What is Modafinil?
Modafinil is a nonamphetamine nootropic drug also considered a ‘wake-promoting agent’. It is the prototypical drug used to treat excessive daytime sleepiness due to narcolepsy, obstructive sleep apnoea, and shift work sleep disorder [1]. Modafinil is a racemate with both enantiomers (D- and L-modafinil) being present in equal ratios. After oral administration, it is metabolised in the liver to inactive acid and sulfone metabolites [1].
What does Modafinil do?
Modafinil works through a variety of neurochemical pathways in the brain: it inhibits dopamine reuptake and modulates a number of other pathways, including noradrenergic, serotoninergic, orexinergic, histaminergic, glutamatergic and GABAergic pathways [1]. The net effect is to increase wakefulness and alertness and enhance cognitive abilities.
Aside from its formal indications, modafinil is employed off-label to counteract sleep inertia, enhance focus and attain peak cognitive performance in normal individuals, such as pupils [1]. It reduces depression-related fatigue as well as improves cognitive performances such as learning, memory and executive functions in various medical conditions, including cancer [2, 3].
As such, while modafinil may be an efficient drug (ie, it does indeed enhance wakefulness and cognitive function), it is by no means devoid of side effects: following intake, the most commonly reported adverse effects are headaches, insomnia, anxiety, diarrhoea, dry mouth and increases in both blood pressure and heart rate [1].
What is Adderall?
Adderall is a prescription drug (among others) that has two active ingredients: amphetamine and dextroamphetamine. It is prescribed to treat attention deficit hyperactivity disorder (ADHD) and a condition known as narcolepsy (excessive daytime sleepiness) [4]. The medicine leads to an increase in stimulation of the central nervous system due to enhancing the function of hormones norepinephrine and dopamine in our brain, which leads to improvement in one’s concentration, memory, organisation and other related brain functions [5].
Adderall, available in both an immediate-release tablet and an extended-release capsule (Adderall XR) [4] – the immediate release will unleash the entire dose in your bloodstream in one or a few seconds, whereas the extended-release version will release the dose in your bloodstream over longer periods [4].
What does Adderall do?
Adderall is prescribed as a treatment for attention-deficit/hyperactivity disorder (ADHD) and narcolepsy. In the case of ADHD, the amphetamine in Adderall increases a person’s levels of attention, and focus and decreases hyperactivity. Adderall is frequently used only as a part of an ongoing treatment program that includes psychological or behavioural therapy [4]. As for narcolepsy, individuals who feel excessively sleepy can take Adderall to stay awake and alert during the day [4].
But it is also true that Adderall is a controlled substance with significant addictive potential and significant abuse potential, and that it should be taken only under medical supervision and with appropriately licensed health professionals [5].
Side Effects of Modafinil and Adderall
Modafinil and Adderall, both used for enhancing cognitive abilities and treating sleep disorders, have a range of side effects.
Side effects of modafinil, a nonamphetamine nootropic drug include, headache, insomnia, anxiety, diarrhoea, dry mouth and an increase in blood pressure and heart rate. Rare serious dermatologic events, including maculopapular and morbilliform rash, erythema multiforme and Stevens-Johnson Syndrome have also been reported in children [1].
Adderall, an amphetamine, has even more side effects in common with Modafinil:
- headache,
- dizziness,
- dry mouth,
- stomach pain,
- nausea,
- vomiting,
- diarrhoea,
- nervousness,
- anxiety,
- irritability,
- trouble sleeping,
- and sweating.
Serious side effects include chest pain, shortness of breath, cold or numb fingers or toes that are discoloured red or blue, fainting, increased violence or violent behaviour, hearing or seeing things, slowed growth in children, and psychosis (highly uncommon for Modafinil, but can be a result of stimulants) [6].
Although both drugs can cause decreased appetite, insomnia and dry mouth, they can also – albeit rarely – cause increases in blood pressure, heart rate, heart attack and stroke, and even death [7].
Of course, if you do experience serious side effects from these drugs, you should contact your doctor right away. Your doctor might need to adjust your medication or dosage to deal with the side effects [6].
Can you take Modafinil and Adderall Together?
Modafinil and Adderall are stimulant compounds, but they behave differently, and they are prescribed to treat different disorders. Modafinil is prescribed for sleep disorders, whereas Adderall is used for attention deficit hyperactivity disorder (ADHD) [8, 9].
The simultaneous use of Modafinil and Adderall doesn’t appear to alter the pharmacokinetic profile of either, as suggested by research that tested this combination of drugs on healthy volunteers: Single oral doses of 200 mg of modafinil and 10 mg of dextroamphetamine (an active ingredient in Adderall) given together showed no clinically significant effects on the pharmacokinetic profile of either agent [10].
In a second study, subjects orally received modafinil (200 mg/day Days 1-7; 400 mg/day Days 8-28) once a day over 28 days, and in the final days (Days 22 to 28), half the subjects received dextroamphetamine (20 mg) orally 7 hours after the previous modafinil. The conclusion indicated that the coadministration of low-dose dextroamphetamine at the dosing regimen above does not impose any changes on modafinil steady-state pharmacokinetics [11].
But, to be clear, while these studies show that there are no major pharmacokinetic interactions between Modafinil and Adderall, meaning that the combination is likely safe for most people to take, this doesn’t mean that there isn’t anyone who might not respond well to this combination.
In some people, it might slightly increase the odds that they could be experiencing adverse events by simultaneously taking Modafinil and Adderall [10].
Always consult with your health care provider before starting, stopping, or changing your medication, to avoid drug interactions and ensure the best advice for your situation.