Evidence supporting the use of: Adrafinil
For the health condition: Narcolepsy

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Synopsis

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

Adrafinil is a synthetic stimulant originally developed in France in the 1970s as a treatment for narcolepsy and related sleep disorders. Its use in narcolepsy is supported by scientific rationale, although it has largely been replaced by its active metabolite, modafinil, which is now the standard of care. Adrafinil is a prodrug that is metabolized in the liver to modafinil, which then promotes wakefulness by influencing neurotransmitters such as dopamine and orexin in the brain. Several early clinical studies in the 1980s and 1990s demonstrated that adrafinil could reduce excessive daytime sleepiness and improve wakefulness in narcolepsy patients, with effects similar to amphetamines but generally with fewer side effects and lower abuse potential.

However, adrafinil is less frequently prescribed today due to concerns about liver enzyme elevation with long-term use and because modafinil offers similar benefits with a more favorable safety profile. Regulatory approval for adrafinil for narcolepsy has been withdrawn in many countries, but its initial use was based on documented efficacy in clinical trials. Therefore, while there is scientific evidence supporting its use for narcolepsy, current clinical practice favors safer alternatives.

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