sclerosis fatigue: does it work?
- Multiple Sclerosis Journal 2011 Aug;17(8):1002-1009. Summary HAGIL (Hamburg Vigil Study): a randomized placebo-controlled double-blind study with modafinil for treatment of fatigue in patients with multiple sclerosis.
- Journal of Neurological Sciences 2017;381:41-54. Summary The pharmacological and non-pharmacological interventions for the management of fatigue related multiple sclerosis.
- Journal of Neurological Sciences 2017;380:256-261. Summary Pharmacological treatments for fatigue in patients with multiple sclerosis: A systematic review and meta-analysis.
- Cochrane Database of Systematic Reviews 2015; Issue 5. Art. No.: CD006788. Full article Pharmacological treatments for fatigue associated with palliative care.
Last updated: November 2017
Last reviewed: November 2017
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