Provigil, a drug that contains the active ingredient modafinil, is a prescription-only medication indicated in the treatment of narcolepsy--sudden, uncontrollable bouts of sleep. However, according to the Oregon State University College of Pharmacy, Provigil is sometimes prescribed "off-label"--at a physician's discretion contrary to its FDA-approved use--to treat depression. Although Provigil is not a conventional medication for treating depression, it can produce effects that may be of benefit to someone suffering from a depressive disorder.
Effects on Mood
Provigil shows some promise for elevating mood in people with depressive disorders such as bipolar disorder and major depressive disorder. According to a 2007 study published by the "Journal of Clinicl Psychopharmacology," modafinil significantly elevated the mood of healthy participants versus a placebo. An 2007 article in the "American Journal of Psychiatry" also reports that in another double-blind study of two groups of participants diagnosed with bipolar disorder--a condition in which the affected person experiences cycles of manic "highs" and depressive "lows"--a significant portion of those taking Provigil reported positive effects on mood. However, there is a downside to Provigil's potential mood-lifting effects--modafinil, as a central nervous system stimulant, also has the potential to increase anxiety, a condition often coexistent with depression.
Effects as an Adjunct to Antidepressants
Stimulants are sometimes used as adjuncts or "supporting" medications in the treatment of depression with more traditional antidepressant medications. These types of medications include amphetamines, methylphenidate. Modafinil is not a stimulant, but acts in a similar manner in the brain--a method of action that could help with depression in concert with other drugs. Oregon State University reports that in theory, Provigil's effects may relieve hypersomnolence--a symptom of depression that causes people to sleep excessively. However, Oregon State also points out that the evidence for these effects are inconclusive--and modafinil's wakefulness-inducing properties may cause unwanted insomnia in depressive patients.
Potential Future Antidepressant
California State University Fullerton states that Provigil is a potential future antidepressant, due to its ability to promote feelings of well-being, improve concentration and reduce fatigue. Additionally, unlike central nervous system stimulant drugs, modafinil has little potential to become habit forming, which may make it a strong choice over stimulant medications to treat depression-induced fatigue, lack of motivation, and anhedonia--the inability to feel pleasure.
Uncertain Effects
It is important to keep in mind that the use of Provigil for its antidepressant effects is off-label, and has not received approval for the FDA for this purpose. As of September 2010, modafinil is only approved to induce wakefulness in those suffering from narcolepsy. The hard data on Provigil's effects on depression is still coming in, and despite the promising aspects of modafinil's effects, more research is needed before the medication can become a staple in depression treatment. Anyone with questions about taking Provigil as well as its effects on depression, should discuss them with a physician or psychiatrist.
References
- Oregon State University College of Pharmacy: The Off-Label Use of Modafinil
- "American Journal of Psychiatry": Modafinil Add-On in the Treatment of Bipolar Depression; Dr. R. H. Belmaker; August 2007
- University of California Davis: Modafinil: A Review of Neurochemical Actions and Effects on Cognition
- "Journal of Clinical Psychopharmacology"; A randomized, double-blind, crossover trial of modafinil on mood; I. Taneja et al.; February 2007
- California State University Fullerton: Future Antidepressants--Modafinil (Provigil)
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