The pick-me-up pill

Provigil (modafinil) is approved by the U.S. Food and Drug Administration only to treat sleep disorders such as narcolepsy (which causes people to fall asleep uncontrollably during the day) and shift-work sleep disruption. But some people are taking it to stay awake and alert when tired or to recover quickly from a time change after traveling. Here, Richard Simon, M.D., medical director of the Kathryn Severyns Dement Sleep Disorders Center in Walla Walla, Wash., answers some questions about this drug.

Q How does Provigil work?

A It acts on areas in the brain having to do with sleep/wake mechanisms. It increases alertness in sleepy individuals, but probably not to normal levels.

Q Can it help with jet lag?

A I'm not aware of any data suggesting it helps one's biologic clock adapt more quickly to time-zone changes. Scientists think there is a "clock" not just in the brain but in other organs, such as the liver; when you cross several time zones, many of these clocks may become out of sync. Provigil relieves sleepiness and fatigue, but does nothing to help other jet-lag symptoms, such as irritability, disorientation and disrupted sleep.

Q Any cautions?

A Provigil has not been sufficiently studied for anything other than the conditions for which it's approved. I would only take it under the direction of a board-certified sleep specialist for approved uses.

To find such a specialist, go to the Web site of the American Board of Sleep Medicine, absm.org/diplomates/listing.htm.

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