One undisputed fact is that Modalert raises levels of histamine in the hypothalamus. The scientific consensus is that this acts to increase alertness in a far healthier way than stimulants like amphetamines.
Modalert is known to block reabsorption along the dopamine transport network. This causes an increase in dopamine concentrations outside of neuronal cells, making dopamine better available to the synapses. Certain research also seeks to identify the locus of Modalert’s tablet monoamine activity. The goal is to establish the drug’s interactions with dopamine within the striatum and nucleus accumbens brain regions. Also under investigation is the drug’s activity on serotonin in the amygdala and frontal cortex and also the activity of noradrenaline in the ventrolateral preoptic nucleus and hypothalamus.
A specific mechanism which was studied involved hypocretins, peptides within the brain which are also called orexins. These orexin brain cells are clustered in the hypothalamic region and extend to various other brain regions, not least those which control the sleep-wake cycle.
Triggering these brain areas will boost the levels of available norepinephrine and dopamine, as well as raising histamine availability in the tuberomammillary nucleus. Animal studies conducted on rats have established the fact that Provigil leads to heightened neurological histamine output. It is theorized that such effects apply also to humans.
The human body has two Orexin receptor sites, identified as 1 and 2. When orexin systems are damaged in animals, the effect is to produce symptoms reminiscent of narcolepsy. In such instances, the administration of Modalert tablet reduces these symptoms in animals and boosts their general alertness back toward baseline. It is theorized this occurs via Provigil’s influence on the orexin pathway.