Modafinil (Provigil) and Adderall are prescription drugs with stimulant-like effects, often compared due to their overlapping uses and mechanisms. Both are used in the treatment of narcolepsy and sometimes used off-label as study aids. However, they have distinct properties, side effects, and abuse potentials. This article aims to provide a detailed comparison of modafinil and Adderall, focusing on their uses, mechanisms, side effects, warnings, and potential for weight loss.
What are Modafinil and Adderall?
Modafinil (Provigil)
Modafinil is a generic drug also sold under brand names such as Provigil, Alertec, and Modavigil. It is approved by the FDA to treat sleepiness caused by conditions like sleep apnea, narcolepsy, or shift work disorder. Modafinil has a unique structure and is not classified as a traditional stimulant, but it does have stimulant-like effects, improving alertness, thinking, and perception.
Adderall
Adderall is the brand name for a combination tablet containing amphetamine and dextroamphetamine, often called mixed amphetamine salts. It is available as a generic drug and is also sold under multiple names, such as Adderall XR and Mydayis. Adderall is a stimulant that increases the concentration of dopamine and norepinephrine in the brain. It is FDA-approved to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. Adderall comes in immediate-release and extended-release forms, with the immediate-release form lasting about 4 to 6 hours and the extended-release form (Adderall XR) lasting up to 12 hours.
How Do They Work?
Modafinil's Mechanism
The exact mechanism of action of modafinil is not fully understood. However, it is believed to work by increasing dopamine levels in the brain by preventing its reuptake, meaning it helps naturally produced dopamine compounds remain in the brain for longer amounts of time. Unlike Adderall, modafinil does not directly stimulate the brain or cause the body to produce more stimulant neurotransmitters.
Adderall's Mechanism
Adderall increases the concentration of dopamine and norepinephrine in the brain. These neurotransmitters are responsible for alertness, focus, and mood. Adderall's long-lasting effect is due to its sustained presence in the system, working for four to six hours.
Read also: Weight Loss with Adderall: What You Need to Know
Uses for Modafinil and Adderall
Modafinil and Adderall are both prescribed to treat narcolepsy. However, they also have other uses:
- Narcolepsy: Both drugs are effective for treating narcolepsy, and the American Academy of Sleep Medicine Association includes both drugs in its treatment recommendations.
- ADHD: Adderall immediate-release tablets are used to treat ADHD in children ages 3 years and older, while Adderall XR capsules are approved for treating ADHD in children ages 6 years and older. Modafinil may be used off-label to treat ADHD in children.
- Obstructive Sleep Apnea and Shift Work Disorder: Modafinil is also used to improve wakefulness in adults with obstructive sleep apnea or shift work disorder.
Dosage and Administration
Here’s an overview of modafinil and Adderall dosages and how you would take these drugs for the conditions they both treat.
Modafinil
Modafinil is also used to improving wakefulness in adults with obstructive sleep apnea or shift work disorder. And Adderall is also used to treat ADHD, but these uses aren’t addressed here. To learn more about the dosages for all conditions these drugs help treat or prevent, see the modafinil dosage article and Adderall dosage article.
Dosage for narcolepsy
Adderall
Adderall immediate-release tablets are used to help treat attention-deficit hyperactivity disorder (ADHD) in children ages 3 years and older. Immediate-release Adderall tablets are also used to treat narcolepsy in children ages 6 year and older. Adderall XR capsules are approved for treating ADHD in children ages 6 years and older. Modafinil may be used off-labe to treat ADHD in children. With off-label use, doctors prescribe a drug for a purpose other than what it’s approved for.
Read also: Does Adderall Help You Lose Weight?
For more information about Adderall, Adderall XR, and modafinil and children, talk with your child’s doctor.
Side Effects
Both modafinil and Adderall can cause side effects, ranging from mild to serious.
Mild Side Effects
Modafinil and Adderall may cause mild side effects. The following table lists examples of mild side effects that have been reported with these drugs.
Serious Side Effects
Serious side effects may also occur in people using modafinil or Adderall. The following table includes serious side effects reported with these drugs. To learn about your specific risk of serious side effects from modafinil or Adderall, talk with your doctor or pharmacist.
- Adderall has a boxed warning for this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “What are the warnings of modafinil and Adderall?” section.
Common Side Effects of Adderall
Adderall tends to have a broader range of side effects, and some people may experience certain side effects more severely than others. The most common side effects include:
Read also: The Truth About Adderall, Weight Loss, and Weight Gain
- Loss of appetite (36%)
- Dry mouth (35%)
- Short-lived blood pressure elevations (up to 35%)
- Insomnia (up to 27%)
- Headache (up to 26%)
- Abdominal pain
Psychiatric side effects reported with Adderall include hearing voices, becoming suspicious for no reason, or becoming manic.
Common Side Effects of Modafinil
The most common side effects of modafinil are headaches, nausea, dizziness, and nervousness. Technically, one side effect of modafinil is trouble sleeping, but since most people taking it struggle with excessive daytime sleepiness, this may not be a problem for some. Modafinil may also cause some rare side effects like irregular heartbeat, agitation, depression, or hallucinations.
Allergic Reactions
For some people, modafinil and Adderall can cause an allergic reaction. In general, symptoms of an allergic reaction can be mild or serious.
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms and can determine whether you should keep taking modafinil or Adderall. If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you’ve had a serious allergic reaction to modafinil or Adderall, they may have you switch to a different treatment.
Warnings and Precautions
Modafinil and Adderall may not be right for you if you have certain medical conditions or other factors that affect your health. The prescribing information for these drugs refers to these factors as warnings.
Boxed Warning for Adderall
Adderall has a boxed warning regarding the risk of misuse and dependence. Stimulants, including Adderall, have a high risk for misuse and dependence. Misusing Adderall can lead to stimulant use disorder, a type of substance use disorder. In rare cases, misusing Adderall can cause serious side effects or death. Using Adderall at higher doses, as well as taking it long-term, increases the risk for dependence.
Before prescribing Adderall, your doctor should evaluate your risk for Adderall misuse and dependence. If they prescribe Adderall to you, they’ll monitor for symptoms of misuse throughout treatment. You should also monitor yourself for symptoms of Adderall misuse, such as using the drug to feel “high” or skipping school or work obligations due to misusing the drug. While you’re taking Adderall, be sure to keep the drug stored securely in a place where others cannot access it.
Other Warnings
In addition to boxed warnings, modafinil and Adderall have other warnings. Before using modafinil or Adderall, talk with your doctor if any of the following conditions or health factors apply to you.
- Warnings for Adderall:
- If you have Raynaud phenomenon or another condition affecting blood flow
- If you have seizures or have had them in the past
- If you have taken a monoamine oxidase inhibitor (MAOI) drug, such as phenelzine (Nardil), in the past 14 days
- Warnings for both modafinil and Adderall:
- If you’ve had an allergic reaction to either drug or any of its ingredients
- If you’re pregnant or planning to become pregnant
- If you’re breastfeeding or planning to breastfeed
- If you have depression, bipolar disorder, or another mental health condition
- If you have or have had suicidal thoughts or behaviors
- If you have heart disease, including high blood pressure or if you’ve had a heart attack
- If you have Tourette syndrome, or another condition which causes verbal or motor tics
- If you have a substance use disorder
- If you have a kidney problem, such as chronic kidney disease
- If you have a liver problem, such as fatty liver disease
Drug Interactions
Both Adderall and Modafinil interact poorly with alcohol. The stimulant nature of the medications can compete with the depressant effects of alcohol, masking signs of drinking too much without actually preventing the problem. Adderall interacts badly with many medications. It should not be taken alongside MAO inhibitors, serotonergic drugs, CYP2D6 inhibitors, proton pump inhibitors, or tricyclic antidepressants. Modafinil interacts poorly with hormonal birth control. It can reduce the effectiveness of birth control due to its inhibitory effect.
Abuse and Dependence
One of the main problems with Adderall is that it may cause dependence and tolerance and be subject to abuse. Adderall has a high potential for abuse due to its wide availability and more potent effects. People often abuse Adderall due to the rush of euphoria from taking a large dose of the drug. Adderall tends to have a very high risk for addiction because it is easy to become dependent on the drug. When you regularly take Adderall, your brain becomes used to high levels of dopamine and other neurotransmitters. When Adderall usage stops suddenly, you may feel physically ill. Withdrawal symptoms for Adderall can include sleepiness, anxiety, depression, irritability, and mental confusion.
Though modafinil doesn’t have significant withdrawal effects, any stimulant drug reinforces taking a drug to a certain degree and can cause dependence and subsequent withdrawal. Modafinil dependence is rare. There have only been a few cases ever recorded of a person who has an addiction to Modafinil. This typically happens when a person takes exceptionally high doses, such as roughly 12 times the average amount, for extremely long periods. Modafinil withdrawal does cause some cravings, but it is mostly just characterized by fatigue and depression.
The difference in the classification of the drugs - Schedule II for Adderall and Schedule IV for modafinil - reflects their different risks for abuse or dependence.
Modafinil and Adderall for Weight Loss
No, neither modafinil nor Adderall are approved for weight loss. To learn more about the conditions these medications are approved for, see “Uses for modafinil and Adderall” in this article. Weight loss was reported as a side effect in studies of Adderall, but was not a side effect in modafinil’s studies. If you’re concerned about weight loss while taking Adderall, let your doctor know. They can review strategies to maintain a weight that’s satisfactory for you.
Switching Between Modafinil and Adderall
Modafinil and Adderall are both approved for treating narcolepsy in adults. You may be able to switch between modafinil and Adderall with your doctor’s approval. If you’re an adult taking modafinil or Adderall for narcolepsy and are interested in switching to the other drug, talk with your doctor. Your doctor can discuss whether the other drug is safe for you to take, and if so, they’ll instruct you on the proper way to switch treatment.
Cost and Availability
Whether you have health insurance or not, cost may be a factor when you’re considering these drugs. Keep in mind that what you’ll pay for either drug will depend on your treatment plan, health insurance, and the pharmacy you use. Modafinil is the generic form of the brand-name drug Provigil. Adderall is a brand-name drug that also has a generic form. You’ll usually pay more for brand-name drugs than generics. If you’re interested in using the generic form of Adderall, talk with your doctor.
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