Modafinil, often sold under the name “Provigil”, is a wakefulness-promoting drug used to treat excessive sleeping in conditions such as narcolepsy and obstructive sleep apnea. However, some also use it as a cognitive enhancer too, to improve focus, memory and executive functioning (ALZ Discovery: 2019). But how does it work? And does it really increase brain power?
Exactly how modafinil works is unknown. It does however seem to have a significant impact on several neurotransmitters including serotonin and glutamate as well as the brain’s histamine systems, all responsible for regulating mood, learning and memory. In particular, however, it is thought to directly alter the concentration of catecholamines, such as adrenaline and dopamine, in the brain in a way that is thought to enhance one’s capacities for executive functioning and focus (Minzenberg: 2008).
Despite these proposed effects however, studies show that the real effects of modafinil are inconsistent and vary according to the prior health of the user. For example, although a systematic review of studies measuring on the drug’s effects between 1990 and 2014 on healthy individuals demonstrated increased performance in demanding tasks, a more recent study, contradicted these findings. Conducted in 2015 on a cohort of healthy university students in a double-blind, placebo-controlled trial, researchers found that although the drug may have helped the students complete non-demanding tasks, few positive effects were seen on more demanding tasks such as studying (Fernandez: 2015).
Despite this however, more positive results have been found among people with preexisting health issues: in this case; remitted depression. In another double blind, placebo-controlled study from 2017, researchers monitored 60 participants either on a single dose of 200mg of modafinil, or a placebo, for changes in their cognitive functions. Drawing conclusions from both neurocognitive tests and the subjective feelings of the participants during the trial, the researchers found that the modafinil group performed significantly better on tests for episodic memory and working memory. Despite these improvements however, they found that modafinil had little effect on planning or sustained attention (Kaser: 2017).
Although interesting results, as most of these trials tested only for a single dosage of modafinil, and with no studies having researched its long term usage, further research is necessary to establish more concrete results and expectations for both healthy individuals and those with pre-existing conditions (Loria: 2016). Due to the lack of funding for cognitive enhancement for healthy people however, findings on its specific benefits at least for healthy individuals may continue to originate from either smaller-scale studies or anecdotal evidence.
To conclude, it appears that although modafinil may increase certain aspects of cognitive functioning, its results in healthy people are variable, and appear stronger for those with pre existing issues than for those without. Despite having some awareness of neurological processes the drug effects and interacts with, how exactly the it impacts the brain is still unknown. Thus, even though anecdotal evidence may still encourage usage of modafinil for its cognition-enhancing effects, more research is needed to understand both how exactly it works, and to what extent it works.
Minzenberg, MJ et al.: Pub Med
Fernandez, A et al.: Pub Med
Kaser, Muzaffer et al: US National Library of Medicine
Battleday, RM et al.: US National Library of Medicine
Loria, Kevin: Business Insider