Armodafinil is a drug used to enhance brain capabilities (one of the smart drugs). The increased use of Armodafinil than Ritalin and Adderall indicates something different in it than others. Armodafinil is R-enantiomer of the student drug Modafinil. The drug can produce mental alertness for long time and do not cause agitation or other side effects. It is R-enantiomer of Modafinil, so, what are the enantiomers and how they could be used in medicines?
The stereoisomers that are not identical or non-superimposable are known as enantiomers. In Greek, the 'enantios' meaning 'opposite' and 'meros' meaning part. One of the classification systems classifies them into R and S enantiomers, regarded as the left and right-handed enantiomers. Enantiomers are known to have different chemical interactions with other enantiomers. Two enantiomers of the same chemical, effect the biological systems in different ways. This property is used in drugs where one of them is for desired effects and the other might be less active, inactive or even cause adverse effects.
This discovery leads to the formation of drugs only with one enantiomeric form, such drugs are called as "enantiopure". Enantiopure drugs help to eliminate some side effects and increase the efficiency of drug for desired effects.
French pharmaceutical company Lafon developed the earlier versions of Armodafinil, these are Modafinil and Adrafinil. The first drug was Adrafinil, developed to treat narcoleptics. It needed to be metabolized first than it converts to active drug Modafinil. The place to metabolize the drug is liver. Adrafinil became outdated when the continuous research led to Modafinil directly. The patent for Modafinil exclusively profited the company for ten years. The further research on the drug lead to the purer form, Armodafinil. Which is enantiopure, that reduces some side effects of the drug too.
The use of one enantiomer is a general practice. The other enantiomer remains inactive in the drug. The active enantiomer in Armodafinil is R-enantiomer. Like the other smart drugs, it is still unknown, how does Armodafinil work? It does not bind to dopamine directly or indirectly but in vitro studies indicate the inhibition of dopamine reuptake. The drug particularly act on system that regulate sleep patterns. The ability of Armodafinil to effect other neurotransmitters was blocked in a research, it was still able to cause desired effects. The or exact way of action is still not determined.
The brand name of Armodafinil is Nuvigil, which is prescribed for the treatment of narcolepsy, shift work sleep disorder (SWSD), obstructive sleep apnea (OSA) and somehow ADHD, Parkinson's disease and muscular dystrophy. It enhances wakefulness and makes you more task-oriented. But, for the persons using multiple drugs, those with high blood pressure and the pregnant women's the use must be prescribed by a doctor.
As for the effectiveness, there are research evidence supporting the drug. JL Chapman and coworkers research on Armodafinil effectiveness for overweight obstructive sleep apnea patients. Those patients cannot tolerate standard treatments. It was a controlled study in which patients provided firstly with 150mg Armodafinil for six months and the time was extended to twelve months. The second diet choose to compare was Placebo. The performance was good on Armodafinil than Placebo at 3 months but was not retained to 6 months. Armodafinil also caused greater fat loss than Placebo.
Considerable numbers of people do night shifts. Many of them ended up having shift work sleep disorder (SWSD), in which their sleep and wake liabilities misaligned. 44.8% of people that work in night shifts got SWSD. Modafinil and Armodafinil both claimed to solve the problem. There are studies that compare the efficacy of both the drugs.
D.V. Tembe and coworkers from India conducted a 12-week study on 212 patients of shift work sleep disorder. The patients were provided with armodafinil(150mg) and Modafinil(200mg) before an hour to night shift. Global assessment for the efficiency and the Stanford Sleepiness Score (SSS) is used to detect any change in patient's routine and hence to determine the efficacy of drug. The rates with Armodafinil were 72.12% and with Modafinil were 74.29% (Comparable). According to the study Armodafinil found to be safe and working drug to treat SWSD. The results for both the drugs were comparable and did not show remarkable difference for the strengths 150mg and 200 mg.
M. Hirshkowitz and colleagues studied Armodafinil for wakefulness found it effective to enhance alertness and long-term memory. They also found it effective against fatigue and tolerated.
Armodafinil is approved by the FDA and passed third phase regularity tests, it proves its safety and tolerability for patients. However, it shows some side effects including headaches, sore throat, fever or skin rashes. The severe ones are less reported. It is more expensive and more addictive than Provigil. Many of the students consider Armodafinil stronger and promising to give them greater boost than Modafinil. The difference in efficacy of Modafinil and Armodafinil is not much reported they are mostly found comparable.