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It is known to increase the activity of dopamine (particularly in the prefrontal cortex), norepinephrine, and histamine, while also influencing orexin (hypocretin) and glutamate systems. This risk is so well-established that modafinil is generally contraindicated for people with a history of bipolar disorder unless under the most careful and closely monitored circumstances by a psychiatrist who is actively managing the condition with mood stabilizers. Crushing tablets, however, is dangerous and strongly discouraged, as it is often a step toward insufflation (snorting), which damages nasal tissues and leads to rapid, unpredictable absorption and increased risk of adverse effects.
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