Modafinil and Neuro-enhancement: Delightful or Dangerous?

What Is It?

Science fiction is abound with neuro-enhancement technologies and medications.  The Bradley Cooper film Limitless is just one example, in which characters discover a street drug that allows them to unleash 100% of their brain power, becoming not just more productive but more charming, cleaner, and more energetic.  But could such a drug ever exist?  Perhaps.  Whilst not on the same level as the drug in Limitless, Modafinil is tipped to be the first true neuro-enhancement drug suitable for healthy people. 

The FDA approved drug, which is marketed as Provigil in the US and the UK is a schedule IV drug, meaning that you must have a doctor’s prescription in order to legally buy it or possess it[1], although there are plenty of off-label versions of the drug being sold on illegal, overseas websites.  At its base, it’s a stimulant that is prescribed to people suffering from sleep disorders such as narcolepsy and is used to increase the cognitive functions of people with neuropsychiatric disorders and shift-work related sleep deprivation[2].  It has later become a nootropic, or ‘smart drug’, taken by healthy people to increase concentration, memory, alertness, energy, and motor skill as well as reducing sleepiness[3]. 

Doctor Peter Morgan from Yale University explains that it is effective because it acts on several different neurotransmitters at once.  It affects your dopamine levels, making you more alert and more interested in things.  It affects your norepinephrine, again improving alertness and focus.  It affects histamine too, which keeps you awake.  It is also believed to enhance short-term memory by as much as ten per cent by influencing the neurotransmitter glutamate[4].  It could affect other transmitters too, meaning that the reaction is different for different people. 

That’s a lot of cognitive improvement from one little pill, and the list of people taking it is impressive.  It’s prescribed to surgeons who need the boost to get them through long surgical procedures whilst maintaining a steady hand.  It’s prescribed to long-haul airline pilots and shift workers.  There are also many famous people who reportedly take it to help with day-to-day living.  Tim Ferriss, author of The 4-Hour Workweek is one, comedian and actor Joe Rogan is another.  Even President Obama is rumored to have taken it[5].  For those not so famous, the internet is littered with case studies and personal proclamations regarding the greatness of this drug and its potential for the future of neuro-enhancement.  All this though, makes it easy to wonder: is it just too good to be true?