Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Adrafinil is a synthetic compound that acts as a prodrug to modafinil, a well-established wakefulness-promoting agent. Its primary mechanism of action involves modulation of several neurotransmitter systems, notably increasing levels of dopamine in the brain by inhibiting dopamine reuptake. This dopaminergic activity is thought to contribute to its cognitive-enhancing and alertness-promoting effects. Clinical studies on modafinil (the active metabolite of adrafinil) have shown increased extracellular dopamine, especially in brain regions associated with wakefulness and executive function. However, the direct evidence supporting adrafinil itself, rather than modafinil, is more limited, as most research has focused on its metabolite due to safety and efficacy concerns.

While adrafinil has been used off-label for cognitive enhancement and to counteract fatigue, it is not approved for these uses in most countries. Its use is primarily justified by its pharmacological similarity to modafinil and by indirect evidence suggesting dopaminergic activity. There is a moderate level of scientific evidence supporting the role of adrafinil (and more robustly, modafinil) in influencing the dopamine system, but further high-quality, direct studies on adrafinil are lacking. Thus, adrafinil can be considered to have a moderate scientific basis for supporting the dopamine system, though clinicians generally prefer modafinil due to a better-characterized safety profile.

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