Modafinil Off-Label Use for Fatigue

Modafinil is a eugeroic or a wakefulness-promoting agent for the treatment of sleeping disorder like sleep apnea, narcolepsy, and excessive daytime sleepiness. Modafinil was developed by Lafon Laboratories in an experiment involving Adrafinil. Modafinil is considered as the main metabolite of Adrafinil. It was first prescribed in France in 1994 and later on, in the US in 1998.

Modafinil, when ingested, have shown many qualities apart from wakefulness. As experienced by the users they found Modafinil has energy boosting effects, it provided them with alertness and motivation. Whereas, this has not been proven but it is considered that Modafinil has such effects which can help people suffering from fatigue.

Fatigue is a person feeling tiredness or exhaustion caused due to weakness, which has a slow onset. It can have both physical and mental causes. Physical fatigue is the lack of ability of a muscle to sustain physical performance. Mental fatigue is a temporary decrease in maximum cognitive performance due to prolonged period of cognitive activity. Fatigue is considered as a subjective feeling, it is often confused by fatigue whereas both are different.

People with multiple sclerosis have reported the off-label use of Modafinil with neurological fatigue and have found it effective.

Cephalon conducted a study in 2000 to evaluate Modafinil as an effective treatment for MS-related fatigue. A group of people (72) who suffered from MS of the unstable degree of severity took two different doses of Modafinil over nine weeks with an inactive placebo. After nine weeks it was found that fatigue levels were self-estimated on standard scales and individuals taking a lesser dose started feeling less fatigued. For the lower dose versus placebo, it showed the statistically major difference. A higher dose of Modafinil was not considered more effective. Even though Modafinil is not legally prescribed to be used for treating fatigue in multiple sclerosis but is used off-label.

Modafinil is also used off-label for sedation and fatigue in many other conditions including;

  • Depression
  • Muscle pain
  • Chronic fatigue syndrome
  • Muscle weakness
  • Opioid -induced sleepiness
  • Spastic cerebral palsy, and
  • Parkinson’s disease.

In some countries, Modafinil has raised interest in the military as an alternative to Amphetamine. The drug usually worked in warfare situations where most troops face sleep deprivation during long missions. It has been used my countries like France, Canada and US and their investment on Modafinil have brought many things to light about the nootropic drug and its medical uses.

  • The government of France pointed out that the foreign legion used Modafinil during secret missions.
  • The UK Ministry of Defence ordered research interested in Modafinil from QinetiQ and spent 3 thousand British pounds.
  • The Indian Air Force announced in 2011 that Modafinil was included in emergency plans.
  • The US Air force has named Modafinil as a “go pill” for fatigue management.

Apart from military, it is mentioned in Canadian Medical Association Journal that it is been used my astronauts for long missions.