I am taking Modafinil 2000mg per day, yes 2000mg.

[Modafinil]

Hi.

I am on Modafinil (Provigil) at a dose of 2000mg per day, this medication is NOT prescribed to me.

I have been taking the above dosage for around 3 months now. Before that I was taking lesser doses. The reasons for reaching such a dose are due to both tolerance to the effects, and to optimize beneficial effects (treatment of ADHD symptoms, intermittent fatigue, and moderate depression). Please note, that at the dose I am on, further tolerance has not occurred, and I do not anticipate ANY need for a higher dose.

I am not willing to see a doctor (in real life) at this time. I weigh 120kg. I have ADHD and depression/ anxiety. I have experienced absolutely no physical or psychiatric side effects from this medicine. My blood pressure is consistently 120/80 and pulse shows no tachycardia and is regular. No evidence of any known side effects, health appears entirely fine, but no tests/examinations have been done.

* I wanted to write more information but deleted a lot due to 2000 character limit.

[Modafinil]

This is not a full response.

I may get banned from here unfortunately.

Sometimes I do what is know as "trolling". It really doesn't indicate how I behave in real life, and my motivations are highly complex. However I had a few beers (usually don't drink too much, or too often, but yes I was on Modafinil0 and I  wrote an extremely provocative / controversial set of opinions in (I think it was ) the Women's Health area. I certainly don't believe what I wrote, but I may get taken off here as a result / account may get shut down I fear.

As a direct result of your response, and primarily because of it, I give my word that within 7 days I will go to a doctor and ask for a blood test of liver function and coagulation numbers, though of course as I stated there are no apparent outward symptoms. I will post the results to you if I am still in communication.

As I have asserted, I believe I can and will reduce the dose, it just means I can't be on it every day, but must have break periods.

I am mostly sober but mildly intoxicated at moment from moderate alcohol consumption. While I am drawn to alcohol, I do not believe it is out of control and I plan to discontinue even moderate usage for a while, its not healthy.

If you are interested, I am on a Disability payment and have not been working in recent years, but I do live with (and I am very supportive towards) two young women, aged 21 and 23, that comes from very disadvantage backgrounds. I have been supporting them for many years, and please I can assure you my motivations are not sexual, and none of us have any sexual interest in each other.

The women are doing well, and one of them has a 4 year old daugther who absolutely adores me. All of them, including the daugher, are lovely and generally acceptably behaved people, but in my strong opinion all of them (and myself ) are profoundly hyperactive.

So I am a very social person, and spend extensive time with others. I don't have a personal partner (and I am obese) but I am overall very happy in life. None of the people demonstrate any concerns for me, and I don't discuss (much) my consumption of Modafinil. There is certainly no suggestion of adverse effects on my behavior or mental health, and I believe mentally I am doing very well.

I know a lot of people, from a multitude of backgrounds, my brother is one position off a corporate execute at the moment (he has an honors degree from university and earns a high salary), I am good friends with a teacher with a degree in psychology, and I know various wealthy and financially disadvantage people. I also know a lot of youth from VERY disadvantage background and I act as a strong support person for them (I relate to them for many reasons, but I had a great deal of problems in my younger life, especially in my teen years.)

I am lucky to be alive really because i have had a lot of serious problems in the past, though for the last decade or so, have shown dramatic improvement. However in my younger years I have abused a large multitude of psychoactive substances.  I won't mention them all, but I have been on massive daily doses of drugs such as Xanax (honestly for a while I was actually taking around 50 x 2mg Xanax per day, believe it or not).

Theoretically the nicotine gum I am on, and have been on for over a decade may pose a risk for me. I chew 300% more than the maximum listedd dosage for this, and have been doing so continually. When I smoked cigarettes it was around 45-50 per day.

I may not work, but I am extensively socially involved with others. Indeed I spent a great deal of time with the 4 year old girl that lives with me on a daily basis. In my strong opinion she is very hyperactive (and wears her mum out massively), but I am very tolerant towards her, and give her attention and she loves me to pieces. To me I consider her really quite unusually bright, she has lots of character for a 4 year old, and is emotionally stable and well behaved despite the fact that she never sits still and has boundless energy levels.

I guess I should look after myself, because a lot of people do rely on and care about me. As I briefly mentioned, I help disadvantage young people, and have been heavily involved providing support and love to 8 main young people (from childhood) from extreme background of abuse and neglect (exceptionally bad background I can assure you). These youth, some of them still young, but most of them now adults have strong love for me and hold me in very high regard indeed. I conclude this from what they say to me.

I will go now. I know I got a bit personal, but I wanted to show that despite not being successful "career wise" and relationship wise, I am very important to many people, and actively involved in many peoples lives.

I will update in regards to reducing my dosage (if I am not banned). Further communication would be very appreciated as I would like to ask some more questions, and in real life I am not at all confident or trusting to talk much to doctors, though I have great admiration for such people.

[Modafinil]

Thank you very sincerely for responding.

I am extremely busy at the moment, so I am only given a quick response, with I will write a more detail one as soon as is possible.

I just want to say that I am planning on reducing the dosage significantly, to reduce the potential for harm.

I have noticed, and it seems to be a an atypical feature of Modafinil, that tolerance rapidly reduce. Three days, massively (but not entirely) reduces tolerance, and it seems to last for a useful amount of time. I believe that by having a tolerance break every 6 days or so (for 3 days) I can most likely reduce my dose to around 800mg per day, which certainly is still high, but much improved :)

I do appreciate your warning about potential long term effects.

In regards to the high dose effects you have described, it seems I experience none of them, I am certainly not aggressive or anxious or anything I can assure you :) I am sure about the increased prothrombin time, however.

I have to go, but if you keep an eye on this thread I can promise you it will be deeply appreciated. I have some more to say, and will be back as soon as I am able.

[Julia M Aharonov, DO]

I am sorry if I seemed dismissive to you, however I truly did not understand what it was you wanted to get out of my answer.  You seem to be very well versed in the subject of Modafinil. I have never met anyone taking the amount you are ingesting, but these amounts have been studies and documented before.
The high-dose effects in clinical studies have included anxiety, irritability, aggressiveness, confusion, nervousness, tremor,
palpitations, sleep disturbances, nausea, diarrhea and decreased prothrombin time. Most however, reacted in a relatively benign fashion.
I still would not condone anyone taking ten fold maximum suggested dose and if you choose to continue, I highly suggest that you see a physician to monitor you liver function and coagulation numbers as well as your cardiovascular system.
You seem to be an extremely intelligent person, thus, you will understand that your actions may have long term consequences later in life which may or may not be reversible.  Please think carefully about what you do to your body and take good care of yourself.

[Modafinil]

Also doctor, I am interested in your opinion on the following.

As I stated a large clinical trial was done with Modafinil on about 1000 children with ADHD.

Although the medicine was not approved for the treatment of ADHD by the FDA (at these high dosages), this matter is somewhat controversial, and it was considered that Modafinil was well tolerated at these high doses in children with ADHD.

In regards to the dosage of Modafinil in relation to mg's of Modafinil vs kg of body weight, the dosage I am taking is essentially the same as the children were exposed to in the ADHD trial, this is partially due to the fact I weigh 120kg.

How much do you think I can relate the clinical data of that ADHD trial, and the mg:kg simularity between my dose and the dose the children were on, in terms of predicting potential likely risks from the dosage I am taking? Also what factors exist besides the fact I am an aduilt, and they were children, that are relevant to potential differences in effect Modafinil will have on my body, even though my dosage on a mg:kg basis is consistent with the clinical experience of that ADHD trial?

[Modafinil]

I already typed a detailed, well thought out response to the doctor, but the STUPID website asked me to log in and lost my post. I AM VERY ANGRY ABOUT THAT.

Doctor, I apologize if my interpretation is incorrect, but you seem to be acting in a dismissive, passively hostile manner towards me. Are you making moral or value judgments about my situation? This is one of the reasons I don't trust general practitioners. I have frequently had difficulty gaining objective opinions on my health matters due to a lack of cooperation from doctors that seem to be making personal and moral judgments about the decisions I have made.

I am sorry if it is not clear to you what sort of information I am after, I hope you can contain your seething resentment to a person such as myself that would dare make a decision regarding their own medical welfare that does not submit to the aristocracy and authority of the medical profession.

(1) I want to know, what risk- if any, you consider I am likely to experience from my dosage on this medicine, taking into account I am not aware of experiencing any ill effects from 3 months of usage. Please be as specific as you can.

(2) You are quite free to express your somewhat person opinion on my behavior, even if it might be considered a criticism, because that is better than no opinion being express at all.

(3) Are you aware of any other similar cases to my own?

(4) What tests can I ask a doctor to get to try and rule out any likely potential problems that my dosage of the medicine might be causing? What tests can I have that will provide some level of rational reassurance that problems are not occurring that are not apparent?

Thank you if you do provide a response. Understand that I am unwilling to talk to a doctor because I have experienced adverse, even hostile, reactions from doctors before. Also I am involved in various highly sensitive legal situations, and due to the fact what I am doing may be a violation of the law, I simply cannot risk providing information to a doctor that can be used by the legal system to persecute me, or used by the legal system to justify decisions made against my best interest, or the best interest of children related to these legal situations.

While in very rare cases Modafinil has been potentially associated with dangerous allergic skin reactions such as  Steven Johnson Syndrome, it is likely the time window for me to potentially experience such extremely rare reactions has passed. All the information I have read strongly suggests that Modafinil seems to have a very toxicity, and what I am doing may very well not be causing me any damage, however I do appreciate that large, clinical studies of such doses have not been conducted. I also appreciate that I am no expert and I am trying to gain information to expand my perspective.

I am potentially willing to reduce my dose, but not discontinue entirely.

[Julia M Aharonov, DO]

If you are not willing to make any changes to your treatment , see no problems with what you are doing, are not willing to see a physician, then I don't see a what you are asking me.

[Modafinil]

I wanted to add some further information/points.

ADHD trials were done on approx 1000 children at the dose of 450mg in Children weighing 35kg+. The higher doses according to mg:kg were observed to be most effective. Children were exposed to around 13mg/Kg. My dose is around 16mg/Kg. My dose is highly comparable to the dose used in ADHD children. The drug was considered generally well tolerated in children. The reasons it was not approved by FDA are complex and controversial.

There have been no recorded fatal overdoses from acute doses much larger than mine (except in combination overdose with other drugs). Dangerous complications were not observed. A study on poisons information data also found the same pattern.

Toxicology tests in various animal testing, indicate that if the LD50 in humans is even partially translatable to human toxicology that the likely LD50 in humans is probably around 100x my dosage.

I am not at risk for Steven Johnson Syndrome and other dangerous skin reactions, because the time window where these RARE diseases are known to occur has passed.