Managing modafinil

For the last year or so I have been deliberately experimenting with a psychoactive, nootropic drug.

You have to know me personally (much better than most of my blog audience does) to realize what a surprising admission this is. I’ve been a non-smoking teetotaller since I was old enough to form the decision. I went through college in the 1970s, the heyday of the drug culture, without so much as toking a joint. I have been open with my friends about having near enough relatives with substance-abuse problems that I suspect I have a genetic predisposition to those that I am very wary of triggering. And I have made my disgust at the idea of being controlled by a substance extremely plain.

Nevertheless, I have good reasons for the experiment. The drug, modafinil (perhaps better known by the trade name Provigil) has a number of curious and interesting properties. I’m writing about it because while factual material on effects, toxicology, studies and so forth is easy to find, I have yet to see useful written advice about why and how to use the drug covering any but the narrowest medical applications.

Before I continue, a caveat that may save both your butt and mine. In the U.S., modafinil is a Schedule IV restricted drug, illegal to use without a prescription. I use it legally. I do not – repeat, do not – advise anyone to use modafinil illegally. I judge the legal restriction is absurd – there are lots of over-the counter drugs that are far more dangerous (ibuprofen will do as an example) – but the law is the law and the drug cops can flatten you without a thought.

Another caveat: Your mileage may vary. This is a field report from one user that is consistent with the clinical studies and other large-scale evidence, but reactions to drugs can be highly idiosyncratic. Proceed with caution and skepticism and self-monitor carefully. You only have one neurochemistry and you won’t like what happens if you break it.

The first thing I should cover is why I get to use this drug legally. Many of you know that I have congenital spastic palsy. Our first weird fact about modafinil is that it is the only drug – indeed, the only medical intervention of any kind – that has improved the motor control of CP patients in controlled trials. This is a more interesting effect than drugs like Baclofen that are merely muscle relaxants.

Yes, modafinil helps me walk better – that’s why I can get it prescribed. I’m not actually very impaired as a normal thing, but it is of medically significant use in the circumstances when I am worst off – mainly, when I’m fatigued or under stress. Modafinil greatly reduces the likelihood that when I am tired or strained I will become extremely clumsy, barge into things, break them, and hurt myself.

Nobody knows how this works. (This is a phrase you will hear a lot in descriptions of modafinil effects.) CP is thought to be actual damage to the brain’s motor control circuitry. For a drug to be able to counteract or override that is bizarre – like observing a broken watch to work better when you pour butter into it – and nobody has any plausible theory about it.

Eppure, si muove. It really works. I have no explanation.

Modafinil has a much better known role as a wakefulness and pro-concentration drug. While on it, you will feel much less need or desire to sleep, and your ability to single-focus concentrate will go way, way up. Furthermore, there is no crash when the drug effect dissipates. And clinical studies indicate the drug has very low toxicity and addictive potential.

Nobody knows how this works. Pretty much all other wakefulness drugs exact a heavy price – they’re toxic, addictive, psychotogenic, derange your sleep cycle, and known or suspected to have baleful long-term effects on your neurochemistry even if you don’t have one of those short-term bad things land on you.

How do we know the drug is benign? Because there is actually decades of field experience with modafinil (and adrafinil, a precursor drug that metabolizes into modafinil) in various military organizations. These drugs were first seriously investigated as go pills for pilots and SpecOps personnel on long-duration missions. They proved an effective (and unexpectedly non-injurious) replacement for dexedrine and other amphetamines.

This isn’t to say the military experience didn’t reveal any problems at all. I am reliably informed by a source close to the field military that in a few cases heavy modafinil users developed a kind of manic Superman syndrome – neglecting self-maintainance, going without sleep for months, overdriving themselves and their units into psychological and physical collapse. Later in this report I will suggest some lessons to be drawn from these incidents.

The things I read about the military experience were a major factor in convincing me to try modafinil. Nothing less than decades of toxic/addictive/psychotogenic effects not showing up at a level above statistical noise would have done for me, personally; I’m extreeeemely protective of my gray matter. I didn’t know of the Superman-syndrome outliers when I began using it; had I known, I would have found it obvious that this is not a problem with modafinil itself but with stupid people interpreting the drug as a license to be stupider.

I should also note that there have been a very few (as in about 5 cases per million) reports of a very nasty necrotic skin disorder called “Stevens-Johnson syndrome” being brought on by modafinil. But this also occurs as an equally rare side effect of a wide range of other drugs, and the incidence pattern suggests to me that the victims have a rare karotype that responds badly to all of them. Just as stupid people gonna stupid, fragile people gonna fragile. This means less than meets the eye.

(After writing the above I learned that my conjecture is correct. There’s a list of SNPs associated with susceptibility with Stevens-Johnson. The source also lists classes of other drugs that are likely to trigger it: antibiotics, analgesics, cough and cold medication, NSAIDs, antiepileptics, antigout drugs, cocaine and phenytoin.)

There have been an even tinier collection of reports (as in, countable on the fingers of one hand) of psychotic breaks in people introduced modafinil with no previous history of mental illness. Again, the incidence pattern creates a strong suspicion that these were fragile people whose neurotransmitter balance could have been messed with by any number of stimuli, and that modafinil was an accidental but not essential cause here.

Earlier I said “you will feel much less need or desire to sleep”, and that is true. However, modafinil does not actually abolish physical fatigue. What it does is (a) reduce your sleep need by about 2/3rds, sometimes more, and (b) sever the link from physical fatigue to drowsiness, distraction, and brain-fog. If you pay attention to your body while on the drug, you will notice that (after a longer time than usual) it is getting sore and clumsy from physical fatigue – but that will present as a sort of neutral mechanical fact that affects nothing about your mental state; your mind will stay clear, sharp, and focused until the dose dissipates.

Now to the last big thing about modafinil: there is clinical evidence of significant increases in IQ while on the drug. To what extent this can be separated from the large boost in ability to single-focus is not clear, and one 2005 study found a boost effect that decreased with increasing IQ. However, recent studies and a 2016 meta-analysis suggest a stronger and more consistent effect than did earlier ones, with significant gains in both executive function and learning capacity. But nobody knows how this works.

I can’t say as much about this from personal experience as I’d like to, because I don’t know how I’d tell if my IQ were elevated. It’s certainly not something one can notice as easily as “Hey! I can really concentrate.” Also, if it’s really true that the effect decreases with increasing baseline IQ, I’d be poorly positioned to notice it.

However: there is practical field evidence that backs up the more positive studies. I am reliably informed that demand for modafinil from STEM students at top universities and people in cognitively-demanding jobs has created a large underground around the drug. If this is true, the drug cops must be practicing benign neglect; to date, modafinil-related criminal charges in the U.S. can be counted on the fingers of one hand and all seem to have been a sort of decorative garnish on more serious indictments.

(Of course, this cannot be relied on to continue. Moral panics have been ginned up on even slighter causes in the past and doubtless will be again.)

I will also say that I notice some differences in my affect while on the drug that are at least consistent with it jacking up my IQ. It makes me feel calm, cerebral, and in control – the exact opposite of the jittery, volatile effect from caffeine or (I’m told) other conventional stimulants. Emotions aren’t gone but they’re a little damped, a little muted. Except, interestingly enough, for my sense of humor; that is fully operational or possibly even enhanced.

Related point: I find the onset bump when the modafinil crosses my blood-brain barrier quite noticeable.

(I’ve heard that one of the commoner street names for modafinil is “zombie”. That makes a lot of sense if you think about how that slight damping of emotional swings is going to register to a person who lives in their emotions most of the time and barely even knows what “calm and cerebral” is like.)

Again, I’m probably not the best person to report on changes in affect. While doing web searches related to this topic I discovered several articles on the theme “ZOMG makes me a different person!”. That’s not my experience at all – rather, modafinil makes me more like me. It chemically pegs my affect to the same place I go naturally when I’m at the top of my game.

And am I actually more productive? Oh hell yes. I can tell by the amount of code and text I get written while on modafinil. Many users report productivity outside their normal range; I don’t get that, but I do get consistent performance at or near my normal peak level for as long as I’m on it.

You may be thinking modafinil sounds too good to be true. You have company; everybody who knows anything about drugs that mess with neurotransmitter balance has the same reaction when they learn the facts. Nobody knows how this works.

Before getting to management strategies, I will report another thing: Some but not all modafinil users develop a tolerance to the drug and require increasing doses to collect the effects they want. Odds of developing tolerance seem, unsurprisingly, to increase with frequency of use.

For the rest of this report, I am going to assume that you are either a U.S. citizen with a narrowly valid medical reason to use modafinil (such as spasticity or narcolepsy) and a legal prescription, or you live in a non-U.S. jurisdiction that does not restrict the drug, or you have other means of legal access. I will further assume that you want to maximize the nootropic and other benefits of modafinil while minimizing the risks.

Let’s inventory the risks:

First: Stevens-Johnson syndrome.

Second: Lifestyle dependency. While the clinical studies suggest very low potential for either physical or psychological addiction, you don’t want to go anywhere near subtler, functional versions of addiction either.

Third: Acquired tolerance requiring increasing doses.

Fourth: Self-damage through ignoring physiological cues partially suppressed by the drug (manic-Superman syndrome would be the extreme example of this).

Now the mitigation methods:

Against Stevens-Johnson, don’t have a fragile karotype. OK, there’s not much you can do to prevent that. So learn the symptoms of Stevens-Johnson syndrome and if you think they’re developing, stop taking modafinil and see your doctor immediately. One bit of good news is that you only have to pass this gate once – if they’re not triggered the first time you take it, they’re not going to be second and later times.

To avoid lifestyle dependency, plan your modafinil use around specific, non-recurring, slightly unusual challenges. Like: you need to not be clumsy and fatigued for a particular martial-arts test. Or, you need to put two or three working days’ worth days of peak effort into a project all at once.

To avoid tolerance buildup, don’t use it often. I seem to have a steady rate of about 1 200mg dose a month. I’m most likely to use it to handle unusual events where I want to be functioning at peak and perhaps expect to get less sleep than normal – SF conventions, for example. I will, as mentioned, also take it before a kung fu test for prophylaxis against palsy effects,

To avoid self-damage, self-monitor. In particular, stay aware of your physical fatigue level. Sometimes when I’m on modafinil and my muscles start getting fatigue-sore after hour 20 or so, I take a hot shower and a short nap to make the muscles happier even though my brain doesn’t need the rest yet.

That’s it, really. The last part, self-monitoring, is I think the most important. The drug will expand the envelope of what you can do; take those gains but treat yourself gently – no need to push the expanded envelope to collapse.

Modafinil is actually a mix of two enantiomers, only one of which is active. Once I use up my last few doses, I will be switching to a variant called armodafinil that is just the purified active enantiomer. I’m told it has a gentler onset and a longer dwell time,

A use for which I can certify it is combating fatigue on long drives. The effect I have seen in this application is so dramatic and benign compared to riskier drugs like amphetamines that I think this is in itself a sufficient argument for making modafinil and its variants over-the-counter drugs rather than prescription – they would would rapidly displace much more harmful substances and probably significantly decrease highway fatalities.

The drug also has much to recommend it for medical personnel, search & rescue people, police, and anyone else who has to work odd shifts under potential stress. The calming, anti-jitter effect is significant here and an improvement over large doses of caffeine, which promotes wakefulness without being particularly pro-concentration.

Finally, of course, there’s flow-state maintenance for programmers. Frankly, I don’t understand why steady use of modafinil is not already so dirt-common among people who code for a living that everyone takes it for granted. The pro-concentration effect is hugely helpful for productivity, and after a year of use I have experienced no downside at all, not even the jitters and wakefulness I would expect from deploying caffeine for similar purpose.

Nevertheless, I’m still wary of taking it more often, because I don’t want to develop that lifestyle dependency. On the other hand, I’ve seen a reason I might want to relax about this more as I get older. A recent study out of Italy suggests that modafinil improves centrality of neural function in elderly people, in effect mitigating or even partly reversing the effects of physical senescence on the brain.

Er, so, anti-senescence on top of everything else? Seems way too good to be true. But the positive results keep rolling in. I shall continue experimenting, self-monitoring, and perhaps occasionally reporting on it here.

70 thoughts on “Managing modafinil

  1. You’ve almost certainly seen Gwern’s writing on this subject as part of researching this post, but just in case: here.

    your ability to single-focus concentrate will go way, way up.

    I think of this as being “tuned in”; I am guessing you would just call it hack mode. It’s a wonderful state to be in, and I do both great work and great play on it.

    It’s also totally out of my control. The capability to hyperfocus comes every couple months for a week or two, like a lightning bolt from a clear sky. I ride it for a while, and then it’s gone. I don’t know how normal that is.

    I’ve been interested in modafinil for a long time as a way to harness that state more reliably. I still haven’t done anything about it, owing to the legal issues you mention. Insert invectives in the drug war’s general direction here.

    • >You’ve almost certainly seen Gwern’s writing on this subject as part of researching this post

      Gwern’s FAQ is linked in the post, which I wrote basically to address the things Gwern does not in my opinion cover well enough.

  2. “For the last year or so I have been deliberately experimenting with a psychoactive, nootropic drug.

    You have to know me personally (much better than most of my blog audience does) to realize what a surprising admission this is.”

    /me steps outside, gets in the 560SL, drives off to a lonely intersection surrounded for a mile in all directions only by corns, soybeans, and cows.

    NO SHIT??!?!!!!

    Merciful fucking $DEITY, Eric, I’d have been less surprised if you’d asked me to share your bed!

    • >Merciful fucking $DEITY, Eric, I’d have been less surprised if you’d asked me to share your bed!

      Quite unlikely. Well, unless the package includes a bundling layer of several extremely sexy women. As experienced systems programmers, I’m sure we could work out a resource-sharing protocol that would fulfill wait-time-boundedness and fairness guarantees.

      • Yeah…

        And I’d have said you messing around with psychoactive drugs was also extremely unlikely!

        • >And I’d have said you messing around with psychoactive drugs was also extremely unlikely!

          You’re not wrong. Unlikely it certainly was.

          Took a very, very exceptional combination of gains and excellent long-term data on (absence of) bad side effects to make me interested.

  3. I have two fear reactions to this.

    First, the usual fear of unknown horrifying side effects that will only be discovered when it is in regular use by a hundred million of people, many of whom will be dependent on it for work or other needs.

    Second, the fear that the drug is just as good as advertised, introducing a fundamental change in human existence. What happens when everyone is using it, or something like it? What parallel technologies will be pursued and applied because this one works so well? This could be the “entry drug” to more radical transhumanist practices.

    One question comes up: could the drug have applications in competitive sports? There’s a mental side to many sports. Golf, for instance – the player not only has to make the shot, he has to think about which shot to try, which means reading the wind and the ground, tracking one’s own performance, and then deciding on the optimal choice. Even ferociously physical sports such as football require thinking and concentration.

    The extensive military experience invites yet another question: are more powerful drugs possible? What is being investigated by the military services of other potentially (or actually) hostile powers? Russia or China would have few scruples in this direction; North Korea, Iran, or jihadists even fewer.

    Parenthetically, I would recall what is known, and recently brought out in discourse, about the use of amphetamines by the German military in World War II.

    • >What happens when everyone is using it, or something like it? […] This could be the “entry drug” to more radical transhumanist practices.

      I wonder about this myself. But I do wonder, not fear it.

      >Parenthetically, I would recall what is known, and recently brought out in discourse, about the use of amphetamines by the German military in World War II.

      I’ve been reading those stories too. They made me wonder: why wasn’t there a huge, visible wave of addiction problems and mental illness in German vets after WWII? One would rather expect it, based on the new evidence.

      Can it be that the battlefield/non-battlefield distinction is a situational wall that operates the same way the difference in setting between taking psychoactive drugs therapeutically and recreationally does? (Rich almost certainly knows that addiction following on use in a therapeutic setting is extremely rare, even when the same drug is highly addictive when taken recreationally by the patient’s doctors…)

      • Basically all German soldiers ended up in POW camps when the war ended for them, so they were subject to cold turkey detox. When they got home sooner or later, there were much more important things, like getting any food at all. And when such drugs became available and affordable again, I think that most ex-soldiers would see those drugs as part of their horrible wartime experiences, which they did want to forget.

    • This drug is already prohibited at esports – as well as many other drugs that may in any way enhance performance (including marijuana – some strains can actually improve concentration). Another wonderdrug is nicethamid (but this one is verboten for anyone with heart issues) – in Poland accessible over-the-counter in any pharmacy.

      Other drug with interesting effect on humans is LSD – but you need VERY small dose of it.

      As for transhumanism – there is no way to stop this. At some point we will get into enhancing our capabilities as much as possible.

    • > What happens when everyone is using it, or something like it?

      Stuff gets done better.

      How many software bugs, hardware defects, protocol errors, and the like–not just in computer stuff, but in EVERYTHING are from normal to moderately bright folks who just weren’t paying enough attention?

      > What parallel technologies will be pursued and applied because this one
      > works so well? This could be the “entry drug” to more radical
      > transhumanist practices.

      Go read the reddit on his. People are looking at every sort of chemical for similar gains.

      Look at what people are claiming about “mindful meditation”.

      I imagine there’s going to be a lot of “brain hacking” going on from here to the middle of WWIV.

      > One question comes up: could the drug have applications in competitive sports?

      Don’t care. Really. It’s UTTERLY irrelevant to me.

      The only issue there is will it be illegal, against the rules or tolerated. Other than that, don’t care.

      I *want* people working on medical, networking, and banking software (add as many fields as you want to that, that’s just off the tips of my fingers) to have as much focus and intelligence as we can get. If there was a pill for conscientiousness I’d want them taking that too.

      I don’t *care* what goes on in professional sports (although it’s impact on the culture is big enough that I suppose force feeding the players conscientiousness pills would be a good idea) as long as the rules are equally enforced.

  4. I think I’d like to try this. I haven’t had a really good hacking run in over a year, possibly several, and my writing process terribly fragmented. While I’ve done a LOT to simplify my life of late, I still long for the calm productivity that should have ensued after that.

    It also sounds like a cure for twitterism, (the inability to think in thoughts longer than 140 characters), which is a disease getting so bad, in my estimation. that it deserves its own entry in the DSM.

    Got any cures for cellphone-itus?

    • He doesn’t, or he’d have cured his own by now :-P.

      But seriously, no drugs necessary for that. Go on vacation somewhere peaceful and out of range of cell service. Leave your phone in your pocket, powered on, in airplane mode. This is operant conditioning: you still have the opportunity to reflexively grab your phone and stare at it, but doing so never provides any reward. Allow a few days for the twitch to go away, and about a week for the conditioning to take hold strongly enough that you won’t immediately revert as soon as you get back to civilization.

      • >He doesn’t, or he’d have cured his own by now :-P.

        Oh. Now I know what you mean.

        Didn’t occur to me as an issue because compared to most of the people I see FTF my case is pretty mild. I do use my phone as a timefiller when, say, in a car, but I’m not very prone to get distracted by it in social situations.

        One of my relevant life choices is to not do Facebook at all. G+ doesn’t generate enough notification traffic to be seriously distracting. Twitter might, but I almost never actually use it. Usually when my phone pings me it’s for Signal traffic that I actually want to see.

  5. Wow.

    The list of effects sounds like a complete psychological profile of me. Reduced mental fatigue, single focus concentration (but not always on what I *want* to single focus on), ignoring physical fatigue and other sorts of self neglect, damped emotions (except anxiety, which runs on the other side of my family from where the modafinil-like stuff came), active sense of humor (seen from inside, at least, those outside often don’t get the joke).

    > Frankly, I don’t understand why steady use of modafinil is not already so dirt-common among people who code for a living that everyone takes it for granted.

    You don’t understand because you’re not a standard nerd. In fact, given that your psychological profile is atypical among hackers, and the standard nerd profile *is* typical, I really wonder if it is wise, given your audience, to talk about the benefits of modafinil.

    If a standard nerd takes modafinil, they’ll superman themselves to death within a month, and they’re probably already doing that (albeit more slowly) without it.

    I mean, I mostly like who I am, but that list of effects is *terrifying*. I think a big part of why I *don’t* code for a living is because I already have all of that stuff to the point that it interferes with productivity, especially cause it’s always on, unlike with taking a pill, where you can take one as you sit down to something productive. And that’s where I’d superman myself to death if I took modafinil: I’d take it get the jump in focus to lock myself in to a productive task, and when I was done with that, I’d settle down to some game to reward myself, and by the time that was over, between my natural being-that-way and the modafinil, I might well have been awake 30 hours before I hit the sack. No. Nonononononono. I cannot go anywhere near anything with that list of effects.

  6. Does modafinil also provide prescient visions? As it expands consciousness it may be the Spice Melange

    I am also a teetotaler, take very good care of myself, but the one thing I am addicted to is ambien and I don’t like it. I’m psychologically dependent on it, I don’t think I can get any sleep if I don’t take one. If you don’t go to bed right away after you take it you end up with scary memory gaps whereby you have to check if you sent any nonsensical offensive text messages. So take this as a warning: keep your sleep cycle natural don’t mess with it.

    • I don’t know if I was chemically addicted to Ambien, but I was at least psychologically dependent, and developed an increasing tolerance to its effects.

      Switching to melatonin got me off of Ambien. I’m now not on either, but coming off of sleep aides completely coincided with a significant change in my sleeping arrangement (getting married). At that point, I think the change allowed me to be off of sleep aides for long enough to loose the psychological dependence.

      • I discovered that wearing yellow glasses the last 90 minutes or so before bedtime was better than either Ambien or melatonin. It also works for my wife. The theory: blue light from modern LCD displays messes with your sleep, and the yellow blocks the blue.

        • >I discovered that wearing yellow glasses the last 90 minutes or so before bedtime was better than either Ambien or melatonin.

          I sometimes use melatonin for sound sleep. This alternative sounds interesting.

  7. I don’t know if this has changed or anything, but I recall seeing on Slate Star Codex a few years ago that while modafinil is illegal in the US without a prescription, adrafinil is perfectly legal over the counter.

  8. My sister was on modafinil for her idiopathic hypersomnia. She was told to never take it after midday because she won’t get to sleep but she can take it at 4pm and crash out at 7pm, and this was while she was taking 1400mg a day.

    She gave me half a card of it and said it is good for concentration, but only if you are able to concentrate on something; interruptions will make you very anxious and annoyed. She also told me about her friends that have tried it and Got Shit Done, but the warning has stopped me from trying it yet, I just don’t get enough time that I can concentrate on one thing without being interrupted.

    I think in Australia it should be much easier to get, but should still require talking to the pharmacist, just so you get warned about what can happen.

  9. I once read a textbook of molecular biology (I’m that kind of geek) and in it, the author makes a statement, over and over, to the effect that “the mechanism for these observations is unknown at this time…” The deeper one gets in real science, the greater the appreciation for the state of our ignorance is. Medicine is much, much worse. So many medical terms are simply Latin/Greek descriptions of observations that do not explain anything.
    I wish you the best in your neurobiological experiment. For myself, I’d be looking for “minimal effective dose”, and any consequences of long term use.

  10. It would be interesting to test this drug using chess players. Perhaps a double-blind clinical study that gave modafinil or a placebo to a cohort of players in advance of major tournaments, and then tracked the progress of their ICF ratings as a surrogate for IQ impact. This has the benefit of a sharp focus on specific cognitive prowess and a well-established yardstick (chess rating).

  11. Some personal observations on more frequent use (from someone who has been programming for 51 years): a 50mg dose on alternate days, taken before breakfast, may provide significant cognitive benefits; reduction in sleep with this dose can be slight; both enantiomers appear to be effective (with different time profiles). YMMV

  12. You write ” (and adrafinil, which is what it turns into when you metabolize it) ”

    However, wikipedia describves Adrafinil as a precursor to modafinil.
    https://en.wikipedia.org/wiki/Adrafinil

    Perhaps you were thinking of armodafinil—the active stereo isomer in modafinil.
    https://en.wikipedia.org/wiki/Armodafinil

    I took modafinil and armodafinil for years to help with MS-related fatigue. I would still be taking them if my insurance would cover them.

    I found that modafinil/armodafinil helped me stay awake all day. But, so do slow-release methylphenidates.

    • >I took modafinil and armodafinil for years to help with MS-related fatigue. I would still be taking them if my insurance would cover them.

      Indian graymarket suppliers will sell you armodafinil for less than $2 a tab – perfectly legal if you have a prescription, though I’m told Customs sometimes holds shipments on a demonstration that you have one.

    • > I took modafinil and armodafinil for years to help with MS-related fatigue. I would still be taking them if my insurance would cover them.

      A generic for armodafinil was approved late last year, and the cost per 90 days for me dropped from a little over $14,000 to just about $1400. Might make it worth trying the insurance again.

      Your story scares me. If insurance stops covering me on it, I’d be in for serious financial hurt, but if they’d done so last year, I’da been properly screwed. My doctor has been unwilling to try different doses because of that.

      • If your insurance stops covering it, you c an get it for cheap from Indian suppliers.

        Cheap as in 92 cents a pill (150mg Armodifinil). If you’re doing 150mg a day that’s less than most people spend on coffee.

        Free Enterprise for the win.

        F*k the government.

  13. Apparently adrafinil is unregulated in the US (legal OTC) and available online for under a dollar a dose. Just a few searches indicated it’s definitely a thing in the nootropic community (learned way more than one new thing today).

    Seems it has therapeutic benefits for ADHD sufferers. I have a borderline case myself, it runs in the family. I self medicate more or less effectively with caffeine. This is fascinating. I may need to do some research.

    Note: I value ME, my *self* and my mind a great deal. I don’t touch *anything* but my daily caffeine and occasionally a bit of alcohol.

  14. @Dave Taht

    >Got any cures for cellphone-itus?

    You mean, distractability, short attention span? DIVA test (DSM-IV based) for adult ADHD, http://www.divacenter.eu/DIVA.aspx?id=505 if bingo getting Strattera prescriped. Unlike Ritalin, it does not get one high, has no addiction potential, it is a noradrenaline reuptake inhibitor. In practice it feels being a bit “excited”. I would compare it to driving a bit too fast, more focus because more excitement, becasue it feels a tad dangerous.

    Ritalin and the like are addictive because they mess with dopamine, which is the expectation hormone, so they feel like gambling, when one feels a looking forward type of excitement that maybe this time, yes, this time I am getting a jackpot. Dangerous.

    This noradrenaline-adrenaline related stuff like Strattera is excitement without looking forward, more in the here in now, like concentrating on driving a bit too fast and dangerously. It is just a focus on the now without happy expectations from the future. It does not affect dopamine.

    And unlike caffeine non-jittery @Greg

    I haven’t tried mediating on it as I stopped meditating a while ago, but I suspect it would work well for it.

  15. I have narcolepsy (technically idiopathic hypersomnia), and I take armodafinil on a daily basis, and I agree largely with your post, but there are some ways my experience with it seems to be different.

    I have been taking armodafinil since June of 2009, if my memory serves me correctly, which was my senior year of high school. For me, it does not seem to impact my concentration (if anything, I am slightly less able to concentrate on tasks I’m not enthusiastic about),

    However, it does keep me awake.

    My junior year of high school I was suffering from bad headaches and falling asleep in classes. I was an honors student, so this was not taken kindly by my teachers. I saw a number of doctors, but my ENT doctor suggested I see a sleep doctor and have a sleep study done before going to the neurologist recommended by my primary physician.

    The sleep study was very telling. I was able to fall asleep faster than nearly anyone who’d taken the study at that still-new hospital before me, and where they try to wake you up every five minutes until you no longer fall asleep, they gave up after 8 iterations with me, I would reliably fall back asleep within a minute, even after being kept up for 10-15 minutes. (the normal person, if I recall correctly, normally fails to fall asleep after 3 iterations.)

    They initially treated me with methylphenidate, which sorta worked. I had fairly nasty side effects, I could not concentrate on tasks, if I was at all low on sleep, it would keep me awake, but not what I would call conscious, and it only lasted 3-4 hours, after which I would crash very hard. Then they put me on Nuvigial (armodafinil).

    The first day I took armodafinil is the first time I think I ever felt like what I imagine most people feel like, and it opened my eyes to just how miserable I had been before. I was awake all day, I could fall asleep at night without issue, and I had no side effects, at all. The constant headaches that I’d originally gone to the doctors for were gone, totally, killed by a drug with a listed side effect of headaches.

    In the 7-8 years that followed, I’ve noticed a few things while taking armodafinil.

    It builds up in my system. After a week of daily doses (250mg), I will start struggling to sleep at night. This is the only time I notice the physical tiredness and mental alertness you mention, though the time before my mental alertness waivers is slim, if I start taking armodafinil on Monday, Saturday evening I will be mentally alert and physically tired for just a couple hours, before I become mentally tired as well, and still be unable to sleep. after three straight weeks of taking it (using half-doses when I don’t need to be overly alert) I’ll start to get anxious, which is not normal for me. Even when it’s majorly built up in my system, abstaining for two days seems to completely clear it and I can resume it again with no problems.

    If I do not get enough sleep, it’ll still keep me awake, but I won’t be as alert, and I’ll be physically fatigued. That’s my state today, an SSD failure last night kept me up late, and as a result I’m not firing on all cylinders today. It will keep me awake all day, but definitely not as alert as I’d be with more sleep. I’ll also hold onto to the effects of the lost sleep until I reset on the Nuvigil again, or get 9-10 hours of sleep one night.

    It curbs my appetite. Without the Nuvigil, I am hungry and tired, all I want to do is eat and sleep, regardless of the amount of food and sleep I get. With the meds, I don’t get super hungry until it starts wearing off in the evening.

    It makes me a bit restless. I can sit at a computer and work for hours (and do, they pay me to do so.), but I have much more of a desire to get up and move.

  16. OK, if I understand this: adrafinil is a precursor to modafinil and is processed to modafinil in the liver, which means that adrafinil is potentially more damaging to the liver, right? So the regulated one is the one that’s *safer* and the unregulated one is the one that’s more dangerous…. Sounds about right.

    • Yes, the one that’s both safer and more efficacious is a controlled substance.

      It’s not about safety, it’s about not letting anyone get ‘high’.

  17. I used this fairly heavilly at university, and do so no longer. My thinking is as follows:

    -It does allow you to concentrate.

    -It means you require less discipline and drive to produce similar quantities of work.

    -It works better for uncreative work than creative stuff.

    If you’re planning on working for your entire life (which most of us are), I don’t really see the advantage of this drug over just developing your discipline and drive. If you really can’t face working, you should probably take a break anyway. Crutches like this just let you ignore your body screaming ‘take it easy’ while you are running straight for burn out. They also stunt the mental muscles and habits you need to self-motivate. Developing discipline and an awareness of your own body is more worthwhile in the long run.

    While I doubt it has any straight-up toxic effects, pushing your body past what it’s supposed to using drugs is bad for you, on a straight psychological level.

    • > I don’t really see the advantage of this drug over just developing
      > your discipline and drive.

      The flip side is that if it helps one be more attentive to the task and produce better work SHOULDN’T YOU BE TAKING IT REGULARLY.

      There are ways (as the OP and others note) to take this without over stimulating and causing problems.

      I tried it last year taking half doses every workday morning to get through the period of the day when I had the worst focus. It made me much more attentive and focused. It did not impact my sleep negatively because it clears the system relatively quickly and I was careful to NOT take it after noon.

      That, and I’ve got messed up sleep anyway, so it really couldn’t get much worse.

    • > I don’t really see the advantage of this drug over just developing your discipline and drive.

      I have lots of discipline and drive. I don’t really have any idea how to develop it further – but modafinil operates as though I had achieved that.

      I don’t know about creative work in general, but it works fine for programming. For me, anyway.

  18. @archerseven

    > (the normal person, if I recall correctly, normally fails to fall asleep after 3 iterations.)

    Apparently, the normal person doesn’t have a 1 year old child. I think all parents are with me here – you git good at exactly this. I was never able to have afternoon, after lunch naps, not as a 3 year old, not as a 30 year old. Anything but pitch black darkness keeps me awake and reading. My toddler “trained” me to do this easily. It was a very new and weird experience to be able to sleep in not-utter darkness. It is a more superficial kind of sleep. I can even think through plans through it, just extremely slowly.

  19. A dozen years ago, a friend of mine got her doctor to prescribe modafinil for a very slight narcolepsy, but she mostly got it so she would never have to sleep again if she didn’t want to.

    That year at the local SF convention, I bummed a couple of pills off her so I could con all day and party all night all weekend long. I could certainly stay up without getting tired just fine, but I discovered that I couldn’t get drunk. That is, even after several very strong drinks, I wasn’t even remotely buzzed.

    I was definitely hung over the next day, though. :-(

    (Caveat: I have ADHD, so my brain doesn’t react like most people’s, so YMMV.)

  20. Glad you finally took the plunge, you mentioned being interested in it eight years ago. Unfortunately the doctors in Japan I’ve asked about it seem to have a moral revulsion to the idea of getting something for nothing which it appears to represent, so the options for a prescription are limited to making a really sincere attempt to fake narcolepsy.

  21. “I wonder about this myself. But I do wonder, not fear it.”

    There are wonders possible. But if you don’t fear as well, you haven’t imagined the whole range of possibilities. It is powerful, and therefore dangerous.

    While I am generally an optimist, I look around now at the world and worry about how humanity is going to manage or mismanage this sort of thing.

    Look at the massive problems developing in IT, just from neglect and cost-cutting and faddishness. Consider NTP: a cornerstone piece of the Net, yet when you looked at the code it was a mess. Or the seemingly intractable problems with security and reliability, and the enormous volume of bugs in major software systems.

    Modafinil and its cousins will open wide opportunities for abuse, and there are numerous bad actors to exploit those opportunities. I don’t really trust the U.S. government, and I really don’t trust Russia or China, or Iran, or the narcos.

    Here be dragons. Golden treasures, too, but definitely dragons.

    • >Modafinil and its cousins will open wide opportunities for abuse, and there are numerous bad actors to exploit those opportunities.

      In my experience modafinil is an almost absurdly mild, benign drug, so much so that I think the very few people behaving stupidly enough to manage to damage themselves with it would simply find some other way to fuck up if it weren’t available.

      Thus, I can’t bring myself to be very worried about it. Lowering sleep need with no debt, improving concentration, boosting IQ, good for treating ADD, blocking alcohol intoxication, some suggestion it might be anti-aging…what do you want, it should give you orgasms, too? :-)

    • >What do you envisage the narcos doing with Modafinil, apart from cutting it with baking soda?

      Ignoring it. It’s not addictive enough for them to care.

  22. @esr: Thus, I can’t bring myself to be very worried about it. Lowering sleep need with no debt, improving concentration, boosting IQ, good for treating ADD, blocking alcohol intoxication, some suggestion it might be anti-aging…what do you want, it should give you orgasms, too? :-)

    Y’know, if it increased sexual function, as opposed to mostly muting sex drive, popular demand might have forced the FDA to approve it quickly. Just speculating.

    As a separate note, I believe the world would be a better place (especially the US part of the world, but also most of the rest of the world that uses largely US-developed pharma) if the FDA were abolished. I don’t see a function it performs that could not be done better by private hands. And hey, as a bonus, miraculin!

    • >Y’know, if [modafinil] increased sexual function, as opposed to mostly muting sex drive,

      Hm. I’ll have to self-monitor to see if I can detect any effect on my sex drive. Are you speaking from experience?

      I’m not really expecting such an effect. The slight damping of emotional swings I’ve reported does not interfere with my ability to enjoy sensation. I would notice if food tasted less good.

    • It didn’t seem to change my sleep at all when I was taking it, but then I’ve always slept like a baby.

      You know, thrashing around a lot making noise and waking up every couple hours in mild discomfort.

  23. Have you done research on Armodafinil, and liver toxicity? Since, you’re not using Modafinil daily it might not be an issue.

    Personally, Modafinil didn’t really do much for me over the month I took it for. Think my dosage was too low for my weight. I did feel a sense of clarity after the first dose of 100mg, but I just wrote it off as a placebo effect, after future dosages having almost no effect.

    I can’t really experiment with it, unless I can convince my doctor to argue I have work sleep shift disorder. It’s way too expensive to take Modafinil off label without insurance coverage. It’s kind of bullshit I can’t get insurance coverage since I do have a neurological condition that would benefit from it. (FDA requiring too many studies for drug approval, and NVLD not being in the DSM yet)

    Doesn’t Modafinil impact the AMPA receptors? Personally, I can’t wait for ampakines to reach the market; Cognitive enhancement will start getting interesting when they do. Experimented with piracetam (works mildly on the AMPA receptors) a few years ago, and noticed improvements to working memory and retrieval, though my episodic memory was gone. The drugs in development are supposedly far more potent, but have issues with toxicity or nausea.

    • >Have you done research on Armodafinil, and liver toxicity?

      Yes. Neither modafinil nor armodafinil has that as an associated risk at above noise level, see, for example, this report.

      Adrafinil, on the other hand, has to be metabolized into modafinil in the liver; that process is rate-limited and heavy use can have hepatotoxic effects.

      >Personally, Modafinil didn’t really do much for me over the month I took it for. Think my dosage was too low for my weight.

      Yeah, 100mg is a low dose for an adult male. When I take it I do 200mg; shortly I’ll switch to 150mg armodafinil.

      >It’s way too expensive to take Modafinil off label without insurance coverage.

      You want one of the Indian suppliers (summary and pointers here). Can be had for $1 or less for 100mg modafinil-equivalent – I say “equivalent” because armodafinil, not containing the inert enantiomer, is 50% more effective.

      >Doesn’t Modafinil impact the AMPA receptors?

      Hasn’t turned up in my research.

  24. There is a wonderful online drug database called “Epocrates” that also comes as a mobile app. You can see what the drug database says about modafinil here:
    https://online.epocrates.com/drugs/2274/modafinil

    If you’re on prescription medications, you can check to see how it interacts with with modafinil by using the drug interaction checker, including such favorites as ethanol and caffeine. The service requires you to provide an email address to create an account for this comparison feature.

    Please remember, I am not a doctor, nor can I guarantee that that drug database is accurate. I only suggest it as it may provide some useful information for people who are curious about the drugs they are putting into their system (including my personal favorites, ethanol and caffeine!)

  25. You are such a pansy. I’ve been regularly taking D-amphetamine for several years and nothing bad happens. And modafinil is amphetamine minus minus.

    • >You are such a pansy. I’ve been regularly taking D-amphetamine for several years and nothing bad happens. And modafinil is amphetamine minus minus.

      You know, if being scared shitless of the long-term effects of amphetamines makes me a pansy, then I cheerfully accept the label.

      • There’s another word for that… now what was it…

        Oh yeah! It’s “Smart”!

        (also prudent, cautious, wise, careful… take your pick)

  26. Based on your observations, I thought I would give it a try myself.

    I found a provider from India who had an unusual ordering method, with payment made the next day through a Chinese payment handler.

    I received the modafinil a short time later by mail in a brown envelope. Yes, it was unmarked except for my name and address.

    The effect I found was very subtle. If am sleep deprived, I find I have difficulty concentrating in the afternoon, or sometimes morning.depending on how much sleep I have missed. Under modafinil, I find that disappears completely. I feel like I can concentrate at a level I’ve not felt since my 20’s and there are no other apparent side effects. It also felt like I was well rested mentally.

    If I am well rested, then I find it hard to tell the difference between days where I have taken modafinil and days that I have not.

    I did not feel like a superman, nor did I feel “extra smart”, but I felt better for not having to fight through a mental fog.

    I am currently using 200mg. Next I will try cutting the dose to see if it still works for me.

Leave a Reply

Your email address will not be published. Required fields are marked *