Full Evaluation of the Nootropic Smart-Drug Modafinil

Benefits of ModafinilModafinil is a wakefulness-promoting (“eugeroic”) agent originally developed in France in the late 1970’s, and introduced to European and American markets as a medical treatment throughout the 80’s and 90’s. It is sold under a wide variety of brand names worldwide, including Alertec, Modalert, Provigil, Resotyl, and Vigimax.

The original medical uses of modafinil were to treat narcolepsy and other sleep-related disorders, such as excessive daytime fatigue and shift-work sleep disorder. It has also has been used by the military to promote wakefulness in soldiers under conditions of sleep deprivation.

Because of modafinil’s remarkable wakefulness-promoting effects, it is being increasingly used as a cognitive enhancer due to its ability to increase alertness and mental focus.

Modafinil Research Background:

The research on Modafinil has at times been confusing and seemingly contradictory, and early research led to seemingly little consensus regarding its effects (enhancing or otherwise) on healthy, non-sleep-deprived subjects. While most studies of modafinil reported general enhancements in executive function, only a small number of early studies provided unambiguous evidence for enhancements in the domains of attention, learning, memory, and creative problem-solving – the primary domains in which enhancements are typically claimed by nootropic enthusiasts.

However, a recent systematic review from 2015 revealed that many of the weak- or null findings could be accounted for by methodological shortcomings. Specifically, the authors explained that a substantial amount of the apparent contradictions present in the earlier scientific literature on modafinil was likely due to the reliance of much of this research work on relatively rudimentary psychometric tests, particularly those designed for detecting and/or assessing potential cognitive deficits in clinical (ill) rather than healthy populations. In contrast, when focusing only on studies that used more sensitive and complex psychometric evaluations, the evidence becomes much stronger in modafinil’s favor. Studies using these more nuanced methodologies paint a picture in which modafinil can be consistently seen to engender a variety of enhancement effects.

Benefits & primary effects of Modafinil

Modafinil’s primary effects include fatigue reduction, improvements in memory retention and recall ability, enhancement of executive function, improvements in learning ability and speed, and sharpening of attentional focus.

In addition to these specific effects, modafinil has a variety of additional benefits:

  • Not a stimulant: Modafinil acts sort of like a stimulant, but it’s actually a eugeroic – a wakefulness-promoting agent. It doesn’t make you speedy or jittery like most classical stimulants do. Modafinil also doesn’t have a crash or withdrawal, the way many smart drugs do.
  • Not addictive: in fact, modafinil has sometimes been used by clinicians as an addiction-cessation aid.
  • Does not cause tolerance: it has been shown that modafinil can be taken regularly over relatively long periods of time without users having to increase the dosage to maintain the drug’s efficacy. This gives modafinil a substantial practical advantage over many other common wakefulness-promoting drugs, such as caffeine.
  • Few to no side effects, low abuse potential: modafinil is not addictive and rarely causes side effects. It thus appears to be remarkably safe as a nootropic, and can be used without a substantial risk of developing dependence.

Mechanisms of action:

The specific neural mechanisms by which modafinil achieves its effects are not yet fully known. Modafinil has been shown to increase dopamine availability in the brain by blocking the activity of dopamine transporters, which slows the rate at which dopamine is “cleared out” of the synapses between neurons. Modafinil also has some effect on norepinephrine, although the significance of this effect and its relationship to modafinil’s psychological enhancement effects remain largely unclear.

Effects of Modafinil:

Fatigue

The most well-known effect of modafinil is its ability to promote wakefulness, even under conditions of extended sleep deprivation. This primary effect has been extensively documented in a wide variety of studies over the past two decades.

  • For example, an early study on the use of modafinil among military personnel discovered that modafinil prevented progressive declines in cognition- and mood-related processes in soldiers undergoing sleep deprivation.
  • Similarly, a 2003 study showed that modafinil significantly reduces fatigue, and even acutely improves attentional capabilities in sleep-deprived subjects.
  • Relatedly, a previous study also reported reduced fatigue and improved cognition in sleep-deprived volunteers, but also noted that modafinil treatment tended to cause subjects to over-estimate their ability on various cognitive tests.

Memory

More recently, the potential for modafinil to produce acute improvements in memory have become a popular area of scientific study. For example, a 2010 study found that modafinil improved working memory in a subject sample with baseline memory impairments, indicating that modafinil was able to recover this underlying memory deficit.

Shortly afterwards, a 2012 study found that modafinil improved memory performance on a learning task in an elderly population with multiple sclerosis. Curiously, the authors did not observe any significant effects on fatigue or alertness in this population; however, a follow-up study in 2013 using a similar sample of MS patients did report such effects.

It should be noted, however, that modafinil’s ability to improve memory has so far only been studied in clinical populations, and it is likely that these subjects have a lower baseline level of memory function than healthy subjects. It is therefore not entirely clear to what extent modafinil might have identical effects in normal users; however, given its clear effects on general alertness, it stands to reason that increasing wakefulness will naturally “spill over” into improving memory as well.

Cognition

There is a considerable body of emerging evidence that suggests that modafinil may have a variety of beneficial effects on cognition in general.

  • A 2003 study found that modafinil improved digit span (working memory), visual memory and pattern-recognition, spatial planning, and stop signal inhibition reaction time (impulse control). The subjects also reported feeling more alert, attentive and energetic, consistent with modafinil’s primary effects. Interestingly, the authors reported that these effects were not dose-dependent, with these benefits emerging even with relatively small doses of modafinil.
  • Similarly, a 2013 study reported that modafinil improved spatial memory and visual pattern-recognition abilities as well as planning and decision-making capabilities. It also increased the patients’ subjective reports of task enjoyment.
  • The results of a 2014 study further support the notion that modafinil improves cognition, this time by manifesting as increased learning rates in a language-learning task paradigm.
  • Most recently, a 2017 study found that modafinil improved visual processing speeds, “set-shifting” (cognitive flexibility), as well as verbal memory and verbal recall abilities in healthy subjects.
  • Relatedly, another 2017 study in chess players found that modafinil markedly improved the subjects’ chess-playing performance. However, the authors also noticed that while modafinil augmented their technical performance, it also made their subjects more prone to losing games by “time outs.” This suggests that, while modafinil may improve cognition in general, this may come at the cost of accurate time perception.

Novel clinical uses

Finally, some recent scientific evidence suggests that modafinil may have potential to treat the symptoms of some common psychological disorders.

For example, a 2007 study in schizophrenia patients found that modafinil treatment improved the deficits in executive functioning that are commonly observed in schizophrenia. At the time, the authors of this study were unable to determine whether- or to what extent this effect may generalize to healthy patients; however, a follow-up study in 2017 provided strong evidence that healthy subjects can indeed benefit from these effects.

Notably, modafinil shows particular promise as a possible treatment for the management of ADHD symptoms. A 2004 study found that modafinil improves inhibitory control in healthy subjects, as well as short-term memory span (working memory), visual memory, spatial planning and stop-signal motor inhibition (impulse control). It also appeared to selectively enhance attentional focus in ADHD patients, while this effect was not significant in healthy controls. A series of follow-up studies subsequently demonstrated that modafinil improves core symptoms of ADHD – namely, attentional focus, hyperactivity, and impulsivity, as reflected in subject self-report and other-ratings of symptom severity and function both in the classroom and at home (2005). As a result, it has been suggested that a 300mg dose of modafinil may be an effective means of mitigating the attentional symptoms in ADHD patients (2006).

Modafinil Safety info:

Modafinil is not addictive, nor generally unsafe. However, care should be taken so as not to take it to stay up for very long periods of time, as this may be harmful in ways that are related to loss of sleep, rather than caused by the drug in itself.

A very rare condition, called Stevens-Johnson Syndrome, can make modafinil very unsafe; however, this underlying condition is very rare, only afflicting 5 per million people. Nonetheless, it is wise to check with a physician before beginning a modafinil regimen to ensure that you are not at risk.

While modafinil is chemically distinct from traditional stimulants, the fact that it has stimulant-like effects means that it should not be taken by anyone with a known history of heart troubles, as this could lead to additional health complications.

Finally, as with all potent nootropics, its safety specifically during pregnancy is largely unknown; thus it should not be taken while pregnant.

Possible side-effects:

While previous studies has solidly established the general safety of modafinil, it is nonetheless a potent pharmacological agent, and the potential for adverse side-effects thus remains a possibility, however remote. Possible side-effects of modafinil include back pain, dizziness, hypertension, diarrhea, headache, nausea, nervousness/anxiety, stomach/digestive issues, and – obviously – insomnia.

Psychologically, some users have also reported tendencies to lose track of time when taking modafinil; although this can be consciously counter-acted by taking appropriate behavioral measures, such as setting up periodic reminders to check the time.

Modafinil Dose & usage info:

Typical doses of modafinil range anywhere from 30-300mg / day, depending on the user’s pharmacological sensitivity and needs.

Modafinil’s effects generally take approximately an hour or so to kick in, and typically last between 6-8 hours per dose.

Modafinil does not specifically need to be taken with food in order to be effective; however, because it can have appetite-suppressant effects, it is generally recommended that modafinil be taken with a full meal, so as not to cause disturbances or complications from subsequent under-eating.

Finally, modafinil requires a prescription to obtain legally, and thus is not readily available over-the-counter. However, the metabolic precursor of modafinil, adrafinil, is more widely available, and does not require a prescription. Adrafinil works by being converted into active modafinil by the liver, and therefore achieves essentially identical pharmacological effects. It should be noted, however, that using adrafinil in this way may put a strain on the liver, and therefore ought to be avoided by those with known liver problems.

In any case, while the existing research on modafinil and its variants strongly indicates that it is quite safe overall, as with all nootropic regimens in general it is always a good idea to discuss any planned nootropic regimens with a physician prior to undergoing any extensive personal experimentation.

Scientific Conclusions on Modafinil Research and Usage

In conclusion, a broad variety of evidence suggests that modafinil may be effective in providing a wide array of benefits in both healthy and clinical populations. These effects encompass a broad range from increased wakefulness / vigilance, to a suite of improvements in cognitive, memory, and attentional functions. Thus, this impressive suite of effects goes a long way towards explaining modafinil’s growing popularity as a nootropic supplement.

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