Ahmedabad: Modafinil, a prescription drug intended to treat sleep disorders like narcolepsy and sleep apnea, is readily available over the counter at medical shops near major hospitals in Ahmedabad. This “smart drug”, as it is often called, is being misused by students and professionals to increase productivity and stay awake for extended periods.
During a Mirror investigation outside Asarwa Civil Hospital, chemists showed no concern for prescriptions, typically asking buyers only about the quantity needed. While tablets are not sold loose, buyers are required to purchase a full pack of 10 tablets. The price for 200-mg dosage is Rs 350, while 100 mg costs Rs 115.
A similar situation was found at medical shops near VS Hospital in Paldi, where chemists readily sell the drug without a prescription. When this reporter inquired about the 200-mg dosage, the chemist replied, “I don’t have 200 mg, but I have 100 mg. Taking two pills at the same time will give the same effect as 200 mg.”
Modafinil is sold under various brand names in India, including Modafinil, Madolert, Modwell, Modafresh, and Modapro.
It is a non-amphetamine central nervous system stimulant. It is primarily used to treat excessive daytime sleepiness caused by narcolepsy, obstructive sleep apnea and shift work sleep disorder. It is also used off-label to treat conditions like ADHD, cancer-related fatigue and depression, although its effectiveness in these cases remains unclear.
While modafinil is touted as a productivity booster, frequent misuse can lead to various side effects. These include insomnia, anxiety, nausea, decreased appetite and even serious issues like heart arrhythmias or Stevens-Johnson syndrome, a potentially fatal skin reaction.
“Many young professionals, including those in corporate and tech sectors, air force personnel, truck drivers, surgeons, and students, misuse modafinil to meet work demands or study for extended hours,” said Dr Urvi Patel, consulting physician and diabetologist. “This pattern of use poses significant long-term health risks, including dependency and the strain of completing large amounts of work,” she said.
Dr Patel added, “The recommended dose is 200 mg daily for narcolepsy or sleep apnea, and before shifts for shift work disorder. Common side effects include headache, nausea and insomnia, while rare but serious risks like Stevens-Johnson syndrome or toxic rashes may occur within six weeks of starting. Any rash should be reported to a doctor immediately.”
“Modafinil can cause a range of unpleasant side effects, including paranoia, palpitations, unquenchable thirst, reduced appetite and even a temporary loss of creative abilities,” cautioned Dr Patel.
“Clinical trials have shown that it can produce euphoric and psychoactive effects, altering thinking, mood and perception, similar to other central nervous system stimulants,” she said.
Upon inquiry about Modafinil and its brand Modalert at a store near Galaxy Tower in Bodakdev, the chemist responded casually, “Jaagwani goli ni vaat karo chho (Are you asking about the drug to stay awake)?” and promptly offered a 200-mg tablet without asking for a prescription.
When contacted about this issue, Dr HG Koshia, Commissioner of the Food and Drug Control Administration (FDCA), stated, “This drug does not fall under the category of Schedule Drugs (which includes drugs with no currently accepted medical use and a high potential for abuse), so we cannot initiate legal action against chemists selling it.
However, any drug labeled with a warning stating ‘To be sold by retail on the prescription of a specialist only’ cannot be sold without a prescription.”
