The doctors noted that such pills are usually not available without prescriptions, but were being procured through unauthorised channels.
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Students try various methods to ward off sleep as they prepare for exams. Downing copious amounts of coffee, walking while reading, and even dipping their feet in cold water are some of the few ‘solutions’ that many have tried.
Prajakta Swarup, a Class 10 student in Lucknow, Uttar Pradesh, took it too far. The girl tried what she considered a sure-shot method to keep the midnight oil burning.
The drastic step made her parents rush her to a hospital — where she was put under intensive care — after she had collapsed at home. The parents later found a bottle of pills in her drawer.
Doctors identified the pill, a potent combination of the stimulant modafinil that could keep the user awake for up to 40 hours at a stretch.
In Swarup’s case, it led to a clot in her brain that caused the swelling of nerves. She had to undergo brain surgery to remove the clot.
She now seems to have learnt a lesson — something many of her peers, too, could take note of.
The incident led to doctors warning students against such practices and calling for reliance only on healthier study practices and stress management techniques to ensure their well-being during exams.
As per reports, Swarup had been staying up all night to prepare for her board examinations, even as her mother kept supplying her with coffee to help her stay awake throughout the night.
Last week, she collapsed at her residence. When taken to a hospital, she was diagnosed with a clot in her brain that had led to the swelling of nerves, even as her parents found the pills.
Expressing ignorance of the particular case, Dr Mahesh Gowda, a Bengaluru-based psychiatrist explained to South First about the medication.
“These pills contain a potent combination of the stimulant modafinil, which are known to keep individuals awake for up to 40 hours at a stretch. They are prescription drugs, which do have the possibility of abuse,” said Dr Gowda, who is also the founder of the Spandana Mental Health Rehabilitation Centre in Bengaluru.
Reports said many students are turning to anti-sleep drugs during the ongoing CBSE board exams to stay up late and study, and this is disrupting their sleep cycles.
These students are also increasing their caffeine intake through tea or coffee. This unhealthy lifestyle is negatively impacting their health, raising questions about the legality of these drugs, stated the reports.
Leading neurosurgeon Dr Sharad Srivastava told news agency IANS about the case, “Shocking though it may sound, an increasing number of students today are taking these anti-sleep pills that help them stay awake during examinations.”
He added that these drugs were being sold over the counter under names like chuniya and meethi, and were being smuggled from countries like Thailand.
Dr Gowda provided insights into the nature of anti-sleep medications, noting that they were often used for purposes enhancing focus and concentration, and reducing the need for sleep — particularly during exam preparations.
These medications fall into the category of stimulants, with methylphenidate being a commonly used example in India.
“Methylphenidate is typically prescribed to children with hyperactivity disorders who struggle with focusing. It is a controlled substance, intended for specific medical conditions,” explained Dr Gowda.
Despite not being recommended for exam preparation, many individuals have reported benefits from its use in maintaining concentration, reducing daytime sleepiness, and promoting wakefulness.
However, it is primarily intended for those diagnosed with attention deficit disorders, such as ADHD, to stay awake and read well rather than for enhancing study capabilities in the general population.
Originally developed for narcolepsy patients, modafinil has found a secondary consumer base among those seeking to improve focus.
It is regulated as a prescription-only medication in India. Nonetheless, doctors said individuals seeking its cognitive or wakefulness benefits often resort to procuring it through unauthorised channels.
Some reports said the drug with modafinil that the girl had taken was known to improve memory, mood, alertness, and cognitive abilities. When combined with high doses of caffeine, the reactions could be quite adverse.
Dr Venkateshwaran R, a consultant of child and adolescent psychiatry at Apollo Hosptial in Chennai, told South First that caffeine itself was a stimulant and all stimulants were known to increase blood pressure.
If caffeine was combined with another stimulant like modafinil, it could be even more dangerous, he said.
Doctors claimed that modafinil helped users stay awake for 20-30 hours or more at a stretch.
Modafinil was acclaimed for its potential to enhance cognitive function, particularly in those lacking sleep, and was believed to sustain wakefulness and alertness over extended periods.
“We prescribe modafinil once in the morning for some people who have met with accidents or have brain damage resulting in disturbed sleep, drowsiness, and sleep-reversal patterns — where they sleep in the morning and are awake at night — and that too after thorough investigations,” explained Dr Sudhir Kumar, a neurologist at the Apollo Hospitals in Hyderabad.
Dr Venkateshwaran said the use of stimulant drugs was specifically high in universities in the UK and the US. Several studies have also been conducted on the use of these drugs.
He stated that the misuse of stimulants was considered a form of drug abuse — similar to that of cannabis, opioids, and alcohol, leading to addiction.
He explained that the medications prescribed for ADHD and hypersomnia, where individuals experience morning drowsiness, are administered under strict medical supervision, including initial health assessments.
Dr Venkateshwaran warned that consuming these substances without a prescription or proper medical evaluation could be extremely hazardous.
Dr Gowda concurred. “Taking medications without a prescription is tantamount to abuse,” he cautioned.
“While many aspire to stay awake and study for exams, it’s essential to understand that the brain requires six to eight hours of sleep and rest for optimal recovery and memory retention. Neglecting necessary rest could lead to abuse,” he further said.
Dr Gowda warned of the potential consequences, “Sleep deprivation can induce seizures, especially in those who are susceptible, as it may cause the brain to become overly active. Furthermore, such practices often lead to poor eating habits.”
On the topic of habit-forming drugs, Dr Gowda explained, “The enhanced focus and concentration these drugs provide can be addictive, leading to substance abuse.”
“While there are numerous instances of abuse overseas, it’s worth noting that in India, stringent laws prevent the over-the-counter sale of these substances,” he added.
“Lack of sleep is itself a risk factor for strokes. For students aiming to excel in exams, burning the midnight oil is not a viable strategy due to a process known as memory consolidation that occurs in the brain,” Dr Kumar noted,
“The brain needs to transfer what we learn into long-term storage, and this process only happens during sleep,” he said.
“A student who forgoes sleep for an entire night might find themselves unable to recall the studied material when faced with the exam paper the next day,” the neurologist added.
Dr Kumar emphasised the importance of consistency in study habits. “Instead of cramming for 18 hours a day in the last two months before exams, dedicate two hours daily to your studies,” he advised.
“Ensure adequate sleep and maintain healthy habits and lifestyle,” he revealed the secret to success.
Neha Cadabam, Psychologist and Executive Director at Cadabams Hospitals, recommended certain healthy study practices:
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