Drug Comparison
For educational purposes only — a decision-support tool, not a substitute for clinical judgment.
Side-by-side rubric across 96 psychiatric medications. Every rating traces to a verbatim primary-source quote — click any cell to see it.
How to read this tool ▾
Rating scale
– Favorable / lower than class baseline
± Minimal / equivocal
+ Low / uncommon
++ Moderate / common
+++ High / very common
++++ Very high / class-outlier
Frequency vs severity
F = frequency, S = severity. Each gets its own pill colored on the same traffic-light scale: green → blue → yellow → orange → red. Click any cell for incidence percentages and NNH.
Evidence tier
A Network meta-analysis / RCT / FDA label
B Cohort / registry / pooled label data
C Expert review / textbook / case series
Sourcing
Click any cell to see the verbatim source quote and citation. Missing data shows n/a.
Data depth
++ Graded — frequency + severity, primary-source traces
+ FDA label — §6 frequency only (dashed border). Click for sub-types.
Blank — not yet checked (not “absent”)
–±++++++++++ABCF = frequency · S = severity · Dashed border = FDA label only · Click cell for details
1 drug selected — Modafinil(click to collapse)
1/4 selected
Modafinil
Provigil
Wakefulness-Promoting Agent · C-IV
FDA-approved indications
- Improve wakefulness in adults with excessive sleepiness associated with narcolepsy
- Improve wakefulness in adults with excessive sleepiness associated with obstructive sleep apnea (adjunct to standard treatment)
- Improve wakefulness in adults with excessive sleepiness associated with shift work disorder
Off-label uses
- ADHD (adjunctive — limited evidence)
- Fatigue in multiple sclerosis
- Depression augmentation (limited evidence)
MechanismWakefulness-promoting agent with uncertain mechanism — likely involves dopamine transporter inhibition and orexin/histamine system activation
Half-life~15 hours
Decision GuideWhen to pick each / when to consider an alternative
Modafinil
Consider when
- Excessive daytime sleepiness — FDA-approved for narcolepsy, obstructive sleep apnea adjunct, and shift work disorder
- Stimulant intolerance or cardiovascular concern — lower sympathomimetic burden and abuse potential than amphetamines (Schedule IV vs. II)
- Residual fatigue despite primary treatment — useful adjunct for persistent sleepiness in OSA on CPAP or depression on antidepressants
- Shift work disorder — only wake-promoting agent with specific FDA indication for SWD
- +1 more
Consider an alternative when
- ADHD treatment — insufficient evidence for FDA approval; two adult RCTs failed primary endpoints; stimulants and atomoxetine are first-line
- Taking hormonal contraceptives — CYP3A4 induction reduces ethinyl estradiol levels; alternative contraception needed during and 1 month after use
- History of SJS/TEN or serious rash — rare but serious dermatologic reactions reported; higher estimated risk in pediatric patients
- Expecting dose-dependent response above 200 mg — efficacy plateaus at 200 mg in most indications; 400 mg adds side effects without clear benefit
- +1 more
| Axis | Modafinil eugeroic |
|---|---|
| CNS | |
Activation / insomnia | |
Headache | |
| Metabolic | |
Appetite suppression / anorexia | |
| GI | |
Nausea / GI (general) | |
| Dermatologic | |
Rash (including SJS/TEN, pruritus, hypersensitivity) | |
| Interactions | |
CYP interactions / DDI profile | |
| Drug-specific / distinctive axes | |
Cardiovascular effects only in Modafinil | |