I am clueless on the pharmacy angle, but I have tons of tricks that I use to keep myself alert while driving. Yea, that falling asleep at the wheel thing is --and should be-- terrifying. A few seconds more than enough time to make a gnasty vehicle accident.

My tricks include:

* Carry a cup of ice and rub my face and neck with a piece of it when I feel the nods coming on.
* Sitting forward in my seat so that my back is not touching the seat.
* Singing while I drive, keeping rhythms and beats on the steering wheel and dashboard.
* Putting the car in park at a stop light and/or pulling over to walk around the car.
* Parking in a safe spot for a power nap. On my super sleepy days, I pause for a power nap before I even start the engine. Power naps --just giving in to the nods for a few minutes-- get me through allot of tough squeezes.

I agree with all of arfie's driving tips. If I pull over to grab a nap I often won't actually go to sleep but in the process of pulling over, safely parking, etc I am stimulated or distracted enough to feel revived. I'm 100% for pulling over, walking one lap around your car and starting right backcourt down the road. Sometimes feeling alert is a little delayed instead of instant but it does happen. Whatever you do just please try not to put yourself or others in danger. Best wishes to you!

Also, avoid driving into the sun. I prefer night driving to daytime but then it's not as safe to pull over.

I don't drive. All of the other narcoleptic that I have personally met drive, and have totaled 2 or more cars each. And... they still drive. Ok, folks so you know how we (narcoleptics) wreck, right? We fall asleep on the accelerator. Yea... not worth it. Even if you survive, what if you hurt someone else?
OK caveat, sometimes there is no choice. (I do understand this.) For me though - I use public transportation, family, and disabled services.

Second thought, do you take naps? I try to nap every 4-5 hours. When I was first diagnosed, they gave me something and kept upping the dose... that never helped. My life did not improve until I broke down and admitted I still need nappy time like the kiddos.

I take 250mg of armodafinil. I started at 150mg but noticed the same result you described. My neurologist added 5mg of Ritalin, but I still found it difficult to stay awake in the afternoon. I am titrating up to 30mg spaced throughout the day. Perhaps a stimulant to give you the boost you need?

Modafinil & Wellbutrin control probably 70-80% of my EDS, for the rest I do strategic napping, yoga nidra meditation (each 15-30 minute session gives me approximately 3 hours of feeling alert), and I always bring adderall with me on car trips where I'll be driving for more than 20 minutes.

Some states require doctors to report to the DMV if they suspect your symptoms aren't well controlled.

If you are at the point where you need to pull over to take a nap on the side of the road, your N is NOT controlled enough for you to be driving. Get your symptoms under control and plan your trips.

Here is how I plan my trips:

1) for trips longer than an hour, identify rest stops at appropriate intervals (park and ride lots, truck stops, cheap motels) BEFORE your drive. A $60 motel nap is a small price to pay for someone's life. Pro tip: Walmart parking lots have 24/7 lighting and surveillance cameras so you can feel safer than napping at some random rest stop.

2) for long trips, find a second driver to share driving shifts. They can probably handle a 3-hr continuous drive, you can drive for an hour or so to give them some rest so you feel like you're sharing the responsibility not just having them chauffeur you around.

3) Visualize that you are driving with loved ones in the backseat. If you feel symptomatic, ask yourself - "is it worth putting their lives on the line? Or should I take a nap at the Comfort Inn?"

4) Before your drive, take a 15-30 minute nap.

5) keep a bottle of your immediate-release stimulant prescription in your car in a valid and labeled RX bottle. Your pharmacist will be happy to print an extra label for the bottle. Loose amphetamines or Ritalin in your pocket is not something you're going to want to explain to the cop who comes over to investigate why there's someone taking a nap on the shoulder of the highway.

6) Learn yoga nidra. 30 minutes of this deep meditation practice is equivalent to 3 hours of deep sleep. For me, I think it's the only deep sleep I get. An hour of nidra feels amazing and I promote it to every doctor or sleep-deprived person I see.

Using these tips, I have managed to drive for 3-5 hours at a stretch and have even completed longer drives of 10 hours.

Tl;dr
Please, do everyone a favor:
Plan your trips and take the nap BEFORE you drive.

I also have Narcolepsy without Cataplexy. Thankfully, I've never fallen asleep except when I lay down to sleep. I tried Modafinil more recently and I did see any difference. The only thing that really helped me is Xyrem to get restorative sleep. (Before taking Xyrem, I was laying down to sleep pretty much all of the time! As soon I would get home from work & any other time that I could.)

Last Dec. I drove 14 hours, knowing that if I felt the least bit tired to pull off and get a room somewhere. But since I left early I was at my destination before it was too late. I would not try it any other way. The return trip I left early and again no issues. The only other med that has helped me is Adderall but I worry about the long term effects and take it sparingly.

I was also on modiafinil when I first started out on medications. I have a run out of the road and that scared me to death that I stopped driving for a long time. However my mom started making me drive with her and that really helps. I like driving again, however just learn your limits.