Talk:Modafinil

Reference to esmodafinil not found on referenced page or internet search

The searching referenced page [7] on NIH.gov for esmodafinil does not find "esmodafinil". Internet search with Google also fails to find relevant info. Lloyd Ewing (talk) 22:03, 30 July 2023 (UTC)

Through further investigation I find many internet occurrences of (S)-modafinil, which leads me to believe that is a more common name for the same chemical.

[1]https://pubchem.ncbi.nlm.nih.gov/compound/S_-Modafinil

Interestingly, Google searches for "s-modafinil" "half life" find enough occurrences to lead me to believe that this is likely to be a significant issue.

I did not find any explanation of whether or why (S)-modafinil is/not or could become available to the public. I have no significant education in chemistry or biology, but I understand that modafinil contains both (S)-modafinil and armodafinil, and apparently they are mirror images of the same chemical.

Perhaps (S)-modafinil is not available because the pharmaceutical companies would not be able to patent the medication? I am not sure whether any of this information is within the scope of this Wikipedia article. Lloyd Ewing (talk) 21:06, 6 August 2023 (UTC)

Hello. I've authored the draft for (S)-modafinil so I thought I'd chime in.

Cephalon would have certainly been able to patent esmodafinil, as they did with armodafinil. Cephalon has never publicly stated why esmodafinil was never marketed on its own, but the reason is presumably that (S)-modafinil's half life is substantially shorter than (R)-modafinil, and it possesses only a third affinity for the dopamine transporter. I'm not sure if this lesser affinity would attenuate the wakefulness effect given modafinil's complex pharmacology, and I could find no paper evaluating the comparative eugeroic properties of modafinil's enantiomers.

The lack of exploration of (S)-modafinil is surprising considering that cephalon has not been shy in the past to acknowledge (and even promote) modafinil's off-label use. There's no doubt that a short acting modafinil formulation comprised of (S)-modafinil is a worthwhile avenue to explore, given modafinil's pre-existing use in circumstances where such a property may be useful (especially in nighttime military and occupational contexts). Oro Temp (talk) 13:02, 26 October 2023 (UTC)

Category:Nootropics

Maxim Masiutin, I saw you removed the Nootropic and a few other categories in Special:Diff/1182852997. I agree with all but perhaps the Nootropic category removal. The other categories are more well-defined and evidence-based, but Nootropics, by its very nature, seems more informal and includes things taken for their purported nootropic effect. Even Nootropic says they are used with the intention of improving cognitive functions (emphasis mine). People certainly take modafinil with the intention of improving cognitive function, and so I think it should remain in that category. I'm not particularly invested in it either way, just thought I'd put in my 2 cents. Kimen8 (talk) 19:41, 31 October 2023 (UTC)

Thank you for your prompt reply. Would you mind I return the nootropics category. We will further watch for the other editors' opinion and behave accordingly, OK? Maxim Masiutin (talk) 19:44, 31 October 2023 (UTC)

No worries either way. Kimen8 (talk) 19:46, 31 October 2023 (UTC)

Thanks, I returned it with appropriate comment. Maxim Masiutin (talk) 19:48, 31 October 2023 (UTC)

Opinions of notable persons

@Bon courage:@Walter Tau:@Kimen8: - Maybe we need a separate apropriate section to put opinions of notable persons, such as the opinion at https://en.wikipedia.org/w/index.php?title=Modafinil&diff=1183154583&oldid=1182868451 However, I don't know whether such a section is welcome in a Wikipedia article about a medication drug, and whether a particular person is notable enough for their opinion to be attached to the encyclopedic data, and medical articles have stricter rules of source appropriateness and reliablility than general Wikipedia, as explained in WP:MEDRS. Putting verbatim opinions about drugs here on Wikipedia may be dangerous becuase some readers may misunderstand an opinion with a reliable information confirmed by reliable research. --Maxim Masiutin (talk) 15:25, 2 November 2023 (UTC)

I don't think so, as "notable people" can (and often do) spout total nonsense about medical topics and so relaying that does not contribute to knowledge. If secondary sources cover such "opinions" there may be a case for inclusion but otherwise, well ... WP:ARSEHOLES. Bon courage (talk) 15:36, 2 November 2023 (UTC)

OK, thank you, that makes sense! Maxim Masiutin (talk) 15:44, 2 November 2023 (UTC)

@Walter Tau -- anyway, your edit added 2 claims:

1. Modafinil and armodafinil have a low abuse potential.
2. D.M. Trott describes his experience as: [...]

The first claim was not backed up by a reliable source that can be identified as such by the rules of WP:MEDRS. If claim #1 was a claim per se, than a reliable source should be added. If claim #1 is supported by claim #2, than it is obviously does not fit the rules of WP:MEDRS. Therefore, regardless of whether a section of opinions of notable persons be added or not, claim #1 should be deleted until a reliable source be found that suits WP:MEDRS. Maxim Masiutin (talk) 15:43, 2 November 2023 (UTC)

People's opinions about drugs, whether they themselves are notable or not, are not noteworthy unless they appear in a WP:MEDRS source. We need to keep our "in popular culture" sections free of quackery influence. Tom Cruse might have strong opinions on it published in a dozen reliable news sources, but including those opinions will not help readers, even if some of them come here looking for such statements of opinion. Sandizer (talk) 11:02, 9 December 2023 (UTC)

Patent protection and litigation

Can you please review the section Modafinil#Patent protection and litigation? Maxim Masiutin (talk) 19:56, 12 November 2023 (UTC)

The section is so WP:UNDUE. I don't even understand how much of it even relevant to aid the reader's understanding of modafinil. It should be heavily trimmed and a huge chunk of it should be removed. --WikiLinuz (talk) 03:16, 2 December 2023 (UTC)

My understandig of the History section from Wikipedia:Manual_of_Style/Medicine-related_articles#Sections is that it is Wikipedia:Manual_of_Style/Trivia_sections and should not aid the reader's understanding of modafinil. Even the meaning of the word "trivia" is unimportant matters. Lawsuits of modafinil related to Cephalon have been covered by mainstream media such as The New York times. Therefore, this patent litigation is prominent enough. However, a shorter recapitulation of the even would have been better, as there are some details that might have been removed. Do you have an idea on which details can be removed and which should be kept?

• https://www.nytimes.com/2010/03/30/business/30drug.html
• https://www.nytimes.com/2002/10/20/business/a-biotech-outcast-awakens.html

Maxim Masiutin (talk) 03:31, 2 December 2023 (UTC)

The policy I was talking about is WP:WEIGHT. It's okay to cover the lawsuits, but it's WP:UNDUE to have multiple large paragraphs of irrelevant information in there. The whole section should be at most two short paragraphs. Wikipedia is not WP:INDISCRIMINATE collection of information. I'll prepare a suggested version. --WikiLinuz (talk) 04:29, 2 December 2023 (UTC)

Please feel free to edit the page straight away to not later mess with references and wikilinks. THank you! Maxim Masiutin (talk) 05:01, 2 December 2023 (UTC)

Rewrote the section, see this diff. --WikiLinuz (talk) 05:10, 2 December 2023 (UTC)

So far, you made a good summary! Maxim Masiutin (talk) 05:22, 2 December 2023 (UTC)

@Maxim Masiutin: IMO this article still requires significant work to make it ready for GA-tier. I suggest that we withdraw the GA nomination, make the changes/polish, and then nominate it once it's ready. Otherwise, it may prematurely fail the review. --WikiLinuz (talk) 06:05, 2 December 2023 (UTC)

Thank you! Let us risk and improve the article while the review is in the queue. If we the article will fail, we will have additional feedback from the reviewer on how to improve the article. Maxim Masiutin (talk) 07:12, 2 December 2023 (UTC)

I have another article about a medication, Ketotifen, pending GA review. Could you please also take a look at it to suggest where should it be improved to meet GA requirements? Maxim Masiutin (talk) 07:17, 2 December 2023 (UTC)

I'll work on other section later, possibly tomorrow or Monday. --WikiLinuz (talk) 05:14, 2 December 2023 (UTC)

Maxim Masiutin - I strongly agree with WikiLunz that it's more useful to withdraw nomination until the article is improved further. It is more usual to request a copyedit that would further an article's quality. Any would-be reviewer would be put off by an article in obvious need of much further work. There is no urgency for any article to reach GA status - better to let it first evolve more.--Iztwoz (talk) 08:57, 2 December 2023 (UTC)

@Iztwoz ok Maxim Masiutin (talk) 09:01, 2 December 2023 (UTC)

GA Review

This review is transcluded from Talk:Modafinil/GA1. The edit link for this section can be used to add comments to the review.

Reviewer: BeingObjective (talk · contribs) 19:01, 30 November 2023 (UTC)

Planning to review: BeingObjective (talk)

GA review – see WP:WIAGA for criteria

1. Is it well written?

   A. The prose is clear and concise, and the spelling and grammar are correct:

   B. It complies with the manual of style guidelines for lead sections, layout, words to watch, fiction, and list incorporation:

2. Is it verifiable with no original research?

   A. It contains a list of all references (sources of information), presented in accordance with the layout style guideline:

   B. 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):

   C. It contains no original research:

   D. It contains no copyright violations nor plagiarism:

3. Is it broad in its coverage?

   A. It addresses the main aspects of the topic:

   B. It stays focused on the topic without going into unnecessary detail (see summary style):

4. Is it neutral?

   It represents viewpoints fairly and without editorial bias, giving due weight to each:

5. Is it stable?

   It does not change significantly from day to day because of an ongoing edit war or content dispute:

6. Is it illustrated, if possible, by images?

   A. Images are tagged with their copyright status, and valid non-free use rationales are provided for non-free content:

   B. Images are relevant to the topic, and have suitable captions:

7. Overall:

   Pass or Fail:

This article fails the GA requirements based largely on a very unclear target audience, and a prose style that is inconsistent. It reads in a confusing manner. This is especially the case in sections that are more technical in nature. BeingObjective (talk) 19:24, 30 November 2023 (UTC)

Thank you for your review of the Wikipedia article about modafinil. I appreciate your time and effort in evaluating the article for the GA criteria. I am glad that you found the article to meet most of the criteria except for the clarity and conciseness of the prose and the focus and summary style of the topic.

I understand that these are essential criteria for a GA article, and I would like to improve the article accordingly. However, I would appreciate it if you could provide me with more specific feedback and suggestions on how to do so. For example, could you please point out the exact sentences or paragraphs you think are unclear, confusing, or inconsistent in the prose? Could you also explain why you think they are problematic and how they could be improved? Similarly, could you please identify the sections or details that you feel are unnecessary or off-topic in the article? Could you also suggest how to summarize them or remove them without losing essential information or context?

I am asking for these clarifications because I want to ensure that I understand your concerns and expectations and address them adequately in the article. I also want to avoid making any changes that might compromise the article's accuracy, completeness, or neutrality, which are also essential criteria for a GA article. I hope you can understand my request and help me improve the article.

Thank you for your cooperation and understanding. Maxim Masiutin (talk) 21:56, 30 November 2023 (UTC)

@BeingObjective: Do you intend on finishing the review as described in Step 4 of the Reviewing process (WP:GAN/I#FAIL)? You wrote that the article failed criteria, but you didn't update the status of the review. That's why I asked on whether you intend to conclude (close) the review. Thank you! Maxim Masiutin (talk) 23:51, 30 November 2023 (UTC)

This review is invalid, and the nomination has been returned to the queue. ~~ AirshipJungleman29 (talk) 18:17, 1 December 2023 (UTC)

Review invalidated

This review is invalidated by the reviewer's request due to lack of time to complete the review:

• GA Review discussion;
• Reviewer's request to invalidate the reviews.

--Maxim Masiutin (talk) 19:55, 1 December 2023 (UTC)

Economics section

Just a note to say that pricing of drugs is not needed or wanted - there was a lot of discussion on this some time ago and the consensus reached was that it is of no relevance to the general reader. Best --Iztwoz (talk) 19:04, 1 December 2023 (UTC)

Thank you very much, I removed it. I saw general guides on the sections on a drug article and prices were required there, but I didn't know that another rule clarified that such prices should be taken from secondary sources. Maxim Masiutin (talk) 00:53, 2 December 2023 (UTC)

There were articles that described the the price of modafinil was artificially inflated:

• https://www.nytimes.com/2004/06/29/health/wakefulness-finds-a-powerful-ally.html
• https://www.nytimes.com/2014/07/07/world/europe/european-students-use-of-smart-drugs-is-said-to-rise.html
• https://www.nytimes.com/2013/06/20/business/global/eu-fines-drug-companies-for-delaying-generics.html

May I use information from those sources to describe this overpricing of modafinil? Maxim Masiutin (talk) 00:57, 2 December 2023 (UTC)

Can you please review this variant about modafinil price concerns? According to WP:NOTPRICE, an independent source and encyclopedic significance for the mention of price is allowed, which may be indicated by mainstream media sources such as the New York Times providing commentary on these details instead of just passing mention; in this case the price was provided in case of overpricing attention to generic drugs. Maxim Masiutin (talk) 01:27, 2 December 2023 (UTC)

@Maxim Masiutin, For what it's worth, I think the information you proposed is relevant and should be included in the article. Vontheri (talk) 09:50, 18 March 2024 (UTC)

Usage § Sleep disorder section

In Modafinil#Sleep_disorders

For the use of modafinil in shift work sleep disorder, according to a 2014 Cochrane review, people who take modafinil and armodafinil probably have a small reduction in sleepiness and an increase in alertness during the night shift, based on evidence at three months' follow-up in people with shift work sleep disorder
— https://www.cochrane.org/CD009776/OCCHEALTH_drugs-for-treating-people-with-sleepiness-during-shift-work-and-sleep-problems-after-shift-work

I don't think this is a reliable source for this (besides that it's WP:UNDUE to have a whole paragraph for a single study). --WikiLinuz (talk) 02:36, 2 December 2023 (UTC)

Fix the first two citations in optimal dosing protocols for modafinil in narcolepsy patients, including the use of doses higher than the recommended dose of 200 mg, as well as split dosing to achieve. --WikiLinuz (talk) 02:38, 2 December 2023 (UTC)

Thank you! Can you please do that change, as you are the same editor as me? Maxim Masiutin (talk) 03:48, 2 December 2023 (UTC)

Can you please review the revised "Uses" section, I have addressed the issues that you have noticed. Maxim Masiutin (talk) 04:01, 2 December 2023 (UTC)

I think the "Sleep disorders" section should be rewritten. It has WP:UNDUE amount of irrelavant information about study protocols (which isn't really helpful for a reader). It should be trimmed. --WikiLinuz (talk) 02:40, 2 December 2023 (UTC)

OK, let me fix that. Maxim Masiutin (talk) 03:49, 2 December 2023 (UTC)

Section contradicts first sentence in lead described as stimulant, section describes as eugeroic.--Iztwoz (talk) 09:04, 2 December 2023 (UTC)

@Iztwoz why do you think it is a contradiction? Eugeroics are classified as central nervous system stimulants because they need to stimulate CNS to promote wakefulness. Maxim Masiutin (talk) 09:31, 2 December 2023 (UTC)

@Iztwoz I tried to resolve the supposed contradiction that you spotted by modifying the lead, please review. Maxim Masiutin (talk) 09:40, 2 December 2023 (UTC)

Usage § Multiple sclerosis-related fatigue

Why is some NGOs given so much WP:PROMINENCE? Their websites are not MEDRS, therefore should be removed and better source should be used. I think unapproved medical uses shouldn't even be in "Usage" section; it should be within it's own "Research" section. --WikiLinuz (talk) 02:49, 2 December 2023 (UTC)

Can you please give a few quotes so I can check and replace with proper quotes or remove the claims which are not supported by a reliable source? Maxim Masiutin (talk) 03:49, 2 December 2023 (UTC)

I think "Multiple sclerosis-related fatigue" under "Usage" should be merged with the "Research" section since modafinil isn't indicated for this condition.

I'm not sure why we should include these two particular organization's guidelines in the first place. Since the Modafinil#Multiple_sclerosis-related_fatigue_(research) is already pretty clear. Any reason? --WikiLinuz (talk) 04:15, 2 December 2023 (UTC)

The section of "Uses" describes current use (approved use) whereas "Research" describes details of studies and current and future research.

While modafinil is recommended of multiple sclerosis by an executive non-departmental public body, in England, of the Department of Health and Social Care, that publishes guidelines, I would propose to keep this use in the "Uses" section. Maxim Masiutin (talk) 04:59, 2 December 2023 (UTC)

See also, https://www.gov.uk/drug-safety-update/modafinil-provigil-now-restricted-to-narcolepsy --WikiLinuz (talk) 05:05, 2 December 2023 (UTC)

Thank you!

@WikiLinuz, @Iztwoz, let me move all the data from lead to the body together with the references. Then we will make a new lead that better aligns to the rules of WP:MOSLEAD without references at all because it will be a recapitulation on what is told in the body; those references in the lead make it harder to read. Maxim Masiutin (talk) 13:30, 2 December 2023 (UTC)

Usage § Bipolar depression

* https://onlinelibrary.wiley.com/doi/10.1111/bdi.12859 This study cited in this subsection is a WP:PRIMARY source and isn't appropriate here. --WikiLinuz (talk) 02:52, 2 December 2023 (UTC)

My understanding that primary sources are research studies on people or cells, whereas reviews of those studies are secondary sources, at least it is specified in WP:MEDDEF.

A secondary source summarizes one or more primary or secondary sources to provide an overview of current understanding of the topic, to make recommendations, or to combine results of several studies. Examples include literature reviews or systematic reviews found in medical journals, specialist academic or professional books, and medical guidelines or position statements published by major health organizations.

The study you cited was a review of 58 primary studies, therefore it is a reliable source. Maxim Masiutin (talk) 04:06, 2 December 2023 (UTC)

You're right. I mistook this source for something else. --WikiLinuz (talk) 04:10, 2 December 2023 (UTC)

Exclusive

@Iztwoz, you wrote "is an exclusive psychostimulant newly classed as a eugeroic, a wakefulness-promoting medication".

My understanding is that modafinil is not exclusive and there are other medications with similar action (given that the exact mechanisms are still unknown) and effects which are not metabolites of modafinil. Examples of such drugs are soliumfetol and pitrisant. Would you mind if I remove the word "exclusive"? Maxim Masiutin (talk) 13:43, 2 December 2023 (UTC)

It was used in the ref given ?--Iztwoz (talk) 14:33, 2 December 2023 (UTC)

It was an article published in 2012. Later articles do not use the word "exclusive" and explain other medications with similar effect. Maxim Masiutin (talk) 15:15, 2 December 2023 (UTC)

Maybe it was exclusive in 2012, but not now. Maxim Masiutin (talk) 15:16, 2 December 2023 (UTC)

Have changed it to atypical with ref Iztwoz (talk) 15:38, 2 December 2023 (UTC)

Can you please use reference linked to an id, such as pmidXXXXXX where PMID exist, or similar to semantic sholar or DOI? Maxim Masiutin (talk) 15:54, 2 December 2023 (UTC)

It is usual and preferred to use named references - they are much easier to look for and normally give the related year as well. Iztwoz (talk) 15:59, 2 December 2023 (UTC)

They are hard to look because editors have to guess while pmid is fixed and have no variance on editor. Do you have a tool to replace all to pmid? Maxim Masiutin (talk) 16:00, 2 December 2023 (UTC)

You can revert if you wish but I suggest you take a look at other edit pages of good articles and B class too.--Iztwoz (talk) 16:05, 2 December 2023 (UTC)

If that were easy than the tool of https://citation-template-filling.toolforge.org/cgi-bin/index.cgi would have generated such refs. Instead, it generates by pmid so that the refs are inherently unique and you don't need to use clunky forms like -2, -3, etc. Maxim Masiutin (talk) 16:11, 2 December 2023 (UTC)

Please just take a look at Gout, Alcoholism, COPD, Epilepsy, Asthma and any other good article - It is far easier to look for a name than a number Iztwoz (talk) 16:21, 2 December 2023 (UTC)

Aren't Amphetamine, 21-Hydroxylase, Selective glucocorticoid receptor modulator, Late onset congenital adrenal hyperplasia not good? Maxim Masiutin (talk) 16:29, 2 December 2023 (UTC)

You can rename references that have no pmid. This renamer probably was not meant to be used for medical articles, it does not know about pmid. Maxim Masiutin (talk) 17:41, 2 December 2023 (UTC)

When you can hundreds of refs it is hard to memorize, easer to refer by pmid, I looked at GA and FA articles to find out the use ref name="pmid....

• Amphetamine
• 21-Hydroxylase
• Selective glucocorticoid receptor modulator
• Late onset congenital adrenal hyperplasia

Maxim Masiutin (talk) 16:18, 2 December 2023 (UTC)

I prefer we use name="pmidXXX" format as well. --WikiLinuz (talk) 20:05, 2 December 2023 (UTC)

This is very convenient when using the https://citation-template-filling.toolforge.org/cgi-bin/index.cgi Maxim Masiutin (talk) 20:10, 2 December 2023 (UTC)

Neat tool. --WikiLinuz (talk) 21:30, 2 December 2023 (UTC)

@WikiLinuz:@Iztwoz:RefRenamer did not support pmid, s2cid or other attributes, but I added support of these attributes to my local version of RefRenamer and asked the author to consider supporting them in the main instance, see Maxim Masiutin (talk) 20:41, 3 December 2023 (UTC)

I make nice reference names (as you did) for all the references except those which had PMID. For works that didn't have PMID but had s2cid, I used that as a reference name. I am sorry that it turned out that way with the references. Maxim Masiutin (talk) 16:11, 3 December 2023 (UTC)

I am moving references from lead to body to make a new clean lead, please disregard if currently the lead is incomplete Maxim Masiutin (talk) 15:20, 2 December 2023 (UTC)

Amphetamine uses names. Others use mixed which is why the Refnamer tool is used.--Iztwoz (talk) 16:37, 2 December 2023 (UTC)

Can Refnamer rename to pmid? Maxim Masiutin (talk) 16:41, 2 December 2023 (UTC)

You didn't edit this page almost and then used an automated tool and tell that it is easier. Maxim Masiutin (talk) 16:49, 2 December 2023 (UTC)

Mechanism of action

There is far too much unneeded detail on connexins that is available on links.--Iztwoz (talk) 15:42, 2 December 2023 (UTC)

Thank you! I removed the details on connexins.

What else should we improve? Maxim Masiutin (talk) 20:03, 2 December 2023 (UTC)

See also WP:TOOMANYREFS. --WikiLinuz (talk) 21:47, 2 December 2023 (UTC)

Reference Names

Please keep the reference names that have a PubMed ID (PMID) as "pmidXXXX", for example <ref name="pmid31422705"> for PMID 31422705, as I rely on this small unique ID to search for the articles, avoid duplication, etc. however, feel free to rename other references that do not have PubMed ID. Maxim Masiutin (talk) 20:08, 2 December 2023 (UTC)

Explanation of Jargon

@WikiLinuz, thank you for your improvement of the article! Please try to keep the explanation of jargon and not remove it, I refer to jargon like "operational tempo". And if you encounter jargon which is not explained, try to explain it for the general audience. That was not me who pointed to this issue. If you see the page revision at about June 2023, you will see tags like, I tried to address all these issues. I agree that "operational tempo" is a jargon worth explaining, moreover, I didn't know it's meaning myself, and when I started to search, I figured out that "operational tempo", which means the rate at which military operations or activities are conducted, whereas increase of the "operational tempo" refers to the enhancement the unit's overall performance and efficiency. There were dozens of such jargon like "operational tempo" or "postmarketing surveliance" which I hope I addressed all of them, but if you find some other which were not tagged as , please let me know or try to address by yourself! Maxim Masiutin (talk) 07:42, 3 December 2023 (UTC)

I didn't find that term be confusing; it's pretty intuitive. "Tempo" comes from music (which generally means "speed"—in musical context for example). But if you think it warrants an explanation, I don't have an objection. If the jargon has its own wiki page, we generally just link to it (but in this case it doesn't it seems so I guess it's okay to have a short explanation). --WikiLinuz (talk) 07:54, 3 December 2023 (UTC)

I am not skilled in music either, I just took the page as it was and found out that this was marked as jargon using a template, and I also didn't know its meaning. English is not my native language and this is first time when I saw this term. Probably English is your language, that's why you didn't find it confusing. Maxim Masiutin (talk) 13:27, 3 December 2023 (UTC)

Please see that diff: jargon tagged Maxim Masiutin (talk) 13:41, 3 December 2023 (UTC)

For example, Postmarketing_surveillance#United_States has its own wikipage so we can just link it there since I think it's not super important to explain it inline (because it's not related to the subject of the article itself). It's good practice to make encyclopedic entries as concise as possible at the same time have relevant info about the subject itself (without giving WP:UNDUE importance to minor details). --WikiLinuz (talk) 08:10, 3 December 2023 (UTC)

This is not WP:UNDUE when you can explain a term in a couple of words or use simpler words, we should not rely on the links always but write in a simpler language instead or use a couple of words explanation when possible. Even Wikipedia:Manual_of_Style/Medicine-related_articles#Writing for the wrong audience advises to avoid jargon when there are suitable plain English words. If you exclude the explanation, that guy will come again and put [jargon] again and will be right. Maxim Masiutin (talk) 13:33, 3 December 2023 (UTC)

Let me ask that person to give reasoning. Maxim Masiutin (talk) 13:36, 3 December 2023 (UTC)

Wikilinks are needed when a reader wants go get details or more information, not when the reader does not know at all; we should write in such a way that the reader would not need to click links. Maxim Masiutin (talk) 14:03, 3 December 2023 (UTC)

The initial editor mentioned that the wikilink should be sufficient (see #Postmarketing surveillance), let it be so. Maxim Masiutin (talk) 14:42, 3 December 2023 (UTC)

Postmarketing surveillance

@Moorlock: you put maintenance tags on the modafinil page, in particular, you tagged postmarketing surveillance as a jargon. Do you think it can be addressed by a wikilink to the postmarketing surveillance article as suggested by WikiLinuz at [2], or should it be addressed some other way, such as giving a 3-4 words explanation on what is it, or rewriting it in a simple language, or something else? Maxim Masiutin (talk) 13:48, 3 December 2023 (UTC)

I think a wikilink would be sufficient. ― Moorlock (talk) 14:21, 3 December 2023 (UTC)

Thank you! Maxim Masiutin (talk) 14:41, 3 December 2023 (UTC)

Should you have time, we would appreciate if you review the article again, because we resolved all the tags that you inserted. Maxim Masiutin (talk) 14:43, 3 December 2023 (UTC)

Reference format

According to Wikipedia:Manual_of_Style/Dates_and_numbers, the editors should refrain from altering the style of elements such as date format, units, and so on, within an article unless there is a significant reason that is not merely a preference for a different style. Engaging in revert-wars over optional styles is not acceptable. If a consensus cannot be reached through discussion regarding the style to be used in an article, the style established by the first major contributor should be respected. My understanding is that this rule also applies to reference formats. Maxim Masiutin (talk) 21:38, 3 December 2023 (UTC)

Usage section

@WikiLinuz, @Iztwoz I moved all mentioning of studies from "Usage" section to "Research" section. Can you please review the research section and mark all claims that are not supported by secondary studies by a header section template, so I could find secondary studies? My understanding that Wikipedia should not discuss all primary research studies unless they are mentioned in the secondary research, anyway, it is better to get research directions from secondary research:

WP:MEDMOS: Research directions: Include only if addressed by significant sources. See Trivia, and avoid useless statements like "More research is needed". Wikipedia is not a directory of clinical trials or researchers. Maxim Masiutin (talk) 11:36, 5 December 2023 (UTC)

@[[User:WikiLinuz], @User:Iztwoz, do you have any idea on how can we improve the article any further, or may we submit it to GA? Maxim Masiutin (talk) 06:15, 7 December 2023 (UTC)

Primary sources

@Bon courage Can you please specify where exactly it relies on primary sources, such as by using {{primary-inline}} as you put the header without being specific. Maxim Masiutin (talk) 08:26, 8 December 2023 (UTC)

@Bon courage I noticed you put one {{rs}} but was also editing the article and occasionally overwritten it, sorry. I will address this problem that you identified, thank you! Should you find some other problems, please let me know! Maxim Masiutin (talk) 08:38, 8 December 2023 (UTC)

The article is crammed with primary sources for WP:BMI, even highly technical WP:MEDANIMAL stuff about rodents. The tag should not be removed until this problem is solved. Bon courage (talk) 08:39, 8 December 2023 (UTC)

OK, let me put back this tag. I will try to remove all those inappropriate sources. However, I'd appreciate if you mark specific places with appropriate inline templates. Maxim Masiutin (talk) 08:45, 8 December 2023 (UTC)

That's a lot of work I've not got time for. The article really needs a thorough source audit and biomedical material relying on primary sources needs to be removed (or get MEDRS sourcing). Just from a glance there are very many such problematic sources. The sourcing is also broken (see errors in reflist). This is an essential step before the article can be considered for GA. Bon courage (talk) 08:48, 8 December 2023 (UTC)

Thank you! I will review and let you know. Maxim Masiutin (talk) 08:52, 8 December 2023 (UTC)

@Bon courage, I have addressed all the issues with primary sources, and the only sections where primary sources left are Pharmacodynamics, Pharmacokinetics and Chemistry. Are primary sources acceptable there, or only that information should be left about invitro and animal studies that is described in secondary sources? Maxim Masiutin (talk) 09:48, 8 December 2023 (UTC)

Primary sources can be used to touch in details, but so far as I can see large portions of the pharmocology material in this article rest entirely on primary sources (some quite old), and their content is asserted as fact in Wikipedia's voice. Wikipedia is meant to be a tertiary source, not a secondary one. Bon courage (talk) 10:03, 8 December 2023 (UTC)

OK, I will rework the pharmocology section. Maxim Masiutin (talk) 10:33, 8 December 2023 (UTC)

@Bon courage, I put secondary sources for the pharmacology material, and removed the information that was not backed by secondary sources. Could you please review and let me know whether the "reliable medical references" header can be removed? Maxim Masiutin (talk) 11:30, 8 December 2023 (UTC)

It no longer looks like a serious problem that merits the tag. Bon courage (talk) 13:57, 8 December 2023 (UTC)

Thank you, I will remove the tag then. Should you notice something bad in the future, please feel free to put the tag back. Maxim Masiutin (talk) 14:01, 8 December 2023 (UTC)

Deviate from prescribed dosages

@Sandizer: I have clarified the "deviate from prescribed dosages", it was a slightly different meaning in the referenced article, which I hope I explained correctly. Please let me know whether it is now OK. Maxim Masiutin (talk) 08:08, 10 December 2023 (UTC)

Brand names

@Kimen8: Your observation about the brand names was correct. Would you mind if I remove them altogether to keep consistency with the other places in the article, where nowhwere the brands are mentioned? Maxim Masiutin (talk) 21:13, 11 December 2023 (UTC)

You will need to be a bit more specific about what my observation regarding brand names was. If you mean my most recent edit where I moved proprietary names into parentheses, then I think it is safe to remove the proprietary name. Those terms are wikilinked and the proprietary name is generally mentioned there in the lede if it's noteworthy anyway. Kimen8 (talk) 21:16, 11 December 2023 (UTC)

I slightly changed the wording in your edit to be a bit less clunky. It is amphetamine (racemic), or dextroamphetamine, or salts thereof. Kimen8 (talk) 21:20, 11 December 2023 (UTC)

About Edit

Hi, Im student from Uskudar University. I edit this article (Neuroenhancement) as an assignment for my course (Recent Development in Biotechnology). I already completed Wikipedia training modules to be proficient in Wikipedia editing. I would appreciate any support.

Best wishes,

Büşra GÜLER Busragulerr (talk) 13:30, 1 January 2024 (UTC)

Hello, this article is about Modafinil, not about Neuroenhancement.

Was your assignment in Modafinil or in Neuroenhancement? Maxim Masiutin (talk) 13:33, 1 January 2024 (UTC)

I would like to assign you about modafinil, which is within the scope of Neuroenhcament. Busragulerr (talk) 13:36, 1 January 2024 (UTC)

Modafinil is not a neuroenhancer but a drug to treat symptoms narcolepsy and other conditions. In healthy people, modafinil can make congition worse. Modafinil may increase confidence in one's own abilities and judgments, which can lead to overestimating one's performance and underestimating the risks or challenges involved in a task. This can result in poor decision-making, reduced learning, and increased errors. For example, modafinil may increased confidence but not accuracy in a gambling task resulint in a average loss comparing to controls that did not take modafinil. Reduced creativity of modafinil may also be the case, as modafinil may impair creativity and divergent thinking, which are the abilities to generate novel and original ideas or solutions. This can limit one's ability to cope with complex or ambiguous problems, or to find new ways of doing things. For instance, modafinil may reduce creativity and flexibility in verbal fluency tasks. Modafinil may have different effects on different types of cognitive tasks, depending on the level of difficulty, complexity, and domain. Modafinil may impair overall speed, efficiency, and accuracy, such as worsening performance on tasks such as a knapsack task, so that modafinil may increase the level of effort, but decreased the quality of effort, in solving the knapsack task, making total time higher and results worse. Modafinil did not improve the cognitive performance of the participants, but rather worsened it. You can refer to those studies if you wish. So you will mention that for neuroenhancment, modafinil negatively affect cognitive performance. But why do you need modafinil for that? There are drugs that negatively affect cognition even more than modafinil. Examples of such drugs that negatively affect performance even at a larger degree than modafinil are anticholinergic drugs, such as amitriptyline, benzodiazepines, antihistamines, antipsychotics, and antispasmodics, as they can impair memory, attention, and speed of information processing by blocking the action of acetylcholine, a neurotransmitter involved in learning and memory; besides that, opioids, such as morphine, oxycodone, and codeine can impair cognitive flexibility, working memory, and reaction time by affecting the opioid receptors in the brain, which are involved in pain perception, reward, and mood regulation; also, antiepileptic drugs, such as carbamazepine, valproic acid, and lamotrigine can impair verbal memory, working memory, and reaction time by altering the electrical activity of neurons in the brain, which are involved in various cognitive functions; and, antidiabetic drugs, such as metformin, sulfonylureas, and insulin, can sometimes and in some cases impair verbal reasoning and memory by affecting the glucose metabolism in the brain, which is essential for neuronal function and survival; and, to certain degree, proton pump inhibitors, such as omeprazole, lansoprazole, and esomeprazole; can impair verbal reasoning and memory by reducing the absorption of vitamin B12, which is important for the synthesis of neurotransmitters and the maintenance of myelin sheath around nerve fibers; so that the drugs above mentionsed, as nagative neuroenhancers can much more affect negatively cognition than modafinil - consider describing them also. Maxim Masiutin (talk) 18:35, 1 January 2024 (UTC)

Delete of the Modafinil#Multiple sclerosis-related fatigue (research) section

I propose to delete subsection Modafinil#Multiple sclerosis-related fatigue (research) (the one from Research section), because it contradicts with the subsection Modafinil#Multiple sclerosis-related fatigue from the Usage section). The subsection from "Research" lists old primary stidies and old review whereus the subsesection from the "Usage" section lists no primary studies and later reviews. The earlier review mentioned in subsection from "Research" found that the evidence is weak and inconclusinve, but later reviews from "Usage" section found sufficient evidence. Therefore, to remove this contradition, I propose to remove the subsection from reseach, as it adds no value and also lists primary research which is not a solid evidence per se, and Wikipedia is not mean to be a collection of reiteration of primary studies. Maxim Masiutin (talk) 13:38, 1 January 2024 (UTC)

Citation after each sentence in Society and culture / economy section

@Whywhenwhohow: Why did you request to put a citation after each sentence in a paragraph from Society and culture / economy section when the proper sources were at the end of the paragraph? Wikipedia does not mandate to put a reference after every sentence. References after each section should be enough. Also, your change from "In 2004 the New York Times reported" to "as of 2004" was an alteration of meaning and was not supported by the original source. Please consider geting a subscription and read the articles referenced. As you requested, put a references after every sentence as you asked, but I think that it is superfluous. Would you mind I remove these "after-each-section" references and keep as it was before? Thank you for cooperation! Maxim Masiutin (talk) 18:00, 1 January 2024 (UTC)

Please keep the citations. Medical articles should be relatively dense with inline citations. WP:MEDMOS. Other parts of the article should have more citations. The discussion and mention of the NYT article doesn't seem neutral WP:NPOV. Is it necessary to mention the name of the NYT in the article? Is the article from 2004 relevant 20 years later (or the other two from ten years ago)? Where are the counterpoints? Is the price in 2004 relevant? Do any of the sources validate the claim about location being a factor in the cost? --Whywhenwhohow (talk) 20:20, 1 January 2024 (UTC)

@Whywhenwhohow you raised good points, let me think a day on how to address them Maxim Masiutin (talk) 04:30, 2 January 2024 (UTC)

I revamped the whole Modafinil#Economics section, so it is now presents the information in historical flow, from earlier to later events which present historical interest. I also removed the reference to NY times, I agree with you that it is not relevant who mentioned what. As for the historical flow that it is now, I hope, this resolves your concenrs of whether some pieces of information are still relevant that was published 10 or 20 years ago. While now the situation changed, this information is intersting from the historical point of view, i.e. to show how the situation evolved over time. Thank you very much again for your valuable contributions.

Still, can you please read the whole Modafinil#Economics section now and let me know whether it is now OK. Maxim Masiutin (talk) 04:43, 2 January 2024 (UTC)

GA Review

This review is transcluded from Talk:Modafinil/GA2. The edit link for this section can be used to add comments to the review.

Reviewer: Tea with toast (talk · contribs) 05:27, 25 January 2024 (UTC)

Thank you, I started resolving the issues that you've mentioned in the #Changes needed section, and I aim to finish today. Maxim Masiutin (talk) 09:25, 29 January 2024 (UTC)

Thank you very much for your contributions as the reviewer. I've implemented all the changes you requested so far. Zerf also made proper edits, removing information that was not properly cited or that was speculative and not appropriate for an encyclopedia.

On promotional-sounding language in the lead: I removed promotional tone by rewriting the sentence, see Talk:Modafinil#Distinct mechanisms of action of modafinil make it an option for sleep disorders when the other stimulants are not desired due to their euphoric effects.

On medical uses: I emphasized that modafinil only treats excessive sleepiness and does not treat cataplexy, although it reduces the frequency or severity of the onset of cataplexy; however, it is not approved specifically for cataplexy.

On bipolar depression, I changed to "depressive phase of bipolar disorder" as it is more correct, and moved text from the research section of bipolar depression to the "depressive phase of bipolar disorder" in medical uses; and renamed the section on research on depression to "major depressive disorder", where modafinil is not efficient. Therefore, we now have clearly differentiated "depressive phase of bipolar disorder" where modafinil is somewhat helpful as adjunct therapy (in the medical uses section) and "major depressive disorder" in the "Research section" where modafinil is not efficient.

On birth defects, there were studies on congenital defects at https://jamanetwork.com/journals/jama/article-abstract/2769999 - but they are primary research, whereas as healthcare authority UK warning that prohibits modafinil during pregnancy and 2 months before getting pregnant is a serious warning that has consequences for the healthcare industry and modafinil use; since it is mostly a prescription medication in many countries, healthcare professionals will probably stop prescribing modafinil to pregnant women due to the warning on the health authority that justify the warning on congenital defects. There is another link to a journal article on the same: https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2771814

I added these links as additional references. I also mentioned that exposure to modafinil during pregnancy increases the risk of malformations in newborns, such as congenital torticollis, hypospadias, and congenital heart defects.

On the fact that modafinil can reduce the efficacy of hormonal birth control, so other forms of contraception should be used, it is listed in the "Interactions" section, but I will added a note in the Contraindications section as well. Still, I think that the more appropriate place to specify that is "Interactions" rather than contraindications because both "modafinil" and "hormonal contraceptives" are drugs that interact with each other.

I also replaced the term "mood switch" with "mood swing" in the text, as you suggested because there is an article "mood swing" in Wikipedia, not "mood switch"; however, the papers cited use the term "mood switch."

You've also asked on whether there are specific birth defects, and I specified the defects.

I thought that it was already mentioned in the "interactions section", in a paragraph about steroid hormones, that modafinil can reduce the efficacy of hormonal birth control, so other forms of contraception should be used. I expended this section to make additional emphasis on that and add more citations which are most relevant.

I added the explanation on why modafinil is not recommended in congential heart conditions or pre-existing heart conditions. However, I could not find explanation why modafinil is contraindicated in a rare glucose-galactose malabsorption. I only found that in monographs without any explanation of the reasons.

On citations: I resolved all the "citation needed" instances. Zefr also helped. Are citations now correct? Is there any work that needs to be done on citations?

Thank you very much again for your contributions on writing the encyclopedia. Please let me know how can we improve the article further, should you have the ideas. In particular, I'd like you be sure that the article meets the GA criteria. If you are in doubt about certain items where the article may not fully meet the GA criteria, please let me know so I could improve it for compliance to the GA criteria. Maxim Masiutin (talk) 03:56, 30 January 2024 (UTC)

Also, I've seen that when filling the GA criteria reference table, you were not sure whether the article is neutral and whether it represents viewpoints fairly and without editorial bias, giving due weight to each. Indeed, the sentence in the lead was not neutral, so I rewritten it. I can further rewrite or delete the information that you may see as not neutral. I have no personal interest in modafinil and my interest is solely to improve the encyclopedia, and promote as many articles to the GA status as I can, but since Wikipedia for me is a hobby, I am limited in the amount of time I can devote. I have written or improved a couple of articles in the past that reached the GA status, and I also nominated several articles now that are waiting for a reviewer to come. Still, I have tried to follow the guidelines how to write a good article for Wikipedia, but I may have missed some points or made some mistakes. I am open to constructive criticism and suggestions for improvement. I hope you can help me make this article a good article for Wikipedia. Thank you for your time and attention. Maxim Masiutin (talk) 04:03, 30 January 2024 (UTC)

Minor issues: there are numerous duplicate links and refs not in order throughout. Dup links can be viewed with this script: importScript('User:Evad37/duplinks-alt.js'); Zefr (talk) 05:33, 30 January 2024 (UTC)

Thank you very much, Zefr! I've used this tool and removed duplicate wikilinks if they were twice in the same subsection. However, if the wikilinks were far apart from each other, I kept them. Maxim Masiutin (talk) 17:20, 30 January 2024 (UTC)

The tool importScript('User:Evad37/duplinks-alt.js'); displayed duplicate wikilinks, but it did not display duplicate references or cases where multiple references placed together were not sorted in ascending order. I manually sorted the references in ascending order in places where there were more than 1 reference. Maxim Masiutin (talk) 17:30, 30 January 2024 (UTC)

Hello, Tea with toast! I noticed you have been absent from the review process for a few days, presumably while preparing additional feedback about the article. Your dedication to thorough evaluation is commendable, and I appreciate your commitment to maintaining the quality of Wikipedia content. Per my understanding of the Good Article review instructions, review timeframes for Wikipedia Good Article nominations can vary based on factors such as the article’s scope and complexity. However, a general guideline suggests that the review process should ideally conclude within seven days. Of course, there are exceptions—such as when a reviewer seeks assistance or clarification on the GA nominations discussion page (Wikipedia_talk:Good_article_nominations). My understanding is that the Good Article (GA) process intentionally maintains a lightweight approach, distinct from the more rigorous requirements of Featured Article (FA) nominations, as outlined in WP:RGA. Rather than striving for perfection, the GA review process aims to ensure that articles adequately meet the GA criteria (without additional rigour). Articles are dynamic entities, akin to living organisms, with room for continuous improvement. Therefore, if the article needs to be better but matches the GA criteria, it can be improved further after getting the GA status. As such, I kindly request your further feedback on the article. Thank you for your time and dedication to maintaining the high standards of the encyclopedia content. I look forward to your valuable input. Maxim Masiutin (talk) 13:09, 8 February 2024 (UTC)

Thank you for your review. I will address the issues that you have pointed out. Maxim Masiutin (talk) 09:25, 13 February 2024 (UTC)

Thanks for the edits! I'm pleased by the changes that are being made. I'm not yet finished with my review, but hopefully I'll have the time to wrap up my end of the review the coming days. Tea with toast (話) 02:07, 5 February 2024 (UTC)

Thank you! Looking forward for further information from you. Maxim Masiutin (talk) 15:11, 5 February 2024 (UTC)

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.
	1b. it complies with the Manual of Style guidelines for lead sections, layout, words to watch, fiction, and list incorporation.	I have concerns about the layout, especially making sure things are in their proper sections. I feel there is a lot of blurring between things that are in "contraindications" and "adverse effects". Similarly, things that are in the "usage" sections, that I think are better suited to "research"; as well as things in the "drug tolerance" and "addiction" that might do better in the "research" section;
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.
	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).	Concerns here. Just as an example, in the section about "cognitive benefits in people with bipolar disorder who are in a remission state", just reading the abstracts for citations #55 and #56, these appear to be metanalyses about the bipolar depression rather than cognitive benefits. (Additionally, I believe this belongs in the "cognitive benefits" section).
	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.
	3b. it stays focused on the topic without going into unnecessary detail (see summary style).	I have concerns about this, especially things that are included in the "research" section.
	4. Neutral: it represents viewpoints fairly and without editorial bias, giving due weight to each.
	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.
	6b. media are relevant to the topic, and have suitable captions.
	7. Overall assessment.	First off, I'd like to express appreciation for all the hard work that has gone into making this a "nearly good" article. I can tell of effort has gone into this article. However, I don't think it meets GA criteria yet. I hope a few things can be corrected so that it can meet criteria in the near future. Tea with toast (話) 03:16, 13 February 2024 (UTC)

Changes needed

I have not completed my review, but below is a list of some of the changes that need to be made to pass the article. There may be more to come. Tea with toast (話) 01:49, 28 January 2024 (UTC)

• Lead
  • Remove promotional-sounding language (e.g. "...unique mechanism of action sets it apart from other stimulants, making it a valuable medication..."

• Medical uses
  • It should be specified that modafinil only treats excessive sleepiness and does not treat cataplexy.
  • It might be best to broaden the off-label use in depression to both unipolar and bipolar depression. I would keep it succinct and make sure is is in agreement with what is presented in the "Research" section. Right now, there are inconsistencies in the "bipolar depression" subsections, including whether or not the medication can induce a manic episode (also, that would be the preferred language instead of "mood switch"

• Contraindications
  • Are there specific birth defects?
  • Should be noted that modafinil can reduce the efficacy of hormonal birth control, so other forms of contraception should be used
  • Is there a reason it is contraindicated for people with congenital problems?

• Citations (ref numbers from this version)
  • I've added multiple "citation needed" tags. Most, I think just might need the reference moved from the end of the paragraph to the end of the sentence
  • Full citation for: 23, 26, 64, 109, 149, 159-164

Reference templates and formatting

There are numerous incomplete, unformatted references needing attention in their respective templates for consistency and GA quality. As a past GA editor, I sense these will likely need manual editing. Citation bot is worth a try, although it appears to have bugs in recent attempts. Zefr (talk) 18:19, 1 February 2024 (UTC)

I have filled {{cite web}} references with appropriate data. The templates such as "cite journal" were adequately filled. The only templates that I found were not adequately filled were "cite web". Thank you for pointing that out. I filled them. Should you think other templates should also be filled, please let me know (specify exactly which templates should be filled). Maxim Masiutin (talk) 21:07, 5 February 2024 (UTC)

On bipolar disorder

You've mentioned two references when you wrote about bipolar disorder. These references, PMID 31643130 and PMID 36561896, that you've mentioned, were about the use of modafinil as an adjunctive treatment in the depressive phase of bipolar disorder, which may feature excessive sleepiness and fatigue.

These articles claim that modafinil increases the effect of the main treatment and is safe and effective, especially for people who do not respond well to standard antidepressants. These articles also claim that modafinil does not significantly increase the risk of mood swings or suicide attempts in people with bipolar disorder. They also claim that modafinil may also have cognitive benefits in people with bipolar disorder who are in a remission state.

You mentioned that the abstract section of these articles does not mention that. In addition, while the abstracts of the articles may not explicitly mention cognitive enhancement, the full text of the articles provides a more comprehensive view of the research. It’s also worth noting that the abstract is often a summary of the key findings and may not include all the details found in the full text of the article.

When I refer to particular articles, I read the whole article, not just the abstract. You may use the Wikipedia Library to read the bodies of the articles. The article PMID 31643130 has free access. The article PMID 36561896 also has free access. In the reason justifying that the article "Modafinil" does not fit the criteria 2b of the Good Article criteria, you mention "just reading the abstracts for citations #55 and #56, these appear to be metanalyses about the bipolar depression rather than cognitive benefits". However, there is a concern about why you refer to the abstract only, not to the whole article. It is true that the articles are not about the cognitive benefits per se but about the use of modafinil in people with bipolar disorder who are in a remission state, who may feature excessive sleepiness and fatigue, and for whom modafinil is used as adjunctive treatment to increase the efficiency of the main treatment and to ameliorate the symptoms of sleepiness and fatigue, and to provide cognitive benefits where the cognitive functions otherwise would have been affected by the sleepiness and fatigue.

I sometimes make quotations in a reference from the body of the article, but some editors dispute this practice and delete the quotation. Therefore, a talk page is a good place to discuss whether an article is appropriate with something in the body but not the abstract. Still for these two articles PMID 31643130 and PMID 36561896, this is not needed since they have free full access.

The study PMID 31643130 concluded the efficiency (a significant improvement in depressive symptoms compared to placebo) and safety of modafinil as an adjunctive treatment.

I appreciate your thorough examination of the article and your commitment to ensuring that Wikipedia provides accurate and reliable information.

I kept these references where needed and added new references when there was a claim on cognitive enhancement in bipolar disorder patients.

Thank you! Maxim Masiutin (talk) 19:21, 14 February 2024 (UTC)

On sections

I improved the sections "Contraindications", "Adverse effects" and "Usage". I also made distinctions between the sections clearer, and deleted mentions of irrelevant studies or moved them to the "Research" section. Maxim Masiutin (talk) 10:47, 23 February 2024 (UTC)

Modafinil#Cognitive enhancement

@Zefr: can you please review the subsection Modafinil#Cognitive enhancement in the Research section, as I rearranged studies mentioned by year and made a conclusion. Maxim Masiutin (talk) 19:51, 27 January 2024 (UTC)

Distinct mechanisms of action of modafinil make it an option for sleep disorders when the other stimulants are not desired due to their euphoric effects

Hello, @Tea with toast! You have indicated that the sentence "Modafinil's unique mechanism of action sets it apart from other stimulants, making it a valuable medication for managing sleep disorders" has a promotional-sounding language, and suggested to removed it. This sentence was in the paragraph after the sentence that other stimulants may produce euthoria whereas modanil may not. When I wrote that sentence, I wanted to emphasize that distinct mechanisms of action of modafinil make it an option to consider when the euphoric effects of potential abuse or dependence are wanted to be avoided. However, that sentence turned out to sound like a promotional statement. I also noticed that, but didn't have the idea at that time how to rewrite it, and, it didn't seem to me at that time to sound such promotional as it was now when I re-read it after some time passed.

Did I understand correctly that you suggested to remove the promotional tone, not the sentence itself that sounded like a promotion? Was my understanding correct that you suggested to rewrite the sentence, if possible, in a more neutral language?

If my understanding was correct, then let me know. I rewritten this sentence. Now it is (quote): "Modafinil has a different mechanism of action from other stimulants, therefore, modafinil is an option for treating sleep disorders when the other stimulants are not desired due to their potential for abuse or addiction." There are other variants to consider, such as "Modafinil works differently from other stimulants, thus it can be used to treat sleep disorders when the other stimulants are not preferred because of their possible addictive effects" or "Modafinil's mechanisms of action are different from other stimulants, which makes it a viable option for treating sleep disorders when the other stimulants are not suitable due to their potential for addiction or abuse".

Here are the other version of this sentence that I used now, with minor tweaks. @Tea with toast, please let me know whether you like the current version, or some variant from below. The feedback from all Wikipedia editors is welcome!

• Modafinil has a different mechanism of action from other stimulants, and this makes it an alternative for treating sleep disorders when the other stimulants are not desired due to their potential for abuse or addiction.
• Modafinil has a different mechanism of action from other stimulants, and this makes it an option for treating sleep disorders when the other stimulants are not desired due to their potential for abuse or addiction that they may cause.

Please note that this sentence is used in the lead, so I wanted to have the language as plain and simple as possible, as required by the Wikipedia rules on the lead section. Maxim Masiutin (talk) 08:43, 29 January 2024 (UTC)

Extra citations

@Kimen8: you noticed that source is on subsequent sentence in a edit by Tea with toast that added a "citation needed" template were you revered that edit. I also noticed that in most templates added by Tea with toast, the citation is given at the end of paragraph. According to Wikipedia rules, citations to support for all the claims made in a paragraph can be done at the end of this paragraph.

We already had a similar discussion #Citation after each sentence in Society and culture / economy section where Whywhenwhohow also proposed to include more citations by adding the "citation needed" templates in a paragraph where there were already sources at the end of the paragraph. Still, Whywhenwhohow quoted the rules, in particular, that "Medical articles should be relatively dense with inline citations" according to WP:MEDMOS.

In my opinion, duplicated citations may be justified when there are several citations at the end of the paragraph, and there is a claim of particular importance supported by less than all those citations so that it may be beneficial to only indicate those citations (citation) that support a particular claim. Also, there may be claims of particular importance when additional citations may be needed from sources of higher quality in the context of that particular claim, so that additional citations may be needed to support this claim, citations that are not given at the end of the paragraph.

So, in my opinion, suggesting additional citations by adding the "citation needed" template is a way to improve the article. In my opinion, additions of such requests should not be reverted even in cases when subsequent sentences have this statement. In the particular case that we had, the source at "StatPearls" was probably not good enough, so that additional sources might have been needed. Such requests should be kept. If such requests are inappropriate, we may first discuss them on a Talk page and then remove them. I prefer to first discuss issues on the Talk page rather than simply removing them unless there is an urgency to revert, such as vandalism or the addition of unsourced information to a biography of a living person.

As I already mentioned, Whywhenwhohow pointed out that Wikipedia’s medical citation guidelines recommend that "Medical articles should be relatively dense with inline citations, with at least one citation for every paragraph, except for the lead section and paragraphs that summarize other cited material". Still, this "at least" statement should not be extensively applied. This is because medical information is subject to frequent change and scrutiny, and requires high-quality sources to ensure accuracy and reliability. Therefore, the guidelines also suggest that "Citations should be placed at the end of the sentence or clause that they support, and should not be placed at the end of a paragraph unless they support the entire paragraph". In our case, my understanding is that the application of Tea with toast of these rules was correct. This requirement to put citations to the end of a sentence or clause that they support is to avoid confusion and ambiguity about which source supports which claim and to make it easier for readers and editors to verify the information. Maxim Masiutin (talk) 09:22, 29 January 2024 (UTC)

Conclusion in the section Modafinil#Cognitive enhancement

Hello, Zefr!

I would like to discuss conclusion in the section Modafinil#Cognitive enhancement. In particular, I am concerned about your edit where you, among other, deleted a conclusion about cognitive enhancement. I agree with that edit in most part except the deletion of the following paragraph: "Despite initial optimism, modafinil's potential to improve cognitive function in healthy individuals and those with post-chemotherapy cognitive impairment remains uncertain due to mixed and inconclusive research results. Current evidence implies that modafinil may not be significantly effective as a cognitive enhancer for non-sleep-deprived individuals."

I read on Wikipedia rules that Wikipedia should not be a catalog of results of particular studies, even meta-analysis studies and review studies. According to these rules, it should be stated and generalized what did these studies found, rather than merely explaining that study X found Y. I tried to make such a conclusion, but you deleted it. Would you mind writing a different conclusion? I found many articles in Wikipedia when there is a long list of study results, so my head messes up and I cannot understand the final point. That's why the rules prescribe to write a summary of what these studies found, without explicitly referring to any particular study, still, they have to be properly cited. That's why I written such a conclusion, because I found such enumeration of studies inappropriate. Still, I didn't dare to delete that long enumeration. So I thought that a conclusion would resolve the issue.

I understand that you may have a different perspective on how to summarize the research on modafinil as a cognitive enhancer. However, I think that deleting the conclusion entirely is not the best way to present the information to the readers. By deleting the conclusion, you are leaving the section with a list of studies that may not be easy to follow or understand for the average reader. A conclusion would help to synthesize the main findings and implications of the research, and provide a clear and concise message to the reader.

Therefore, I kindly request you to reconsider your edit and either restore the conclusion that I wrote or write a new one that reflects the current state of the research. I think that this would improve the quality and readability of the article, and adhere to the Wikipedia policies and guidelines on summarizing research. Maxim Masiutin (talk) 14:00, 29 January 2024 (UTC)

Concerning the last paragraph of this section, there is no reason to state there was "initial optimism", as that is original research and is inaccurate - no reputable review stated that perspective.

Further: 1) the use of modafinil in people who received chemotherapy should not be discussed because a) the source is an outdated (2011) opinion article, and b) the article found it was not different than placebo anyway - as this is not worth mentioning, I removed it.

2) the other two sources in the paragraph, here and here are already discussed and dismissive of any significant modafinil effect. I see no justification to expand discussion of such negative results. Zefr (talk) 16:40, 29 January 2024 (UTC)

Thank you for your opinion. What do you think on this: https://en.wikipedia.org/w/index.php?title=Talk%3AModafinil&diff=1200505802&oldid=1200494156 ? Maxim Masiutin (talk) 17:13, 29 January 2024 (UTC)

I rewritten the summary of the studies to present the findings in such a way that the results of the reviews are not contradictory. Can you please review the section now? Maxim Masiutin (talk) 09:44, 30 January 2024 (UTC)

@Zefr: For example, a 2020 review found that modafinil had a small, positive effect on memory updating, whereas a 2019 review on mental function in healthy, non-sleep-deprived people found that the drug did not improve cognitive function in non-sleep-deprived persons. Did these reviews contradit each other? Besides that, a 2015 review found whilst most studies employing basic testing paradigms show that modafinil intake enhances executive function, only half show improvements in attention and learning and memory, and a few even report impairments in divergent creative thinking. In contrast, when more complex assessments are used, modafinil appears to consistently engender enhancement of attention. Question is, did 2020 review evaluate "complex assessments" or "basic testing paradigms" to figure out positive effect on memory updating? We should make a summary of all this. Maxim Masiutin (talk) 17:12, 29 January 2024 (UTC)

If there's a review summarizing what you state, then that should be used rather than a user doing the editorializing. Zefr (talk) 17:17, 29 January 2024 (UTC)

OK, I will think on what can we do with that, let us keep it as is for now. Thank you for your help in editing. Maxim Masiutin (talk) 17:30, 29 January 2024 (UTC)

Thank you for your trimming. I am OK with the trimmed versions, as long as the sections are not deleted altogether. Maxim Masiutin (talk) 11:25, 2 February 2024 (UTC)

Inflammation

@Zefr: You also deleted the "Inflammation" subsection from the "Research directions" section via this edit: https://en.wikipedia.org/w/index.php?title=Modafinil&diff=1199334323&oldid=1199332564

As a reason for deletion, you specified "speculation from primary research". However, the articles cited in that subsection, such as PMID 32311496, PMID 34794237, PMID 37864981 were systematic reviews and meta-analysys, they were not primary research as you mentioned. These articles correctly described the current research directions of anti-inflammatory properties of modafinil.

Please consider restoring this information. Maxim Masiutin (talk) 17:19, 29 January 2024 (UTC)

You do not need to ping me for every discussion issue - obviously, I'm watching the article and talk page.

The brain or liver "anti-inflammatory" hypothesis for modafanil seems quite preposterous as the 3 sources are based on animal or in vitro models, preliminary human studies, and admission that the concept is "controversial and far from conclusive." No WP:MEDRS review supports such an idea. Zefr (talk) 17:38, 29 January 2024 (UTC)

@Zefr I understand that these anti-inflammatory properties are not proven, but these reviews believe that such properties are woth analyzing. When we are in a Research Direction section, we should mention topics of current research if these topics are touched by significant sources, such as the reviews I cited, we should also mention that this is an area of research. And sorry for the pings. What do you think if we mention it as research area, in a way it was mentioned in a subsection that you deleted, or in some other way? Do you have access to the full text of all the eorks cited in that deleted section? Maxim Masiutin (talk) 19:13, 29 January 2024 (UTC)

oops, sorry again: when I clicked Reply, it automatically put a Wikilink that pings. I will have to be careful and manually delete it. Maxim Masiutin (talk) 19:21, 29 January 2024 (UTC)

Still, this is an area of ongoing research direction. Can you please restore this section somehow, maybe with different content? Maxim Masiutin (talk) 09:41, 30 January 2024 (UTC)

Zefr, I wanted to ask you to not make substantial deletions or otherwise substantial edits while the article is in the GA review, because such edits may trigger violation of GA crriteria 5 (Stable: it does not change significantly from day to day because of an ongoing edit war or content dispute) (WP:GACR). If you think that some information is inappropriate, please comment at Talk:Modafinil/GA2 about that information instead of deleting this information. Insect.eate - thank you for keeping an eye on the page and that you reintroduced deleted content at at this edit. Maxim Masiutin (talk) 07:30, 1 February 2024 (UTC)

You seem to be more motivated to check off GA status than to provide a concise, review-sourced article.

This edit was justified because the prior content was leading the reader with conjecture and synthesis from loosely-related primary research - if a source reviews lab studies, it is still a weak source for an encyclopedia.

I would prefer nothing is said about possible anti-inflammatory activity because it is just a projection of possible effects from what can be interpreted as an experimentally "dirty" drug on diverse neuronal targets as studied in the lab, disabling understanding of an anti-disease property in humans. The available literature is far too premature for encyclopedic content. Zefr (talk) 17:58, 1 February 2024 (UTC)

I am OK with the current concise version of the inflammation section, as soon is inflammation is mentioned at all in the research directions. I saw many primary studies on animals and cell cultures, so I think it is worth mentioning. Maxim Masiutin (talk) 11:18, 2 February 2024 (UTC)

Pharmacodynamics section

This trimming was justified because the existing content and sources are from basic lab research, leading to jargon-filled conjecture and synthesis of possible modafinil effects. The remaining content is mostly consistent with the 2023 Greenblatt summary which is really all we need to say and source, as it is concise and relatively easy to follow for the general, non-science encyclopedia user.

The pharmacodynamics section should follow the MEDMOS guide about "writing for the wrong audience": it is not a comprehensive medical or pharmaceutical resource. Zefr (talk) 17:23, 1 February 2024 (UTC)

Zefr, I think it is really important to distinquish between the level of evidence required to determine if a drug works (review articles of human clinical trials) vs. how a drug works. The later is normally relies on lab/animal studies, not human studies. Invasive human clinical trials to determine mechanism are not ethical. I agree with you that it is not permissible to imply efficacy in humans based on laboratory studies. But that is not was done here. Efficacy has been supported with MEDRS compliant sources. The mechanism of how it works has not been completely worked out. Discussing leading theories of how it works is fair game. We should always strive to make articles understandable to a wide auidence. But the pharmacodynamics section is inherently technical, so writing it in a technical manner is somewhat unavoidable. Boghog (talk) 17:44, 1 February 2024 (UTC)

Sources in the lede

I disagree with the opinion behind this revert. The lede "is the first thing most people will read upon arriving at an article, and may be the only portion of the article that they read."

For a drug widely misunderstood and misused particularly by young adults, it would be useful to have concise, lay-friendly reviews in the lede, such as MedlinePlus, Drugs.com, or the Greenblatt summary. Zefr (talk) 17:40, 1 February 2024 (UTC)

Thank you for discussing that on the talk page. I agree with that edit on substance, but can you please not add references (citations) to the lead section to keep it clean and easy to read? and make sure instead that the claims that made in the lead are duplicated in the body with correct. I will add a substituted template "Leadcite comment" for future information for the editors. it is common for citations to appear in the body and not the lead, see WP:MOSLEAD and MOS:LEADCITE. Can you please do the edit, but without adding citations to the lead, and make sure the information is present in the body and is cited in the body? Thank you! Maxim Masiutin (talk) 11:16, 2 February 2024 (UTC)

Pretty much every sentence in a medical article, including the lead, should have a citation. Readers should not have to search for relevant text or relevant citations within the document. Please see discussions about citations at WT:MED, WP:MEDMOS, WP:MEDRS, and WP:MEDCITE. -- Whywhenwhohow (talk) 22:50, 2 February 2024 (UTC)

@Whywhenwhohow I read discussions about citations that you mentioned but there wasn't mentioned anything specific about the lead. Maxim Masiutin (talk) 05:50, 3 February 2024 (UTC)

Medical articles should be dense with citations and that includes the lead. WP:MEDCITE has a section about citations in the lead. MOS:LEADCITE states Complex, current, or controversial subjects may require many citations. Please get consenus at WT:MED before removing citations from the lead of medical articles. --Whywhenwhohow (talk) 05:59, 3 February 2024 (UTC)

@Whywhenwhohow this essay you refer doesn't aim to mandate a rule, it describes a use case; the information in the lead section of modafinil is not complex or controversial, it is mostly the same as can be found in a leaflet (monograph). Anyway, you try to misinterpret the rule and mandate your understanding of the rules. Maxim Masiutin (talk) 10:36, 3 February 2024 (UTC)

There is no logical reason not to have general references in the lede to aid users who may be doing a quick check on what modafinil is and what reputable consumer sources say about it. Also, the current lede does not adequately highlight the potential adverse effects and interactions with prescription drugs, warnings for existing clinical conditions, or overdosing. Proceeding with an edit. Zefr (talk) 19:43, 3 February 2024 (UTC)

Can you please also add the reference to the last paragraph at the lede, that ends with "cognitive functions? If you wish the lead had reference, than the reference use in the lead has to be consistent, you should not expect other people continue a change that you begun over an otherwise valid page (when the rules give options). Maxim Masiutin (talk) 17:48, 4 February 2024 (UTC)

I've added the missing references to the lead Maxim Masiutin (talk) 15:10, 5 February 2024 (UTC)

"It is classified as an eugeroic (a wakefulness-promoting drug) rather than a classical psychostimulant due to its lack of euphoric effects." This statement was removed from the lede because modafinil does have euphoric properties, according to the DailyMed (under Drug Abuse) and the monograph under Abuse and Misuse Potential. Zefr (talk) 17:30, 5 February 2024 (UTC)

Thank you for pointing that out. I also re-read the review studies and found out that they don't completely rule out euphoric effects, they mention that the euphoric effect in modafinil exists, but it is lower than in classical stimulants such as cocaine or amphetamine. I modified the section "Addiction and dependence" and "Sleep disorders", mentioning that modafinil has euphoric effects, albeit to a lower degree than classical stimulants. Maxim Masiutin (talk) 18:33, 5 February 2024 (UTC)

Small clarifications for general audience who are not health care practitioners

I tried to make the text to understand for the general audience as much as possible, and tried to use simple terms whenever possible. When I could not find a simple term, I wrote short explanations. For example, there were an explanation "CPAP is a device that is used during sleep to deliver pressurized air into the nose and mouth to keep airways open and prevent breathing interruptions."

It is easier to read the text when there are the explanations, rather than clicking hyperlinks.

The user Whywhenwhohow made some good edits, I like those edits, still, one of the edits deleted this explanation.

Whywhenwhohow: can you please restore that explanation, or, if you think that it is too long, add a shorter explanation on what is CPAP? Maxim Masiutin (talk) 12:51, 8 February 2024 (UTC)

age restrictions

@Whywhenwhohow: Regarding your revert here, I looked over the references you added and can't find anything about age limits. I believe you, don't get me wrong, I'm just a bit confused. I originally removed the sentence because I interpreted "age limits" to mean restrictions similar to how there are age restrictions on the purchase of alcohol or tobacco in most countries, which wouldn't make sense for a drug that requires a prescription to begin with. I found this reference which states "PROVIGIL is not approved for use in children for any medical condition", however my understanding is that physicians can still choose to prescribe the drug off-label to patients of any age, similar to how lamotrigine is frequently prescribed off-label for a wide range of conditions. I also found this source that says "Children under 16 years old: not recommended". Note "not recommended" does not mean "completely prohibited". Are you aware of a specific law or regulation that specifically prohibits the prescription of modafinil to patients under 17 or 18 or whatever age? I think the sentence at least needs rewording, to avoid others having the same misconception that I had, that sales were age restricted in a way analogous to alcohol or tobacco.

Also, may I kindly request that when reverting an edit due to a problem with a portion of that edit, that you instead only revert the specific part of the edit that you disagree with, instead of the entire edit? As I mentioned in the edit summary, I was doing two things: I was removing the sentence about "age limits", and also "updating terminology". I assume you have no objections to the latter portion of my edit, as you took part in the relevant discussion and didn't raise any objection to me making those types of changes. (for example, a quote from you: "I think your next step is to copyedit a dozen articles. Aside from improving the articles, it would let you know if your ideas about improvement will scare up any opposition (I don't expect any)." I'm going to go ahead and re-do that portion of the edit I made. In the mean time, could you please let me know what your thoughts are about rewording the sentence about age limits to avoid others misinterpreting it in the way that I did?

Thank you! Vontheri (talk) 20:34, 28 February 2024 (UTC)

I apologize, I just realized that I had you confused with another editor! When I said you had participated in the previous discussion and I quoted you, I was actually referring to @WhatamIdoing. You have similar names, both are similar lengths and multiple words and both start with "W". This entire time I thought you were the same person! Very sorry! Vontheri (talk) 20:50, 28 February 2024 (UTC)

I agree with you about partial roolbacks. In the https://en.wikipedia.org/w/index.php?title=Modafinil&diff=1211018837&oldid=1210884185 I didn't find any part that could be kept. Maxim Masiutin (talk) 12:32, 29 February 2024 (UTC)

Did you see where that type of terminology (such as oral/by mouth) has been discussed previously? My preference was for "oral". Saying "oral administration (swallowed by mouth)" was agreed on as a compromise. Same goes for similar terms such as "intramuscular (injection into a vein).

I am adding "if taken during or two months prior to pregnancy." to the part about "harm to the fetus", as otherwise it sounds as though it is only harmful during pregnancy.

And by the way, I removed "broken down", not added it, so you were restoring (rather than reverting) my edit when you made that change.

Regardless, my primary concern was regarding the sentence about "age limits", as though it is certainly possible this exists in some country, I at least can't find anything confirming this for the United States. I do see references saying it is not approved for use in children, but nothing saying the prescribing of it to children is specifically restricted. Doctors prescribe drugs off label all the time, including prescribing drugs to children that have only been approved for use in adults. I can't find any source (including the ones @Whywhenwhohow found) that says anything about Modafinil being a special case in this regards. There certainly are specific medications that are restricted in specific ways. For example, if buprenorphine is prescribed as maintenance therapy for opioid addiction, it may only be legally prescribed by a physician who has undergone a specific certification (although any physician is free to legally prescribe buprenotprhine to other patients for other reasons, such as for pain control.) Perhaps modafinil has a similar specific restriction on prescribing it to children, but I can't find any evidence of this anywhere. Vontheri (talk) 18:09, 29 February 2024 (UTC)

I also found this source from the Mayo Clinic that implies it can be prescribed to children. Quote "Teenagers and children younger than 17 years of age—Use and dose must be determined by your doctor." Vontheri (talk) 18:25, 29 February 2024 (UTC)

I am not sure whether Mayo Clinic is a reliable source, let us experience colleague editors let us know. Maxim Masiutin (talk) 18:30, 29 February 2024 (UTC)

Thank you very much for your edits. I think that the age limit is a sensitive topic. If FDA does not approve it for children, that we should not imply that the doctors may prescribe it off-label. Maxim Masiutin (talk) 18:32, 29 February 2024 (UTC)

Sure, but we should also not say something that is not true and say that there are "age limits" that specifically prevent it from being prescribed to children. How would you feel about changing the sentence to something like "Modafinil is not FDA approved for use in children and teenagers under age 17"? Vontheri (talk) 18:48, 29 February 2024 (UTC)

@Vontheri that should probably be ok. Maxim Masiutin (talk) 22:10, 29 February 2024 (UTC)

I suggest using '... for use in people under age 17' in that sentence.

In addition, the off-label use may be restricted in some countries. --Whywhenwhohow (talk) 22:45, 29 February 2024 (UTC)

@Whywhenwhohow "some countries" may attract Maxim Masiutin (talk) 22:49, 29 February 2024 (UTC)

For example, France has restrictions on off-label use.

https://www.insideeulifesciences.com/2021/07/06/new-early-access-and-off-label-use-rules-in-france/

-- Whywhenwhohow (talk) 22:53, 29 February 2024 (UTC)

That is much better! :-) Maxim Masiutin (talk) 23:20, 29 February 2024 (UTC)

FYI, some more on off-label.

https://jaapl.org/content/early/2020/11/24/JAAPL.200049-20

https://www.morganlewis.com/pubs/2023/10/fda-issues-draft-guidance-on-off-label-statements-a-new-frontier-or-acknowledgement-of-the-status-quo

https://www.dechert.com/knowledge/onpoint/2021/8/fda-issues--final-rule--on-drug-and-medical-device-marketing.html

-- Whywhenwhohow (talk) 23:32, 29 February 2024 (UTC)

@Whywhenwhohow great findings! that's why I eas so concerned about promoting off-label use Maxim Masiutin (talk) 23:34, 29 February 2024 (UTC)

I'm changing the sentence to "Modafinil is not FDA approved for use in people under age 17." Of course, the situation may be different in France or other countries that don't recognize FDA approval (some small countries that don't have their own FDA/EMA equivalent also recognize FDA approval, so it doesn't apply only to the U.S.), so I'll leave information about non-FDA-following (such as France) countries for someone else who is familiar with those countries' policies on pediatric use of modafinil or off-label use of drugs in general.

The specific reason it was not approved by the FDA for pediatric use was because of an increased risk in that population of Stevens–Johnson syndrome after taking modafinil. source (I would add that part the the article too, but Citer keeps giving me an error message for some reason, and I'm too tired at the moment to fill out the whole citation manually... there's probably a better reference that is more WP:MEDMOS-style for the same information out there, anyway.)

And by the way, nothing I said or was proposing to say was intended to be promoting off-label use, only recognizing the reality that it does occur and is, except in a few specific circumstances, completely legal. What is illegal (in the United States) is for drug manufacturers to advertise, market, or otherwise encourage off-label use of their drugs. Vontheri (talk) 01:33, 1 March 2024 (UTC)

You can just fill DOI and title and I will keep the rest via the Wikipedia:Citation expander. As for the substance, I would defer to my colleagues to come up with the opinion. Maxim Masiutin (talk) 01:56, 1 March 2024 (UTC)

I will do that later when I have more time.

Sorry, I don't understand, what substance are you referring to? And opinion about what? Vontheri (talk) 03:08, 1 March 2024 (UTC)

@Vontheri I mean the essence of the issue. Maxim Masiutin (talk) 03:10, 1 March 2024 (UTC)

Of which issue? Sorry, I'm not trying to be difficult, I just honestly don't understand what you mean.Vontheri (talk) 03:13, 1 March 2024 (UTC)

@Vontheri I mean I did only express my intention to expand the citation you mentioned without expressing any opinion about the context around the citation. Maxim Masiutin (talk) 03:15, 1 March 2024 (UTC)

Oh okay, I think I understand now. I thought by "substance" you meant the definition of the word that is "drug" or "medication", thus my confusion. Vontheri (talk) 03:17, 1 March 2024 (UTC)

@Vontheri there are 6 citations after the sentence about age in the lead, could you please keep at most 2-3 best sources? Maxim Masiutin (talk) 03:00, 1 March 2024 (UTC)

Whywhenwhohow added those 6 citations, not me. I didn't remove any because I thought he should be the one to decide which to keep or not since he is the one who added them. Vontheri (talk) 03:06, 1 March 2024 (UTC)

@Vontheri ok, thank you for letting me know. Maxim Masiutin (talk) 03:11, 1 March 2024 (UTC)

@Vontheri I agree with you. Maxim Masiutin (talk) 03:11, 1 March 2024 (UTC)

Parkinson's disease

Apparently modafinil has been used to treat excessive daytime sleepiness in Parkinson's. Could somebody competent add a section about this please? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4252229/ 92.239.195.55 (talk) 17:50, 16 March 2024 (UTC)

There is too little information, there was one small controlled trial of 19 adult patients. We need more, bigger controlled trials to appear and wait for a review or a meta-analysis on these trials, see WP:MEDRS for more details on the procedure. Maxim Masiutin (talk) 22:00, 18 March 2024 (UTC)