Modafinil has been hailed as the first legitimate pharmaceutical nootropic drug. It enhances cognition without the extravagant effects that are often associated with psychostimulants like amphetamine or methylphenidate.
Cognitive performance and mood were disrupted when participants worked the night shift, but modafinil attenuated these disruptions. It also did not affect DSST or BPM activity at doses that were efficacious in improving attention.
How it Works
Developed to treat narcolepsy, modafinil has long been used off-label as a cognitive enhancer in healthy people. Many white-collar workers obtain it and its close relative, armodafinil, off the internet without a prescription. This is problematic, since these drugs have side effects and can be dangerous if they are not taken properly. It is also unclear how these drugs work to improve cognitive function.
Although studies have shown that modafinil 200 mg increases performance in sleep-deprived individuals, few have assessed its effect in well-rested people. The researchers in this study wanted to find out whether modafinil improves cognition in healthy people by testing it on a task that measures attention. They found that modafinil significantly improved attention in humans on the 5C-CPT. This enhancement was driven by a strong trend in increased target detection, but not by decreased false alarm rate or overall response times (Fs(2,58)=1.95, ns; Table 1).
These results suggest that the pro-cognitive effects of modafinil may be independent of its effects on hyperarousal in healthy volunteers. This finding would be a significant advance in understanding how this drug enhances cognitive functioning in healthy people, and might help to guide future efforts to develop more targeted pro-cognitive therapeutics. This could include identifying specific targets in the brain that mediate these effects. Further research will also be needed to determine the specific mechanism through which modafinil improves 5C-CPT performance.
Side Effects
While modafinil enhances productivity in people who are sleep-deprived, it has a variety of side effects in healthy people. These include insomnia, headache, stomach aches and nausea. These side effects are usually mild, but they can be serious if you are taking it for unapproved purposes. In addition, it can become addictive if used regularly.
A growing number of professionals are using nootropics like modafinil to stay ahead in competitive work environments. The use of these drugs in the workplace raises many ethical issues, especially when it is done without a doctor’s prescription. In addition, the use of these drugs can lead to unrealistic expectations of employees and put their health at risk.
Studies show that people who use modafinil to improve their performance often have erratic thinking, which can make it hard to get good answers to complex questions and may cause them to make mistakes that could affect the quality of their work. The drug also has the potential to negatively impact creativity. In a study of healthy participants, modafinil did not increase working memory or the flexibility of thought processes, but it did improve decision-making and planning. The drug is classified as a stimulant and has been banned in competition by the World Anti-Doping Agency, except when it is prescribed to treat narcolepsy. However, the drug is still widely used to enhance performance in athletes without narcolepsy.
Dosage
In clinical trials, Modafinil (Modvigil 200 mg) has been shown to be a potent drug with cognitive enhancing effects in sleep disordered patients. However, to date only a few small studies have examined its effects on cognition in non-sleep disordered subjects. The results have been mixed and a great deal of ethical debate has surrounded the subject.
In one study, both the 200 mg and 400 mg doses of modafinil improved DSST performance relative to placebo during night shift work. However, this study differed from previous investigations in that participants were not trained on the cognitive tasks before participation. This difference could have influenced the results.
Another study found that Modafinil reduced the total number of missed hits and false alarms during DSST testing. The study also found that modafinil increased the number of correct answers on both days of testing. However, the study found no significant difference in tracking speed or reaction time.
The study’s authors suggest that these results are consistent with the notion that modafinil enhances cognition by inhibiting oxidative stress and increasing creatine-phosphocreatine production. They further speculate that the effect of modafinil is mediated by its inhibition of cytochrome c in the mitochondria, which normally transfers electrons from complex III to complex IV to produce water. This activity is known to reduce the amount of reactive oxygen species (ROS) produced by the mitochondrial electron transport chain.
Recommendations
In healthy individuals, modafinil appears to enhance cognitive performance on some tasks, such as the digit span test and delayed matching, but not others (eg, perceptual memory and arithmetic reasoning). One placebo-controlled study found that a 4-day regimen of 200 mg daily modafinil reduced errors on the WCST and Hayling sentence completion task relative to placebo, and also improved performance on divided attention, immediate recall, a version of the digit span test, and the TOL spatial planning task.
In addition, modafinil may increase creatine phosphate and ATP production in the mitochondria. This is thought to occur by blocking the oxidation of L-alanine and inducing a cyclic AMP reaction that leads to the accumulation of amino acids within the cell. Modafinil and its cousin armodafinil are Schedule IV drugs in the United States, and therefore require a prescription to obtain.
