Actually, if you go by the statistics, humans spend more money to stay awake and alert than to catch a sleep.

It is true that people with insomnia (difficulty in going to sleep) collectively spend millions of dollars and pesos a year on sedatives and sleeping pills, but this pales in comparison to the amount of money people spend on coffee, tea, and chocolate. Truth is, caffeine, which minimally enhances wakefulness and alertness, is the most widely used drug in the world.

At any rate, the drug you heard about is modafinil, an oral preparation which enhances wakefulness while keeping the person alert and vigilant.

This drug has been prescribed in France since 1994 and in the US since 1998. It allows people to remain awake without impairment of job performance. It also improves memory and produces a sense of euphoria that is typical of other central nervous system stimulants.

Who could definitely benefit from this wakefulness drug? When first introduced, the US Food and Drug Administration (FDA) approved the marketing of modafinil only for the treatment of narcolepsy, a neurological condition characterized by excessive uncontrollable daytime sleepiness.

In September 2003, however, an advisory panel to the US-FDA endorsed the use of the drug in treating sleepiness that is caused by obstructive sleep apnea and shift work sleep syndrome. Then in November 2005, Cephalon, the pharmaceutical company that markets the drug in the US, received an approval letter from the US-FDA to market Sparlon, a brand name of a tablet containing modafinil, for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) in children (from six years old) and adolescents. By the way, the drug, as far as I know, is not yet available in the Philippines.

Who else could potentially benefit from modafinil? Results of recent research studies suggest that the drug can have beneficial effects on people with Alzheimer’s disease, age-related memory loss, fatigue induced by multiple sclerosis, excessive sleepiness of unknown reason, spasticity secondary to cerebral palsy and jet lag.

In January 2005, a small study conducted by researchers at the University of Pennsylvania also found out that modafinil may help recovering cocaine addicts fight their addiction.

Who else is interested in modafinil? The military for one. Imagine a soldier who can fight 24 hours a day, seven days a week. Actually, modafinil can keep a person awake and alert for up to two days only, not indefinitely. In trials using army helicopter pilots, the pilots on modafinil stay awake for almost two days while remaining as focused, alert, and with the same problem solving skills as the well-rested.

Then, after an eight-hour sleep, they can go up and do it again for another 40 hours.

Research results suggest that modafinil is relatively safe, effective and well-tolerated. The exact mechanism of its pharmacologic effects is not well understood, but it is notably different and far safer than amphetamines or cocaine – central nervous system stimulants whose side effect is wakefulness – but it is not devoid of adverse effects.

Compared to amphetamines and cocaine, which incidentally are illegal drugs, modafinil is less likely to produce jitteriness, anxiety, hyperactivity, and paranoid delusion. It does not have a rebound effect (i.e., it does not cause excessive sleepiness after its effects have waned) and it has no withdrawal symptoms, which implies that it is not addicting. But the abuse potential of the drug is high because of the psychoactive and euphoric feelings that it creates.

The most commonly observed side effects of modafinil, although seen only in a small percentage of patients are headache, nausea, nervousness, rhinitis, diarrhea, back pain, anxiety, insomnia, dizziness and dyspepsia. Rarely, it causes palpitation and hypertension.

The drug is taken as a single dose to be taken shortly after waking; its effects last for most of the day without preventing normal sleep at night.

Incidentally, modafinil is included in the list of substances that athletes are banned from taking that has been issued by the World Anti-Doping Agency.

Address inquiries on health matters to Dr. Eduardo G. Gonzales, DLSU College of Medicine, Dasmariñas, Cavite 4114.