Here is a fascinating new study, using the narcolepsy drug modafinil (Provigil) for gambling. It has also been shown to be helpful for ADD, especially the low energy and motivation states. Enjoy!
Zack M, Poulos CX. Effects of the atypical stimulant modafinil on a brief gambling episode in pathological gamblers with high vs. low impulsivity. J Psychopharmacol. 2008 Jun 26.
Abstract: Pathological gambling (PG) is a serious psychiatric disorder afflicting 1-3% of the general population. Experimental evidence indicates shared neurochemical substrates for PG and psychostimulant addiction. Impulsivity characterizes one key subtype of PG. Therefore, medications that ameliorate psychostimulant addiction and impulsive syndromes might also benefit impulsive PG subjects. The atypical stimulant, modafinil reduces cocaine abuse and impulsivity in patients with ADHD.
The present study sought to determine if modafinil (200 mg) would reduce the reinforcing effects of slot machine gambling in PG subjects, and if this effect was stronger in high (H-I) vs. low (L-I) impulsivity subjects (N = 20). A placebo-controlled, double-blind, counterbalanced, repeated measures design was employed. Apart from bet size, which declined uniformly in both groups under drug, modafinil had bi-directional effects in the two groups. In H-I subjects, the drug decreased desire to gamble, salience of Gambling words, disinhibition and risky decision-making. In L-I subjects, modafinil increased scores on these indices. Modafinil also differentially affected blood pressure response to the game in the two groups.
These findings for modafinil appear to fit well with a growing literature demonstrating bi-directional effects of D2 agonists as a function of trait impulsivity. Impulsivity could critically moderate medication response in PG.
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My husband became seriously addicted to Provigil, Dr. Amen. Although it is generally regarded as a nonaddictive medication, there is also a blackbox warning regarding the potential for addiction. In my husband’s case, he was massively overusing this medication, spending as much as $1,700/month on it, self-prescribing it (he is a physician), and lying and stealing over it…generallly showing all the signs of addiction. It ruined our marriage. I’m telling you this because most people believe this medication is nonaddictive, and I believe the truth should be know, perhaps to prevent this addiction in others. Thanks.
Mary, I’m so sorry you went through that.
I’m wondering about the addictive aspects your husband experienced, whether further substances were involved. If one were addicted to Rx medications and was forced to cop to it, modafinil would be an excellent choice to name as a sole addiction.
Modafinil has been a lifesaver for me. Since I take quite a bit of it, your post raises the question of how more could be better. If I take it when I’m exhausted, I merely become acutely aware of just how tired I am. Many medicines have a shorter half-life in my body than they should, especially when I’m exercising a lot and/or under stress, and modafinil is no exception. Under medical supervision, I’ve taken up to 100 mg 4x / day. It could easily have been 6x / day, but I was worried about my liver.
It’s made such a difference in quality of life for me that modafinil is not a med I’m willing to consider dropping. If that’s addiction, I insist on being enabled. Assuming ca. $10 / 200mg pill, $1,700/month comes out to about 5.5 200mg pills or 1100 mg / day, which for a large man with a stressful schedule sounds roughly comparable to my high dose. And that was anything but thrilling.
All those questions aside, I’d like to understand why modafinil would be used against pathological gambling. Addicts traditionally present a compliance challenge; they’re unlikely to take a pill daily or before gambling. Sustained-release monthly naltrexone injections seem a better option to my lay brain, especially if the patient would try to abuse modafinil.
I requested that my oncologist prescribe Modafinil or Provigil because I have chemo brain. I had chemotherapy almost 5 years ago and it affected my ability to focus and concentrate. It also affected my short term memory and I have a very difficult time learning anything technical. If I read a book or watch a movie, I barely remember anything about it. All day I feel like I just woke up and feel like I need to drink coffee all day. Any suggestions on what I can do for chemo brain?