Modalert 200 mg affects dopamine, norepinephrine, and histamine, not cortisol. The adrenal glands produce cortisol in reaction to stress, which controls metabolism, immunological response, and inflammation. While modafinil increases wakefulness and alertness via increasing dopamine transmission, its impact on cortisol is unclear. Some research show that modafinil's stimulant-like characteristics may indirectly increase cortisol release, causing a stress response. Only little and inconsistent data supports modafinil's direct effect on cortisol levels. Individual modafinil reactions vary. Stimulants raise alertness and excitement, which may temporarily raise cortisol. Except when modafinil is misused, this rise seldom lasts. Modafinil, like any medicine, should be used as recommended and monitored for side effects. A doctor can help you manage cortisol levels and modafinil's effects.