ADRAFINIL VS MODAFINIL: COMPARISON, EFFECTS AND DOSAGE
Adrafinil vs Modafinil: Similarities
Modafinil and adrafinil are or were used to treat the same medical conditions, namely narcolepsy, idiopathic hypersomnia, and obstructive sleep apnea (Dubey et al., 2009). In addition, adrafinil was administered to elderly individuals in France until 2011 to enhance mental functioning (Docherty, 2008). Meanwhile, modafinil is being investigated as an off-label treatment of ADHD (Kim, 2012). Both, however, are classified as psychostimulants and are available in forms suitable for oral intake. Modafinil and adrafinil are nearly alike in chemical structure except that adrafinil is a precursor drug to modafinil (Rao et al., 2008). Once administered, adrafinil is transformed by the liver into modafinil so that both drugs produce the same active metabolite which is modafinilic acid (Dubey et al., 2009). They belong to the same class of monoaminomimetic agents, or those that influence monoamine re-uptake and release, known as alpha-1 adrenergic agonists.
Adrafinil vs Modafinil: Legal Status
Modafinil is classified as a Schedule IV drug defined by the US Drug Enforcement Administration (DEA) (2011) as “drugs with a low potential for abuse and low risk of dependence.” As a controlled substance, modafinil can only be obtained through physician prescription. It is illegally being sold online leading to several drug raids in the US and UK as part of an international effort to halt the sale of illicit and counterfeit drugs through the Internet (Boseley, 2012; Vivian, 2010). On the other hand, adrafinil has never been approved by the FDA and is therefore, unscheduled and unregulated in the United States. It was discontinued in 2011 because of risks that were found to exceed the benefits but some websites also continue to market it as a smart drug. Moreover, modafinil and adrafinil are included in the World Anti-Doping Agency (WADA) list of prohibited drugs in sports (Dubey et al., 2009). The agency is currently leading the global campaign against doping among athletes.
Adrafinil vs Modafinil: Benefits
Modafinil and adrafinil enhance the dopaminergic and noradrenergic systems to bring about vigilance, alertness or wakefulness (Docherty, 2008; Milgram et al., 2000). Both drugs may also affect learning. In a study of the canine model of aging, the administration of 20 mg/kg adrafinil resulted in significant enhancement of learning indicated by lesser errors and fewer trials in meeting the criteria pertaining to intensity or size discrimination tasks (Milgram et al., 2000). Electroencephalograms (EEGs) of the dogs revealed alpha and beta waves associated with being awake, attentive, and alert. In aged humans, 7 clinical investigations conducted between 1989 and 1991 had shown that adrafinil was a successful treatment of reduced arousal, attention, and memory, mild depression, and problems with sleep (Siwak et al., 2000). No amphetamine-like side effects were noted.
Adrafinil vs Modafinil: Dosage
Modafinil use has similarly been associated with improved cognitive functions and attention in healthy subjects without adverse effects or indications of tolerance (Akintomide & Rickards, 2011; Wood et al., 2013). In human studies, different dosages of modafinil, namely 200-400 mg once daily, 200 mg twice a day, or 400 mg with an added 200 mg (split dose) showed an improvement in daytime wakefulness based on baseline measures (Wise et al., 2007). The group with the higher dose, i.e. 400 and 200 mg (600 mg a day) per day, had improved alertness scores than those who took 200 mg only. Although all groups showed enhanced executive functioning, those in the split dose performed better. Executive function includes working memory, reasoning, problem solving, task flexibility, planning and execution (Harvard University, 2013). Further, modafinil was investigated for use by soldiers in active combat duty. In studies, modafinil was associated with enhanced vigilance, and thus sleep inhibition, as well as reduced impulsiveness in responses when in a sleep-deprived state (Chaterjee, 2006; Kim, 2012). There was also a reduction in combat fatigue that developed from extended hours of military duty, anxiety, and fear. The effect of modafinil on wakefulness is further emphasized in a study combining the drug with other psychostimulants. The addition of 600 mg of caffeine and 20 mg of amphetamine to 400-mg doses of modafinil restored vigilance in healthy adults compared with placebo (Kim, 2012). This finding was observed following 44 straight hours of no sleep among participants. Sleep recovery is a concern following long periods of wakefulness. However, the use of modafinil compared to placebo was not associated with sleep recovery (Kim, 2012). The ideal dosage of Adrafinil is between 600-1200mg. Adrafinil is water soluble and can be taken with water or juice on an empty stomach. It should be taken in the morning since taking this in the afternoon or evening can cause insomnia. Patients should take Adrafinil in lower quantities to start with, and can gradually elevate to higher recommended dosages.
Adrafinil vs Modafinil: Side Effects
Both modafinil and adrafinil were also discovered to enhance locomotor activity in animal studies. The level of activity was dependent on the dose administered. In a sample of cancer patients, a 4-week pilot study of modafinil administration demonstrated a reduction in fatigue, mood elevation, and improvement in quality of life (Blackhall et al., 2009). Fatigue also improved in clinical trials of modafinil in patients with depression, multiple sclerosis, and amyotrophic lateral sclerosis (Lange et al., 2009). One study showed a synergistic effect of relief of both fatigue and depression in patients diagnosed with depression. Another important benefit of modafinil and adrafinil is the relatively few side-effects subjectively reported by study participants or noted by investigators. Although headache is a frequent side-effect, it can be alleviated by slowly increasing the drug dosage (Mignot, 2012). Increased blood pressure and anxiety are also other reported side effects. SDFT (2015). Adrafinil vs Modafinil: Comparison, Effects and Dosage