Sleeping is one of the most basic and important functions of the human physiology. It is vital in order to replenish the bodies supplies and it works in tandem with the circadian rhythm however 1 in every 2000 people is roughly affected by the disease called narcolepsy; in which sleeping and waking cycle is disrupted and is manifested as excessive daytime sleepiness, episodes of involuntary sleeping, cataplexy (sudden loss of power in the muscles), hallucinations ( hearing or seeing things without a stimulus) and sleep paralysis ( temporary inability to move while waking up or falling asleep).
Having been first discovered in the late 19th century, it gained a lot of interest in the 20th century specially post world war 2 and it was researched that the lateral hypothalamus was the culprit. There was a reduced number of orexin (hypocretin) producing neurons in the lateral hypothalamus which resulted in the symptoms of narcolepsy [orexin being responsible for regulating appetite and wakefulness among other functions]. The need for an effective treatment eventually lead to the discovery of Modafinil among others.
The goal of the treatment is first to reduce daytime sleepiness, the associated uncontrollable sleep episodes and second to improve the tone in the muscles. As both are not present in every patient, they are classified and treated differently. Modafinil has emerged as the first line treatment for symptoms regarding sleep and sodium oxybate for cataplexy.
Modafinil has replaced the traditional central nervous system stimulants because of its superior efficacy, better control and fewer side effects compared to Amphetamines, Methylphenidate, Mazindol, Selegiline and Pemoline. We will now compare Modafinil with the alternatives; note worthy to mention here that one can easily buy Modafinil online.
The oldest medicine being used for narcolepsy are amphetamines having been used since the 1930s (compared to Modafinil which was licensed by the FDA in the US in the 1990s). it basically increases the quantity of neurohormones dopamine and noradrenaline whereas Modafinil in addition to those increases serotonin and glutamate as well; the former having a significant beneficial effect on the quality of life . They both act on areas of the thalamus and the hippocampus, Modafinil in addition acts on the amygdala. However, being somewhat old and generalized drug amphetamines come with a lot of side effects as it acts on many other areas of the brain as well, they include irritability, headache, nervousness, palpitations, insomnia and less often anorexia, nausea, excessive sweating and psychosis. Tolerance is another issue meaning u have to increase the dosage to get the same effect, our body adapts. In recent years it has also become an addictive drug specially with the advent of methamphetamines. To clarify Modafinil on the other hand is a more specific drug in terms of treating narcolepsy as it is a wake promoting drug having very few side effects and no tolerance develops to it.
Methylphenidate is a N-methyl derivative of amphetamine and does not have a major effect on monoamine storage. It has a much shorter half life (3-7 hours) compared to up to 9 hours for Amphetamines. It is 13.8 hours for Modafinil ( as the objective is to promote wakefulness a longer half life is good). Again however methylphenidate tolerance has been reported among patients. Another drug similar with similar pharmacological properties as the amphetamines is the imidazole Mazindol. It was effective in 50-60% of the people suffering with narcolepsy in promoting wakefulness however it has been removed from the market of various countries as it has been known to cause valvular abnormalities in the heart after regular use in some patients.
Selegiline is a selective irreversible MAO-B inhibitor usually prescribed in the early stages of Parkinson disease has shown to significantly reduce excessive daytime sleepiness. Having a half life of around 10hrs it has to been taken in a large dose of around 10-40mg at which dietary restrictions are applicable to avoid a hypertensive crisis. Pemoline is a oxazolidine derivative with a half life of 12hrs is usually better tolerated than the amphetamines but as it had shown a high chance to induce fetal hepatic-toxicity its use was also discontinued.
To elaborate more on the superior Modafinil, it is unique in structure, neurochemical profile and behavioral effects inhibits both norepinephrine and dopamine transporters thus increasing their concentration. It also increases serotonin and glutamate in the brain, whereas it decreases the GABA levels. It achieves this by elevating the histamine levels in the hypothalamus. It effects dopamine ( by blocking uptake at the dopamine transporter) in striatum and nucleus accumbens, norepinephrine in the hypothalamus and venterolateral preoptic nucleus and serotonin in the amygdala and prefrontal cortex. It is mainly metabolized in the liver and both the liver and the kidney play a role in its excretion. Minor side effects including headache, nausea, anxiety and insomnia were reported in only about 10% of the patients taking it. A 90% chance at a good quality of life while fighting narcolepsy is Modafinil's way of saying buy Modafinil.
Apart from Modafinil's wake promoting properties, Modafinil is also marketed as a cognition improver. It has proven to be a break through drug and because it has a vast biochemical action profile and therefore it has various uses. Modafinil has shown improved performance in kids suffering from ADHD (Attention Deficit Hyperactivity Disorder). Modafinil is also effective in patients with negative psychosomatic symptoms, depersonalization disorder and seasonal affective disorder. Other conditions where it has improved quality of life and performance include:
- Resistant depression and other types;
- Fatigue due to systemic illness;
- Sleep apnea;
- Fatigue syndromes;
- Bipolar disorder;
- Delayed sleep phase syndrome;
- Parkinson disease;
- Weight loss;
- Beneficial in opioid and cocaine addiction;
- Motion sickness;
- Cognitive enhancer;
- Used by armies.
To make it easier in the modern world it is possible to buy Modafinil online. I have seen a good number of patients benefitting from Modafinil and leading better lives in the fight against Narcolepsy.