Talk:Modafinil/GA3

GA review

The following discussion is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.

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Article (edit | visual edit | history) · Article talk (edit | history) · Watch

Nominator: Maxim Masiutin (talk · contribs) 21:24, 23 December 2024 (UTC)

Reviewer: Czarking0 (talk · contribs) 16:40, 1 February 2026 (UTC)

StartCzarking0 (talk) 16:40, 1 February 2026 (UTC)

Nom is #1 author with >40% of the content written.Czarking0 (talk) 16:41, 1 February 2026 (UTC)

Earwig results look fine to me.Czarking0 (talk) 16:51, 1 February 2026 (UTC)

Organization

• I think the "Society and culture" section is poorly named. The paragraph with Modafinil's use varies by region. and the subsequent one should be included in that section. This seems like the sort of thing that could be better communicated with a map?Czarking0 (talk) 16:53, 1 February 2026 (UTC)

  "Society and culture" section and its subsections are standard per WP:PHARM. Acceptable? For Legal status, converted paragraphs to wikitable, don't know how to make maps, never did them. Maxim Masiutin (talk) 10:38, 9 February 2026 (UTC)

• The occupational section is not in summary style. The information can be accomplished with two or three sentences.Czarking0 (talk) 17:14, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 10:59, 9 February 2026 (UTC)

• The exact mechanisms of action of modafinil are not known This seems like an important thing to state outside of the addiction subsectionCzarking0 (talk) 17:14, 1 February 2026 (UTC)

  Done in Pharmacodynamics lead. Maxim Masiutin (talk) 11:00, 9 February 2026 (UTC)

• Keep the Interactions section as prose.[User:Czarking0|Czarking0]] (talk) 17:14, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 11:01, 9 February 2026 (UTC)

• Make Pharmacology the second section[User:Czarking0|Czarking0]] (talk) 17:14, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 11:01, 9 February 2026 (UTC)

• Colors produced by modafinil with various reagents Seems like too much detail to me[User:Czarking0|Czarking0]] (talk) 17:14, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 11:01, 9 February 2026 (UTC)

• The Brand names section would work better as a table with some explanation of where they apply. Could have columns for countries and regulation Czarking0 (talk) 22:27, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 11:01, 9 February 2026 (UTC)

• Originally developed in the 1970s by French neuroscientist Michel Jouvet and Lafon Laboratories, modafinil has been prescribed in France since 1994,[162][38] and was approved for medical use in the United States in 1998. This has nothing to do with Economics.
• smart drug and sports usage should be covered in the Usage section[User:Czarking0|Czarking0]] (talk) 17:14, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 11:02, 9 February 2026 (UTC)

• History section has too much coverage of adrafinil. Historical figures for prescription volumes would be great here.[User:Czarking0|Czarking0]] (talk) 17:14, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 11:02, 9 February 2026 (UTC)

• The utility of the Research section is not clear to me. For example, why not include the information here with the ADHD information above?[User:Czarking0|Czarking0]] (talk) 17:14, 1 February 2026 (UTC)

  Separate per WP:PHARM structure. Maxim Masiutin (talk) 11:03, 9 February 2026 (UTC)

• Caution is advised when prescribing Not clear how this relates to research. A claim like this would need WP:MEDRS. To me, this section seems to be a different manifestation of the same problem that leads to MEDRS. Wikipedia is a not a good place to summarize cutting edge medical research.Czarking0 (talk) 00:53, 9 February 2026 (UTC)

  Removed POTS sentence. Maxim Masiutin (talk) 11:03, 9 February 2026 (UTC)

Sources

• The talk page discussion regarding MS treatment needs to be resolved.Czarking0 (talk) 16:58, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 11:03, 9 February 2026 (UTC)

• In children, modafinil is more effective than placebo for treating ADHD symptoms This seems like a cherry-picked claim from the meta analysis but I have not read the source yet. Placebo is rarely the important comparison for something as common and with as many treatments as ADHD.Czarking0 (talk) 17:06, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 11:03, 9 February 2026 (UTC)

Length

Update: All concerns in this section have been addressed.Czarking0 (talk) 22:46, 8 February 2026 (UTC) I do not immediately dismiss this based on length. It is at 6-7 thousand words readable prose size. That might be fine. However, I do look for statements to remove.

• Given its approved status in the US to treat narcolepsy, physicians can also prescribe modafinil for off-label uses, such as treating ADHD in both children and adults. This is overly US focused and is a general statement about how off-label use works in the US rather than a claim about the article subject.Czarking0 (talk) 17:07, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 11:04, 9 February 2026 (UTC)

• The Canadian Network for Mood and Anxiety Treatments (CANMAT) As a more general point, this is functioning as an attribution rather than an important regional claim. If the regional claim was the important part then my advice is to simply the article by dedicating a section to regional variation and then not making regional points elsewhere. If this should merely function as an attribution I recommend reworking it so it does not need attribution and combining info with rest of section.Czarking0 (talk) 17:07, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 11:05, 9 February 2026 (UTC)

• 2021 meta-analysis concluded that attribution not needed, I'll stop this comment but my point is to give the whole thing a pass over to remove places where MEDRS yield an unnecessary attribution. Czarking0 (talk) 17:08, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 11:05, 9 February 2026 (UTC)

• The effectiveness of modafinil as a cognitive enhancer is still debated. Some studies suggest significant increases in cognitive abilities, while others indicate mild to nonexistent cognitive improvements. Either the first sentence or the second is redundant depending on how much detail you feel is important. Similar issue in other areas such as and in cases with signs of CNS stimulant-induced mitral valve prolapse or left ventricular hypertrophy.[107][108] The package insert in the United States cautions about using modafinil in people with a documented medical history of left ventricular hypertrophy or those diagnosed with mitral valve prolapse who have previously exhibited symptoms associated with the mitral valve prolapse syndrome while undergoing treatment involving central nervous system stimulants.Czarking0 (talk) 17:21, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 11:05, 9 February 2026 (UTC)

• No significant changes in body weight have been observed in clinical trials, although decreased appetite and weight loss have been noted in children and adolescents. Certainly you do not plan to list all the side effects that do not occur? What is the point of this statement?Czarking0 (talk) 17:17, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 11:05, 9 February 2026 (UTC)

• Unlike other stimulants, modafinil does not induce a strong subjective feeling of pleasure or reward, which is commonly associated with euphoria, an intense feeling of well-being.[21] Euphoria may be an indicator of a drug's potential to be abused. Substance abuse is a compulsive and excessive use of the substance despite adverse consequences. Explaining what substance abuse is is clearly off-topic when you did not explain what a CNS stimulant is.Czarking0 (talk) 17:17, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 11:06, 9 February 2026 (UTC)

• even in people who have a history of cocaine addiction Why are we talking about people with a history of cocaine addiction now? Czarking0 (talk) 17:34, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 11:05, 9 February 2026 (UTC)

• modafinil was the 302nd most commonly prescribed medication in the United States cutCzarking0 (talk) 22:30, 1 February 2026 (UTC)

  Done (removed "302nd") Maxim Masiutin (talk) 11:06, 9 February 2026 (UTC)

• with just over 1,000,000 prescriptions. Point in time info works better as a graphCzarking0 (talk) 22:30, 1 February 2026 (UTC)

  Removed (as for 302nd). Maxim Masiutin (talk) 11:07, 9 February 2026 (UTC)

• This means that it is a drug with a perceived low potential for abuse and low risk of dependence; still, the use of Schedule 4 drugs in Australia is restricted to those who have a valid prescription from a medical practitioner. Way too much detail about specific drug relation in a single country. None of this is specific to Modafinil. Make similar adjustments elsewhere.Czarking0 (talk) 22:33, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 11:07, 9 February 2026 (UTC)

• such as sprinter Kelli White in 2003,[224] cyclist David Clinger[225] and basketball player Diana Taurasi[226] in 2010, and rower Timothy Grant in 2015, summary style does not cal for naming all these people(talk) 22:37, 1 February 2026 (UTC)

  Removed names of individual athletes Maxim Masiutin (talk) 11:08, 9 February 2026 (UTC)

All concerns addressed Maxim Masiutin (talk) 11:04, 9 February 2026 (UTC)

Writing

• required Cephalon Who is cephalon? Czarking0 (talk) 17:18, 1 February 2026 (UTC)

  Explained in History: "biopharmaceutical company acquired by Teva in 2011". Maxim Masiutin (talk) 11:04, 9 February 2026 (UTC)

• The reasons why Pretty much never use this phrase. Just say the reasonsCzarking0 (talk) 17:22, 1 February 2026 (UTC)

  Done Maxim Masiutin (talk) 11:04, 9 February 2026 (UTC)

• which is the narrowing of blood vessels No way you are explaining vasoconstriction but not contraindication, mitral valve prolapse, left ventricular hypertrophy. Decide what background knowledge the appropriately broad audience needs to understand this article then edit the whole thing to be understandable to that audience. I suggest the average nurse should be able to understand this so I don't think you need to explain what vasoconstriction is. I doubt the average nurse really understands this transition Despite being a CNS stimulant.Czarking0 (talk) 17:22, 1 February 2026 (UTC)

  Removed vasoconstriction Maxim Masiutin (talk) 11:10, 9 February 2026 (UTC)

• Modafinil is also contraindicated in people with congenital problems like galactose intolerance, lactase deficiency, or glucose-galactose malabsorption} Maybe just drop congenital? The thing that makes these complications similar is not really that they are congenital.(talk) 11:04, 9 February 2026 (UTC)

  Removed congenital and other debatable statements. Maxim Masiutin (talk) 11:11, 9 February 2026 (UTC)

• The Tolerence section is a little too bullet pointy. Czarking0 (talk) 17:30, 1 February 2026 (UTC)

  Changed to prose. Maxim Masiutin (talk) 11:12, 9 February 2026 (UTC)

• the amphetamine scale of the addiction research center inventory, sympathomimetic jargon Czarking0 (talk) 17:30, 1 February 2026 (UTC)

  Removed the jargon. Maxim Masiutin (talk) 11:13, 9 February 2026 (UTC)

• The LD50 info would be better communicated with a bar chart.Czarking0 (talk) 17:38, 1 February 2026 (UTC)
• Modafinil's patent history involves several key developments. removeCzarking0 (talk) 22:31, 1 February 2026 (UTC)
• This should probably just be one sentence. Renal excretion of unchanged modafinil usually accounts for less than 10% of an oral dose. This means that when modafinil is taken by mouth, the only approved route of administration, less than 10% of the drug is eliminated from the body through the urine without being metabolized by the liver or other organs. The rest of the drug is either metabolized or excreted through other routes, such as feces or bile.Czarking0 (talk) 00:22, 9 February 2026 (UTC)

  Fixed to one small sentence. Maxim Masiutin (talk) 11:23, 9 February 2026 (UTC)

  In Substance dependence section, I restructured to clarify that "efficacy" refers to reducing drug use and maintaining abstinence. The original buried this goal early and then said "failed to demonstrate efficacy" without clear referent. Now reads: "failed to show that it helps reduce drug use or maintain abstinence." Maxim Masiutin (talk) 11:28, 9 February 2026 (UTC)

• with high negative symptom scores jargon Czarking0 (talk) 17:30, 1 February 2026
• studied for stimulant dependence and cocaine addiction, but clinical trials have failed to demonstrate efficacy Not clear what the efficacy being studied is. Czarking0 (talk) 17:30, 1 February 2026

In Schizophrenia, addressed the jargon concern - it says "prominent negative symptoms (such as reduced motivation or social withdrawal)" rather than "high negative symptom scores." This parenthetical explanation makes the clinical term accessible. --Maxim Masiutin (talk) 11:29, 9 February 2026 (UTC)

Modafinil/armodafinil tested as add-on to antipsychotics.

Results: no benefit for positive symptoms (hallucinations, delusions) or cognition. May slightly help negative symptoms (low motivation, social withdrawal) in acute schizophrenia, but not in stable patients. Even where effective, the benefit is among the smallest of all add-on medications studied. Maxim Masiutin (talk) 11:30, 9 February 2026 (UTC)

Coverage

still, in 2004, the price of modafinil in the US was around $120 or more per monthly supply.[213] However, the availability of generic versions has increased since then and may have driven down prices. Is this really the best you can say? I would think you can make a plot of prices over time. This is outdated and vague.Czarking0 (talk) 22:29, 1 February 2026 (UTC)

I gave explanations on unexplained medical jargon and addressed, I hope, all the issues that you raised, thank you for your review. Please find updated article. As for the "Society and culture", I took the recommended order from the article template at https://en.wikipedia.org/wiki/Template:Article_templates/Drug,_treatment,_or_device Maxim Masiutin (talk) 10:32, 7 February 2026 (UTC)

 Done Czarking0 (talk) 22:48, 8 February 2026 (UTC)

Modafinil is also prescribed for shift work sleep disorder. Several of the sources I reviewed covered shift work sleep disorder intervention with a similar focus to narcolepsy intervention. I am worried that there is a coverage or at least balance issue here since this seems to be the only statement on this.Czarking0 (talk) 00:19, 9 February 2026 (UTC)

Agreed, this was underrepresented. Expanded from two sentences to a full paragraph. Now includes: recommended dosing (200 mg before shift, per FDA label), trial outcomes from Czeisler et al. 2005 (improved wakefulness, reduced attention lapses, fewer commute accidents), functional/quality-of-life improvements (Erman et al. 2007), and the Cochrane review conclusion (Liira et al. 2014) noting positive evidence with associated adverse events. Maxim Masiutin (talk) 13:33, 14 February 2026 (UTC)

Citation formatting

• The sentence beginning with The cost of modafinil needs a multiref.Czarking0 (talk) 22:55, 8 February 2026 (UTC) This applies in several other places such as Modafinil has been studied for

  Added "US" to denote it is US only Maxim Masiutin (talk) 11:32, 9 February 2026 (UTC)

• Currently FN8 "Pharmacokinetic and pharmacodynamic ..." maybe should have Article Commentary: prepended? It is in the source title.Czarking0 (talk) 00:44, 9 February 2026 (UTC)

  "Article Commentary" is a journal type/section designation, not part of the title proper. Wikipedia citation guidelines cite the actual title as printed on the article, excluding genre labels. Maxim Masiutin (talk) 11:33, 9 February 2026 (UTC)

Spot checks

• Modafinil tablets contain lactose.  Not done I do not think any of the sources here support this statement.Czarking0 (talk) 22:56, 8 February 2026 (UTC)

  Fixed: added FDA label ref (confirms lactose monohydrate). Maxim Masiutin (talk) 11:34, 9 February 2026 (UTC)

• primarily used for treating narcolepsy I do not believe the sources presented support the "primary" characterization. Not doneCzarking0 (talk) 00:16, 9 February 2026 (UTC)

  Thank you! I removed "primarily" from lead and body. Maxim Masiutin (talk) 11:34, 9 February 2026 (UTC)

• Military forces in several countries, including France, the United States, and the United Kingdom, have used modafinil as an alternative to amphetamines for managing fatigue during combat operations and extended missions.  Done
• The two major circulating metabolites of modafinil are modafinil acid (CRL-40467) and modafinil sulfone (CRL-41056). What are these letter codes? I was not able to verify them in the source. Rest of the statement is good.Czarking0 (talk) 00:44, 9 February 2026 (UTC)

  Removed all CRL codes. Maxim Masiutin (talk) 11:35, 9 February 2026 (UTC)

• post-anesthesia sedation remains investigational A claim like this cannot rely on sources from 2008. Not doneCzarking0 (talk) 00:55, 9 February 2026 (UTC)

  @Czarking0 thank you, I will resolve everything tonight. Maxim Masiutin (talk) 07:59, 9 February 2026 (UTC)

  Removed sentence. Maxim Masiutin (talk) 11:35, 9 February 2026 (UTC)

Given that several of these were failed, I plan to do several more spot checks Czarking0 (talk) 23:33, 9 February 2026 (UTC)

• Modafinil is occasionally prescribed off-label for individuals with attention deficit hyperactivity disorder (ADHD) I'll count this as  Done but I do not think this is a great summary of the sources.
• Modafinil is used off-label as an adjunctive treatment for the acute depressive phase of bipolar disorder.[54][55][56] Meta-analyses have found that add-on modafinil and armodafinil are more effective than placebo for treatment response and remission  Done
• Elimination half-life is in the range of 10 to 12 hours,[10][90] subject to differences in sex,[93] in cytochrome P450 genotypes, liver function and renal function This sentence is too unclear to verify. What is the part after sex claiming?Czarking0 (talk) 05:04, 10 February 2026 (UTC)

  Agreed, unclear. Reworded to: "...with individual variation depending on sex, cytochrome P450 genotypes, liver function, and renal function." All four factors are now clearly listed as independent variables affecting half-life. Maxim Masiutin (talk) 19:22, 13 February 2026 (UTC)

• enzymes of the cytochrome P450 group of enzymes. This phrase is also unclear to the point that I am unable to verify.Czarking0 (talk) 05:06, 10 February 2026 (UTC)

  The source says "metabolized hepatically through the cytochrome-P450 system". I think a claim much closer to the source is warranted. Czarking0 (talk) 05:08, 10 February 2026 (UTC)

  Agreed, awkward and unclear. Changed to "enzymes of the cytochrome P450 system," matching the source (Greenblatt 2022/StatPearls: "metabolized hepatically through the cytochrome-P450 system"). Maxim Masiutin (talk) 19:23, 13 February 2026 (UTC)

  Agreed, awkward and unclear. Changed to "enzymes of the cytochrome P450 system," matching the source (Greenblatt 2022/StatPearls: "metabolized hepatically through the cytochrome-P450 system"). Maxim Masiutin (talk) 19:23, 13 February 2026 (UTC)

• Cephalon faced legal issues for promoting off-label uses and paid $425 million in fines in 2008.  Not done Source says there was only $50 million in fines and the $425 million is an additional settlement. Also the faced legal issues phrasing is not neutral they "plead guilty to one misdemeanor violation of the U.S. Food, Drug and Cosmetic Act". This is really too many failed spot checks

Ok, can you please review the whole article and ensure that there will be no issues with future spot checks? Normally this level of failed spot checks would constitute a GAF, but you have been responsive and done a good job and the failures were not major. Therefore, I will wait for one more round of corrections, do another round of spot checks and if any fail then I will mark the review as failed otherwise I will say it passed.Czarking0 (talk) 19:32, 12 February 2026 (UTC)

As for Cephalon, agreed on both points. Rewritten to: "In 2008, Cephalon, the manufacturer of Provigil, pleaded guilty to a federal criminal charge related to its promotion of off-label uses of Provigil and two other drugs, paying $425 million in fines and settlements." Fixes: (a) replaced vague "faced legal issues" with neutral factual "pleaded guilty to a federal criminal charge" per the source; (b) corrected "$425 million in fines" to "$425 million in fines and settlements" since the total included both criminal fines and civil settlement.

I have no idea on what else do I have to edit. Maxim Masiutin (talk) 19:24, 13 February 2026 (UTC)

I do not know either. Did you review the whole article to ensure there will not be new issues when I make more spot checks? Czarking0 (talk) 22:56, 13 February 2026 (UTC)

I reviewed the article. It was mostly good to my eyes. Although I removed the "As of..." statements and found newer sources if they existed. Maxim Masiutin (talk) 13:36, 14 February 2026 (UTC)

Modafinil performs moderately (but better than armodafinil or solriamfetol)[40] as a drug to overcome excessive daytime sleepiness caused by obstructive sleep apnea  Not done This is not a fair characterization when Neshat et. al say "Solriamfetol, notably at 300 mg, is the most effective" Czarking0 (talk) 22:13, 14 February 2026 (UTC)

Lead

Lead needs more work to reflect the higher quality this article is now at.Czarking0 (talk) 00:13, 9 February 2026 (UTC)

Added one sentence to the end of first paragraph: This adds history and legal status - two key aspects missing from the lead - with minimal change. Uses existing refs (Hersey_2024, Provigil FDA label). Maxim Masiutin (talk) 11:38, 9 February 2026 (UTC)

I hope I resolved the issues in the head Maxim Masiutin (talk) 15:38, 12 February 2026 (UTC)

I am still not convinced on the lead. For example misuse or abuse is mentioned twice without saying that the potential is low. In the body, the low potential for abuse is one of the main points I understood. Statements like Modafinil is not approved by the US Food and Drug Administration (FDA) for use in people under 18 years old. Are not very lead worthy. I think a less precise summary sentence about the global status of the drug is quite attainable. You have changed the article a lot and made a lot of improvements. I think the lead just needs to reflect those changes.Czarking0 (talk) 15:46, 9 February 2026 (UTC)

@Czarking0 ok, I will do that Maxim Masiutin (talk) 16:30, 9 February 2026 (UTC)

1. "misuse or abuse" mentioned twice without saying potential is low - Fixed. The phrase "misuse or abuse" is gone.Instead, paragraph 2 explicitly states: "modafinil has low addiction and dependence potential and does not produce strong euphoria" - directly addressing the your main concern.
2. FDA under-18 statement - Removed. This overly specific US-centric detail is no longer in the lead.
3. Global legal status - Simplified to: "It is a prescription medication in most countries" instead of detailed US-specific regulations.

Maxim Masiutin (talk) 15:33, 12 February 2026 (UTC)

Table

Rate	Attribute	Review Comment
1. Well-written:
	1a. the prose is clear, concise, and understandable to an appropriately broad audience; spelling and grammar are correct.	I think this would need to be improved for FA but good enough for GA
	1b. it complies with the Manual of Style guidelines for lead sections, layout, words to watch, fiction, list incorporation, and table accessibility.	I still think the lead could use better refinement but it is good enough for GA
2. Verifiable with no original research:
	2a. it contains a list of all references (sources of information), presented in accordance with the layout style guideline.	Looks good
	2b. reliable sources are cited inline. All content that could reasonably be challenged, except for plot summaries and that which summarizes cited content elsewhere in the article, must be cited no later than the end of the paragraph (or line if the content is not in prose).	See failed spot checks
	2c. it contains no original research.
	2d. it contains no copyright violations or plagiarism.
3. Broad in its coverage:
	3a. it addresses the main aspects of the topic.	I think relative weighting could use some additional reflection but coverage is there.
	3b. it stays focused on the topic without going into unnecessary detail (see summary style).	I think it is good but I have some outstanding concerns for the next review. For example, I just removed a lengthy explanation of CPAP machine that was probably off topic
	4. Neutral: it represents viewpoints fairly and without editorial bias, giving due weight to each.	I worry a bit when comparison with other drugs comes in. See the failed spot check I just removed. However I do nto have any glaring violations at this time.
	5. Stable: it does not change significantly from day to day because of an ongoing edit war or content dispute.
6. Illustrated, if possible, by media such as images, video, or audio:
	6a. media are tagged with their copyright statuses, and valid non-free use rationales are provided for non-free content.	I am not convinced File:Modafinil 200mg.jpg is CC0. I think it is USSIMPLE but taking a photo of a design does nto give you title to that design. Same with File:Modafinil-generic-aspendos.jpg.
	6b. media are relevant to the topic, have suitable captions, and have alt text.
	7. Overall assessment.	Too many failed spot checks. All the sources need to be checked.

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.