In 2003, David Plotz, a busy writer and father of a toddler, was feeling sleep-deprived and run-down. Unable to catch up on rest, he searched for a solution other than sleep that might improve his performance on both the home and career fronts.
He began taking modafinil, a drug developed in France and approved by the Food and Drug Administration in 1998 to treat narcolepsy or daytime sleepiness. Modafinil is a memory-improving and mood-brightening psycho stimulant that enhances wakefulness -- not unlike cocaine or amphetamines.
Sleep-deprived groups ranging from truck drivers to the military have experimented with modafinil, marketed for nearly a decade by Cephalon under what Plotz calls the "creepy, pharma-Orwellian" name Provigil.
Military officials have found it so effective that some now refer to it as a "super drug." But its off-label uses have created a rich debate on how far to push the limits of the human body.
For Plotz, the results were immediate.
"I am the picture of vivacity," he wrote on Slate.com.
Even with only five hours sleep, he could write twice as fast and felt alert.
"I have a desperate urge to write, to make reporting calls and to finish my expense account – activities I religiously avoid," he wrote. "I find myself talking loudly and quickly. A colleague says I am grinning like a 'feral chipmunk.'"
But Plotz ended the experiment after three days, in part because it was so effective. He was worried that he would one day stash pills, scour the Internet for discounts and become addicted to a life of high energy.
Despite his concerns, Plotz never did quit using Provigil. He restocked his supply and uses it twice a year for long-distance drives or bouncing back after a period of little sleep.
"The drug is fantastic," Plotz, now acting editor at Slate.com, told ABC News. "I am my best self. I just feel alert -- at the time period where you feel yourself to be at your sharpest and wittiest and your brain clicks."
A seemingly perfect stimulant, clinical trials found modafinil to be less likely than amphetamines to cause jitteriness or anxiety or have a "rebound" or "crash" effect. And because it does not produce a "high," it has never become a street drug, according to the New York University Sleep Center.
Tired and frenetic Americans are asking their doctors for more and more modafinil prescriptions, and college students have embraced the super drug for all-night study sessions.
In 2006, annual sales of modafinil were nearly $600 million, about one-third of Cephalon's earnings, according to the company's annual report. And about 90 percent of those sales are for off-label uses.
Doctors prescribe the drug to truck drivers, shift workers and people who experience disorders like sleep apnea. Other experimental uses of the drug are for Alzheimer's disease and for depressives who sleep or eat too much. Some suggest it might be useful for jet lag.
"The temptation for healthy people to use such a drug is tremendous," said Jonathan D. Moreno, a biomedical ethics professor at the University of Pennsylvania who wrote an article about military experiments on mental fatigue called "Juicing the Brain" in the November 2006 issue of Scientific American.
"Frequent flyers get prescriptions for the stuff, and it is sure to be the next craze on college campuses among students who want to pull all-nighters or just be able to party hardy for days."