Modafinil Side Effects: the Serious Impact of the Smart Drug

Last Updated: October 12, 2021

Authored by Roger Weiss, MD

Reviewed by Michael Espelin APRN

Modafinil is the generic name of a wakefulness drug sold under various brand names such as Provigil, Alertec, and Modafinil, of which the commonest brand name known is Provigil. It is popularly useful amongst military personnel and organizational workers that are active during the odd hours of the day to keep them fully awake, and healthy. Coupled with that, it is a useful drug in treating patients with sleep disorders such as narcolepsy (often described as a chronic neurological disorder in which a region of the brain responsible for normal circadian rhythms undergoes alteration, resulting in abnormal sleep patterns, especially excessive sleeping during the day hours) and obstructive sleep apnea or hypopnea syndrome which is characterized as sudden wakefulness from sleep because of obstruction of the respiratory airways.

This article will look into and investigate the side effects of Modafinil, as well as differentiating between the short-term and long-term Modafinil side effects. It will help to give enough information about the different complications of Modafinil and how it affects the body during several physiologic conditions. Besides the health complications and side effects, it will also dive into the importance of getting urgent medical treatment for Provigil effects because of their lethal toxicity.

What are the Side Effects of Modafinil?

Modafinil, often publicly labeled as the smart drug all over various pharmacies and stores because it keeps one mentally awake and alert for long periods, with no necessary distraction. Also called nootropics, it is a cognitive enhancer drug, and healthy individuals use it for improving their overall effectiveness. Because of the addictive and dependency potentials of Provigil, it may cause severe issues in those using the drug, as the individual dependence on Provigil will become too high and will experience the side effects of Modafinil.

Provigil Side Effects Affect Both the Mind and the Body Health, and May Comprise:

  • Increased concentration
  • Cognitive difficulties
  • Head rushes
  • Headaches and migraines
  • Nausea
  • Drowsiness
  • Difficulty staying asleep/problems in sleeping (sleepiness)
  • Eye pain
  • Back pain
  • Loss of appetite
  • Shortness of breath
  • Constipation
  • Tremors of body parts
  • Spastic muscles and difficulty in movements
  • Dry mouth
  • Excessive thirst
  • Heart-burn
  • Flushing and sweating
  • Epistaxis/Nose-bleeding
  • Tingling, burning, and numbing sensation of the skin (Paresthesia)
  • Flushings
  • Depression
  • A lack of anxiety
  • Mood swings
Muscle Spasms

Other side effects of this medication are dangerous and if experienced, the attention of any medical facilities or health personnel, such as the doctor is paramount.

These Side Effects are:

  • Anxiety
  • Hoarseness
  • Puritis/itching
  • Peeling skin
  • Blisters and rashes
  • Hives on the skin
  • Breathing and swallowing difficulties
  • Angina/Chest pain
  • Arrhythmias/Pounding, fast and irregular heartbeat
  • Hallucinations
  • Thoughts of self-harm and suicide
  • Abnormally exciting moods and frenzies
  • Swelling of the face region

These drug side effects are extremely dangerous and often predispose dangers and harm to both the user, those around him, and his community at large, affecting both their mental and physical health. For example, eye pain can lead to loss of sight at a very early age, shortness of breath leaves the user at risk of complete blockage of airways in a worst-case scenario, angina can lead to heart failure, loss of appetite can make the user suffer from extreme forms of anorexic conditions and cognitive difficulties which potentates into a drastic reduction in the mental capacity which includes the intelligent quotient and logical reasoning. At zero points such as this, the individual might have to remain in psychiatric rehabilitation or medical facilities until the addiction subsides drastically.

Short-Term Effects of Modafinil Consumption

Modafinil is a drug designed for short-term use, with a half-life of 12-15 hours. There are still some common short-term side effects that are mild and disappear within a day or two.

Short-Term Side Effects of Provigil Include:

  • Headaches: Also known as sinus pressure. According to most of the researches done on Modafinil, this is the most commonly reported short-term effect, and its due to increased stimulation and production of two neurotransmitters used in increased wakefulness, which includes glutamate and orexin. The overproduction of these neurotransmitters leads to migraines. Also, due to increased concentration rates provided by Provigil, users forget to drink water and sleep appropriately, and this causes dehydration and fatigue, which eventually leads to prolonged headaches.
  • Loss of coordination: associated with anxiety and nervousness, especially in users with a positive history in the usage of nootropic drugs. According to the U.S. National Library of Medicine, most users, after 7-9hours, experience a certain level of anxiety. However, this level of anxiety differs in various users. Some users do not have the capability of taking many doses of Provigil as it causes a lack of coordination, while others can take as much as 200 mg of Provigil without anxiety.
  • Increased Awareness: At first, this is a positive sign of Provigil as this leads to mental enhancement and higher cognitive pre-processing, but increased awareness for over lots of hours takes a down-turn as it becomes very difficult to relax afterward, leading to hallucinations and other negative symptoms.
  • Depression: Modafinil is an anti-sleeping medication, and it keeps one awake for long periods; lack of sleep and disruption of the normal sleep-wake cycle can lead to the triggering of the onset of mental health issues. Also, the brain needs lots of rest for its normal functions, and because of the lack of adequate rest, Provigil induces a negative effect on the brain, causing mental stress.

According to the U.S. National Library of Medicine, this medication may also affect the skin, resulting in the appearance of small red patches often known as eruptions or skin rashes which are painless but are often itchy and uncomfortable. The skin rashes are because of an allergic reaction to the drug (Modafinil rash), which is because of a type-1 hypersensitivity reaction or an Immunoglobulin E reaction.

Long-Term Effects of Modafinil Use

Provigil long-term side effects are highly dangerous if not taken care of urgently. The long-term effects of Provigil can affect the user both physically and psychologically. In addition, the users can develop great Provigil tolerance over time, and this can lead to an overdose of the medicine causing lethal doses intake and drug toxicity, which can eventually lead to death, majorly because of the medicine’s narrow therapeutic index.

Other Dangers of Modafinil Long-Term Effects May Include:

  • Hallucinations: this occurs when an increased dose of Provigil is used. Although not commonly seen, it occurs in individuals with an underlying disease such as bipolar disorder and Kleine-Levin syndrome. Also, people who are overly stressed and end up using high doses of Provigil often end up with auditory and visual hallucinations.
  • Irregular Heartbeat/Chest Pain: it is often perilous for people with cardiovascular problems to use Provigil because it increases blood pressure because of the stimulation of neurotransmitters which influence the blood pressure and heart rate. It is leading to increased contractility of the heart, which in users with cardiovascular abnormalities results in arrhythmias or Irregular heartbeats and chest pain commonly referred to as Angina which can radiate to the jaw, the shoulder, the back of the lower arm, and sometimes to the back.
  • Sores: there are often white patches of sores and blisters around the mouth, which can be painful.
  • Bleeding/Bruising: seen amongst women of reproductive age when used with hormonal contraceptives. It leads to unnecessary bleeding from the wall of the vaginal endometrium.
  • Stevens-Johnsons Syndrome (skin-rashes): Provigil, when taken for long periods, can lead to a triggering of the immune system leading to an auto-immune infection that can cause a haywire behavior of the immune system, causing them to release various cell-death signaling molecules leading to a large amount of cell death by causing the formation of red and purple blisters on the skin which can burst open leading to skin rashes and making the skin susceptible to persistent, recurring infections.
An Elderly Woman Has Heart Pain

Modafinil can also cause sleep deprivation, leading to a loss of concentration and insomnia in which one may not sleep at all or in any cohesive pattern, which can cause poor retention skills, inability to recall old memories and form new ones, poor decision making, and feeling of tiredness and lethargy. Also, long-term use can lead to permanent chemical imbalances in the brain and prolonged constant alertness, which may leave the person in an uncomfortable, fluctuating mood.

Does Modafinil Cause Weight Loss?

Although Provigil is not a core weight loss drug, it is now known that continued use of the drug can result in a 10-hit decrease of the total body mass, and there are lots of causes responsible for this loss in the body mass index. The main reason is due to the constant increase of dopamine by directly blocking its transporter.

Loss of Appetite

It is important to know Provigil itself does not cause weight loss, but it leads to the creation of several behavioral occurrences that can trigger weight loss, and one of these habits is the loss of appetite. At the initial stage of taking Provigil, most users feel less hungry, and this is because of a neurotransmitter released in the brain called dopamine. It helps to achieve lots of tasks, and it gives happiness to the user. The release of this hormone inhibits certain centers in the brain, which are hunger and appetite centers. This reduces the intake of food, leading to loss of appetite.

Enhanced Cognitive Functions

Provigil takes to have a high cognitive function, and this precipitates to an increase in mental performance, which leads them into making smarter and reasonable decisions in terms of their dietary intake.

Increased Level of Dopamine

Provigil leads to the stimulation and the upregulation of dopamine receptors in the brain. This leads to increased levels of dopamine, which helps in activating the reward centers in the brain and helps in the reduction of pleasure-seeking, such as food.

Also, Modafinil, when used with other drugs, can lead to an increase in weight loss. Such drugs include clozapine and olanzapine, which are antipsychotic drugs. Provigil, when taken under depression, can induce weight loss.

Modafinil Weight Loss: Doctor is Holding Measuring Tape

Provigil Promoted as A Weight Loss Aid

Provigil is a wondrous drug for weight loss because of its fast effects on weight loss, although the major cause for the Provigil weight loss is unknown. Doctors fully advise that if using the drug to reduce weight loss, it is also advisable to put in an effort because the drug increases physical energy, and expenditure of the energy reduces weight loss.

How Will Weight Loss Be Influenced?

Weight loss using Provigil does not happen in a day (It could take 9-12months to see a visible result). It happens because of several factors, which includes:

  • Reduced calorie intake
  • A higher desire for physical activity (I.e., exercise)
  • Feeling of satiety with reduced appetite

How To Prevent Modafinil Side Effects

Modafinil side effects are prevented by lowering a Provigil dose to the barest minimum or the median safety dose in which there are no side effects. This must be done by consulting the appropriate medical personnel. Also, similar drugs that function like Provigil but with a lesser side effect should be administered in place of Modafinil. Finally, drugs that combine with Provigil to create an adverse effect should not be administered or taken.

Frequently Asked Questions

Does Modafinil Cause Hair Loss?

Although it’s very rare for Provigil to cause hair loss, prolonged use of Provigil in older women between 50-59 and who have multiple sclerosis and take the drug (Aubagio) can have hair loss, probably because of the drug interactions. Also, since Provigil is mostly used in young people, it increases physical energy, which can lead to stress and lack of sleep, which induce massive hair loss.

Modafinil and Pregnancy

Modafinil causes congenital malformations when used in pregnancy. It is a potential teratogen and causes deformities in babies. Therefore, pregnant women should avoid using Provigil.

Is Modafinil Overdose Possible?

Yes, the maximum recommended daily dose for Provigil is 400mg per day. Taking above this required daily amount causes overdose.

Modafinil Overdose Signs and Symptoms are:

  • Insomnia
  • Agitations
  • Restlessness
  • Confusion
  • Hallucinations
  • Nervousness
  • Chest pain
  • Slow, fast, or pounding heartbeat
  • Nausea
  • Diarrhea
  • Tremors

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Page Sources

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  5. Modafinil: Why 'smart drugs' are not the brightest option,27 December 2020. Consumer Information(Question and Answer) By the Australian Department Of Therapeutic Health. https://www.tga.gov.au/community-qa/modafinil-why-smart-drugs-are-not-brightest-option
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Published on: April 18th, 2017

Updated on: October 12th, 2021

About Author

Roger Weiss, MD

Dr. Roger Weiss is a practicing mental health specialist at the hospital. Dr. Weiss combines his clinical practice and medical writing career since 2009. Apart from these activities, Dr. Weiss also delivers lectures for youth, former addicts, and everyone interested in topics such as substance abuse and treatment.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.