Perhaps it is inevitable in this day and time that some people will find a way to abuse any prescription drug. But it feels more like a personal affront when it’s a drug whose proper use is so effective against certain sleep disorders.

Provigil is the trade name for modafinil, a stimulant that was approved by the FDA in 1998 for the treatment of narcolepsy and some other sleep disorders that compromise daytime alertness. It is a carefully regulated drug because it’s a stimulant. But a small number of people are obtaining it over the Internet and using is for alertness and cognitive enhancement.

Abuse of Provigil is not new, but last week the Nightline television news magazine covered this phenomenon.

The only time it is ever appropriate to use Provigil is under the supervision of a doctor for treatment of excessive sleepiness that is caused by narcolepsy, obstructive sleep apnea or shift work disorder.

The best way to improve mental and physical performance during the day is to get enough sleep the night before. Consolidation and reorganization of memory occurs during REM sleep.

Provigil works by activating the sleep-wake center in the brain, making people who take it feel energized and alert.

There is little evidence that Provigil or any drug can improve memory and learning. There are potential side effects, including headache, upset stomach and dizziness, as well as less common but more serious side effects, such as severe rash or an allergic reaction that affects the liver or blood cells. More importantly, since these are not FDA-approved uses there has been no study of long-term use in this way.

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