Modafinil vs. Adderall: Which Is Best?

Attention deficit/hyperactivity disorder (ADHD) is a common and treatable neurodevelopmental disorder that affects people of all ages and backgrounds.

Modafinil and Adderall are both prescription stimulant drugs that may be used to treat ADHD by enhancing several neurotransmitters and receptors in the brain such as dopamine and norepinephrine. They are also occasionally known as “smart drugs” (or cognitive enhancements) since in small doses of off-label use they may help someone with their ability to focus. Neither drugs are available for over-the-counter use.

So, when it comes to Modafinil vs. Adderall, which is best? Below, let’s discuss the similarities and differences, side effects, and costs of each medication for ADHD.

What is Modafinil?

The primary use of Modafinil (also called Provigil) is not actually to treat ADHD symptoms. Instead, Modafinil works typically to promote wakefulness and treat a select number of sleep disorders in adults, including obstructive sleep apnea, shift work sleep disorder, sleepiness, and narcolepsy. However, it can also be used off-label for ADHD.

What is Adderall?

Adderall is among one of the most talked-about brand name ADHD medications. It has been approved by the Food and Drug Administration (FDA) to treat ADHD since the year 1996. In addition to ADHD, Adderall may be prescribed to individuals with a diagnosis of narcolepsy. The drug was approved to treat narcolepsy two years after it was approved for ADHD in 1998. Unlike Modafinil, Adderall use is not intended for shift work sleep disorders or sleep apnea.

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Adderall contains a mix of amphetamine salts: Dextroamphetamine saccharate, amphetamine aspartate, dextroamphetamine sulfate, and amphetamine sulfate. Sometimes, the appeal of Modafinil is that it’s not an amphetamine, like Adderall. However, amphetamines may be a more effective treatment of ADHD and are often regarded as such.

One study found that 48% of participants who took Modafinil experienced what was rated as either "much" or "very much" improved in symptoms. Another study found that 10 out of 11 participants, all of which were children, experienced significant improvement in symptoms. It is relevant to note, however, that the FDA has not approved the use of this medication in children.

Modafinil may be prescribed for ADHD under a number of different circumstances, and it can be effective in the reduction of ADHD symptoms based on studies like these, but it is unlikely to be the first recommended prescription medication.

If you have questions about why your doctor chose a specific medication for you or someone in your care, contact them directly with any questions you have.

Side Effects

Both Modafinil and Adderall come with potential side effects.

Modafinil

Common side effects of Modafinil include:

• Rapid heart rate or heart palpitations
• Difficulty sleeping or insomnia
• Loss of appetite resulting in weight loss
• Anxiety or feelings of nervousness
• Changes in mood or psychiatric symptoms
• Stuffy or runny nose
• Indigestion
• Headaches
• Stomach pain
• Dry mouth
• Dizziness
• Nausea

Adderall

Common side effects of Adderall include:

• An increase in blood pressure
• Rapid heartbeat or heart palpitations
• Difficulty sleeping or insomnia
• Loss of appetite resulting in weight loss
• A decrease in weight
• Anxiety or feelings of nervousness
• Changes in mood or psychiatric symptoms
• Headaches
• Stomach pain
• Vomiting
• Dry mouth
• Dizziness
• Withdrawal symptoms from discontinued use

Even side effects that overlap or can occur when taking either medication may be more common for individuals who take one of these medications over the other. Modafinil may be prescribed or recommended when more serious side effects of other medications occur as it typically has fewer side effects.

If you notice symptoms of an allergic reaction or anything else it is a cause for concern when taking Modafinil or Adderall, make sure to receiving appropriate medical advice by consulting with a medical professional. Serious interactions and risks can occur in some instances.

Drug Interactions, Warnings, and Risks

Most medications come with potential risks, and adverse effects.

Here are some of the common drug interactions, warnings, and risks that you may see affiliated with Modafinil and Adderall.

Modafinil

Interactions:

There are 446 known medication interactions that can occur in individuals who take Modafinil, some of which are major. Mediation interactions with Modafinil include but aren’t limited to birth control and MAOIs. Notably, modafinil can reduce the efficacy of hormonal contraceptives.

Warnings and risks:

This medication comes with a number of rare but notable risks. These include:

• Stevens-Johnson Syndrome (SJS)*.
• Cardiovascular events.
• Allergic reactions.

*This is a rare but potentially fatal rash that can occur when taking medications such as Modafinil and Lamictal.

Modafinil is a Schedule IV controlled substance.

Adderall

Interactions:

There are 180 known medication interactions that can occur in individuals who take Adderall, some of which are serious. Notably, monoamine oxidase inhibitors or MAOIs, a type of antidepressant medication, may cause malignant hyperpyrexia and various neurological toxic effects when taken with Adderall and should not be taken within 14 days of Adderall.

Warnings and risks:

• Suppression of growth rate in children.
• An increased risk of serotonin syndrome.
• Cardiovascular events.
• Allergic reactions.
• Drug dependency and/or misuse.

Adderall is a Schedule II controlled substance.

Standard medical monitoring from a prescribing physician is vital for those who take Modafinil or Adderall and can prevent serious risks from taking place. Make sure to tell your doctor about any other medications and supplements that you’re taking, as well as any other medical conditions you have, including but not limited to seizure disorders and mental health conditions.

This way, they can check in with you about any potential interactions and adjust your medications as needed. Drug interactions can be mild, moderate, or severe - some simply increase or decrease the effects of specific medications.

Costs

Even when a medication is prescribed for the same reason, there can be stark differences in cost. There are a number of factors that impact the final or exact cost of your medication.

Modafinil

For 30 tablets (or a monthly supply) of 200 mg generic Modafinil, the average price is $883.33.

Adderall

The average price for 60 tablets of 20 mg immediate-release Adderall is $84.99. If you took immediate-release Adderall at 20 mg twice daily, this would be a monthly supply. For 30 capsules of 30mg generic Adderall XR, the average price is estimated at $135.56.

The dose of medication you take may impact the cost. Your doctor will determine the appropriate dosage of either medication based on factors such as your weight and age and might adjust the dose you take if needed at any point in time.

If you face challenges in covering the cost of your medication, there are things that you can do. For those with health insurance, your insurance may cover a portion of these medications. Manufacturer coupons may also be available.

Talk with your doctor or pharmacist to learn more about your options. Medication can be used in conjunction with other forms of help and support, including but not limited to behavior therapy, games, parenting practices, diet, and accommodations at work or school.

Takeaway

Medication is a research-backed treatment for those with ADHD. Adderall is a commonly prescribed central nervous system stimulant (similar to Ritalin and Vyvanse) among those with ADHD, and it has been FDA approved to treat ADHD since the year 1996.

Modafinil is a wakefulness prescription drug that is FDA-approved for sleep disorders, such as narcolepsy, and may be used off-label for ADHD in some cases. Modafinil and Adderall should both be taken only as prescribed and directed by a healthcare professional.

An individual who lives with ADHD may experience symptom reduction when they take both medications, which suggests that both could be helpful treatment options. Adderall is more likely to be prescribed first, however, and maybe more effective.

This article is for informational purposes and is not a substitute for individual medical or mental health advice. Please consult with your or your child's prescribing doctor before changing, starting, or stopping a medication routine.