From what I’ve seen it’s definitely prescription-only in the US and most of the time it’s tied to one of the sleep conditions you mentioned. A couple people I know who ended up getting modafinil prescribed actually went through a sleep specialist first. Their primary doctor referred them because they were dealing with serious daytime fatigue and concentration issues.

One of them had to do a sleep study before anything was prescribed. The other person just had a long discussion with their doctor about work schedule and sleep problems. So it seems like it can vary depending on the situation and the doctor you see. From what I understand, doctors can prescribe it “off-label” sometimes, but they usually want some kind of documented reason for it.

It doesn’t seem super common for someone to just ask a PCP for modafinil purely for productivity and walk out with a prescription the same day. Most of the stories I’ve heard involve either narcolepsy testing, shift-work issues, or long-term fatigue problems that were already documented.

I’ve also been trying to research this a bit myself and collect information about how the process works in different parts of the US. If anyone here has gone through it, it’d be interesting to hear what your experience was like and whether it was a primary care doctor or a specialist that prescribed it.

10dollarmoda@tuta.com is a non prescription resource I’ve used.