Synopsis

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

Adrafinil is a synthetic compound that acts as a prodrug to modafinil, a well-known wakefulness-promoting agent. Its primary mechanism of action is believed to involve stimulating the central nervous system (CNS) by increasing levels of neurotransmitters such as dopamine and norepinephrine, indirectly supporting the sympathetic nervous system (SNS). The SNS is responsible for the "fight or flight" response and is part of the autonomic nervous system.

Clinical and preclinical studies have shown that adrafinil increases alertness and reduces symptoms of fatigue, likely by enhancing adrenergic activity. This is achieved through inhibition of dopamine reuptake and possible effects on other monoamine systems. Because the SNS is driven by catecholamines such as norepinephrine, substances that increase these neurotransmitters can be considered as supporting SNS function, at least in terms of physiological activation. However, adrafinil is not typically prescribed specifically for "supporting the sympathetic nervous system" in a clinical sense; rather, its approved and documented uses are for promoting wakefulness, especially in individuals with sleep disorders like narcolepsy.

The evidence for adrafinil's effects is largely extrapolated from its metabolite modafinil, which has a more robust clinical profile. While adrafinil does increase sympathetic tone due to its CNS-stimulant properties, the use of the term "support" is somewhat nonspecific. The rating of 3 reflects moderate evidence for increased sympathetic activity, but less direct clinical indication for general SNS support.

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