![]() ![]() Clinical trials have shown that it substantially improves subjective alertness and the ability of people with narcolepsy to stay awake on the Maintenance of Wakefulness Test. This drug works by increasing brain levels of norepinephrine and dopamine. Solriamfetol is a new medication that is taken in the morning and can improve alertness across the day. 6 However, there is no evidence that brain injury occurs in narcolepsy patients who take amphetamines at moderate doses on a regular basis. For most people this is not a concern, but the medication should be taken only in the way your doctor recommends.Īt very high doses, such as those used by people who abuse methamphetamine, amphetamines can injure the brain. Amphetamines can disrupt sleep, cause headaches or anxiety, and, rarely, trigger altered thinking such as mania or psychosis. People with hypertension or heart problems should not take amphetamines, as they can increase blood pressure and heart rate, trigger heart problems, and, very rarely, cause sudden death. Individuals should discuss with their doctors the exact timing and dosing of their medications, to reduce the likelihood of side effects.Īt reasonable doses, many people can take amphetamines with little trouble, but these medications should be used thoughtfully. Many people find it most convenient to take the longer-acting form in the morning and sometimes again at midday, with a shorter-acting pill prior to times when sleepiness is worst, such as in the late morning or afternoon. Most amphetamines are available in short-acting forms that improve alertness for three to four hours, and longer-acting forms that last for six to eight hours. To a lesser degree they can also increase brain levels of two other wake-promoting chemicals, serotonin and norepinephrine. Methylphenidate (Ritalin, Concerta, Metadate, and Methylin) is closely related to the amphetamines and has similar benefits and side effects.Īll these medications improve alertness by increasing brain levels of dopamine. Some of the most common are dextroamphetamine (Dexedrine) and a mixture of amphetamines and dextroamphetamine (Adderall). These medications are among the most effective for reducing sleepiness, but side effects are moderately common.Ī large variety of amphetamines are clinically available, and individuals may respond better to one than to another. Since the 1930s, amphetamines have been used to improve alertness in narcolepsy and other conditions. Modafinil also makes birth control pills much less effective, so women taking modafinil should use an alternate method of birth control.Īmphetamines and related medications. Very rarely, it can produce a severe and dangerous rash that warrants immediate medical attention. Overall, modafinil produces fewer side effects than some of the other wake-promoting medications, but it can cause headache, nausea, and occasionally insomnia. Some people find that it wears off in the early afternoon and may prefer to take half of the prescribed dose in the morning and the other half after lunch. Modafinil usually improves alertness for about eight hours, so most people find it convenient to take the medication in the morning. Large clinical studies have shown that modafinil and armodafinil reduce feelings of sleepiness as measured by the Epworth Sleepiness Scale, and moderately improve the ability to stay awake on the Maintenance of Wakefulness Test (MWT). Modafinil likely increases alertness by increasing brain levels of dopamine, a wake-promoting chemical in the brain. Modafinil, a very effective and popular medication for reducing sleepiness in narcolepsy, now comes in two forms: 1) the original formulation (Provigil or generic modafinil) is a mixture of active and inactive compounds, and 2) the newer form (Nuvigil or armodafinil) is the purified active compound. However, addiction or abuse seems very rare in people with narcolepsy taking these medications regularly at the appropriate doses. People using high doses recreationally can become addicted and dependent, requiring higher doses of the drug and exhibiting signs of withdrawal when the drug is discontinued. Some of these medications, such as amphetamines and gamma-hydroxybutyrate (the active ingredient of sodium oxybate), have the potential to be abused. All these medications have the potential to produce side effects, including some that are severe, so they should only be used as recommended by a doctor. For people with more severe sleepiness, however, amphetamines or sodium oxybate often produce the best results. For people with mild to moderate sleepiness, modafinil or armodafinil are often good choices. ![]()
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