It's worth noting that not everyone responds to modafinil. If you've had genetic sequencing done (I had mine done by 23andme), you can predict your response by checking your Rs4680 status. http://www.snpedia.com/index.php/Rs4680
rs4680(G;G) carriers deprived of sleep respond quite well to 2x 100mg
modafinil in terms of improved vigor and well-being, and maintained
baseline performance with respect to executive functioning, whereas
rs4680(A;A) individuals barely responded to the drug at all.
I'm A;A, and normally have almost no response to modafinil. I discovered, however, that I have significant modafinil response while on an MAOI (transdermal selegiline). I've stopped taking it recently, since I've finally tracked down the primary causes of my excessive sleepiness, (very deficient in vitamin D and cortisol). Modafinil has been a massive help both with fatigue and depression, and let me stay functional and productive through a difficult time in my life while I tracked down the actual problems.
Contrary to what some doctors tell you, it is really hard to fix a Vitamin D deficiency with dietary supplements. Go to a tanning salon and get 250,000IUs in 10 minutes. Of course this is going to be a bit weird if you are naturally dark skinned, but far more effective than taking pills.
Citation? I ask because I'm interested in making sure I'm healthy, not to just be a jerk on the internet, and if that's true I'm doing something wrong.
No citations exist. My comment was directed at the grandparent whose original symptoms warranted taking dangerous MAOIs. In that case, I would consider an off literature treatment to fix the vitamin D deficiency as fast as possible. Tanning beds are carcinogenic and not recommended for general health.
I started taking MAOIs while trying to deal with depression. SSRIs had pretty severe cognitive side-effects for me, and low doses of transdermal MAOIs have a better risk profile than traditional oral MAOIs. You're right about dangerous, though. I first started modafinil while on the MAOI, and didn't find out that it didn't work for me off of it until I stopped using the MAOI due to apparent serotonin toxicity, which you don't want to screw around with.
Oral vitamin D is not taken up by the body all that well. If you do have a D deficiency and you're taking oral supplements, be sure to get your levels checked after 6 months. You may need to up your dose or get some direct sunlight.
For me at least, this is certainly true. Even with significant dietary supplements and spending more time outside, I've only been able to get up to about 25 ng/mL. This is a significant improvement for me, as my initial levels were below the sensitivity of the test, at <0.25 ng/mL, but still not ideal. I hadn't considered visiting a tanning salon; I may try that soon if things aren't notably improved after the next time I get this tested.
Deficient in cortisol? That sounds very interesting... Isn't that the stress hormone? What kind of effects was that having on your life, other than the sleepiness?
Specifically, cortisol normally has a significant peak in the morning with waking, but I don't have that. My cortisol levels throughout the day are about flat, so normal for the evening, but not elevated in the morning. According to my doctor, this isn't too unusual, and should adjust up to normal levels after some months of supplementation. I just started supplements two weeks ago, and I'm definitely far more awake during the day and have a much easier time starting the day, but I haven't noticed any other significant changes, so I don't know anything else attributable to this. The only other changes I've noticed have been pretty minor, like an easier time exercising, and maybe a bit more irritable.
Chiming in: cortisol IS "the stress hormone" but "stress" in the body sense is not the same thing as we think of "stress" in our daily lives.
With my chronic fatigue syndrome, there was a period where I had signs of "adrenal fatigue." My body would not produce sufficient cortisol and it REALLY showed. Symptoms included difficulty with physical activity, e.g. standing up or climbing stairs, an overwhelming agoraphobic-in-a-mosh-pit feeling in my head when faced with making any kind of decision, weighing facts, or even too much sensory input (e.g. talking to me while touching me or touching me while I tried to tie my shoes), etc. I would jerk away and have a sobbing meltdown because I couldn't cope. Among people with adrenal/cortisol issues, that is called a "crash".
So I have learned that sensory input, thinking, information processing, etc., are all types of stress on the system. Cortisol is required for the body and brain to "rise to the challenge" of almost every kind of effort, not just "I'm freaking out" type stress. In the case of the OP, staying awake was clearly a challenge his body could not rise to because it had insufficient cortisol on hand.
