> I haven't seen this effect documented anywhere though.
Astereognosis (loss of 3d perception) is a documented side effect of modafinial use - in fact, it was the ONLY documented unwanted effect of modafinil when it got approved, IIRC.
My co-ordination improves considerably with great omega 3 intake (3-10 grams per day) after a few days. This has been described in several places, though as far as I know was not studied rigorously.
As a northern Brit, the tea flows like water in the office I work at. It's quite hard to resist, again, as a northern Brit.
I get mine paid for by insurance.
Here is the conclusion:
"I will come strongly on the side of saying that anyone who wants to build a startup should stay away from any regular or semi-regular Modafinil use, as it will impair their judgement enough to make up for any apparent gain in productivity, and I would further posit that any founder who takes Modafinil regularly has a habit (as I did) of taking on potentially large, unknown long-term liabilities for small short-term gains, which is not a good thing."
I needed every single one of those tablets though.
I travel extensively for work and I'm often called upon to be "on" when I arrive somewhere, in their time zone, and/or drive to a final destination when I arrive. Since sleep deprivation is something that has twice almost killed me (or others) while operating a vehicle, I decided to get that prescription and deal with the problem rather than continue to be unsafe.
What I can say is this: Modafinil works. The effect is very subtle but it very clearly eliminates what might be termed "sleep pressure" or the effect of the body trying to FORCE you to sleep. It doesn't actually do anything for your sleep REQUIREMENT.
One nice thing about Modafinil: you can sleep on it. If you take a pill and then have an opportunity to sleep, you can. It doesn't FORCE to to stay awake like other stimulant drugs do.
So it'll keep you from nodding off at the wheel of a vehicle, but won't do anything to help you perform at your BEST when you use it for an extended period of time.
I take it very occasionally (say, once every month or so) and only for a 24 hour period. That kind of on-/off cycle is designed to minimize any side effects and keep me from using it to replace sleep.
On another note: the US special operations community has been using Modafinil (along with other stimulant drugs) to help solidiers/sailors/marines/airmen to overcome the effects of extended sleep deprivation. I've confirmed this directly with members of those communities and their experience mirrors mine. Modafinil is a useful drug, with minimal reported side-effects, that is better than other stimulants because of its low abuse potential and non-euphoric profile.
I occasionally take prescribed Modafinil for daytime somnolence resulting from sleep apnea. On the occasions I use it, it's the difference between having the energy and clarity to contribute or not being able to bring much at all to the table.
The only side effect I've noted is a minor increase in anxiety, not enough to be problematic.
It's been exceptionally helpful for me. YMMV.
I took a look at the symptoms for Shift Work Sleep Disorder, decided that I was a close match for that cluster of symptoms and took my story to the doc.
Modafinil is not really prone to abuse. It isn't a euphoric, so using too much isn't going to give you a "high". Consequently, doctors are more likely to give you a prescription for it. That's not the case for an abused drug like Adderall.
HOWEVER: all drugs have side effects. I think Modafinil is relatively safe but YMMV.
This is my experience too. My first order of Modafinil was actually an afterthought tacked on to an order of Propranalol (after deciding I'd had enough of being stunted by anxiety). It turned out that the Modafinil was way more effective than the Propranalol, although this is no longer the case for me. After an extended period of taking Modafinil, I find that my heart rate increases too much when I'm anxious. Not quite sure what caused this shift (could be tolerance, or my guess is heightened awareness of the effects after taking it for so long). However, taking Modafinil with Propranalol works wonders. Funky pee be damned!
"Most studies done on the l-theanine-caffeine combination have a l-theanine to caffeine ratio that isn't consistent with ratios you would expect from most teas. The studies used about twice as much l-theanine as caffeine by weight. The ratio found in most teas is reversed, with the possible exception of high quality green tea. Tea also increases fluoride intake which may lead to skeletal or other health problems when consumed in excess."
I'd just like to put in a word for good deep-steamed sencha (fukamushi-cha), and for special occasions the more expensive gyokuro. Brew it properly and it's very, very delicious, and the effects are just lovely. You easily get four brewings from one dose of tea leaves. I drink it most days at work and it's such a delight!
L-theanine is meant as an addition to high levels of caffeine to reduce the negative effects of caffeine.
/r/nootropics has a lot of useful information in their wiki  and the community is pretty friendly and helpful to newcomers.
See for example:
I think what most healthy individuals looking into substances like this actually want, are nootropics. I want to draw a line here between cognitive enhancers and nootropics though. All nootropics are cognitive enhancers, but not all cognitive enhancers are nootropics. Nootropics have to enhance learning and memory, while being extremely safe and actually neuroprotective (from the disruption of memory formation from chemical and physical damage). Nootropics are generally safe and beneficial for everyday use and with the racetams, Rhett actually have a better effect overtime.
Also, what's the cost for a monthly supply with insurance?
I've found it excellent for combatting tiredness, and it can improve my focus, but nothing like the Limitless-esque drug the author talks about. Admittedly I've only taken 100mg at a time, but still - about 5 hours after I take it, I tend to become cranky. I get obsessive about things, rather than focus, and if my obsession falls on the wrong thing, I find myself having wasted 6 hours on writing up or investigating some hare-brained business scheme, rather than my work.
I have easy, legal access to it, and I only take it these days if my sleep is majorly disrupted. If I was getting the benefits the author was, I'd take it every day.
If you have “an Everest of work”, the solution is to get less work, not to take drugs. Be the person you are.¹
① (Not applicable to actually prescribed medication or care from a licenced professional.)
Nearly as many people have the experience of going to a doctor, getting diagnosed with something moderately uncommon, and going through a trial-and-error treatment process where they are guiding what happens as much or more than the doctor.
So no, they are not necessarily insane. What is covered by prescription varies a lot from country to country, and the line is at least as much about medical economics as it is about safety. There are plenty of things that aren't available over the counter not because they're more dangerous, but because they were discovered after the FDA was created and because the financial incentives are to keep them as prescription drugs.
Strawman. I said “or be deemed safe for sale over the counter”.
> many people have the experience of going to a doctor, getting diagnosed with something moderately uncommon, and going through a trial-and-error treatment process where they are guiding what happens as much or more than the doctor.
The key word here are, I think, “going to a doctor”, as opposed to unsupervised self-medicating, or at least without supervision of a trained and licenced professional.
> What is covered by prescription varies a lot from country to country […]
Yes; see my other comment. (https://news.ycombinator.com/item?id=8869314)
Alcohol is not in fact safe for sale over the counter. But still, we sell it over the counter. Having a licensed professional involved on average makes some things better, but only on average, and only for some things. You don't have to be insane to say, "For X, I know better than my doctor." Indeed, that's an important component of people getting optimal treatment outcomes, doctor or no.
Then you should have made that point explicitly. Instead, it looks like you are arguing against something I did not write.
And yes, the line is very arbitrary. However, that doesn’t mean that it does not exist, or that you are free to set it anywhere you feel like without worry or care. Unless you have the enormous resources to research on your own (but you don’t, nobody does), you should pick some other party which has done so (scientifically) and has subsequently set the line somewhere. And unless you have reason to doubt their veracity, you should adhere to that line. No, “I feel like it, it could be fun” or “I could make more money by using these performance-enhancing drugs” are not good enough reasons.
> that doesn’t mean that it does not exist, or that you are free to set it anywhere you feel like without worry or care
Speaking of arguing against something I didn't write...
> > […] that you are free to set it anywhere you feel like […]
I didn’t really mean you personally; I probably should have written “one” instead of “you”. The reason I didn’t is that it flows much worse, and “you” is also often used in that sense.
"5,000 people under age 21 die each year from alcohol-related car crashes, homicides, suicides, alcohol poisoning, and other injuries such as falls, burns, and drowning. [...] More than 190,000 people under age 21 visited an emergency room for alcohol-related injuries in 2008 alone." from http://www.niaaa.nih.gov/alcohol-health/special-populations-...
If somebody invented it today, it would be thoroughly illegal. My point here is that teddyh's conflation of "legal to buy without a prescription" and "safe" is incorrect.
Fine, so exclude alcohol for being a special case as it was grandfathered in. I’ll readily grant this, since reclassifying something from safe to non-safe is generally risk-free. How does this affect the issue at hand, which was about Modafinil, Provigil and the like? If you think that alcohol is a special case, treat it as such; either it is an exception since it was grandfathered in, in which case it shouldn’t fall under the categories which you should consider safe merely because they are non-prescription, or it really is safe, in which case my argument is still valid. You can’t have it both ways, and it is really an irrelevant outlier example. What matters is not how I categorize it, but how you categorize it, and however you do, the argument works.
I am saying that what you claim as a clear bright line is in fact a wide blurry line that zigzags all over the place. The majority of Americans screw with their metabolisms and brain chemistry every day without the involvement of a doctor. And they do it based on nothing more than, "Well, that seems ok."
That Modafinil currently requires a prescription while caffeine and alcohol don't is mainly historical accident. That tells us very little about their relative safety. So again, your conflation of "legal" with 'safe" so you can call people insane doesn't really work.
There are obviously some things which affect metabolisms and brain chemistry which are either perfectly harmless or things that should obviously be permitted without supervision, e.g. exercise. Likewise, there are many, many things which nobody should ever mess with without serious medical consultation and possibly exploration of all other alternative options.
The question is, how does one draw the line between them? The government/state/doctors (one’s local FDA equivalent) purports to do this, and they have a lot in their favor, with large budgets, scientific studies and general trustworthiness. They are, however, hampered by tradition (e.g. grandfather clauses) and politics (e.g. drug war). This makes them obviously imperfect. The second, fallback, alternative, which people have relied on for as long as people have existed, is the grapevine. Hearsay, rumors, anecdotes, fads, trends, that sort of thing. These also have obvious problems, which I trust I don’t need to enumerate further.
My first argument is this: However imperfect the first option is, it is obviously better than the second option. I also suggested a third option, namely to select another large institution with the same advantages as the first option, but perhaps with less of the disadvantages. One could even mix and match, and, for instance, follow the FDA’s recommendations for all things except for weed, where one might choose to follow the equivalent authority in Portugal or maybe the Netherlands. My second argument is that with this third option, simply choosing the fallback second option is, indeed, of questionable sanity and prone to self-selection, cherry-picking and other kinds of experimental failure, all of which leads to bad science and extremely questionable and unreliable results.
The first option is the simple one, and is obviously acceptable. The third option is reasonable. The second one is indefensible given the availability of the other two.
The ease by which people fall to the second option when the first (large, traditional and authoritative) one fails them reminds me of this passage from Father Brown in The Oracle of the Dog (G. K. Chesterton, 1926):
‘ […] It’s part of something I’ve noticed more and more in the modern world, appearing in all sorts of newspaper rumours and conversational catchwords; something that’s arbitrary without being authoritative. People readily swallow the untested claims of this, that, or the other. It’s drowning all your old rationalism and scepticism, it’s coming in like a sea; and the name of it is superstition.’ He stood up abruptly, his face heavy with a sort of frown, and went on talking almost as if he were alone. ‘It’s the first effect of not believing in God that you lose your common sense and can’t see things as they are. Anything that anybody talks about, and says there’s a good deal in it, extends itself indefinitely like a vista in a nightmare. And a dog is an omen, and a cat is a mystery, and a pig is a mascot and a beetle is a scarab, calling up all the menagerie of polytheism from Egypt and old India; Dog Anubis and great green-eyed Pasht and all the holy howling Bulls of Bashan; reeling back to the bestial gods of the beginning, escaping into elephants and snakes and crocodiles; and all because you are frightened of four words: “He was made Man.”’
The people I know who self-experiment certainly do better than running with, as your section option suggests, fads and hearsay. That's true both when they're using things that are legal but have mysterious health impacts and things that are sold by prescription but have reasonably well understood health impacts.
That you are ignorant of what they're up to isn't license to call them insane.
“Now, I might be quite wrong, maybe they do know all these things. But I don’t think I’m wrong, see, I have the advantage of having found out how hard it is to get to really know something, how careful you have to be about checking the experiments, how easy it is to make mistakes and fool yourself. I know what it means to know something. And therefore, I can’t… I see how they get their information, and I can’t believe that they know it – they haven’t done the work necessary, they haven’t done the checks necessary, they haven’t done the care necessary. I have a great suspicion that they don’t know.”
— Richard Feynman, The Pleasure of Finding Things Out (1981)
This is why we have large double-blind studies with control groups, and published papers, and peer review, and committees, and so forth – it’s really hard to actually know something. By contrast, it’s extremely easy to read a lot about something, listen to what a lot of people say about it and come to have what you might consider a reasonable, well-informed opinion about something, and therefore think you know something. But you don’t then actually know, you just think you do.
Doctors have a reasonably good general medical background, but most of them have little or no idea on specific issues that they have not encountered directly in their recent practice. When something like that comes up, they go research it. Given typical patient loads, they research it quickly.
It is very easy for people to do that research themselves. They have access to all the same material that doctors do. Educated laypeople will quickly end up knowing more than the average doctor about their specific conditions.
This was especially obvious to me when dealing with my mom's cancer. E.g.: https://www.quora.com/If-you-had-15-minutes-to-educate-a-doc...
Or pop over here, where HNers are currently discussing how an active advocate made a huge difference for another cancer patient, and how scarily little doctors know: https://news.ycombinator.com/item?id=8886164
With well-documented drugs like modafinil, your average GP will have little or no advantage in prescribing them over an educated layman who has really studied the topic. Indeed, the way many drugs with mental effects get used in practice is a doctor saying, "Well, let's try this." Followed by, "Does that feel better?" When I was my grandfather's conservator, his GP did exactly that with Prozac. When I asked some follow-up questions, it was painfully clear that he knew approximately nothing about the drug other than that the pharma marketroid said it could help with moods.
The point of the medical licensing system isn't to create perfect wisdom and great outcomes. It's to place some broad limits to limit some obvious harms and establish a mechanism of control. It should be no surprise that smart and motivated people can, in specific and limited circumstances, do better than that very low bar.
Anyway, you’re talking about individual doctors; I was talking about the medical establishment as a whole, and in particular the FDA (or their local equivalent) and the medical scientists who do the studies upon which the FDA’s decisions are based. I have more faith in these sorts of institutions than any single random GP doctor – I don’t let my views on them tar the whole system with doubt.
> It should be no surprise that smart and motivated people can, in specific and limited circumstances, do better than that very low bar.
Yes, there are exceptions to every rule. But everyone believes themselves to be the exception, so you can’t trust your own opinion.
That seems very rude and uncalled for.
> I said “or be deemed safe for sale over the counter”.
You also said "Any medication [that] I use ...". So, are you saying that these rules are just for yourself or that everybody should follow the same logic that you do because you think it's the only logic and that anyone else who follows any different logic is "insane" as you said earlier?
In any case ~ I'm guessing you've never tried Marijuana, but what I'm really wondering is if you think all Marijuana users are insane? If the answer is no, then you're obviously contradicting your own argument. Otherwise, I'll have to conclude that you're just being a ridiculously overbearing ultra-conservative dickhead who speaks in one word sentences like "Strawman".
> ...you should find some other suitable scientific institution to trust.
Why? Because you said so? You didn't give a reason why you think that revealed knowledge is somehow better than rational knowledge....
If I know large groups of people who take a certain drug whether it be Modafinil or Marijunana and everybody reports positive effects...I feel quite confident enough to self-experiment. How am I insane?
> To instead trust random people’s anecdotes on the internet is quite possibly the worst thing you could do.
Do you have any proof that that's what's happening though?
In my experience people don't read one article and make a decision. They typically use this thing called a Search Engine to find out more information about the topic and end up reading dozens of articles, studies, user testimonials, etc.
> [Do] you think all Marijuana users are insane?
The people who live where it is legal are certainly not insane (necessarily). The people who don’t might choose to place their trust in credible scientific institutions other than their local government or doctors, and those people are not necessarily insane either. However, if you choose to smoke weed for a reason like “all my friends are doing it” or “I read about how some other people claim to be doing it” then yes, that is slightly insane and idiotic.
> Why? Because you said so?
No, but because it would be obviously better to do what I wrote than to trust a too-small non-random (often self-selecting) sample of stories of unknown veracity.
> > Strawman.
> That seems very rude and uncalled for.
It was a strawman argument. I never called for avoiding caffeine or exercise just because these things affect people’s mood – I explicitly exempted all things which do not require a doctor’s prescription. To pretend I said otherwise and argue against it is a strawman argument.
I trust random strangers on the internet to provide me with accurate and useful information about the composition and subjective effects of various experimental drugs far more than I trust the official bodies in charge of regulating them, because the official bodies are proven to be untrustworthy, while random strangers on the internet may or may not be untrustworthy.
To instead trust random people’s anecdotes on the internet is quite possibly the worst thing you could do.
You have to have tasks all lined up and the interwebs unplugged (selfcontrol doesn't help if you know how to disable it)
I rarely see this mentioned, but I cannot agree more. In my experience with Modafinil, if I had tasks lined up before the effects took hold, I was golden and would obliterate that to-do list/etc. But if I were left with 'nothing to do', it was just like you described...the rabbit hole just got deeper.
So many people have had wildly different experiences with modaf (as with any drug really)...for me it's biggest positive was that context switching, mentally, became nearly 'free'. Generally my biggest hurdle in completing tasks through the day is when I finish with one task in one context and am tasked with unloading all of that information and jumping into something new...this is where I procrastinate, or generally just struggle with maintaining pace. While taking modafinil that penalty was seemingly non-existent. I was able to bounce from problem to problem, project to project with no mental penalty or friction. Quite amazing really.
Though I generally just don't find the sensation while taking them enjoyable or even worth it in many cases...increased heart rate makes me and my hands sweat (and smell), tight jaw and general inability to just 'relax'. I bought 60 nearly two years ago and have taken maybe 10 of them. I'm also a contractor who doesn't work under any or much stress/pressure, which may have something to do with my apathy towards their positive effects.
To each their own, I can absolutely see how this drug has and can change people's lives.
This uncontrollable concentration applies to all levels on all tasks, which is why modafinil kills creativity, at least for me. If I have lot of grunt job that doesn't require creativity, sure, modafinil will make me plow through it. However, in today's world valuable grunt work is rare, so it's not that useful. It kills task-related mind wandering, it kills daydreaming, it kills original thought.
Sort of a zombie state really.
Constant use would probably make me a top burger-flipper at McDonald's or similar, but that's it.
Another very big cons is its long half-life, which eventually results in sleep deprivation. Sleep at normal hours becomes next to impossible.
Good for emergency situations when I have to be able to function despite severe sleep deprivation (like not sleeping for one or two nights).
This sounds like my daily life, actually. (I'm pretty sure I have ADHD). I've tried modafinil a couple of times, and interestingly, I have the opposite reaction- I find that it makes me quicker on my feet, more 'on edge'. I respond and react to things faster.
2) Arrington also has an article on it http://techcrunch.com/2008/07/15/how-many-of-our-startup-exe...
In my experience, I've found it to be a very pleasing but subtle option, and when taken with stimulants, reduced some of the unwanted side effects I experienced. The only negative side effect I had from Intuniv was noticeable hypotension, but since I didn't experience much ADHD-related change between doses, I probably could have stepped down to a lower dosage to combat that. I only stopped because I was trying to get pregnant, and once it's okay again, I'll start back on Intuniv most likely :)
There's also Strattera, though I have no personal experience with that.
Last week I went off of it for two weeks just to see if I could discern any difference. I felt my mild depression return and I couldn't lift myself out. With the supplement, I can.
Very expensive, but I'm going to keep using it as I feel the results are worth it. Their website cites published clinical studies to it's efficacy.
Disclaimer: I have no relationship with the company other than being a customer and I don't derive any direct or indirect benefits from sales of their products. Just sharing this in case it helps someone and to see if anyone else has experience with their products.
So for the sake of my learning curve, can anyone clue me in to the reasons for down votes? I don't take them personally. Just curious and wanting to learn. Is it because the comment seems spammy? Or is it off topic? Sloppy writing?
gwern's articles on how they try out drugs is very good at explaining how to do blinding etc. and is actually credible. Do something like that and you'll definitely get upvotes.
† No judgement here, but the burden of proof is quite high when you're claiming a properly tested medicine doesn't work and a supplement does.
Really my purpose in the comment wasn't to convince anyone they should take this. My intention can be summed up by "Hey, I tried this and it seems to work for me and is safe; it's just vitamins. If it piques your interest, do your own research on it and decide whether you want to try it"
 - https://en.wikipedia.org/wiki/Provigil
 - https://en.wikipedia.org/wiki/Toxic_epidermal_necrolysis
 - https://en.wikipedia.org/wiki/Stevens-Johnson_syndrome
So yeah, 1/1000 chance going by that study alone, which doesn't say much since the drug has been prescribed millions of times in the US and abroad with no significant mention of SJS outside of the study. In short, it's just ass-covering medical paranoia.
What has been shown is that modifinil can mess with liver enzymes over time, and that should be scary enough to tell people not to use the drug long-term.
My own experience with the drug is pretty similar to the article's, but without the strange addition-like component this guy seemed to have. I was able to quit cold turkey after a month without so much as an after thought, and I still use it from time to time when my autoimmune disorder flairs up and causes fatigue and brain fog that not even ten cups of coffee can cut through.
Also, the effects of modafinil are obvious. In addition to being coffee++, the metabolites make your urine and sweat smell weird. If someone says modafinil didn't work on them, it's probably because they ordered it illicitly and got counterfeit drugs.
Are you perhaps thinking of a different nootropic? From your description, piracetam seems much more likely. It typically comes in powder form, and its effects can be charitably described as subtle.
Side note: If you're interested in nootropics and modafinil, I highly recommend gwern's articles on the subjects.
Powder is not unheard of: Air Sealed use to sell modafinil powder sourced from Sun, which was apparently legitimate and quite competitive on a per mg basis.
But as far as I know, they were the only powder source and they shut down quite a while ago (maybe 2011? I'd have to check my price-tables to see when I dropped them), and only in the past few months have any new powder vendors showed up (on the blackmarkets). So unless one of us is considerably off on dates or my knowledge of modafinil sellers is less complete than I thought, I'm not sure where noname123 could've gotten modafinil powder.
But I felt like it stole time from me, I could be productive and happy all week on it, and then I'd be depressed and tired all weekend as a I took a drug holiday. It was worth it to me when I was younger, but now that I have kids, I can't trade time like that.
And, as far as I can tell, it doesn't work on me. Ordered some from an online pharmacy, took it for ten days straight... no detectable change.
I too have tried them, and the effect is so intense that it's a deterrent from actually using them.
There is definitely opposition. It's mostly on religious grounds, a la "My beliefs dictate that I should prevent you from 'playing god', because that privelege is reserved for my deit(y|ies).".
Oh, that includes Modafinil, and I'm counting the days until someone notices Phenylethylamine.
You can't ban chocolate in the current world.
Dark chocolate can contain up to 0.7% of PEA.
But, gotta be careful with stuff like this. It sounds great, but is it really gonna be you who controls the drug ?
Maybe, but it might not always work out that way...
It just sounds extremely incautious to me.