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 to improve focus, memory, and executive functioning (ALZ Discovery: 2019). But how does it work? And does it really boost brain function?
Exactly how modafinil works is unknown. However, it seems 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, it is thought to directly alter the concentration of catecholamines, such as adrenaline and dopamine, in the brain in a way thought to enhance executive functioning and focus (Minzenberg: 2008).
Despite these supposed effects, however, studies show that the real effects of modafinil are inconsistent and vary according to the user's prior health. While a systematic review of studies measuring the effects of drug effects between 1990 and 2014 on healthy individuals demonstrated increased performance in demanding tasks, a more recent study contradicted these findings. In this study, 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, more positive results have been found among people with preexisting health issues- in this case: remitted depression. In a 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 function. Drawing conclusions from both neurocognitive tests and the participants' subjective feelings 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).
As most of these trials tested only for a single dosage of modafinil over a short period, further research is necessary to establish more concrete results for both healthy individuals and those with preexisting conditions (Loria: 2016). Due to a lack of funding for cognitive enhancement for healthy people, however, evidence on its benefits, at least for healthy individuals, may continue to come 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 vary and appear stronger for those with preexisting issues. Despite some awareness of the neurological processes the drug affects and interacts with, how exactly it impacts the brain is still unknown. Thus, even though anecdotal evidence may still encourage modafinil usage for its cognition-enhancing effects, more research is needed to understand to what extent it actually 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