Eugeroics

Wakefulness-promoting agents, a family defined by what they do rather than by a shared skeleton. Modafinil and its enantiomer armodafinil inhibit dopamine reuptake weakly and the remainder of their mechanism is still unsettled; adrafinil is a prodrug the liver must convert to modafinil, and raised liver enzymes are why it is treated as the worse way to get there; solriamfetol is a straightforward dopamine and noradrenaline reuptake inhibitor and behaves more like a stimulant than the others.

Promoting wakefulness is not the same as removing the need for sleep, and the debt accrues unnoticed. Modafinil induces CYP3A4, which lowers blood levels of hormonal contraceptives and of a good deal else in this tree. Serious skin and hypersensitivity reactions are documented and are why the drug carries a warning. Dependence is less prominent here than in the transporter-reversing stimulants, which is not the same as absent.