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Modafinil is an analeptic drug, prescribed for narcolepsy, obstructive sleep apnea and shift work disorder. Headache, nervousness, insomnia, agitation, confusion, personality disorders, tremor, anxiety; GI disturbances; hypertension, palpitations, tachycardia; angioedema; psychosis, depression, mania, abnormal LFTs. May increase modalert 100mg online of ciclosporin, oral contraceptives. Avoid alcohol. Uncontrolled moderate to severe hypertension or cardiac arrhythmias; history of left ventricular hypertrophy or ischaemic ECG changes, chest pain, any clinical signs of mitral valve prolapse. The mechanism of modafinil is unknown but it appears to exert its stimulant effects by reducing GABA-mediated neurotransmission.

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Although the context of practice may change and improve, it is likely that most radiotherapy services will continue to be organized in such a way that the patients needs will be partly met through the use of PGDs and partly through supplementary prescribing. Clinical circumstances will dictate when each would be used and a rule of thumb could be the following.

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