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A Wonder Drug For Shiftworkers?

© Stephen Weistling

The article in the L.A. Times immediately caught my eye. Jane Jaegers works as a 911 dispatcher in Santa Clara County, California, and works the night shift. When at work, she displays many of the common symptoms of shiftwork: Fatigue, drowsiness, and inattention. She sometimes takes No-doz or other caffeinated drugs, which gets her through the shift, but when she gets home, she stays "wired", and the sleep she gets is fitful at best. Her social life leaves much to be desired, and she's simply tired of being tired.

When Jane found out about a study regarding a new "wakefulness" drug, she was intrigued. And after signing up, she's glad she did. Jane now takes a couple of small pills called Provigil before leaving for work, and reports that the new drug helps her stay awake during her shift without the "buzz" usually associated with the stimulants of choice among shiftworkers. In fact, some patients who have tried Provigil return to their doctors and say it isn't working. They don't have that "hyper" feeling they expected. But further analysis shows they aren't sleepy, either.

Provigil (also known as Modafinil) has currently been approved by the U.S. Food and Drug Administration for narcolepsy, a disease whose main symptom is the continual and uncontrollable urge to sleep. But researchers are very interested in the possibilities of Provigil with shiftworkers and others who must stay awake for those durations of the day which normally are used for sleep.

Provigil is not classified as a stimulant, although some still refer to it as such. It does not work like traditional stimulants, which attack the entire nervous system. Instead, it causes changes in the brain itself. Doctors aren't sure exactly how Provigil works, but they believe that it inhibits an acid in the brain that is modified by serotonin. In other words, in might have something to do with the region of the brain that triggers sleepiness that we/ve discussed in previous articles.

It has been also been used with patients suffering from sleep apnea, a disorder commonly associated with bouts of "sleep," where the subject continually wakes up and fights for breath thoughout the night. This disconnected sleep pattern usually leaves sufferers walking around like zombies during the day. Their use of Provigil now allows them to be more awake and alert during the day, letting their normal treatment for apnea to be more effective.

One of the main benefits of Provigil seems to be its near-absence of side effects. Without that "wired" feeling, patients report it is much easier to sleep when they need to rest, with only a single dose of Provigil before their shift. Because of the drug's more selective action on the brain rather than the whole nervous system, researchers are intrigued about the possibilities for shiftworkers. Although some have complained about headaches and mild nausea, the vast majority of users experience no side effects at all. And it is not addictive.

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