Modafinil is a stimulant drug marketed as a 'wakefulness promoting agent' and is one of the stimulants used in the treatment of narcolepsy. Narcolepsy is caused by dysfunction of a family of wakefulness-promoting and sleep-suppressing peptides, the orexins, whose neurons are activated by modafinil. The prexin neuron activation is associated with psychoactivation and euphoria. Modafinil activates glutamatergic circuits while inhibiting GABA. To improve wakefulness in patients with excessive daytime sleepiness EDS associated with narcolepsy.

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Indicated to improve wakefulness in adults with excessive sleepiness associated with shift work disorder SWD. Risk of skin reactions eg SJS, toxic necrolysis, and drug rash with eosinophilia and systemic symptoms ; discontinue if rash or other hypersensitivity reactions occur. Not recommended in patients with angina, cardiac ischemia, street value of 200mg provigil history of myocardial infarction, left ventricular hypertrophy, or mitral valve prolapse. Use with caution in severe hepatic impairment, elderly, history of: depression, psychosis may exacerbate psychiatric symptoms, or mania. May reduce effectiveness of steroidal contraceptives 1 month after discontinuation of drug therapy.

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