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Front Biosci (Landmark Ed). 2019 Jan 1;24:564-575.

Modafinil and orexin system: interactions and medico-legal considerations.

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Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
Department of Experimental Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
Department of Biomedical and Biotechnological Science, University of Catania, Via Santa Sofia, 97 - 95123 Catania, Italy.
Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy,
Complex Structure of Neuropsychiatry Childhood-Adolescence of Ospedali Riuniti of Foggia, Foggia, Italy.
Department of Experimental Medicine, Section of Human Physiology and Unit of Dietetic and Sport Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy.
Anatomy Department, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Università degli Studi della Campania,Luigi Vanvitelli, Naples, Italy.


Modafinil (Mo) is increasingly being used as an enhancement drug rather than for its therapeutic effects. The effects of this drug have been examined in attention deficit disorders, depression, mental fatigue, and in enhancing concentration. The drug possesses wakefulness-promoting properties which are mediated through the interaction of orexinergic system with the activated sympathetic nervous system. Mo exerts a synergistic effect on the orexin system, controls energy expenditure and strengthens the ability of the individual to exercise. Some view Mo as a drug that enhances sports performance, since it induces a prolonged wakefulness and decreasing the sense of fatigue. These characteristics being similar to conventional stimulants have allowed Mo to emerge as a novel stimulant requiring medico-legal considerations. However, more studies are needed to better understand the mid and long-term effects of the drug on user/abuser.

[Indexed for MEDLINE]

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