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Medicine: This Will Keep You Awake
Provigil, the anti-tiredness pill made by local company Cephalon, may be the ultimate lifestyle drug of the 21st century. Is sleep obsolete?
By Carol Saline
- Photo courtesy of photos.com
LIKE MOST BUSY DOCTORS, Center City internist Matthew Frankel makes a valiant effort to keep up with the latest pharmaceuticals. But with medications flooding the market, some simply escape his radar. So it wasn’t surprising that six years ago, he was unfamiliar with a new drug called Provigil, which was FDA-approved for excessive fatigue related to narcolepsy. It caught his attention when a letter from an insurance company landed on his desk, saying the company wouldn’t pay claims for Provigil without a validated diagnosis of narcolepsy. “I have several thousand patients, and fewer than a handful are true narcoleptics,” Frankel explains. “But fatigue is one of the most common complaints I get in my office. Everybody’s stressed and short on sleep.”
When an invitation to a dinner seminar about the drug came from Cephalon, the Chester County pharmaceutical company that manufactures Provigil, Frankel promptly accepted. While the lecture was informative, the real excitement came in the Q&A that followed. One doctor stood up and asked if Provigil could be used for patients who were simply tired. “Soon the audience is going back and forth about how they’re prescribing Provigil for this and that, what impressed them, how it worked like a stimulant but wasn’t addictive and didn’t cause jitters,” Frankel recalls. “I went to two or three of these seminars, and it was always the doctors, not the company, touting the drug for all kinds of problems.” Since then, Frankel has prescribed Provigil about 50 times — and would do it more if he weren’t uncomfortable prescribing drugs off-label.
If you haven’t yet heard of Provigil, you will. Although it’s supposed to be used for only three medical conditions — narcolepsy, shift-work sleep disorder and sleep apnea — you don’t have to be a drug salesman to see that its potential goes far beyond that. Indeed, it may be the perfect drug for our busy 21st-century lives. A potent waker-upper, it can give you the energy infusion of several cups of strong coffee or the kick-start of an amphetamine, but without the accompanying jitters and heart palpitations. Moreover, its rush is no more potent than that of a sugar-packed candy bar — and it’s considered perfectly safe and non-addictive.
That’s one reason why it’s fast becoming the physician’s off-label drug of choice for the exhaustion and lethargy associated with problems as varied as depression, head trauma, Parkinson’s disease and multiple sclerosis. It’s also why some people have started using it as a performance enhancer. The Air Force gives it to pilots to help them stay awake and alert on long missions, while athletes have admitted to using Provigil as a performance-booster. And it’s gaining an underground following among college students at exam time, as well as with competitive workaholics looking for an edge on the achievement treadmill.
When an invitation to a dinner seminar about the drug came from Cephalon, the Chester County pharmaceutical company that manufactures Provigil, Frankel promptly accepted. While the lecture was informative, the real excitement came in the Q&A that followed. One doctor stood up and asked if Provigil could be used for patients who were simply tired. “Soon the audience is going back and forth about how they’re prescribing Provigil for this and that, what impressed them, how it worked like a stimulant but wasn’t addictive and didn’t cause jitters,” Frankel recalls. “I went to two or three of these seminars, and it was always the doctors, not the company, touting the drug for all kinds of problems.” Since then, Frankel has prescribed Provigil about 50 times — and would do it more if he weren’t uncomfortable prescribing drugs off-label.
If you haven’t yet heard of Provigil, you will. Although it’s supposed to be used for only three medical conditions — narcolepsy, shift-work sleep disorder and sleep apnea — you don’t have to be a drug salesman to see that its potential goes far beyond that. Indeed, it may be the perfect drug for our busy 21st-century lives. A potent waker-upper, it can give you the energy infusion of several cups of strong coffee or the kick-start of an amphetamine, but without the accompanying jitters and heart palpitations. Moreover, its rush is no more potent than that of a sugar-packed candy bar — and it’s considered perfectly safe and non-addictive.
That’s one reason why it’s fast becoming the physician’s off-label drug of choice for the exhaustion and lethargy associated with problems as varied as depression, head trauma, Parkinson’s disease and multiple sclerosis. It’s also why some people have started using it as a performance enhancer. The Air Force gives it to pilots to help them stay awake and alert on long missions, while athletes have admitted to using Provigil as a performance-booster. And it’s gaining an underground following among college students at exam time, as well as with competitive workaholics looking for an edge on the achievement treadmill.
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