As for the long-term safety of amphetamines, the jury is out. Unfortunately it's not very easy at all to measure neurological changes in human beings—mostly because you can't experiment on them and then cut their brains up to see what happened—and most of what we know about the toxicity of drugs in humans is the result of extreme adverse reactions or animal models. Amphetamine is acutely neurotoxic for many animals, including some other primates, for example, but is not known to be so for humans. Does dopamine receptor downregulation occur with chronic use? Almost inevitably. But the question is to what degree, and how reversible it is. Might it contribute to the hastening of the death of dopaminergic neurons? Nobody knows for sure. A year or two ago I did a thorough examination of the literature and found several meta-analyses that failed to make any specific conclusions about the long-term effects of clinical amphetamine usage.
What is known for certain are anecdotal reports of problems. Go to ADD forums, various drug forums, etc., and you'll find plenty of people who took Adderall for many years and claim they are not the same anymore and that there's no going back—fatigue, brain fog, and a host of other maladies, even after long periods of abstinence. Of course, everyone is different and it seems like some people tolerate amphetamines for years or decades just fine.
Personally I love the stuff for occasional recreational use but would never, ever risk taking it on a regular basis for any considerable period of time.
Modafinil it seems is much less neurologically stressful than amphetamine. If you insist on taking stimulants every day, then modafinil is surely the safer bet. No matter what you take, it's *vitally important* to take drug holidays of at least a week or more, lest your tolerance continue to grow steadily over the course of months or even years.
I take Ritalin extended release and it's good to keep me more awake but jittery but provigil helps get my mind awake and clears the SEVERE brain fog. I'm taking a combo of both right now. I like provigil so much more for me but i have negative side effects from it that aren't as bad as the Ritalin (SEVERE dry mouth, mouth sores, dead taste buds on my tongue, etc) But insurance approval was a pain! I have narcolepsy without C fyi
I had to take Ritalin until my insurance agreed to cover Modafinil, and I didn't like the Ritalin. Definitely "crashed" as it wore off. Modafinil feels like a more gradual wearing off if that makes sense. Ritalin made me jittery. Just felt more "normal" on Modafinil than Ritalin.
I tried both, but I really have ADD and N. I tried to switch from Adderall to Modafil and I did for a few months. At first I was fine but as time went on my ADD got bad and was not being helped. I just went back to Adderal and feel so much better but I am getting headaches. I've been really stressed out lately so I'm not sure it's the meds. My doctor said I could only use one or the other so I'm sticking with Adderall.
Some people have great success on both, one, or neither. I think we are all very different. For me, armodafinil and modafinil didn't work. I felt completely disconnected. Like my brain and body weren't communicating. It was disorienting and scary. But that was just my experience. So I stick to adderall. But if you've never tried modafinil or armodafinil I think it's worth giving it a shot to see if you do better on that than on adderall.
I'd been on Ritalin since 2005 until this past week when I was switched to Adderrall XR. i I've also taken Provigil and Nuvigil, but currently take Provigil in combination with Adderrall. I prefer the Provigil, as there are less side effects.
I take low doses pf both. At the dosing I can tolerate, Provigil does nothing for executive functioning (I do have a prior ADD diagnosis but jury is out as to whether or not it's separate from or a side effect of narcolepsy sleep deprivation), and Adderall does nothing for sleep attacks.Neither addresses cataplexy.
I had to switch to modafinil from methylphenidate, as the methylphenidate gave me palpitations and tanked my appetite to the point where it was a chore to force down a cup of yogurt. Modafinil worked perfectly for me.
Modafinil did a fantastic job for me (almost perfect), but I had an allergic reaction to it (and Nuvigil) so I gave Vyvanse a try. It did a mediocre job for helping me stay awake, but it made me feel anxious and uneasy.
Neither worked well for me on their own. I now take both. 200mg modafinil in the morning, 20 mg adderall in the afternoon as a booster. I also get another 100 mg of modafanil that I can either take in the morning with the AM modafinil dose or in the afternoon, as needed. I usually just take the full 300mgs of modafanil in the morning and the adderall in the afternoon. This combination seems to work best for me, but really I'm still just as sleepy, except now instead of napping all the time I Just feel lazy and can't fall asleep if I try when I feel like I need a nap in the afternoon because my brain won't shut off even if my body is tired... my doc says this means the medicine is working, it prevents me from napping but doesn't give me energy. That makes me sad because I thought I would get some energy, but the doc says that I just need to accept that I may never be at 100%.
Modafinil interacts badly with my birth control pill and makes it less effective so I take Adderall. It works well enough for me. But if you also happen to be on hormonal BC, check for interactions there.