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Modafinil
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==Addiction and dependence== Despite being a [[CNS stimulant]], the addiction and [[drug dependence|dependence]] liabilities of modafinil are considered low.<ref name="Provigil FDA label" /><ref name="modafinil-schedule-IV-1999">{{cite web|volume=64|issue=17|publisher=Department of Justice|series=Federal register|title=64 FR 4050 - Schedules of Controlled Substances: Placement of Modafinil Into Schedule IV|date=January 27, 1999|vauthors=Sapienza F|url=https://www.govinfo.gov/app/details/FR-1999-01-27/99-1791|access-date=February 5, 2024|archive-date=February 5, 2024|archive-url=https://web.archive.org/web/20240205144036/https://www.govinfo.gov/app/details/FR-1999-01-27/99-1791|url-status=live}}</ref><ref name="pmid33435717" /><ref name="pmid23065655">{{cite journal | vauthors = Mignot EJ | title = A practical guide to the therapy of narcolepsy and hypersomnia syndromes | journal = Neurotherapeutics | volume = 9 | issue = 4 | pages = 739β752 | date = October 2012 | pmid = 23065655 | pmc = 3480574 | doi = 10.1007/s13311-012-0150-9 }}</ref> The exact mechanisms of action of modafinil are not known,<ref name="pmid32032921"/> and it is believed that pharmacological profile of modafinil is different from that of the classical stimulants such as [[cocaine]] or [[amphetamine]].<ref name="pmid22375280"/> Although modafinil shares biochemical mechanisms with stimulant drugs, it is less likely to have [[Mood elevation|mood-elevating properties]].<ref name="Provigil FDA label" /> The similarities in effects with [[caffeine]] are not clearly established.<ref name= "pmid22375280"/><ref name="Warot-1993">{{cite journal|vauthors=Warot D, Corruble E, Payan C, Weil JS, Puech AJ|date=1993|title=Subjective effects of modafinil, a new central adrenergic stimulant in healthy volunteers: a comparison with amphetamine, caffeine, and placebo|journal=European Psychiatry |volume=8|issue=4|pages=201β208|doi=10.1017/S0924933800002923|s2cid=151797528 }}</ref> Unlike other stimulants, modafinil does not induce a strong subjective [[Pleasure|feeling of pleasure or reward]], which is commonly associated with [[euphoria]], an intense feeling of well-being.<ref name="pmid32341841"/> Euphoria may be an indicator of a drug's potential to be abused. Substance abuse is a compulsive and excessive use of the substance despite adverse consequences.<ref name="pmid22542906">{{cite journal |vauthors=de Wit H, Phillips TJ |title=Do initial responses to drugs predict future use or abuse? |journal=Neurosci Biobehav Rev |volume=36 |issue=6 |pages=1565β76 |date=July 2012 |pmid=22542906 |pmc=3372699 |doi=10.1016/j.neubiorev.2012.04.005 }}</ref> In comparison to classical stimulants, modafinil exhibits a low propensity for abuse, as it lacks significantly expressed pleasurable or euphoric effects.<ref name="pmid32341841"/> Albeit to a lower degree than classical stimulants, modafinil still can produce psychoactive, euphoric, and subjective effects typical for abused stimulants.<ref name="Provigil FDA label"/><ref name="Drugs.com-Monograph-2023"/> Modafinil was not observed to promote overuse or misuse, even in people who have a history of cocaine addiction.<ref name="pmid16741217">{{cite journal | vauthors = O'Brien CP, Dackis CA, Kampman K | title = Does modafinil produce euphoria? | journal = The American Journal of Psychiatry | volume = 163 | issue = 6 | pages = 1109 | date = June 2006 | pmid = 16741217 | doi = 10.1176/ajp.2006.163.6.1109 }}</ref> Despite the initial belief that modafinil carried no abuse potential, emerging evidence suggests that it works at the same neurobiological mechanisms as other addictive stimulants. Consequently, there exists a potential risk of modafinil abuse, necessitating prudent consideration and caution when prescribing or using this medication.<ref name="pmid35366192"/> Modafinil exhibits a lower response on the amphetamine scale of the addiction research center inventory, suggesting reduced propensity for abuse compared to amphetamine.<ref name="pmid35990796">{{cite journal |vauthors=Martins B, Rutland W, De Aquino JP, Kazer BL, Funaro M, Potenza MN, Angarita GA |title=Helpful or Harmful? The Therapeutic Potential of Medications with Varying Degrees of Abuse Liability in the Treatment of Substance Use Disorders |journal=Curr Addict Rep |volume=9 |issue=4 |pages=647β659 |date=2022 |pmid=35990796 |pmc=9376579 |doi=10.1007/s40429-022-00432-9 }}</ref> The US [[Drug Enforcement Administration]] has classified modafinil as a [[Controlled Substances Act#Schedule IV controlled substances|Schedule IV controlled substance]];<ref name="modafinil-schedule-IV-1999"/><ref name="Provigil FDA label" /> the medicine is recognized for having valid medical uses with low addiction potential.<ref name="pmid23065655" /><ref name="pmid16669720"/> The [[International Narcotics Control Board]] does not classify it as a narcotic or a psychotropic substance.<ref name="INCB yellow">{{cite web | publisher= [[International Narcotics Control Board]] |title=Yellow List: List of Narcotic Drugs Under International Control |series=In accordance with the Single Convention on Narcotic Drugs, 1961 [Protocol of March 25, 1972, amending the Single Convention on Narcotic Drugs, 1961] |date=July 2020 |edition=59th |url=https://www.incb.org/incb/en/narcotic-drugs/Yellowlist/yellow-list.html |access-date=January 12, 2022 |archive-date=January 16, 2022 |archive-url=https://web.archive.org/web/20220116102908/https://www.incb.org/incb/en/narcotic-drugs/Yellowlist/yellow-list.html }}</ref><ref name="INCB green">{{cite web | publisher= International Narcotics Control Board |title=Green List: List of Psychotropic Substances Under International Control |series=In accordance with Convention psychotropic substances of 1971 |date=July 2020 |edition=31st |url= https://www.incb.org/incb/en/psychotropics/toolkit.html |access-date=January 12, 2022 |archive-date=January 18, 2022 |archive-url= https://web.archive.org/web/20220118201426/https://www.incb.org/incb/en/psychotropics/toolkit.html |url-status=live }}</ref>
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