The lowdown on a pick-me-up - Vital signs: news and trends for your well-being

The FDA has given the go-ahead for expanded use of the prescription pick-me-up medication Provigil (modafinil).

The drug was first approved in 1998 to treat narcolepsy, an uncommon condition in which sufferers fall asleep uncontrollably during the day. This January the FDA added two other indications for its use: excessive sleepiness resulting from sleep apnea and shift-work sleep disorder. Provigil doesn't stimulate the entire brain but works selectively through the brain' s sleep-wake centers to activate only the cortex, which is crucial for wakefulness, according to manufacturer Cephalon Inc.

Side effects are minimal and Provigil is not addictive, but some doctors urge caution.

Weary workers and athletes are already taking the drug, at $5 to $7 a pop, to improve daytime performance at the office or on the playing fields, says Richard O'Brien, M.D., sleep specialist and medical director of the Alpha Sleep Diagnostic Centers in Denver.

"Probably one-third of the time, Provigil is being used inappropriately, either as a performance enhancer or an aid to treat sleep deprivation," he says.

O'Brien's concern is that indiscriminate use of Provigil will increase, masking underlying medical problems responsible for sleepiness, such as sleep disorders, poor sleep habits or an underactive thyroid.

COPYRIGHT 2004 Weider Publications
COPYRIGHT 2004 Gale Group