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What we've learned about Modafinil recently
| Ⓒ By Jonathan Roseland |
I'm not a doctor, medical professional, or trained therapist. I'm a researcher and pragmatic biohacking practitioner exercising free speech to share evidence as I find it. I make no claims. Please practice skepticism and rational critical thinking. You should consult a professional about any serious decisions that you might make about your health. Affiliate links in this article support Limitless Mindset - spend over $300 and you'll be eligible to join the Limitless Mindset Secret Society.
The Science
It would be an understatement to say that it's been thoroughly studied; in total over a thousand pieces of published research on Modafinil can be found on Pubmed, with an impressive 580 human research papers in the last 10 years alone.
This article will summarize the science that's been done on Modafinil in 2017. In 2017 alone there were 80 papers published about it but don't worry I'm not going to summarize every single one because a lot of them are not very interesting.
Why 2017?
Often science does not always age well. In researching anything related to neurobiology, which is a pretty innovative field, you should have some preference for recency, Also in 2017 62 scientists and physicians along with five United States senators petitioned the National Library of Medicine & National Institutes of Health to change their rules and make public the funding sources of studies before 2017 researchers could more or less bury the funding sources of their science behind paywalls. Now it's upfront for everyone to see. This makes science more honest.
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I've used Modafinil over a hundred times but, believe it or not, it's NOT my favorite smart drug.
However, I use it consistently because it consistently puts me in a really focused state and it does an exceptionally good job doing what its original pharmacological purpose was: keeping you really AWAKE.
There's a second reason I like it and recommend it highly to Biohackers seeking performance enhancement which is that it has good science backing it up. A lot of "Nootropics" are case studies of marketers trying to make a quick buck by misinterpreting bad science, Modafinil, on the other hand, is a drug that a rigorous scientific epistemologist could appreciate.
Wakefulness
A 126-person human trial out of Guy's Hospital, London evaluated it in treating central Hypersomnia, From the study: Thirty-nine percent of the patients demonstrated a complete, 25% partial and 36% a poor response to treatment.
Central Hypersomnia is like super insomnia, and it's regarded as one of the most severe sleep dysfunctions. So it speaks to the power of Modafinil that the majority of the patients experienced transformative recovery.
A UK paper on the subject of military combat surgeons who have to often perform surgeries in a sleep-deprived state mentioned Modafinil being an effective method for combating fatigue.
Modafinil helped a person disabled by Pilocytic Astrocytoma to recover their consciousness and communication ability, as verified by Polysomnography which is a type of sleep study.
But you already know that Modafinil is a wakefulness agent, For the rest of this article I'll focus on findings from recent research that might surprise you.
Memory
One case report out of North Carolina indicated that Modafinil may have caused resistance to propofol because of its effect on neural pathways that activate consciousness.
Propofol is a bit of a mysterious drug with the official purpose of getting rid of memories and it often causes unconsciousness, so it's kind of like the flashy thing in the Men in Black movies. I suppose then that Modafinil is a good drug to take if you're going to be having a close encounter of the third kind.
An Austrian animal study noted that the R-Isomer, at least, of Modafinil has cognitive enhancing effects [on] spatial memory.
Working Memory
A randomized double-blind, placebo-controlled trial of 60 patients noted that it improved both...
- Working memory - This is like the RAM of your conscious mind that you use for problem-solving.
- Episodic memory - This is your memory of your past. The house lived in as a child, your first job, your first kiss, etc
English-Turkish team of researchers concluded
...modafinil (200 mg) could improve episodic memory and working memory performance in patients with remitted depression. Modafinil may have potential as a therapeutic agent to help remitted depressed patients with persistent cognitive difficulties.
However the patients in this study were recovering from depression, often people will have retarded working and episodic memory even after the more obvious symptoms of depression go away. So this does not guarantee that Modafinil will increase your baseline memory if you are otherwise healthy and not depressed.
If you're a healthy (younger) person who would like to improve their memory...
My recommendations are Piracetam along with the Adaptogen stack of Panax Ginseng and Ginkgo Biloba.
Biohackers are always very interested in hacking memory a reliable tool for doing this is Dual N-Back brain training which even raises your IQ. Modafinil is such an intense promoter of focus that brain training while dosed is like weight lifting on creatine, it's going to work out your mind a lot more.
So I'd venture that using the two in combination for 30-45 days would be a pretty effective Biohack for raising your IQ.
Cognition
A significant portion of Modafinil users are not people suffering from narcolepsy but otherwise healthy people seeking performance enhancement to work or study harder.
An American study focused specifically on this usage
The domain-specific attentional benefits of modafinil have yet to be quantified objectively in healthy human volunteers...
Modafinil significantly enhanced attention (d prime) in humans...
These results indicate that modafinil produces domain-specific enhancement of attention in humans not driven by hyperarousal...
Another American study totaling 60 patients evaluated its utility in improving recovery from cognitive impairment caused by time in an intensive care unit.
An Italian study of healthy elderly people noted
The main finding of the study is that modafinil promotes enhanced centrality, a measure of the importance of nodes within functional networks... Present findings provide functional data supporting the hypothesis that modafinil can modulate the cortico-cerebellar connectivity of the aging brain.
So this is implying greater levels of connectivity between the regions of the brain...
One of the more interesting pieces of research in 2017 was a study of nearly 3000 chess games played by Germans that compared Methylphenidate, modafinil, and caffeine. It concluded
Only when controlling for game duration as well as when excluding those games lost on time, both modafinil and methylphenidate enhanced chess performance as demonstrated by significantly higher scores...
Interestingly, the study suggests that Modafinil decreased the decisiveness of the players. The players markedly spent more time reflecting and thinking about their next move. So if a given day, project, or task demands decisiveness you may want to reach for a different smart drug than Modafinil.
Depression
A German review concluded that it may be effective for treatment-resistant depression. From its abstract
[Modafinil] might be an option for depressed patients who are not responding to antidepressant monotherapy or established augmentation strategies.
Behavior
Another German study administered 200 milligrams and studied how it affects decision-making behavior
We applied a task that separately tests the choice of previously rewarded behaviours (approach) and avoidance of previously punished behaviours... Modafinil but not placebo induced a significant bias towards approach behaviour as compared to the frequency of avoidance behaviour.
I'll admit I'm a bit confused by this study, is it saying that Modafinil makes you more likely to approach? Does this mean it's a good drug for pickup artists doing daygame?
That certainly hasn't been my experience, I think Modafinil is a pretty lousy drug for any kind of socializing. I'll try to get a statement from the researchers to clarify.
Either way, Modafinil does change your personality while you're dosed on it.
ADHD
A Korean meta-analysis looked at the results of multiple human studies done to determine its value as a treatment for ADHD. From its abstract
An extensive search of databases and clinical trial registries resulted in five published short-term randomized, double-blind, placebo-controlled trials.
The results showed that modafinil more significantly improved ADHD [scores] than placebo...
In terms of commonly observed side effects, modafinil showed significantly higher incidence of decreased appetite... and insomnia
In University Culture
Interestingly a softer science study looked at how Modafinil and the use of study drugs are regarded morally in UK and anglosphere universities. The authors of the paper conducted focus groups totaling 66 students From its abstract
We find that [pharmacological cognitive enhancement] resilience among UK university students is mediated by normative and cultural judgments disfavoring competitiveness and prescription drug taking. [pharmacological cognitive enhancement] risk can be augmented by social factors such as soft peer pressure and normalization of enhancement within social and institutional networks.
Speaking of social life and social dynamics a Swiss study noted that
...modafinil increased misclassifications of emotions as angry on the [Facial Emotion Recognition Task]
As I've said elsewhere, Modafinil is NOT my go-to social smart drug.
Stroke Recovery
A double-blind, placebo-controlled human trial of 232 Australians noted its helpful effect on the debilitating fatigue that often follows a stroke. It concluded:
Participants receiving modafinil reported a significant decrease in fatigue... and improved quality of life... compared with placebo
But Modafinil doesn't always outperform the placebo, from an American clinical trial treating fatigue in those suffering from an autoimmune disease of the liver.
In patients with [Primary Biliary Cirrhosis] who have fatigue, treatment with modafinil for 12 weeks was safe and fairly well tolerated; however, it did not result in beneficial effects on fatigue compared with patients treated with placebo
Vs Addiction
An animal study demonstrated that Modafinil decreased conditioned place preference induced by amphetamines. I find this interesting because conditioned place preference is a Pavlovian method where an animal goes to a specific location in its maze or living environment and is given a stimulating drug, thus it develops a preference for that place and gets excited there about getting high
Perhaps this indicates that Modafinil could be helpful to addicts in recovery who get that enticing Serotonin hit whenever they pass by a place where they used to indulge their self-destructive vice.
Pregnancy
A Spanish study on narcoleptic women administered it to 6 pregnant women, without adverse effects on the women or their pregnancies.
Motor Enhancement
As many casual users will attest, Modafinil enhances your motor control. It will likely make you a little more graceful on the basketball court or dancefloor.
An animal study noted that it improved motor impairment, which makes it an option to consider for those suffering from Parkinson's.
Conclusion...
I'm optimistic that bad science is on the decline (at least in regard to smart drugs like Modafinil). There are already a number of double-blind, placebo-controlled, randomized human trials pre-registered for Modafinil research in 2018.
It appears also that research institutions are figuring out that there's a tremendous public interest in Nootropics or smart drugs that can be used by healthy young people to make them happier, healthier, and more productive.
This indicates science getting more into the prevention and empowerment business as opposed to just being in the business of treating sick people.
Finally...
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