I use modafinil regularly. I have (had?) some variant of ADD, and while it does not trouble me as much as it did when I was younger, it can still be frustrating, mostly if I am trying to focus on work I don't particularly enjoy. I use it between a few times a week and a few times a month (my desire to take it at all fluctuates quite a bit). I'll take 10-25mg in the morning and get on with my day. I generally don't re…
Sanity check fail: 10mg is an implausibly small dose, so small you'd have to grind the pills and measure tiny quantities of powder. Are you sure you're not thinking of a different drug, or off an order of magnitude?
Modafinil Is Wall Street’s New Drug of Choice
41–50 of 72 posts
Re: Modafinil Is Wall Street’s New Drug of Choice
#42As I read this, I can't help but be reminded of the old adage, "There ain't no such thing as a free lunch".
I wanted to provide a personal story to counter a lot of the enthusiasm and carelessness around modafanil. I'm a software engineer, and I've dabbled on and off with modafanil for a little less than a decade now, including several one-week runs of hardcore usage, without sleep, during contracting gigs in my early-mid twenties.
I'll start by saying that I still think modafanil can be extremely useful as a tool, and that, until I recently ran out, I would still take 100-200mg of modafanil if it were no more than once a week (with an effort to make it not more than twice a month), so I still feel the risks and unknowns can be worth the tradeoff. But make no mistake - modafanil is an effective medication, and like all effective medications, it has side effects, (light) mental habituation, and potentially life threatening side effects if used improperly.
At the end of one particularly rough 9 days or so of straight usage during a major release for a contract, averaging 3 hours of sleep once every two to three nights (and the rest solidly awake), I settled with the team at a 24-hour diner right before release, and had an all-potato breakfast. My stomach had been steadily gaining in acidity over the week, but I had ignored it. A couple of hours later, I threw up and accidentally inhaled a small amount of the most corrosive stomach acid I've ever felt. When I coughed it out I tasted blood, and shortly after found it harder to breath. The bleeding was so profuse that I found it necessary to handstand over a hotel bathroom sink to let it all drain out without choking me. Luckily the person who had dropped me off was nearby - I phoned him and he took me straight to the hospital. I never had experienced that level of lung trauma before, and I've had a lot of hospitalization events related to some pretty severe asthma in my life, and it was this moment more than any other in my life that I seriously considered that I might die. In the end, I made it out with a light lung infection, and was treated at the hospital for an allergic reaction. I've never been able to eat potatoes since without experiencing an allergic reaction.
I can't seem to find a citation for this right now, but I remember reading at one point that modafanil is an agonist in the histamine receptor family. I am not a neurologist, and I know that the histamine receptor family can have very contradictory effects due to them being a modulator of the release levels of neurotransmitters dopaminergic and serotonergic pathways, and is also more publicly famous as being the target of the antagonist, Benadryl. I generally think about the vigilance instilled by Provigil as the same kind of vigilance you may have experienced during the beginning stages of an infection. The immune system revs up, you get warmer, you don't want to move around as much (as opposed to amphetamine based stimulants that seem to give you physical energy you want to burn off), and you slip into a more introspective and determinedly focused state. But vigilance comes at a price, and if you keep burning carelessly through your internal resources without replenishing them, eventually you'll start burning the wick (you) too. Something will fail. Sometimes catastrophically.
Re: Modafinil Is Wall Street’s New Drug of Choice
#43I use modafinil regularly. I have (had?) some variant of ADD, and while it does not trouble me as much as it did when I was younger, it can still be frustrating, mostly if I am trying to focus on work I don't particularly enjoy. I use it between a few times a week and a few times a month (my desire to take it at all fluctuates quite a bit). I'll take 10-25mg in the morning and get on with my day. I generally don't re…
Sanity check fail: 10mg is an implausibly small dose, so small you'd have to grind the pills and measure tiny quantities of powder. Are you sure you're not thinking of a different drug, or off an order of magnitude?
The 100 mg pill is a 13 mm oval. [2]
So it seems entirely plausible to me to use a pill cutter to cut it into 8 or 10 roughly equal parts.
[1] http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=14770 [2] http://pillbox.nlm.nih.gov/pillimage/search_results.php?geti...
Re: Modafinil Is Wall Street’s New Drug of Choice
#44"It was like walking around on a winter day when it just snowed." Reading that made me want to move back to the East Coast. Not take Modafinil, which is probably a good sign.
Re: Modafinil Is Wall Street’s New Drug of Choice
#45Wow, this sounds amazing! Sign me up!
Re: Modafinil Is Wall Street’s New Drug of Choice
#46As I read this, I can't help but be reminded of the old adage, "There ain't no such thing as a free lunch".
Slightly OT: I am surprised to hear this sentiment on HN as often as I do. It seems to imply a somewhat Luddite-like fear of technological advancement, versus the generally positive interest I would expect from hackers. Am I off base? I'm not talking about modafinil specifically (no opinion there) but more generally.
Evolution has given us a brain that is so complex that we still have very little understanding of how it actually functions. So do I believe that a drug company came up with a way to improve upon evolution and make the brain better? No, I do not. And I think that's a pretty reasonable initial stance to take given the facts at hand.
Re: Modafinil Is Wall Street’s New Drug of Choice
#47Let me tell you its no fun. Even if this pill solves the depression and inevitable mental issues, I doubt it helps the rest of your body handle the lack of sleep.
Your body just tends to fall apart. You start spraining random muscles (even ones you did not know you had), you gain weight very quickly, etc. This is just not worth it. Just do us all a favor and get some sleep.
Re: Modafinil Is Wall Street’s New Drug of Choice
#48Earlier quoted context omitted.
Well the no free lunch theory is I think wrong, we are vastly better off with modern medicines. We are already getting free lunches of longer and heather lives. My experience, obviously not scientific, with modafinil is mild mania, grumpiness/quick to anger (What I think is the tiredness coming through), increase concentration and attentiveness to a task. My intelligence goes down. Mixed with alcohol it can cause bla…
You're missing his point, which is a reasonable one. If the human body truly functioned better with modafinil, then evolution would have given us humans that naturally produced modafinil. That isn't the case, so the assumption is there is some downside to the drug, and one that actually outweighs the positives. However, the article makes modafinil seems like an obviously positive thing and that taking the pill fixes…
Given that our brains have been under heavy evolution, there's no particular reason to think we're at a local optimum.
The environment we've evolved for is not the one we are currently in. What was adaptive 1,000, 10,000, or 100,000 years ago may not be what we need today.
Your definition of "optimum" and your genes' may differ wildly. For example your genes build disposable bodies for the same reason humans build disposable cars: there's no sense in working ever harder to keep the old model going when making a new one is easier.
On the other hand, I've got a similar sentiment from a different perspective: it is surprisingly easy to to FUBAR an evolved system. We're still trying to figure out what effects electric light has on humans. [1] Anybody who thinks they've figured out all the subtle effects of a drug like this is fooling themselves.
Re: Modafinil Is Wall Street’s New Drug of Choice
#49Well if this isn't a somewhat glowing endorsement of a pill that is being abused, I don't know what is. As someone who is close friends with someone suffering from narcolepsy who actually needs this pill to function normally, I find it worrying people are abusing a pill that can have some serious side-effects. Good job publicly endorsing a pharmaceutical drug NY Mag. I have a feeling as word spreads, the abuse will m…
I've been taking Modafinil @ 200-400mg/day off and on since 2003, with probably a total of 4 years of usage in that time span, together with Xyrem for about a year in 2004 and punctuated by ritalin for a year or so around 2008-09. I personally only take it when I have to and try to avoid taking it on days on which I think I can manage without it.
Yes, it can be habit forming, but only psychologically and only weekly. I can totally see it being habit forming when "taken together with" a demanding worklife. If you aren't working lots of hours where you need to stay focused the entire time, there is little motivation to take modafinil. It's not any "fun" and the "high" you get is not from the drug itself, but the ego boost from getting a lot of shit done. People don't get "addicted" to the drug but to the feeling of productivity.
On top of that, it has little to no side effects. It might have exacerbated my bruxism slightly but that's about it.
However there is one risk with it and that is sleep deprivation. My number one advice to anyone that takes it is to never take it after about 11am in the morning (or less than 12 hours before the time you intend to sleep). If you follow that one rule, I can't foresee people having any issues with it long term. The problem with taking it less than 12 hours before bedtime is that it has a half-life of about 6-8 hours meaning that it's mostly worn off by 12 hours and sleep "no longer feels optional at that point. This approach lets your feel awake, alert, productive and focused during your daylight hours when you plan to be working.
If however someone does break that rule, it's easy to lapse into a messed up sleep cycle and that itself can lead to someone feeling more and more tired the longer it goes on leading to trying to fix the problem with more modafinil.
The side effects cited from Internal Medicine (“hypersensitivity reactions and neuropsychiatric adverse effects”) aren't a product of modafinil per se, but a constant accumulated lack of sleep. Add to that the fact that the symptoms of sleep deprivation are pretty much indistinguishable from schizophrenia and you have an explanation from those side effects.
I doubt that abuse of this drug would do anything to impact my ability to get this medicine even if such abuse was widespread. It's not a trivial thing for someone to fake a diagnoses with narcolepsy, like you can do with ADD/ADHD or anxiety disorders. A bona fide diagnosis requires a polysomnogram and MSLT if you don't show any serious signs of apnea. If one were to try to fake it, they probably need advice from an actual narcoleptic like myself to know what to say and do to fake one or both of those tests.
Plus, modafinil isn't even the most restricted narcolepsy drug. Xyrem is, which is basically pharmaceutical grade GHB. That drug only comes from one pharmacy in the country and is overnighted in massive boxes so that it can't be trivially stolen. The boxes are huge for two tiny bottles. TBH the only thing that prevents narcoleptics from getting access to a drug they need like xyrem (a necessity if you have cataplexy) are drug costs. If you don't have group insurance or if narcolepsy/cataplexy are pre-existing conditions for your insurance, then Xyrem will set you back around $50k to $80k a year last time I checked. I don't know street prices for drugs, but I imagine that they are 100-200x more expensive than a legitimate prescription. The reason for the cost is the fact that it's an orphan drug, meaning that the costs of bringing it to market are spread across a very small potential target market. Even that's kind of absurd since it's sleep benefits were known from back in the 80s when GNC sold it OTC well before any clinical trials. FWIW Faking cataplexy is largely impossible if your doctor performs the blood test available to diagnose it.
Re: Modafinil Is Wall Street’s New Drug of Choice
#50Placebo effect? I understand that drugs have slightly different effects on each person, but I have never felt any of that stuff.
I experimented with 100mg tablets of Modafinil for a few years because I can't concentrate. It did nothing for my concentration, nothing I could discern, at any rate. Modafinil did help to get rid of my sleepiness: if the task/meetings/lectures dragged a bit, I'd actually nod off. Modafinil fixed that.
Write-ups such as this one on nymag make Modafinil sound like something to trip on. Very misleading.
> At the very least, doctors have warned that modafinil can bring about sleep deprivation
I call BS.