Modafinil vs. Adderall: A Side-By-Side Comparison

Modafinil and Adderall are medications that produce stimulant-like effects and are both used in the treatment of narcolepsy. However, they have different chemical structures, which contributes to their distinct side effects and addiction potential.[1] They’re both used in the treatment of narcolepsy and may be misused – without a prescription – as study aids for college students.

There are significant differences in the way modafinil and Adderall are structured, which impacts their side effects and addiction potential.

What Is Modafinil?

Modafinil, which goes by the brand name Provigil, is a central nervous stimulant drug that’s often referred to as a eugeroic medication, which is a medication that promotes alertness and wakefulness.[2][3] It’s approved by the FDA to treat daytime sleepiness in people who have different conditions, including:

• Narcolepsy
• Shift work disorder is a disorder that involves a disruption of normal sleeping hours when one is working nights
• Sleepiness that occurs in other medical conditions like obstructive sleep apnea Modafinil is a Schedule IV controlled substance by the DEA.

What Is Adderall?

Adderall is the brand name for a combined drug that includes amphetamine and dextroamphetamine.[4] This combination of drugs is approved by the FDA to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. Both of the main ingredients in Adderall are central nervous system stimulants.

This drug comes in immediate-release and extended-release forms (Adderall XR). The immediate-release form lasts about 4 to 6 hours, while the extended-release form lasts about 12 hours. Adderall is a Schedule II controlled substance by the DEA for its significant risk of abuse and physical dependence.

Differences Between Modafinil and Adderall

Modafinil has a unique structure and is not a stimulant like Adderall, but it does have stimulant-like effects and improves alertness. It can keep people awake and enhance thinking and perception. Experts aren’t exactly sure how it works, but they have indicated that it enhances several chemicals and neurotransmitters in the brain, such as serotonin, dopamine, glutamate, histamine, and GABA.[5]

Though modafinil doesn’t have significant withdrawal effects, any stimulant drug reinforces taking a drug to a certain degree and can cause dependence and subsequent withdrawal. Some people report reduced energy, lack of motivation, and depression following the discontinuation of modafinil, so it’s often tapered to reduce any potential for withdrawal effects.[6]

This drug is approved by the FDA to treat sleepiness caused by apnea, narcolepsy, or shift work. Off-label, it may be used for multiple sclerosis and Parkinson’s disease, as well as illicitly by students, military, and executives, to combat sleep deprivation and fatigue. Similarly, Adderall is effective for treating people with narcolepsy or ADHD. It’s also been used illicitly as a study aid or party drug among high school and college students, with approximately 7.5% of seniors and college undergrads misusing it.[7] It stimulates the concentration of dopamine and norepinephrine in the brain, though the exact mechanism of action is not known.

Side Effects of Modafinil and Adderall

The side effects of modafinil are mild compared to those reported with Adderall, though modafinil can increase the heart rate and blood pressure and should not be taken by people with a history of certain heart or heart valve problems.[8] Most people who take modafinil report headaches as a side effect, followed by nausea.

Other side effects may include anxiety, rhinitis, back pain, insomnia, and gastrointestinal discomfort like indigestion or diarrhea, though these side effects are much less common.[9] Modafinil can impact the effectiveness of estrogen and progestogen oral and implantable contraceptives.

For people with allergies, rare life-threatening rashes have developed with modafinil. Stevens-Johnson Syndrome and drug-induced hypersensitivity syndrome were reported. There’s limited research into the long-term effects of modafinil. Adderall has a broader range of side effects. The common side effects are loss of appetite, dry mouth, blood pressure spikes, insomnia, headache, and abdominal pain.[10]

Sexual dysfunction, fast heart rate, nervousness, and a slowed growth rate in children have also been reported. Some people are more sensitive to stimulants and may develop confused thought processes, no matter what dosage they take. Side effects like manic symptoms, hearing voices, and increased suspiciousness can occur.[11] With psychotic disorders or bipolar conditions, the symptoms may become worse with Adderall.

Adderall is not appropriate for people with heart disease, high blood pressure, glaucoma, or overactive thyroid. It also carries a significant risk of tolerance and dependence. If Adderall is stopped abruptly, it can cause withdrawal with extreme tiredness, sleep disturbances, and depression.

The difference in the classification of the drugs – Schedule II for Adderall and Schedule IV for modafinil – reflects their different risks for abuse or dependence. Adderall is known to be a significant potential drug of abuse, particularly for focus as a study aid, a weight loss drug, or as a drug that enhances the psychoactive effects of other drugs.[12]

“Modafinil is sometimes misused along with other substances as a ‘cognitive enhancer,’ with the misconception that it makes people ‘smarter,’ although it primarily improves wakefulness and focus without directly enhancing innate cognitive abilities.”The perception that modafinil and Adderall are cognitive enhancers is incorrect, as these drugs may improve focus, but high doses can actually inhibit attention and concentration.[13] People who abuse Adderall have lower academic achievement.[14]

Stimulants and Alcohol

Neither modafinil nor Adderall should be taken with alcohol. Though they have different effects, taking stimulants like modafinil or Adderall with a depressant like alcohol won’t “cancel each other out.” Instead, it sends the brain mixed messages. People often report blacking out after only minor amounts of alcohol while taking modafinil, but people who mix alcohol and Adderall often have more severe side effects.[15]

Stimulant Abuse and Addiction Treatment

Adderall and modafinil have the potential for abuse and addiction, though Adderall has much more serious abuse risks and more severe withdrawal symptoms. If you or someone you know is struggling with modafinil or Adderall abuse, help is available through evidence-based addiction treatment. Though stimulant withdrawal isn’t usually life-threatening, it can be unpleasant.

Both drugs may be tapered to reduce the withdrawal effects, but medical detox may be recommended to avoid severe side effects and relapse risk. With medical detox, you have a full medical team to monitor your symptoms and keep you as safe and comfortable as possible. Once detox is complete, you may transition into an inpatient or outpatient treatment program.

Depending on your individual care plan, this may include individual therapy, group therapy, behavioral therapies, and holistic therapies to address the motivations behind drug misuse and develop healthier coping strategies and stress management techniques.

Take the Next Step

Whether you’ve misused modafinil or Adderall or you are struggling with dependence on a prescription, Ocean Recovery is here to help. There’s always hope for a new, healthy life free from addiction. Contact us today to learn more about our treatment programs.