Provigil – Wakefulness in Rats increased
We found that after a single icv injection of MOD (10mug/5mul) the extracellular levels of dopamine (DA) and l-DOPA collected from the nucleus accumbens were increased and decreased, respectively. Separately, the icv administration of MOD (10mug/5mul) to rats enhanced wakefulness (W) whereas diminished sleep during 4h.
Lastly, the alertness induced by MOD was partially antagonized by the sleep-inducing endocannabinoid anandamide (ANA). We conclude that MOD enhances the extracellular levels of DA, promotes W and its effects on sleep are partially blocked by ANA.
Provigil and treatment debilitating fatigue
Provigil may be a potentially effective treatment for primary biliary cirrhosis (PBC)-related fatigue. About 42 patients were given a 3-day trial of 100-200 mg Provigil. Response was defined as increased energy, decreased somnolence and sleep requirements, and improved daily function.
Patients with positive responses were continued indefinitely on the medication. During the initial trial period, 31 (73%) patients had complete response and continued to take the medication. Eleven (26%) had no response. In long-term follow-up (average 17.7 months), 25 (81%) patients continued to take 100-200 mg Provigil daily.
Provigil for Shift Work Sleep Disorder
Health Canada approved a new indication for Provigil (Alertec tablets, made by Shire BioChem, Inc), allowing its use for the symptomatic treatment of excessive sleepiness in shift work sleep disorder.
The approval was based on data from a double-blind, 12-week study in 209 patients showing that nightly treatment with 200 mg of Provigil increased sleep latency from baseline (1.7 ± 0.4 vs 0.3 ± 0.3 minutes; P = .002) and improved clinical symptoms in a greater proportion of patients (74% vs 36%; P < .001) compared with placebo.
Provigil-treated patients also experienced a decrease from baseline in the frequency and duration of attention lapses during nighttime testing, contrasting with the increase observed among those receiving placebo (Psychomotor Vigilance Test score, –2.6 vs 3.8; P < .001).
In addition, patients receiving Provigil therapy reported fewer accidents or near misses while driving home from work compared with those receiving placebo (29% vs 54%; P < .001).