"The most tempting drug for our society to come along in decades,” David Dinges, Univesity of Pennsylvania
While Provigil is FDA-approved only for narcolepsy, OSAHS and SWSD, many physicians are prescribing it for patients who do not suffer from one of these conditions but exhibit similar symptoms. It is estimated that 90% of the Provigil use in the United States is "off-label". An off label use is one that was not studied as a part of the FDA approval process.
Note that modafinil is a schedule C-IV controlled substance and should not be treated lightly. It is illegal to sell this drug to people who do not have a doctor's prescription. (See page on importing Provigil from overseas pharmacies.)
Provigil is being subscribed to millions of people for "off-label" or “lifestyle” uses, including:
- Age-related memory decline
- Attention deficit disorder
- Depression
- Fatigue caused by high-pressure jobs requiring long hours
- Fatigue caused by chemotherapy treatment for cancer patients
- Fatigue experienced by persons suffering from diseases such as multiple sclerosis
- Fatigue experienced by people who need to be awake and alert for extended amounts of times such as soldiers, truckers or students cramming for finals
- Jet lag
- Memory problems associated with Alzheimer’s disease
- Post-anesthesia grogginess
- Sleepiness caused by other prescription medications
- Treatment for cocaine addiction
Currently, many clinical trials are taking place to assess the effectiveness in using Provigil to treat other conditions than EDS associated with narcolepsy, OSAHS and SWSD. There have been no long term studies on the effects of recreational use of Provigil.
Insurance Coverage
Will insurance cover Provigil? In general, yes, insurance policies treat Provigil the same as any other prescription drug if it is for an approved use. Narcoleptics with good insurance can probably get it. Insurance companies know, however, that many prescriptions for Provigil are off-label, and they may be wary of people buying this expensive medicine if they suspect the intent it purely performance enhancement.
Modafinil as adjunctive therapy in depressed outpatients
Provigil to treat cocaine addition
Which clinical conditions are responsible for impaired alertness?
Letter in American Journal of Psychiatry on Off-Label Uses of Modafinil