Modafinil has been prescribed to treat sleep-related conditions (sleep apnea and narcolepsy) in the US since 1998. It heightens alertness similarly to caffeine. Research has found that the drug also boosts higher-order cognitive function without causing severe side effects.
In 2015, a pair of researchers from Harvard Medical School and the University of Oxford evaluated all published research papers (from Jan 1990 to Dec 2014) on the cognitive enhancement with modafinil. They wanted to get a more consistent understanding.
Twenty-four studies examined the benefits associated with modafinil, including flexibility, creativity, planning and decision making, and learning and memory. Their systematic review found that the inconsistent results between all the studies were because the methods used to evaluate the drug strongly affected the outcomes. Also, the performance-enhancing capacity varied according to the task – the more complex the job, the better modafinil worked.
This year, another randomized, double-blind study was conducted by different researchers to analyze how the drug enhances healthy people’s cognitive control. However, the ultimate goal was to see if it could potentially help people with mental disorders.
The abstract begins by saying:
Cognitive control regulates cognitive and emotional systems to facilitate goal-directed behavior in the context of task-irrelevant distractors. Cognitive control deficits contribute to residual functional impairments across psychiatric disorders and represent a promising novel treatment target. Translational evidence suggests that modafinil may enhance performance in executive functions; however, differential effects on regulatory control in cognitive and emotional domains have not been examined.
Study author Benjamin Becker, a member of the neuSCAN Lab and professor at the University of Electronic Science and Technology of China, explained further:
An essential function of executive processes is the cognitive control of interferences by distracting and conflicting information to facilitate goal-directed behavior in everyday life. Impairments in this cardinal cognitive domain have been demonstrated across major psychiatric disorders such as depression and often persist after recovery, thus leading to long-term impairments in everyday life. The conventional psychopharmacological treatments often allow to control the affective symptoms of psychiatric disorders, yet do not improve the cognitive deficits.
Accumulating evidence suggests that modafinil – approved medication for narcolepsy – can improve cognitive control in healthy subjects and psychiatric patients. However, cognitive control regulates not only other cognitive functions but also emotional functions. For instance, emotional conflict processing is vital for everyday life, such that threatening or social-emotional stimuli convey important information to redirect our attention and effects of cognitive enhancers on these emotional processes may interfere with everyday functioning.
To see if the drug interferes with emotional processes, the researches had seventy-two healthy men participate in a trial study. They were randomly assigned to receive a placebo or 200mg of modafinil. Then, they completed assessments of cognitive and emotional conflict processing. While performing the tasks, the researchers monitored their brain activity using functional magnetic resonance imaging (fMRI).
Becker told PsyPost:
We found that, compared to placebo, modafinil specifically enhanced cognitive conflict performance and concomitantly increased activation in the inferior frontal gyrus and its functional communication with the dorsomedial prefrontal cortex. Both prefrontal brain regions are key nodes in the cognitive control network, and higher activation in these regions may underpin the improved control of cognitive conflict after modafinil administration.
In contrast, we did not observe the effects of modafinil on emotional conflict processing, suggesting highly specific effects on cognitive conflict processing. We additionally assessed whether modafinil affected the subjective perception of performance via ratings and a metacognitive task and found that modafinil enhanced objective cognitive performance but did not affect subjective performance perception or affective state.
Overall, our findings suggest that modafinil has the potential to enhance cognitive control processes while leaving emotional processes unaffected. The pattern of cognitive-enhancing effects in the absence of effects on affective process suggests a promising candidate to selectively improve cognitive control in healthy and clinical populations.
While modafinil was developed to treat excessive sleeping, it has been widely used as a ‘smart drug’ to boost cognitive performance when alertness and concentration are desired. It is trendy among students to study. However, the researchers were interested in its potential to enhance cognitive control in neuropsychiatric patients.
Becker said:
The overarching aim of our study was to determine whether modafinil might be a suitable adjunct treatment to enhance cognitive control in neuropsychiatric patients. However, putative cognitive enhancers, including modafinil, are increasingly used as ‘smart drugs’ by healthy individuals in lifestyle contexts or to enhance performance in academic or other competitive contexts. Whereas our findings suggest a promising potential of modafinil to selectively enhance cognitive performance while not affecting emotional processes, the effects of longer-term use and potentially detrimental effects in other domains remain unknown.
Cognitive-enhancing drugs affect every individual differently, like any other medication. And while there appear to be minimal side effects among all the studies, the long-term effects are still unknown. Therefore, taking the drug must be done under special consideration. Furthermore, children and teens shouldn’t take it unless absolutely necessary because it could affect the developing brain’s ability to adapt to new situations, and could increase the risk of addictive behaviors.
