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Provigil and Nuvigil

Provigil and Nuvigil are prescribed to patients with narcolepsy, obstructive sleep apnea and shift work disorder. The medications can have serious side effects, including psychiatric issues, serious skin rashes and potential for abuse.

  • Written by
  • Last update: August 26, 2025
  • Est. Read Time: 5 min read
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  • Written by
  • Last update: August 26, 2025
  • Est. Read Time: 5 min read
Key Takeaways
  • Provigil and Nuvigil are prescribed for sleep disorders
  • Psychiatric issues, including mania, psychosis and depression, can develop when taking these medications
  • Some patients also developed serious and potentially life-threatening skin conditions

Provigil and Nuvigil are both prescription stimulants used to help adults with sleeping disorders be more awake and alert. Both medications are Schedule IV controlled substances, meaning they have a relatively low, but clinically significant, potential for abuse.

Both drugs have side effects that can cause serious harm to patients, including skin problems, like rashes, and psychiatric issues, including mania, psychosis and depression.

Many patients who were prescribed these medications and experienced adverse side effects are taking legal action against the drug makers. An antitrust lawsuit claimed that Provigil’s manufacturer delayed generic and more affordable options. Other cases claim that Provigil and Nuvigil manufacturers failed to warn consumers about skin and mental health impacts.

What Are Provigil and Nuvigil Prescribed For?

Provigil and Nuvigil are prescribed to treat three sleep disorders: narcolepsy, obstructive sleep apnea and shift work disorder.

Provigil is the brand name for a drug called modafinil, a stimulant that the FDA approved in 1998. In 2007, the FDA approved another variant of the medicine, called Nuvigil, with the active ingredient armodafinil. The medications are similar, but armodafinil typically has longer-lasting effects.

Both medications were approved to treat three sleep disorders:

Narcolepsy:
Narcolepsy is characterized by extreme drowsiness that often causes you to fall asleep suddenly without warning.
Obstructive sleep apnea:
Obstructive sleep apnea interferes with your breathing when you sleep, causing your throat muscles to relax so much that they block your airway.
Shift work disorder:
Shift work disorder is a health problem that can develop in people who work at night. It can cause difficulty falling asleep or staying asleep, as well as sleepiness at undesirable times.

The American Academy of Sleep Medicine warned that the medications are only approved for the treatment of these three conditions. The organization stresses that the drugs shouldn’t be used for cognitive or performance enhancements, nor should they be prescribed off-label for these reasons.

Despite this, these drugs are often prescribed off-label for conditions such as ADHD and depression.

Provigil and Nuvigil Side Effects: Psychiatric and Physical Risks

Both Provigil and Nuvigil can cause similar side effects, like anxiety and headaches. Below are some of the most common side effects experienced by patients taking these medications.

Common Provigil and Nuvigil Side Effects
  • Anxiety/nervousness
  • Diziness
  • Dry mouth
  • Headaches
  • Insomnia/ difficulty sleeping
  • Loss of appetite
  • Nausea
  • Shaking
  • Sweating
  • Vomiting

Some of these side effects are more common in Provigil vs. Nuvigil, or vice versa. However, patients taking either medication risk experiencing any or all of these complications.

Serious Risks of Provigil and Nuvigil

Some serious Provigil and Nuvigil side effects can develop from using the drugs. If you develop any of the symptoms listed below, you should consider seeking immediate medical attention.

Serious Provigil and Nuvigil Side Effects
  • Psychiatric issues, including hallucinations, mania, anxiety, depression, psychosis and suicidal thoughts.
  • Skin reactions, including Stevens-Johnson Syndrome, a rare and serious skin disorder involving the mucous membranes. It begins with flu-like symptoms, then leads to a painful rash that causes blisters to form, which spread throughout the body. While the top layer of affected skin usually sheds and patients recover, the condition can be fatal.
  • Breathing problems.
  • Increased heart rate or heart palpitations.

Some evidence also suggests an increased risk of birth defects in infants who were exposed to these medications in utero.

Abuse Potential and Withdrawal Risks

The active ingredients in Provigil and Nuvigil can be addictive, which has resulted in the medications being classified as Schedule IV controlled substances. The controlled substances are classified by severity. For example, Schedule I substances, such as heroin, are the most addictive and Schedule V substances, such as certain cough medicines, have the lowest abuse potential.

Regarding Provigil and Nuvigil, their psychoactive and euphoric effects are the primary force behind their addictive potential. The way they alter mood, perception and thinking, and their impact on the brain’s pleasure centers, can contribute to the drugs becoming habit-forming.

Because your body can become reliant on these medications, you may experience withdrawal symptoms if you abruptly stop taking them. If you experience any of the symptoms below after stopping Provigil or Nuvigil, it may be withdrawal.

Provigil and Nuvigil Withdrawal Symptoms
  • Abnormal heart rhythms
  • Aggression
  • Chills
  • Confusion
  • Nausea
  • Shaking
  • Sweating
  • Vomiting

Seizures and suicidal thoughts can also occur as a result of withdrawal, but these side effects are less common.

Some students take these medications off-label as a study enhancement drug and can become dependent on them.

FDA Safety Alerts and Label Revisions

Both Provigil and Nuvigil labels contain warnings about the risks of serious rash, including Stevens-Johnson Syndrome. These warnings were added after the FDA requested a label update in 2007.

The FDA sent a letter to Cephalon, the drug manufacturer at the time, stating, “Based on the rate of serious skin and other hypersensitivity reactions with modafinil in clinical trials and the post-marketing setting, we are requesting that you adopt a bolded statement in the Warnings section describing the risk.”

In addition to the bolded warning, the FDA also requested a statement describing two hypersensitivity reactions observed in patients during clinical trials and urged additional follow-ups and future clinical trials to better understand the risks.

Provigil and Nuvigil manufacturers have been under fire in the past concerning their medications.

Teva Pharmaceuticals, which acquired Cephalon, Inc. in 2012, settled a lawsuit with the Federal Trade Commission (FTC) for $1.2 billion in 2015. The FTC had filed an antitrust lawsuit, alleging that Cephalon had paid off generic drug manufacturers to delay the release of a generic version of Provigil.

The organization argued that delaying the release of a generic version of Provigil was an anticompetitive move called “pay for delay.” This tactic allegedly allowed Cephalon, as the sole manufacturer of Provigil at the time, to overcharge consumers for Provigil.

More recently, patients who were harmed by the drugs are filing Provigil and Nuvigil lawsuits. Many pending cases involve allegations of failing to warn of dermatological or psychological risks. If you believe these drugs have harmed you, you may want to consult with an attorney to explore your legal options.

What Patients Should Know and Do Next

If you or someone you love uses Provigil or Nuvigil, you should be aware of potentially serious side effects. These include:

  • Mood swings, hallucinations and other mental health changes
  • Chest pain
  • Skin rashes

If you experience any complications, you should seek medical treatment as soon as possible. Be sure to document the issue in case you wish to pursue future legal action.

You can also report a problem to the FDA’s MedWatch program. The FDA uses these reports to identify problems with drugs and medical devices and take appropriate action, including publishing safety alerts when necessary.

Please seek the advice of a medical professional before making health care decisions.