Introduction that the concept of cognition refers


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.

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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.

term of pharmaceutical neuro-enhancement is being used for the exploitation of
psychoactive drugs, usually consumed by healthy individuals, with the goal of
improving one’s cognitive abilities (Franke & Lieb, 2010). This type of
practice is gaining more popularity especially among student populations whereas
drugs like Modafinil are increasingly used for their cognitive enhancing
effects (Talbot, 2009; Franke et al., 2011).

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).



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.

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.

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.

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)

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.

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.



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.



seems 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.

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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