Provigil (Modafinil) is a drug which is being used as a therapy for narcolepsy and sleep apnea. It promotes alertness and wakefulness which helps with shift work sleep disorder. It has a wide range of use as an off-label medicine and it is schedule IV controlled substance. It acts as a dopamine reuptake inhibitor. On the other hand, there is Adderall, which is a combination drug which contains amphetamine salt mixture and it is mostly used for ADHD (attention deficit hyperactivity disorder) and narcolepsy. It affects similar to Provigil and blocks the reuptake of dopamine and norepinephrine in a presynaptic neuron which increases the levels in extraneuronal space. Provigil is in use since 1998 after the FDA approval, unlike Adderall which is approved 2 years before (1996).
They are fairly similar and both approved by FDA in the similar period of 2 years of difference. They are both used for narcolepsy treatment and both have wide off-label use due to their cognitive stimulative effects. Adderall is the first choice for ADHD therapy, but Provigil has higher variance effect.
They both have a similar mechanism of action, although Provigil mechanism of action is still unknown. It affects histamine levels, dopamine, norepinephrine, and serotonin. It affects many receptors and substances in the body resulting in stimulative effects (eugeroic). Adderall acts primarily on dopamine and norepinephrine reuptake inhibiting their entrance in the cells. Some say Provigil is a safer option when compared to Adderall for a long-term use due to its lesser possibility for dependence, tolerance, and the potential for abuse. Here is the comparison.
Provigil vs Adderall Comparison Chart
We will start the comparison by reviewing the chart comparison between these two drugs. On on hand, there is eugeroic Provigil and on the other Adderall, the psychostimulant drug. There are some similarities, but also differences between those two.
|Approved uses||Narcolepsy. Obstructive sleep apnea. Shift work sleep disorder.||ADHD. Narcolepsy.|
|Ingredients||Modafinil||Mixed Amphetamine Salts (75% Dextroamphetamine / 25% Levoamphetamine)|
|Formats||Tablet||IR (Immediate release) or XR (Extended release)|
|Dosages||100 mg/200 mg||IR: 5 mg/7.5 mg/10 mg/12.5 mg/15 mg/20 mg/30 mg or XR: 5 mg/10 mg/15 mg/20 mg/25 mg/30 mg|
|Manufacturer||Cephalon Inc.||Shire Pharmaceuticals|
|Legal Status||Schedule IV (US)||Schedule II (US)|
|Mechanism of action||Functions by inhibiting reuptake of dopamine and elevating histamine levels in the hypothalamus. It also increases levels of other monoamines such as norepinephrine / serotonin / and activation of orexin peptides. Specifically, it may stimulate orexin receptors (OX1 and OX2) to promote wakefulness. The drug may also activate glutamatergic circuits / inhibit GABA neurotransmission / and enhance electronic coupling.||Functions by increasing levels and inhibiting reuptake of stimulatory neurotransmitters such as dopamine and norepinephrine. It acts as a TAAR1 agonist and VMAT2 inhibitor.|
|Half life||12 hours||11 to 13 hours|
|Common side effects||Dizziness. Headache. Insomnia. Nausea. Nervousness.||Abdominal pain. Appetite loss. Diarrhea. Dizziness. Dry mouth. Fever. Headache. Insomnia. Irritability. Nausea. Nervousness. Vomiting. Weight loss.|
|Date approved||(1998)||February 13 (1996)|
|Effect duration||6 to 8 hours||IR: 4 to 6 hours / XR: 12 hours|
|Investigational uses||ADHD. Cognitive enhancement. Chronic fatigue syndrome. Delayed sleep phase syndrome. Depersonalization. Depression. Drug addiction. Fibromyalgia. Jet lag. Multiple sclerosis. Parkinson’s disease. Weight loss.||Stroke rehabilitation. Treatment-resistant depression.|
Differences: Provigil vs Adderall
There are a lot of differences, which you can see in the chart above. Adderall is a more popular drug, even if it’s an older drug, which was produced 2 years before Provigil. It has a greater effect on dopamine and thus, better effects on cognitive functions. Provigil is marked as a “Schedule IV” while Adderall is marked as a “Schedule II” controlled substance. They have similar effectiveness for narcolepsy and excessive daytime sleepiness.
Provigil is in a group which has a lower potential for abuse, where it is classified as a “Schedule IV” drug. Adderall has greater potential for abuse since it’s classified as a “Schedule II” drug, the same category as cocaine and morphine. The prescription for Provigil can be refilled up to 5 times within 6 months without a signature from your doctor while Adderall is not refillable. Each new bottle has to go with a new prescription. This strong control over Adderall is due to its high potential for abuse. You develop a tolerance fast and you require a higher dose to obtain the same effect, creating a habit of taking higher doses of your own which you should not do. It is also greater dependence over Adderall versus Provigil, where people taking it become psychologically and physically dependent on its effects. This is due dopamine concentration, where the Adderall has a higher impact on its levels in comparison to Provigil minor dopaminergic effects. The Adderall creates the rush which is abused for euphoria experiences. Adderall can also result in stimulant psychosis when snorting.
Dosage And Formats
Adderall is manufactured in different dosages and formats. The formats are immediate release (IR) and extended-release (XR) capsules. The immediate release lasts about 4-6 hours while extended release can last up to 12 hours. There is a wider range for Adderall, including IR doses in 5 mg, 7.5 mg, 10 mg, 12.5 mg, 15 mg, 20 mg, and 30 mg and XR doses of 5 mg, 10 mg, 15 mg, 20 mg, 25 mg, 30 mg. It has a wider range of doses and formats in comparison to Provigil.
Provigil has 2 doses of tablets which are 100 mg and 200 mg. They both last from 6-8 hours. Reviewing the chart, we see that Adderall has double the formats and triple the dosing options for each of its formats.
Mechanism Of Action
Provigil has still an unknown mechanism of action, although some aspects are known. It does inhibit the reuptake of dopamine binding with dopamine transporters in the brain and it influences histamine levels in the hypothalamus. It also increases norepinephrine and serotonin in the brain. It affects orexin receptors which regulate wakefulness which is useful for excessive daytime sleepiness therapy.
It is also considered to affect the GABA levels in the system and also stimulating gamma brain waves in the nervous system which are responsible for cognitive functions and awareness.
Adderall has a greater effect on dopamine and norepinephrine and it stimulates cognitive functions more than Provigil. It is reuptake inhibitor of dopamine and norepinephrine.
This can be different when comparing effectiveness for different conditions. They are both used for narcolepsy and both drugs have shown significant effects when compared to placebo effects in double-blind, randomized studies.
When analyzing cognitive functions, Adderall may have a greater potential for enhancement due to a dopamine rush. It can last for a longer time, so it can be a better option for long-lasting therapy of wakefulness. Provigil effects are shorter, from 6 to 8 hours, in comparison to XR format of Adderall which lasts up to 12 hours.
Adderall is the recommended therapy for ADHD while Provigil can be an option, but it is usually not considered.
Since those two medicines are in different classes, it can be compared side by side. Adderall is highly prescribed medicine for ADHD, where it held 38% therapy for ADHD in 2013. In 2012, it was one of the most prescribed medicine, holding the 70th spot in the chart.
Adderall is considered more popular and it can be due to its price, which is cheaper than Provigil. 30 day supply of Adderall IR will cost you approximately 300$ and for XR 220$ while 30 day supply of Provigil of 100 mg will cost you about 800$ and 200 mg up to a 1000$. Considering there are generic formats of these medications, they will cost you less. With generic Adderall, you can go with 50-75$ per month, and with Provigil from 150-300$ a month.
Side Effects And Withdrawal
Due to dopamine rush, Adderall has more side effects, including appetite reduction, dizziness, insomnia, weight loss, headaches, abdominal pain, diarrhea, dry mouth, fever, irritability, anxiety, vomiting. Provigil has fewer side effects: insomnia, nervousness, headaches, dizziness, nausea.
When it comes to withdrawal, Adderall is the worse option. It has stronger symptoms and it can last for a long time. Those who are on Adderall withdrawal can sense cognitive impairment, sleepiness, fatigue, ADHD symptoms worsening, slow metabolism and brain functions, depression. This is all up to the reduction of dopamine levels in the brain. Since Provigil doesn’t have that impact on dopamine, it can be easier to discontinue. Thus, Provigil has milder withdrawal symptoms and some say there is no “withdrawal” when it comes to Provigil.
Which Drug Is Better? Provigil Or Adderall?
Depending on the condition treated, you may opt for a different medicine. When treating narcolepsy, Provigil can be a better option due to fewer side effects, the potential for abuse and dependence and close to none withdrawal symptoms. Some may opt for Adderall to its dopamine rush which has a better effect on cognitive functions. It is produced in numerous formats and dosings which can be convenient.
Which do you prefer and why? Feel free to comment bellow and share your experience when using these drugs.