Modafinil, sold under the brand name Provigil among others, is a medication to treat sleepiness due to narcolepsy, shift work sleep disorder, or obstructive sleep apnea(OSA). In OSA continuous positive airway pressure is the preferred treatment when using the drug.
In recent times, it’s been revealed that this may not be the only use for the drug. In fact, it has been revealed it may be useful for cognitive enhancement. “Cognitive enhancement” is commonly associated with drug use or the use of devices to improve cognition, technologies that have on the whole been established in laboratory animals or through a history of use in humans (Dubljevic, 2015). Researchers have found that modafinil boosts higher-order cognitive function without causing serious side effects. Modafinil, which has been primarily prescribed in the U.S. since 1998 to treat sleep-related conditions such as narcolepsy and sleep apnea, heightens alertness much as caffeine does.
A number of studies have suggested that it could provide other cognitive benefits, but results were uneven. To clear up the confusion, researchers then at the University of Oxford analyzed 24 studies published between 1990 and 2014 that specifically looked at how modafinil affects cognition. In their review, which was published in 2015 in European Neuropsychopharmacology, they found that the methods used to evaluate modafinil strongly affected the outcomes. Research that looked at the drug’s effects on the performance of simple tasks–such as pressing a particular button after seeing a certain colour–did not detect many benefits.
Yet studies that asked participants to do complex and difficult tasks after taking modafinil or a placebo found that those who took the drug were more accurate, which suggests that it may affect “higher cognitive functions–mainly executive functions but also attention and learning,” explains study co-author Ruairidh Battleday, now a medical doctor and Ph.D. student at the University of California, Berkeley.
Although many doctors very likely prescribe the drug off-label to help people concentrate–indeed, a 2018 study found that 22 percent of Americans had taken prescription brain-boosting drugs in the past year and that 4.1 percent had used modafinil–trials have not yet been done on modafinil’s long-term effectiveness or safety, so don’t bank on it being your number one option just yet. Studies of the drug have been “carried out in a controlled scientific environment and usually only looked at the effects of a single dose,” explains neuropsychologist and review co-author Anna-Katharine Brem, then at Oxford–so no one yet knows whether it is safe for long-term use in healthy people. Nor is it known whether modafinil might lose its edge with repeated use, a phenomenon familiar to many coffee drinkers.
Side effects are another important consideration. Modafinil has been shown to cause insomnia, headache and stomachache in select users, and some research suggests it could be addictive. Although these kinds of problems may be worth enduring for a drug that treats an illness, “if you don’t have a medical condition, the risks versus benefits change dramatically,” says Sharon Morein-Zamir, a psychologist at the University of Cambridge, who studies ethical considerations associated with the use of cognition-enhancing drugs. “For some the benefits will likely outweigh risks, at least some of the time,” she says, whereas “for others this may not be the case.” A pill you take to ace an exam, for instance, won’t do you much good if it also causes a gruelling stomach ache.
It has been revealed that, as with most drugs, different considerations have to be taken into account when using the drug with people in different circumstances. In children and young teens, special care needs to be taken. Cognition-enhancing drugs could present unique risks to the developing brain. Several clinical trials found modafinil to be safe when given to children with attention-deficit/hyperactivity disorder (ADHD), but the trials lasted only a few months, making it difficult to be certain of the potential effects of long-term use. In a 2014 review article examining the biochemical effects of modafinil and other common “smart drugs,” researchers at the University of Delaware and Drexel University raised concerns that the use of these drugs could affect the developing brain’s ability to adapt to new situations and might increase the risk for addictive behaviours.
People with lower average IQs have been seen to benefit more from the drug. Research suggests that cognition-enhancing drugs offer the greatest performance boost among individuals with low-to-average intelligence. These findings led University of Oxford researchers to propose in a 2014 paper that if such drugs were selectively given to people who need them most, many ethical concerns about the drugs’ use would be alleviated, and they might even reduce opportunity inequality.
Again, special care must be taken with senior citizens in society who wish to take the drug. Some studies suggest that older adults may not derive much benefit from cognition-enhancing drugs. One study found that methylphenidate (Ritalin), which boosts working memory and attention in young adults, had no effect on performance among healthy elderly volunteers who were asked to perform various cognitive tasks.
As with any drug which aims to boost cognitive enhancement, there are pros and cons. While it has been proven there may be some benefits to the purchase of generic modafinil, it is simply too soon to tell whether or not it is worth it or not, whether it is safe or dangerous in the long term, or whether it will really affect you in the way you want it to. In short, you should probably wait until a bit more research has been done before you jump in to purchasing the drug.