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Introduction

Cognitive processes are either natural or
artificial, conscious or unconscious. Nehlig (2010) argues that the concept of
cognition refers to the capacity to process information, apply knowledge and
change preferences. Cognition is a rather broad and complex term that involves
various mental processes such as attention, memory, executive control
functions, language, psychomotor functions and perception. Recently, certain
drugs initially meant to treat certain psychological disorders are used by
healthy individuals for their cognitive enhancing capacities (Franke &
Lieb, 2010).

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Cognition can be enhanced
by several drugs or substances which pass through the blood-brain
barrier. A cognitive enhancement drug or a nootropic drug is meant to stimulate
and facilitate the connection between synapses, aiding in improvements of
several mental processes such as the ones mentioned above. One of those drugs
being classified in the nootropic category is Modafinil that this paper further
explains in detail. The use of this drug without prescription gained popularity
amongst high-school and university students (Talbot, 2009; Franke et al.,
2011).

         
Modafinil is known under multiple other names such as Provigil,
Modavigil or Alertec and it is a centrally active alpha 1 adrenergic agonist
drug, meaning that the
drug stimulates alpha adrenergic receptors in the brain. This nootropic drug is
produced by Lafon Labs in France
and it is a FDA-approved medication with wakefulness-promoting properties (Kumar, 2008).
Modafinil is a neurocognitive enhancement drug and is categorized as a
psychostimulant given its
wakefulness properties. Modafinil is a cognitive enhancer (CE) that has
received much media attention, however its mechanism of action remains somehow
obscure (Zolowska et al., 2009; Seeman et al., 2009). This CE was initially
being marketed in the 1990’s in France as a treatment for somnolence, sleep
apnea and narcolepsy but it quickly gained popularity in the Western world
given its perceived benefits by individuals. However, nowadays many individuals
involved in academical settings use or even abuse this drug in hope that they
will gain its benefits to achieve academical success and improve their academic
performance (Patrigde et al.,
2011).

 

 

 

Benefits

Undoubtedly, the most research being done
on the effects of Modafinil is about sleep disorders and narcolepsy since Modafinil has
significant benefits in improving this condition. (Parkes, 1988). However,
certain studies focus on the cognitive enhancement qualities of the drug such as
improvements in cognition, mood and affect.

         
Randall et al. (2005) argue that not all individuals in academical
settings benefit equally from taking the nootropic drug to increase their
cognitive performance. The study showed that individuals with a lower mean average of IQ would benefit more
from the effects of Modafinil than the ones with a higher mean average of IQ.
This finding could be explained by the fact that the individuals who score
higher on the IQ scales could have a limited detection of some of Modafinil’s
effects. However, the lower mean average IQ group scored above-than-average IQ
levels in the general population, hence the researchers proposed that studying
this effect on a less high-performing group could lead to interesting results.

         
The performance effects of Modafinil in healthy adults have been
evaluated in three controlled studies. The first study conducted by Goldenberg
et al. (1986) aimed at evaluating the effect of a morning dose of 200 mg on EEG
indicators of vigilance and daytime sleep latency. Decreased EEG indications of
fatigue such as the theta/alpha ratio waves were discovered, similar to those
observed with d-amphetamine following a 200-mg dose, but they did not find any
changes in behavior from a placebo control. The second study by Saletu et al.
(1986) followed a morning administration of 200 mg, respectively 400mg and 600
mg of Modafinil. This study demonstrated that the individuals experienced
enhanced concentration, complex reactions, cognitive functions and increased
critical flicker frequency threshold with a paradoxical decrease in psychomotor
activity. The third study by Benoit et al. (1987) found that a 200-mg
night-time dose of Modafinil in volunteers that have been sleep deprived
reduced their subjective sleepiness and improved their performance on search
and memory tests.

         
Similarly, to the findings of Benoit et al. (1987), Kaser et al. (2017)
found that patients with remitted depression whom were given Modafinil could
improve on episodic memory and working memory test performances. In healthy
humans, working memory, recognition memory, sustained attention and other tasks
dependent on cognitive executive control are being enhanced with Modafinil
(Sesack et al., 1998; Tassin et al., 1978)

         
Consistently with the other studies mentioned in the paper on the
relation between this certain CE and memory, studies with mice have also been
conducted. Béracochéa et al. (2001) studied rodents and indicated that
Modafinil could improve working memory performance in a dose-and-delay dependent manner.
Moreover, the processing of contextual cues is also enhanced with Modafinil, nevertheless
these effects may be augmented with sustained dosing regiments.

         
Hunter et al. (2006) argue that Modafinil has been proven to help among
psychiatric populations as Modafinil improves attention and response inhibition
in infants and adolescents with ADHD. This benefit could be related to
Modafinil effect in modulating performance along the speed-accuracy curve for
responsive individuals. Among adult psychiatric patient population, there is
evidence that Modafinil improves several prefrontal-dependent cognitive
functions in conditions such as schizophrenia, major depression and adult ADHD.

 

Risks

Even though, CEs have positive effects on cognition,
their impact is still ambiguous. Ragan et al. (2013) argue that the evidence
for harms to the individual is obvious but less likely to be taken into
consideration by the consumers. They state that all of these drugs have toxicological histories and that
their side-effects might not be always psychiatric. One such example is the
fact that Modafinil was reviewed by the European Medicines Agency in 2010, who
concluded that the benefits do not outweigh the risks of this CE and that the drug is not
adequate for usage in conditions other than narcolepsy which is potentially a
serious life-threatening condition (European Medicines Agency, 2010). The
agency also advised that Modafinil should not be prescribed for certain issues
such as sleep apnea, shift-work sleep disorder and hypersomnia, given its risks
of serious skin reaction, suicidality, depression, psychosis, and the risks of
cardiovascular diseases out-weighted the benefits generally. Therefore, the
European Medicines Agency did not approve the drug as being a safe cognitive
enhancer for healthy individuals.

 

Conclusion

Modafinil appears to have multiple
positive enhancement effects on one’s cognition such as improved working
memory, enhanced sustained attention and episodic memory in patients with
remitted depression (Kaser et al., 2017). The CE drug has effects even on
aiding in several psychiatric conditions such as ADHD, major depression and the
frontal lobe-dependent functions in schizophrenia (Hunter et al., 2006). However,
one must be aware of the side-effects of this nootropic drug and even more so,
if the drug is being abused. The proportion of people using the drug in the
academical setting has increased dramatically recently which leads to controversy and to
more emphasis being put onto
the effects and benefits of Modafinil. The drug has some positive effects on
cognition, but their impact has little support as
there is limited research on this topic.                  Even though the evidence for
harms to the individual is obvious it is rarely taken into consideration when
using this CE drug. Randall et al. (2005) and Muller et al. (2004) state that
Modafinil is unlikely to provide great cognitive benefits to already
high-performing individuals such as the individuals in the higher IQ group.

         
Therefore, one should also be aware of the negative effects that are not
so clear, compared to the positive cognitive effects described in the paper.
Given its physiological negative effects the European Medicines Agency did not
agree with the approval of the drug as being a safe cognitive enhancer.
However, hence the literature on the effects of Modafinil is relatively limited
as the drug is rather new, further research should be conducted on this topic. Additionally,
some of the findings in past literature have controversial findings or
different effects. Hence, there is still a lot to discover about this drug and
its implications, side-effects and benefits and to which dosage of Modafinil
could be used to improve certain cognitive and physiological functions to
maximize one’s performance.

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