How To Get Rid Of Modafinil Headaches - A Detailed Analysis

Published 2016-11-29 01:00:00 by Michael | modafinil side-effects

modafinil headaches

Does modafinil give you a headache? I personally get modafinil headaches on occasion. Headaches are one modafinil side effect that I'm intimately familiar with.

Headaches are the most common adverse effect of modafinil 1. About one-third of individuals taking modafinil will encounter this side effect. So if you're experiencing headaches that's not at all unusual or cause for alarm. Modafinil-related headaches are not dangerous.

There are four types of headaches:

  • Tension-type headache
  • Migraine headache
  • Chronic daily headache
  • Cluster headache

The headache most commonly associated with modafinil is the tension-type headache.

Modafinil Headache Symptoms

These are the signs that you're experiencing a Provigil-induced headache:

  • Pressure or tightness around both sides of the head or neck (bilateral headache)
  • Pain isn't worsened by activity
  • Pain does not throb
  • Pain severity varies over the course of the headache
  • Muscle tenderness, particularly in the head, neck, or shoulders
  • No nausea or vomiting
  • No aura

How To Get Rid Of Modafinil Headaches

Summary of Recommendations

  • Cover the basics first. Make sure that you’re well-hydrated, have eaten something nutritious in the last 3 hours, and are getting enough sleep. Avoid the temptation to use modafinil to function on less sleep. Sleep is precious! (Further reading: The Sleep Optimization Checklist.
  • Lower the dose. Consider lowering your dose of modafinil in the future. Modafinil-induced headaches are dose-dependent, so lower does are less likely to result in headaches. The most commonly prescribed dose of modafinil is 200mg (or 150 mg for armodafinil). Thus you might try halving your dose to 100 mg (under your physician's supervision).
  • Split your doses. In addition to lowering your dose, you can also take modafinil in two divided doses, e.g., 50 mg in the morning and 50 mg in the afternoon. The downside of this strategy is that taking modafinil later in the day can impinge on sleep quality.
  • Stretch and massage. Taking frequent breaks to stretch and massage your neck and shoulders can help alleviate the kind of tension-type headaches that modafinil causes.
  • Try an anxiolytic. Based on anecdotal evidence, modafinil headaches go hand-in-hand with anxiety and hyperarousal. Consider adding a mild anxiolytic (anxiety-relieving agent) to your regimen. I've found the following to be helpful:
    • Lavender2
    • Melatonin (if nighttime)
    • L-theanine3
    • Magnesium. Magnesium gently blocks NMDA recpetors. Modafinil boosts glutamate which activates NMDA. Mangesium has headache-relieving properties in itself, but it may specifically help modafinil-induced headaches.
    • Phenibut. Phenibut really more of a drug than a supplement, though it is available over-the-counter the US. It has pronounced anxiolytic effects.
  • Try an NSAID. Take an NSAID like ibuprofen or aspirin. Modafinil doesn’t have any serious drug-drug interactions with most NSAIDs.
  • Avoid caffeine. Caffeine has a complex relationship with headaches; it can exacerbate headaches or relieve them depending on the individual circumstances. However since modafinil is already stimulating, add caffeine into the mix can cause problems if you’re headache-prone.
  • Take a bath. I've long found baths to relieve modafinil-induced headaches. One precaution is to make sure that you don’t overheat since modafinil can rarely raise your core body temperature. Baths have a beneficial effect on headaches by dilating your blood vessels. Pregnant and elderly individuals should avoid taking hot baths.
  • Avoid glutamate. Avoid supplements that contain either glutamate or compounds that are metabolized to glutamate in the body:
    • MSG - found in fast food, MSG confers the unami taste.
    • Aspartate or DAA - an amino acid that’s used to synthesize glutamate in your body. Aspartate can be found in many body building supplements like ZMA.
    • Glutamate in food. Dietary sources include: foods matured, cured, or preserved, such as matured cheeses (Parmesan and Roquefort) and cured meats, fish sauce, soy sauce, and soy protein.
  • Headache remedies. I know what your thinking, home remedies are bullshit. But some headache remedies have been tested in randomized double-blind, placebo-controlled trials and deserve consideration.
    • Ginger 4
    • Peppermint oil5
    • Lavender oil[^3]
  • Go for a run. Vigorous exercise can relieve headaches6. Like taking a bath, exercise dilates your blood vessels. Exercise also reduces pain sensitivity by increasing natural (endogenous) opioids like endorphins.

Typical Treatments For Tension-Type Headaches

If you went to a phyisician and presented with a run-of-the-mill tention-type headache, what would your doctor say? The typical treatments for tention-type headaches are as follows:

  • NSAIDs like Ibuprofen
  • Amitryptaline - this is an old-school tricyclic antidepressant that is probably the most effective headache medication on the planet - but it has a harsh side effect burden.
  • Non-pharmacologic: relaxation, exercise, stress management, good sleep hygiene

What Causes Modafinil Headaches?

Surprisingly, headaches aren't well understood 7. The brain itself is not sensitive to pain because it lacks pain receptors. Many areas around the head and neck do have pain receptors, including the extracranial arteries, middle meningeal artery, cranial and spinal nerves, and meninges. Most headaches result from irritation of the meninges and surrounding blood vessels.

Most modafinil headaches are actually tention-type headaches. Tension-type headahces are cause by overstimulation of peripheral afferent neurons from head and neck muscles

Modafinil headaches are likly caused by excess activation of peripheral neurons. The Yerkes-Dodson Law states that there is an optimal level of arousal to facilitate learning and memory. Too much arousal impairs performance and can lead to anxiety, headaches, and so forth. Conversely not enough arousal leads to fatigue, disengagement, and brain fog.

The mechanism of modafinil involves many neurotransmitter systems. Modafinil affects orexin, glutamate, dopamine, and other signaling molecules. Excess glutamate is linked to headaches. For example, there’s a link between the food additive MSG (monosodium glutamate) and the development of headaches 8, though some have called this link into question 9.

Modafinil Headache Frequency

modafinil headache side effects frequency

Headaches is the most common side effect of modafinil. Therefore it's no surprise that you might be experiencing this side effect.

Modafinil Headaches and Choline

Both too much and too little choline can contribute to headaches. The evidence surrounding the choline-headache link is mostly anecdotal, so please don’t leap to conclusions.

Modafinil doesn’t directly affect acetylcholine or choline metabolism. Therefore there’s little reason to think that modafinil-induced headaches would be related to choline supplementation.

Reduce Modafinil's Half-Life

Undesirable modafinil side effects like headaches or insomnia may prompt you to want to rid your body of modafinil as quickly as possible.

One downside to modafinil is that it has a relatively long half-life of 13 hours. Since modafinil is a long-lasting wakefulness enhancer it's no surprise that many people experience insomnia on the drug.

Unfortunately, there is no documented method to reduce the half-life of modafinil.

Modafinil and Headaches According to Reddit

Reddit is a great place to learn about and research modafinil's benefits and side effects. Both /r/nootropics and /r/afinil are helpful resources.

Here are some excerpts from Reddit that I found pertinent on the question of Provigil headaches.

Browndude97 wrote10:

It happened today the dreaded mod headache, I just started taking Modalert last Sunday and it's been great I've taken it for this whole week minus Wednesday when I took a day off(felt like crap that day). It's Friday now and I started the day off okay and then slowly a couple hours passed and I started feeling the headache it wasn't too bad at first but it got really bad after 5-6 hours, I ended up napping to see if it would help and it was difficult but I managed to fall asleep for two hours and now it's even worse this headache is not getting any better any ideas on what I could do to make it subside?

PS I have been drinking lots of water and I ate a decent amount of food so these can't be the problem. I drank some Gatorade to see if it was just me being dehydrated but I don't feel any better…

Here's a synopsis of the suggestions in the Reddit thread:

  • Take only 50 mg modafinil and supplement caffeine
  • Alternatively take two separate doses of 50 mg each and avoid the caffeine
  • Take breaks to stretch. Since modafinil-induced headaches are usually tension-type headaches, take breaks to stretch your neck and sholders.

Synconin wrote11:

Ive tried both armodafinil and modafinil and for some reason when i take either i get a throbbing headache for hours. I drink plenty of water while i take it however i am a relatively new user of both. I take 200mg moda or 150mg armodafinil. I only take it once every 2 days max.

References

[^3] Sasannejad P, Saeedi M, Shoeibi A, Gorji A, Abbasi M, Foroughipour M. Lavender essential oil in the treatment of migraine headache: a placebo-controlled clinical trial. Eur Neurol. 2012;67(5):288-91.

  1. Kim D. Practical use and risk of modafinil, a novel waking drug. Environ Health Toxicol. 2012;27:e2012007. 

  2. Woelk H, Schläfke S. A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder. Phytomedicine. 2010;17(2):94-9. 

  3. Kimura K, Ozeki M, Juneja LR, Ohira H. L-Theanine reduces psychological and physiological stress responses. Biol Psychol. 2007;74(1):39-45. 

  4. Maghbooli M, Golipour F, Moghimi esfandabadi A, Yousefi M. Comparison between the efficacy of ginger and sumatriptan in the ablative treatment of the common migraine. Phytother Res. 2014;28(3):412-5. 

  5. St cyr A, Chen A, Bradley KC, Yuan H, Silberstein SD, Young WB. Efficacy and Tolerability of STOPPING for a Migraine Attack . Front Neurol. 2015;6:11. 

  6. Gil-martínez A, Kindelan-calvo P, Agudo-carmona D, Muñoz-plata R, López-de-uralde-villanueva I, La touche R. Therapeutic exercise as treatment for migraine and tension-type headaches: a systematic review of randomized clinical trials . Rev Neurol. 2013;57(10):433-43. 

  7. Loder E, Rizzoli P. Tension-type headache. BMJ. 2008;336(7635):88-92. 

  8. Baad-hansen L, Cairns B, Ernberg M, Svensson P. Effect of systemic monosodium glutamate (MSG) on headache and pericranial muscle sensitivity. Cephalalgia. 2010;30(1):68-76. 

  9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2802046/ 

  10. https://www.reddit.com/r/afinil/comments/55avk6/modafinil_headache/ 

  11. https://www.reddit.com/r/afinil/comments/2xbvtv/getting_headaches_while_using_modafinil_and/ 

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