HSA issues warning on modafinil, a potent drug used to improve alertness after woman develops severe skin reactions

The woman developed Stevens-Johnson syndrome, a life-threatening skin condition with blistering and severe peeling of the skin after taking the product, Modalert 200. PHOTO: HEALTH SCIENCES AUTHORITY

SINGAPORE - The Health Sciences Authority (HSA) has warned the public against taking modafinil, a potent prescription medicine used to increase one's alertness, which is not registered locally.

This comes after a woman in her 30s developed Stevens-Johnson syndrome (SJS), a life-threatening skin condition with blistering and severe peeling of the skin after taking the product, Modalert 200.

According to a statement by HSA released on Tuesday (Feb 6), the woman took modafinil on alternate days for more than three weeks to increase her alertness as she worked long hours.

She first developed an itchy rash, which subsequently spread to her whole body.

This was followed by severe peeling of her skin, pain in her throat, multiple mouth ulcers and conjunctivitis. She was hospitalised for her condition.

Modafinil is available in some countries as a prescription drug that reduces excessive sleepiness associated with conditions such as narcolepsy, HSA said.

These patients experience excessive daytime sleepiness and they have a tendency to fall asleep suddenly in inappropriate situations.

However, there have been reports of students and adults taking the drug as "cognitive enhancers" to improve focus and memory, HSA added.

The authority warned that self-medication with modafinil for these purposes is not appropriate and could be harmful due to its stimulant effects on the brain.

Other severe side effects include heart problems, hypertension and psychiatric conditions, such as anxiety, hallucinations or mania.

Skin reactions, including SJS, and a more severe form of the condition, such as toxic epidermal necrolysis, have also been reported with the use of modafinil.

These conditions can lead to hospitalisation, serious health complications or even death.

Those who recover may also suffer from long-term side effects such as skin scarring and blindness.

Psychologist Daniel Koh from Insights Mind Centre said there is also a risk of overdose and addiction to the drug.

"With any medicine that stimulates your system... after a while, the body will need higher doses for the same effectiveness," he said, adding that users may suffer from withdrawal symptoms and medical problems if they were to stop taking the drug.

Last June, ST reported that more students, some as young as 16, were using "smart drugs" such as modafinil to obtain better grades.

The report said the drugs could be purchased from a local website, online platforms such as Carousell, and messaging services like Telegram. However, a check on Tuesday found that these online avenues have since been taken down.

HSA advised consumers to be cautious when buying health products from unfamiliar sources, such as online platforms, even if these are recommended by relatives or friends.

The supply and sale of unregistered health products is an offence under the Health Products Act, unless authorised by HSA for use in special circumstances by a doctor for patients under his care, it said.

Those found guilty of supplying or selling unregistered health products may face a fine up to $50,000 or jail term up to two years or both.

Anyone with information on the sale and supply of modafinil from unauthorised sources may contact HSA's enforcement branch on 6866 3485 during office hours or e-mail hsa_is@hsa.gov.sg

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