'Smart Pill' May Enhance Thinking

Modafinil found to enhance cognitive abilities for patients who are not sleep-deprived

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Pop a pill to boost your brainpower — it’s been a theory for a while but may now be closer to reality.

A large review of multiple studies has found that modafinil (brand name Provigil) — primarily meant to treat narcolepsy — may improve alertness and concentration even when patients are not sleep-deprived. Although promising, these findings may raise ethical concerns about using the medication in the absence of medical need.

“This is the first overview of modafinil's actions in non-sleep-deprived individuals since 2008, and so we were able to include a lot of recent data,” said co-author Dr. Ruairidh Battleday in a press release. “… It appears that modafinil more reliably enhances cognition: in particular 'higher' brain functions that rely on contribution from multiple simple cognitive processes.”

Dr. Battleday, of the University of Oxford, and Dr. Anna-Katharine Brem, of Harvard Medical School, conducted this literature review.

Modafinil was originally developed for narcolepsy patients. People with narcolepsy suddenly fall asleep at all times of the day and night, in the middle of whatever they are doing.

Modafinil is also approved by the US Food and Drug Administration (FDA) for excessive sleepiness from obstructive sleep apnea and shift work disorder. The medication helps people stay alert and concentrate.

Modafinil is sometimes used off-label — outside of the FDA-approved uses — for conditions like attention deficit hyperactivity disorder and Parkinson’s disease.

Drs. Battleday and Brem analyzed 24 studies conducted between 1990 and 2014. These studies looked at the effects of taking modafinil. They assessed memory, learning, planning, decision-making and flexibility.

Modafinil enhanced decision-making and planning, Drs. Battleday and Brem found. It did not appear to improve memory or flexibility of thought.

On longer and more complex tasks, modafinil was consistently tied to cognitive benefits.

Most of the side effects were minor. They included insomnia, headache, stomach ache or nausea. Some of those were also reported in the placebo (fake pill) groups tested against modafinil.

Dr. Brem noted that these findings may raise ethical concerns.

"So, we ended up having two main conclusions: first, that, in the face of vanishingly few side effects in these controlled environments, modafinil can be considered a cognitive enhancer; and, second that we need to figure out better ways of testing normal or even supra-normal cognition in a reliable manner," Dr. Brem said in a press release. "However, we would like to stress the point that with any method used to enhance cognition, ethical considerations always have to be taken into account: this is an important avenue for future work to explore."

Modafinil is not currently approved for use in cognitive enhancement, especially in the absence of medical need. It is available only with a prescription and is considered a controlled substance.

This review was published in the August issue of the journal European Neuropsychopharmacology.

The authors disclosed no funding sources or conflicts of interest.

Review Date: 
August 21, 2015
Last Updated:
August 30, 2015