Provigil (modafinil) is prescribed for the treatment of narcolepsy, shift work sleep disorder (SWSD), and daytime sleepiness associated with sleep apnea.
Nuvigil is chemically similar to Provigil, but Cephalon says its effects are longer-lasting than Provigil. The drugs weren’t tested head-to-head in clinical efficacy trials, but Cephalon says the drugs were compared in terms of concentrations in plasma.
Sleep loss will result in performance deficits, including increased variability in performance, slowed physical and mental reaction time, increased errors, decreased vigilance, impaired memory, and reduced motivation and laxity. There is no consensus on the extent of impairment resulting from a given amount of sleep loss.
Depending on the performance task measured, after 17-19 h of sustained wakefulness, decrements in task performance are equivalent to, or worse than, those seen at a blood alcohol concentration of 0.05%,(40) and about 20-25 h of wakefulness will result in performance decrements equivalent to a blood alcohol concentration of 0.10% on some tasks. Generally, complex performance tasks seem to be more sensitive to the effects of sleep loss than simpler tasks.
Provigil treatment was initiated for a patient with severe fatigue associated with chronic low back pain and neck pain. There was dramatic improvement in fatigue and associated function.
Fatigue is a symptom that is frequently found in chronic pain patients with low back pain and/or neck pain. At the present time, no specific psychopharmacological treatment for this problem has been identified. Provigil is a wakefulness-promoting agent that the FDA has approved for the treatment of excessive daytime sleepiness associated with narcolepsy.
There have been reports on the use of Provigil for the treatment of fatigue in various neurological syndromes. This literature is reviewed.
It is the first such case report in the literature. The significance of this finding to the treatment of pain-associated fatigue is discussed.