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The "smart drug" modafinil actually does work for some people, improving their performance on long and complex tasks, also enhancing decision-making and planning skills, a new review of studies finds.

Modafinil, also known by its brand name Provigil 200 mg, is approved by the Food and Drug Administration to treat people with sleep disorders such as narcolepsy. But the majority of the drug's users — such as students who take it to study for exams — use it off-label, believing it may help them focus. This is despite the lack of strong evidence to date showing that the drug actually works this way.

"This is the first overview of modafinil's actions in non-sleep-deprived individuals since 2008, and so we were able to include a lot of recent data," Ruairidh McLennan Battleday, a co-author of the new review and a lecturer at the University of Oxford in England, said in a statement. The recent studies of the drug have used more-complex tests of cognition than those employed previously, and found that modafinil indeed enhances thinking, he said.

Past studies showed mixed results for modafinil's effects on healthy, non-sleep-deprived people. However, for the new paper, the researchers reviewed 24 placebo-controlled studies in healthy people that were published between 1990 and 2014. The studies included more than 700 participants total, and tested a variety of aspects of thinking, including planning and decision-making, flexibility, learning, memory, and creativity.

Modafinil improved only certain features of cognition, the researchers found. In general, the drug appeared to improve what researchers call executive function, the ability to sift through new information and make plans based on it. Modafinil also somewhat enhanced people's ability to pay attention, learn and remember, the researchers found.

But the drug didn't consistently help participants on simple tests of attention, the scientists found. It had "little effect on creativity and motor excitability," they said, and it did not significantly improve people's working memory, flexibility of thought or ability to divide their attention.

Modafinil has few side effects. The 70 percent of the studies that looked for mood and side effects found only some instances of insomnia, headache, stomachache or nausea, all of which were also reported in placebo groups.

"In the face of vanishingly few side effects in these controlled environments, modafinil can be considered a cognitive enhancer," said Anna-Katharine Brem, another co-author of the study and a postdoctoral researcher at Oxford.

What is Provigil?

Provigil (modafinil) is a prescription medication. It’s most often used to treat excessive sleepiness caused by narcolepsy, obstructive sleep apnea, and shift work.

Provigil belongs to a class of medications called stimulants. It comes as 100-mg and 200-mg oral tablets.

Studies show that Provigil increases the ability to stay awake compared to a placebo in people with narcolepsy, sleep apnea, or shift work sleep disorder. Provigil is considered a first-choice medication option for decreasing sleepiness in people with these conditions.

Is Provigil a controlled substance?

Yes, Provigil is a controlled substance. It’s classified as a schedule IV prescription drug. This means it has an accepted medical use but may also cause physical or psychological dependence and may be abused.

The government has created special rules for how schedule IV drugs can be prescribed by a doctor and dispensed by a pharmacist. Your doctor or pharmacist can tell you more.

Provigil generic

Provigil 200 mg is available in a generic form called modafinil.

Generic drugs are often less expensive than the brand-name version. In some cases, the brand-name drug and the generic version may be available in different forms and strengths.

Provigil uses

The Food and Drug Administration (FDA) approves drugs such as Provigil to treat certain conditions. In addition to these uses, Provigil is sometimes used for purposes that aren’t approved by the FDA.

Approved uses for Provigil

Provigil is FDA-approved for improving daytime sleepiness caused by the following medical conditions:

• narcolepsy
• obstructive sleep apnea
• shift work sleep disorder

Provigil for depression

Provigil 200 mg is used off-label for depression in people for whom antidepressants alone don’t fully treat their condition. Taking Provigil along with antidepressants has been shown to improve symptoms of fatigue and excessive tiredness in people who have depression.

Provigil for MS

Provigil is sometimes prescribed off-label to treat symptoms of fatigue caused by conditions such as multiple sclerosis (MS). An analysis of clinical studies showed that Provigil can improve symptoms of fatigue in people with MS.

Provigil for anxiety

Provigil is not usually prescribed off-label for treating anxiety. However, some people say that Provigil gives them more focus, calm, and confidence in social or stressful situations. Because of this, Provigil may be misused for treating social anxiety or performance anxiety.

Provigil for weight loss

Provigil can cause loss of appetite in some people who take it. Because of this side effect, some people misuse Provigil as a weight loss aid.

Dosage for shift work sleep disorder

For excessive sleepiness due to shift work sleep disorder, the typical dosage is 200 mg taken about one hour before the start of your work shift.

Dosage for people with liver problems

If you have severe liver problems, your doctor will likely prescribe a lower dosage. The recommended dosage for people with this condition is typically 100 mg daily.

Dosage for seniors

Seniors may be more sensitive to the effects of Provigil, especially side effects. If you’re over 65 years of age, your doctor may prescribe a lower dosage.