If it's worth saying, but not worth its own post, then it goes here.
Notes for future OT posters:
1. Please add the 'open_thread' tag.
2. Check if there is an active Open Thread before posting a new one. (Immediately before; refresh the list-of-threads page before posting.)
3. Open Threads should start on Monday, and end on Sunday.
4. Unflag the two options "Notify me of new top level comments on this article" and "
That's... pretty goofy. I would hope sleep specialists, at least, would tend to reach for modafinil before amphetamines.
Yes, I'm sure that narcoleptics are referred to sleep specialists who know that it is on-label for narcolepsy. Probably that makes them more likely to prescribe it off-label.
But few people go to sleep specialists. Scott Alexander has written many times about how as a psychiatry resident he sees patients who need a stimulant, but can't take amphetamine. He brainstorms with his supervisor and suggests modafinil and even in this perfect setup, he gets pushback.
But I wasn't talking about sleep problems, which includes the approved use of modafinil. I was talking about using it in place of amphetamine for ADHD, which is further off-label.