Diva
04-16-02, 02:04AM
(News (http://www.latimes.com/features/health/la-041502sleep.story)) -- What if you could take a pill and stretch your day--by skipping sleep?
That sounds like the stuff of science fiction, but a drug called Provigil could make it possible. Studies have shown that this new medication allows people to remain awake and attentive when their bodies normally crave shut-eye, without suffering the unpleasant side effects and risk of addiction associated with caffeine, amphetamines and other stimulants.
Researchers caution that the long-term health consequences of avoiding slumber by taking Provigil, or any drug, aren't well understood.
And the makers of Provigil go out of their way to state that the drug is strictly for patients who feel sleepy during the day due to diagnosed medical disorders. Yet as its reputation grows, doctors may soon find themselves faced with a difficult question: When is sleepiness a sickness?
"This drug is going to bring up some very interesting ethical dilemmas," says Dr. Mark Mahowald, director of the Minnesota Regional Sleep Disorders Center in Minneapolis and an expert on the causes of daytime sleepiness. "Do you prescribe a stimulant medication for someone who is intentionally sleep deprived?"
Currently the U.S. Food and Drug Administration has approved Provigil only for the treatment of one condition, narcolepsy, which causes a sudden and uncontrollable urge to sleep. But Cephalon, the West Chester, Pa.-based company that sells Provigil, hopes to win FDA approval within a few years to market the drug as a pick-me-up for people plagued by sleepiness associated with any medical condition. Many doctors in this country already prescribe Provigil "off-label," that is, for conditions not approved by the FDA (which is a common and perfectly legal practice). Those conditions include depression, sleep apnea, Parkinson's disease and multiple sclerosis.
Drug Is Not Classified as a Stimulant
Provigil was developed in France in the 1970s. Although no one is sure how it works, animal studies show that the medication--unlike other drugs that induce wakefulness--doesn't seem to dramatically increase levels of dopamine, a neurotransmitter associated with arousal and alertness.
Caffeine and older prescription stimulants buzz the entire central nervous system, causing jitteriness, insomnia and other unwanted effects. When people who use coffee or amphetamines to stay awake finally doze off, they often remain in bed for much longer than usual, their bodies paralyzed by the need for "rebound sleep." Provigil, meanwhile, seems to target only the part of the brain that keeps us awake. When its effects wear off, the user resumes a normal sleep pattern.
"Provigil isn't considered a stimulant per se, though it has a wakefulness effect," says Dr. Jed Black, director of the Stanford Sleep Disorders Clinic, who is involved in the shift-work study. Although Black says Provigil isn't effective for all patients, it helps many people haunted by daytime sleepiness keep on their toes. While a few users report mild nausea, most don't feel a thing other than awake and alert. When patients switch from older stimulants to Provigil, says Black, they often return to his office and say, "It's not working. I don't feel revved up." Yet tests usually show that their ability to stay awake is much improved.
In "Faster: The Acceleration of Just About Everything" (Vintage, 2000), author James Gleick writes about our changing notion of time. Reached by e-mail, he was dubious about using a drug to lengthen our days. "In a time-obsessed age, this is the Holy Grail," said Gleick. "Cheating sleep is the closest thing we have to cheating death." However, until scientists better understand the phenomenon known as sleep, he was quick to add, "Beware of miracles."
Do you really think that taking a drug, rather than getting the sleep that you need, is a good idea? The abuse that could and will happen with this drug is so obvious. People ignore warning labels. The idea that they could stay awake will overcome any good judgement and then someone's going to get hurt or die. What comes nect? Say it with me... Law suit. I think that it can help people with sleeping disorders, but I disagree with allowing the general public use it for 'all nighters.'
That sounds like the stuff of science fiction, but a drug called Provigil could make it possible. Studies have shown that this new medication allows people to remain awake and attentive when their bodies normally crave shut-eye, without suffering the unpleasant side effects and risk of addiction associated with caffeine, amphetamines and other stimulants.
Researchers caution that the long-term health consequences of avoiding slumber by taking Provigil, or any drug, aren't well understood.
And the makers of Provigil go out of their way to state that the drug is strictly for patients who feel sleepy during the day due to diagnosed medical disorders. Yet as its reputation grows, doctors may soon find themselves faced with a difficult question: When is sleepiness a sickness?
"This drug is going to bring up some very interesting ethical dilemmas," says Dr. Mark Mahowald, director of the Minnesota Regional Sleep Disorders Center in Minneapolis and an expert on the causes of daytime sleepiness. "Do you prescribe a stimulant medication for someone who is intentionally sleep deprived?"
Currently the U.S. Food and Drug Administration has approved Provigil only for the treatment of one condition, narcolepsy, which causes a sudden and uncontrollable urge to sleep. But Cephalon, the West Chester, Pa.-based company that sells Provigil, hopes to win FDA approval within a few years to market the drug as a pick-me-up for people plagued by sleepiness associated with any medical condition. Many doctors in this country already prescribe Provigil "off-label," that is, for conditions not approved by the FDA (which is a common and perfectly legal practice). Those conditions include depression, sleep apnea, Parkinson's disease and multiple sclerosis.
Drug Is Not Classified as a Stimulant
Provigil was developed in France in the 1970s. Although no one is sure how it works, animal studies show that the medication--unlike other drugs that induce wakefulness--doesn't seem to dramatically increase levels of dopamine, a neurotransmitter associated with arousal and alertness.
Caffeine and older prescription stimulants buzz the entire central nervous system, causing jitteriness, insomnia and other unwanted effects. When people who use coffee or amphetamines to stay awake finally doze off, they often remain in bed for much longer than usual, their bodies paralyzed by the need for "rebound sleep." Provigil, meanwhile, seems to target only the part of the brain that keeps us awake. When its effects wear off, the user resumes a normal sleep pattern.
"Provigil isn't considered a stimulant per se, though it has a wakefulness effect," says Dr. Jed Black, director of the Stanford Sleep Disorders Clinic, who is involved in the shift-work study. Although Black says Provigil isn't effective for all patients, it helps many people haunted by daytime sleepiness keep on their toes. While a few users report mild nausea, most don't feel a thing other than awake and alert. When patients switch from older stimulants to Provigil, says Black, they often return to his office and say, "It's not working. I don't feel revved up." Yet tests usually show that their ability to stay awake is much improved.
In "Faster: The Acceleration of Just About Everything" (Vintage, 2000), author James Gleick writes about our changing notion of time. Reached by e-mail, he was dubious about using a drug to lengthen our days. "In a time-obsessed age, this is the Holy Grail," said Gleick. "Cheating sleep is the closest thing we have to cheating death." However, until scientists better understand the phenomenon known as sleep, he was quick to add, "Beware of miracles."
Do you really think that taking a drug, rather than getting the sleep that you need, is a good idea? The abuse that could and will happen with this drug is so obvious. People ignore warning labels. The idea that they could stay awake will overcome any good judgement and then someone's going to get hurt or die. What comes nect? Say it with me... Law suit. I think that it can help people with sleeping disorders, but I disagree with allowing the general public use it for 'all nighters.'