Provigil vs Dexedrine

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Overview

Provigil

Dexedrine

Comparative Analysis

Introduction

For patients suffering from excessive sleepiness due to narcolepsy, sleep apnea, or shift work disorder, certain drugs that stimulate the central nervous system can help enhance wakefulness and alertness. Provigil (modafinil) and Dexedrine (dextroamphetamine) are two such medications often prescribed for these conditions. They both influence neurotransmitter activity in the brain but target different mechanisms. Provigil is a stimulant drug thought to increase dopamine levels by blocking the reuptake of this neurotransmitter into nerves. On the other hand, Dexedrine belongs to a class of drugs known as amphetamines which increase amounts of norepinephrine, dopamine, and serotonin in your brain by stimulating their release from nerve endings.

What is Provigil?

Modafinil (the generic name for Provigil) was a significant advancement upon the first class of stimulant medications, such as amphetamines like Dexedrine. Modafinil was first approved by the FDA in 1998 as a wakefulness-promoting agent for treating narcolepsy and other sleep disorders. Unlike Dexedrine, which increases levels of dopamine by slowing its re-uptake into brain cells, modafinil has an uncertain mechanism of action but is thought to work on several neurotransmitter systems simultaneously. It's prescribed not only for sleep disorders but also off-label uses including ADHD and cognitive enhancement in otherwise healthy individuals. While both drugs can potentially cause side effects such as insomnia or headache, modafinil generally has fewer side effects than Dexedrine because it does not primarily act on dopamine — thus avoiding typical amphetamine-related issues like addiction or withdrawal symptoms.

What conditions is Provigil approved to treat?

Provigil is approved for the treatment of specific conditions such as:

  • Narcolepsy, a chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep
  • Obstructive Sleep apnea (OSA), a potentially serious sleep disorder in which breathing repeatedly stops and starts during sleep
  • Shift Work Disorder (SWD), a condition that affects people who frequently rotate shifts or work at night.

How does Provigil help with these illnesses?

Provigil, also known as modafinil, works to promote wakefulness by altering the natural chemicals (neurotransmitters) in the brain. It is believed to do this through its action on dopamine—a neurotransmitter that plays a crucial role in sleep regulation, mood and reward pathways. Rather than blocking reabsorption like Prozac does for serotonin, Provigil inhibits the dopamine transporter which increases the availability of dopamine within the neurons.

Dexedrine (dextroamphetamine), on the other hand, also promotes wakefulness but it operates slightly differently. In addition to increasing levels of dopamine by blocking its reuptake into neurons, Dexedrine stimulates release of additional stores of dopamine and norepinephrine within these cells. This leads to elevated levels of these neurotransmitters available for signal transmission.

Both drugs are used primarily to treat conditions characterized by excessive sleepiness or difficulty maintaining alertness such as narcolepsy or ADHD. The choice between them will hinge upon individual patient factors including side effect profiles and specific symptoms present.

What is Dexedrine?

Dexedrine is a brand name for dextroamphetamine, which is an amphetamine that stimulates the central nervous system. Its effects are similar to other drugs in this class and include increased energy, focus and alertness. Dexedrine works by increasing levels of norepinephrine, dopamine, and serotonin in the brain by reducing their reabsorption. It was first approved by the FDA in 1976.

As Dexedrine is not a eugeroic like Provigil (also known as Modafinil), it does not specifically promote wakefulness but increases overall activity levels. This difference means that its side-effect profile also varies from that of eugeroics - it can cause loss of appetite and weight loss (common side effects of amphetamines). However, Dexedrine's effect on dopamine can be beneficial for treating attention deficit hyperactivity disorder (ADHD) or narcolepsy symptoms where typical eugeroics such as Provigil may not be effective.

What conditions is Dexedrine approved to treat?

Dexedrine is a central nervous system stimulant that has received approval from the FDA for the treatment of:

  • Attention Deficit Hyperactivity Disorder (ADHD), which can lead to an increase in attention and decrease impulsiveness and hyperactivity in patients with ADHD.

  • Narcolepsy, a neurological disorder that affects the control of sleep and wakefulness, resulting in excessive daytime sleepiness and intermittent, uncontrollable episodes of falling asleep during the daytime.

How does Dexedrine help with these illnesses?

Dopamine is a neurotransmitter that plays various roles in the body, influencing motivation, reward, attention and regulating body movements. In line with this, low levels of dopamine have been linked to attention deficit hyperactivity disorder (ADHD). Dexedrine works by increasing the availability of dopamine in the brain which helps improve focus and reduce impulsivity and hyperactivity in ADHD patients. Its action on norepinephrine may also play a role in its effectiveness as an ADHD medication. Since it does not significantly affect serotonin levels like SSRI antidepressants do (such as Prozac), it is sometimes prescribed when a patient does not respond well to non-stimulant medications for ADHD such as Provigil or may be combined with them.

How effective are both Provigil and Dexedrine?

Modafinil (Provigil) and dextroamphetamine (Dexedrine) are both stimulants used to treat narcolepsy, sleep apnea, and shift work sleep disorder. They were approved by the FDA several years apart with Dexedrine being the older drug having been available since the 1970s while Provigil was introduced in late 1990s. The two drugs act on different neurotransmitters: Modafinil works primarily on dopamine and norepinephrine pathways whereas Dexedrine directly stimulates adrenergic receptors of the central nervous system.

A double-blind clinical trial conducted in 2000 compared these two medications for effectiveness in treating narcolepsy; it found that patients given either medication experienced similar improvements in excessive daytime sleepiness and there were no significant differences between them based on established metrics like Epworth Sleepiness Scale scores. Adverse effects differed slightly, with those taking modafinil more likely to experience headaches and nausea while those on Dexedrine reported increased incidence of dry mouth.

In a review published in 2015 summarizing multiple studies comparing modafinil with other stimulants including amphetamines like Dexedrine, it was concluded that modafinil is equally effective as these traditional treatments but has a lower risk of side effects such as jitteriness or rebound hypersomnia when discontinued abruptly. This fact along with its lesser potential for abuse has made it a preferred choice among clinicians dealing with disorders characterized by excessive sleepiness.

The same review also noted that despite its efficacy comparable to other stimulant drugs, use of dextroamphetamine is typically considered only after non-stimulant or newer agents have failed due to concerns about possible dependence development or cardiovascular risks associated with long-term use. Nonetheless, because of its greater potency at promoting wakefulness than most alternatives except perhaps methylphenidate (Ritalin), it may be an optimal treatment for patients who do not respond adequately to less potent drugs.

abstract image of a researcher studying a bottle of drug.

At what dose is Provigil typically prescribed?

Oral dosages of Provigil typically range from 100-200 mg/day, with studies indicating that a dosage of 200 mg/day is sufficient for promoting wakefulness in individuals experiencing excessive sleepiness associated with narcolepsy, obstructive sleep apnea or shift work disorder. For Dexedrine, the usual dose to treat ADHD in adults is 5–60 mg daily, given in divided doses. Children aged six years and older may start on an initial dose of 5mg once or twice daily. In either population, if there are no improvements observed after a few weeks; dosage can be adjusted accordingly under medical supervision. The maximum dosage that should not be exceeded per day for Provigil is 400mg and for Dexedrine is 60mg.

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At what dose is Dexedrine typically prescribed?

Dexedrine treatment is typically initiated at a dosage of 5-10 mg per day. The dose can then be gradually increased to 20-40 mg/day, divided into two or three doses, with intervals of 4 to 6 hours between each dose. The maximum daily dose is generally around 60mg, which may be administered in separate doses throughout the day and should not be exceeded without medical consultation. This adjustment in dosage could prove beneficial if there is no significant response to the initial prescribed amount after a few weeks of treatment under doctor's supervision.

What are the most common side effects for Provigil?

Common side effects of Provigil (modafinil) and Dexedrine (dextroamphetamine) can include:

  • Nervousness
  • Excitability
  • Insomnia
  • Sleep disturbances or drowsiness
  • Dry mouth, thirst, or frequent urination
  • Loss of appetite/weight loss
  • Diarrhea or constipation
  • Increased heart rate/palpitations
  • Sweating
  • Headache/dizziness/migraine
    -Tremors/shaking -Mood swings/anxiety/depression/aggression
    -Nausea/vomiting/stomach pain/increased liver enzymes. In rare cases, both medications can cause serious adverse reactions including chest pain/angina, sudden changes in vision/hearing/taste/smell/sensitivity to light/noise/touch. It is important to note that these medications should only be taken under the supervision of a healthcare provider.

abstract image of a patient experiencing side effect

Are there any potential serious side effects for Provigil?

While Provigil and Dexedrine are both central nervous system stimulants, they do have different side effects. With Provigil (modafinil), some potential serious side effects include:

  • Unusual behavior or thoughts of hurting oneself
  • Allergic reactions such as hives, difficulty breathing, swelling in your face or throat, skin rash with blistering and peeling
  • Changes in vision including blurred vision or seeing halos around lights
  • Heart issues marked by fast/pounding/irregular heartbeat, chest pain
  • Low sodium levels leading to headache, confusion, severe weakness, vomiting
  • Extreme mood changes including agitation or confusion

On the other hand with Dexedrine (dextroamphetamine) the following critical side effects may occur:

  • Thoughts of suicide or self-harm
  • Signs of an allergic reaction: hives; difficult breathing; swelling of your face/lips/tongue/throat
  • Chest pain characterized by a pounding heart rate/fast heartbeats/fluttering chest feeling like you might faint
    -Signs of serotonin syndrome: hallucinations/agitation/fever/sweating/shivering/fast heart rate/muscle stiffness/twitching/loss of coordination/diarrhea

If you experience any more than mild versions of these symptoms while taking either medication contact a healthcare provider immediately.

What are the most common side effects for Dexedrine?

When comparing Provigil to Dexedrine, it's important to understand the potential side effects of Dexedrine. Some individuals may experience dry mouth or a change in their sense of taste. It can also cause constipation and other digestive issues like nausea, upset stomach or loss of appetite. Insomnia is another common concern with Dexedrine use, as are feelings of restlessness and anxiety. Some users report experiencing headaches or dizziness, and in rare cases blurred vision has been reported. Physical responses such as rapid heartbeat or tremors might occur too. Less commonly, there may be a rash or other skin reactions and weight loss due to suppressed appetite. In extreme circumstances, people have reported feeling agitated or hostile while on this medication.

Are there any potential serious side effects for Dexedrine?

Dexedrine, while being an effective medication for treating ADHD and narcolepsy, can sometimes have severe side effects. If you experience any of the following symptoms after taking Dexedrine, seek immediate medical attention:

  • Signs of a hypersensitive reaction: rashes or hives; fever; swollen glands; difficulty breathing or swallowing; swelling in your face, throat or tongue.
  • Severe changes in mood including depression or suicidal thoughts.
  • Uncontrolled movements like tremors or convulsions.
  • Confusion and unusual behavioral changes such as aggression and paranoia.
  • Vision problems such as blurred sight, painful eyesight accompanied by redness and swelling
  • Fast-paced heartbeats that are irregular
  • Signs of a hyperactive episode including racing thoughts with increased energy levels leading to impulsive behavior. You might also feel unusually elated along with experiencing insomnia.

If you notice any of these signs it is important to discontinue the use of Dexedrine immediately and consult with your healthcare provider.

Contraindications for Provigil and Dexedrine?

Provigil and Dexedrine, like many other stimulant medications, can exacerbate symptoms in some individuals. If you notice any significant adverse effects such as palpitations, chest pain, or changes in your mood or behavior including confusion or hallucinations, please seek immediate medical attention.

Neither Provigil nor Dexedrine should be taken if you are currently using or have recently discontinued the use of monoamine oxidase (MAO) inhibitors. It's crucial to always inform your healthcare provider about all the medications you are taking; MAOs need around two weeks to completely leave your system before it is safe to start either Provigil or Dexedrine to avoid potentially dangerous drug interactions.

How much do Provigil and Dexedrine cost?

For the brand name versions of these medications:

  • The price of 30 tablets of Provigil (200 mg) averages around $900, which works out to about $30/day.
  • The price for 60 tablets of Dexedrine (5 mg) is approximately $300, working out to roughly $10/day.

Thus, if you are in a higher dosage range for Dexedrine (i.e., 20 mg/day or higher), then brand-name Provigil may be less expensive on a per-day treatment basis. However, cost should not be the primary factor when deciding which medication is right for you.

Regarding generic versions and their costs:

  • Modafinil (the generic version of Provigil) can cost anywhere between $0.80 and $2.80 per day depending on your daily dose.
  • Dextroamphetamine (the generic version of Dexedrine) is available in packs ranging from 15 up to hundreds with costs starting as low as around $.25 - $.75 per day based on your prescribed daily dose.

Remember that prices vary due to several factors such as location, insurance coverage and pharmacy chain used; always consult with your healthcare provider before deciding what's best for your situation.

Popularity of Provigil and Dexedrine

Modafinil, which is also known by its brand name Provigil, was estimated to have been prescribed to about 1.4 million people in the US in 2020. Modafinil accounted for just over 7% of prescriptions among stimulants used for conditions like narcolepsy and sleep apnea-related fatigue. However, it appears to be a common “atypical” stimulant (not classified as an amphetamine or other broad class of stimulants). The prevalence of modafinil has seen a steady increase since its FDA approval in 1998.

On the other hand, dextroamphetamine, including brand versions such as Dexedrine, was prescribed to roughly half a million people in the USA in 2020. In the US, dextroamphetamine accounts for just under 3% of overall prescription stimulants and around 2% of all ADHD medication prescriptions. Despite being one of the older medications on the market with decades-long use history dating back to World War II era for treating various disorders like depression and obesity along with narcolepsy and ADHD more recently – its prevalence has remained relatively constant over recent years.

Conclusion

Both Provigil (modafinil) and Dexedrine (dextroamphetamine) are well-established in the treatment of sleep disorders such as narcolepsy, and have been demonstrated in many clinical studies to be more effective than placebo treatments. In some instances, these drugs may be used together but this should only be under careful supervision by a healthcare provider due to potential interactions. They work differently: Provigil influences the dopamine system indirectly without leading to excessive release of dopamine, while Dexedrine primarily increases the amount of circulating dopamine.

Provigil is generally seen as a first-line treatment for conditions like narcolepsy or sleep apnea due to its lower potential for addiction compared to traditional stimulants. Dexedrine may also be used as an initial therapy or could serve as an adjunctive medication when required.

Both medications are available in generic forms which can significantly reduce costs for patients who must pay out-of-pocket expenses. Patients might require time for their bodies to adjust after initiating either modafinil or dextroamphetamine; hence immediate effects might not always be noticeable.

Side effect profiles are similar between both drugs including headache, anxiety and nausea but Provigil tends not induce appetite suppression commonly associated with Dexedrine use. As with any medication that affects brain function, individuals using either drug need close monitoring especially during initiation or dose adjustment phases of therapy because mood changes could occur requiring urgent medical attention.