Adderall
Adderall is the brand name for a combination form of two drugs: amphetamine and dextroamphetamine. The drug combination has been approved by the U.S. Food and Drug Administration (FDA) to treat attention deficit hyperactivity disorder (ADHD) and the sleep disorder narcolepsy, a disorder in which patients may experience sleep disturbances during the day and during activities. Onset of illness) driving). The two main ingredients in Adderall are both central nervous system stimulants.
Adderall is available in an immediate-release form (Adderall IR) and an extended-release form (Adderall XR). The immediate-release form of the drug lasts about 4-6 hours; the extended-release form usually lasts about 12 hours.
Adderall is classified as a Schedule II controlled substance. Therefore, it is considered to carry a significant risk of abuse and physical dependence.
Modafinil
Modafinil, better known by the brand name Provigil, is also a CNS stimulant drug. Modafinil, often called a high-potency drug, is a drug that promotes alertness and wakefulness. Modafinil is FDA-approved to treat daytime sleepiness in people with a number of different conditions, including:
- narcolepsy
- Shift work disorder, a formal disorder involving disruption of normal sleep schedules while working at night
- Drowsiness seen in other conditions, such as obstructive sleep apnea
Modafinil is also a controlled substance, but is much less controlled/severe than Adderall. Modafinil is classified as a Schedule IV controlled substance. The differences in the formal classifications of Adderall and Modafinil suggest that overall research and federal opinion are that Adderall is a more dangerous drug of abuse than Modafinil.
All stimulant drugs have a similar mechanism of action. Therefore, even when comparing prescription stimulants such as modafinil, which are considered relatively mild, to stimulants with significant abuse potential, such as cocaine, the findings suggest that these drugs have similar mechanisms of action. Some sources will attempt to capitalize on this finding, stating that similar mechanisms of action suggest similar potential for abuse; however, this is not always the case.
It is believed that Adderall actually increases intracellular production of the excitatory neurotransmitters dopamine and norepinephrine by blocking the reuptake of these neurotransmitters and by releasing these neurotransmitters from their storage units in neurons. concentration to exert its effect. Modafinil is also thought to affect several different neurotransmitters, including excitatory neurotransmitters such as dopamine and glutamate (increasing their availability), and decreasing inhibitory neurotransmitters such as gamma-aminobutyric acid (GABA) availability.
off-label uses
Despite their approved uses, these drugs are often prescribed for uses for which they are not formally approved. This is true for many different types of medications.
Off-label uses of Adderall are intended to take advantage of its stimulant effects. Adderall can be used to manage weight, increase alertness, and address obesity.
Modafinil is also used to treat conditions that its stimulating effects may treat, including treating various neurological disorders (such as multiple sclerosis or Parkinson's disease), fatigue and sleepiness in cancer patients, and even treating clinical depression in patients. of fatigue.
Modafinil is a much milder stimulant than Adderall, and its mild stimulant properties allow it to be used in a variety of situations to address drowsiness and sleepiness without causing anxiety, nervousness, irritability, or agitation. Adderall is a stronger stimulant and must be used in moderation.
Modafinil is not approved for the treatment of ADHD; however, it can be used off-label for this purpose. As of this writing, there are a few small controlled studies showing that modafinil is an effective treatment for ADHD. Research shows modafinil:
May be more effective than placebo in treating ADHD symptoms.
It may be as effective as methylphenidate (eg, Ritalon, Concerta) in treating ADHD, but with fewer side effects.
Compared with dextroamphetamine (an ingredient in Adderall), it may be equally effective in treating ADHD.
It should be noted that modafinil is not a drug approved to treat ADHD. Insurance companies may not approve it for this purpose, so the cost of the drug may not be paid when prescribed for this purpose.
