Modafinil has been shown to improve cognitive performance in healthy individuals. It can also boost energy levels, and reduce fatigue. It may be the first drug to truly deserve the label of cognitive enhancer.
Twelve participants with effectively stable BD were randomly assigned to modafinil tablet australia or placebo adjunctive to a mood stabilizer. Weekly in-person visits tracked side effects and mood symptoms as well as neurocognitive functioning.
Moderate to Severe Cognitive Impairment
When someone is suffering from moderate to severe cognitive impairment, it may be important for them to discuss their concerns with a healthcare provider. A provider will take a detailed history, including information on any changes in memory and thinking that the person has experienced. The provider will also do a physical exam to look for any potential causes of the problems. For example, the provider may order blood tests to check thyroid hormone levels and vitamin B12 deficiency. They may also order cerebrospinal fluid tests (spinal tap) to rule out autoimmune conditions or neurodegenerative disorders.
Modafinil is a prescription medication that has been shown to enhance cognition in healthy, non-sleep-deprived people. It has been shown to improve cognitive function in several types of tasks, including memory, attention, and executive functions, although it does not seem to help creativity.
One study found that modafinil improved composite scores of speed of memory and quality of episodic secondary memory compared to placebo after 8 weeks of treatment. Those taking modafinil also had better performance on tasks that required planning and working memory. However, the medication did not improve paired associates learning, which requires divergent thinking skills.
The modafinil and placebo groups in the study were well-matched for age, gender, premorbid IQ, clinical features, fatigue severity, anxiety level, and depression symptoms. In addition, the test versions were similar to allow for independent assessment of effects on cognitive enhancement.
Insomnia
Insomnia is more common as we age. It can cause problems with memory, mood, and physical functioning. Some medications used to treat insomnia can also make you drowsy which can impact your ability to do things like drive. Your GP may try some sleep strategies and relaxation techniques with you before considering medicines to help improve your sleeping patterns. They may also refer you to a specialist who can offer cognitive behavior therapy (CBT). CBT is a talking treatment that helps you change the thoughts and behaviors that keep you awake.
A small study found that Modalert 200mg Australia improved some measures of cognitive function during sleep deprivation in healthy volunteers. These include attention and executive functions such as the ability to think divergently and suppress distractions. Modafinil was more effective than methylphenidate and dexamphetamine on these tests and did not appear to have the anxiogenic effects seen with some other stimulant drugs.
Modafinil acts as an atypical dopamine reuptake inhibitor alongside the inhibition of noradrenaline and the release of orexin neuropeptides and histamine to increase arousal. This is in contrast to other psychostimulants which act mainly by increasing dopamine and noradrenaline concentrations, but also increase levels of the inhibitory amino acid GABA and inhibit reuptake of orexin and histamine.
The improvements seen in this study are unlikely to apply outside of a clinical research setting. However, these findings are encouraging and should be followed up with larger studies.
Depressive Symptoms
Several studies indicate that modafinil may be effective in improving depressive symptoms and cognitive impairments associated with depression. Symptoms of depression can include unexplained sadness or a loss of interest in activities (including work and hobbies). Difficulty thinking or concentrating. Feelings of worthlessness or guilt. Poor appetite, weight loss, or increased use of alcohol and other drugs.
One study of breast cancer patients found that a 4-day course of 200 mg modafinil improved performance on a version of the Hayling sentence completion test and a WCST that requires cognitive control, compared to a placebo. Interestingly, these improvements were associated with activation of the dorsolateral prefrontal cortex and anterior cingulate cortex as measured by fMRI.
Another study used a double-blind, placebo-controlled parallel design to assess the effects of 200 mg modafinil on cognitive function and mood in non-sleep-deprived healthy volunteers. Participants underwent neuropsychological testing and completed a visual analog scale to measure subjective feelings of contentment, alertness, tranquillity, and calmness. The results indicated that modafinil significantly improved spatial working memory, planning at the most difficult levels of the Cambridge Neuropsychological Test Automated Battery, and episodic secondary memory. However, it did not improve nonverbal tests of divergent and convergent thinking or a new measure of creativity called the Group Embedded Task.
Mood Disorders
Modafinil has been shown to improve performance on a variety of computerized cognitive tasks in humans. For example, in a placebo-controlled trial using the CDR system which incorporates both custom-designed tests (eg spatial working memory) as well as tests that have a more general methodology (digit vigilance, group embedded figures), modafinil improved performance compared to placebo (Beracochea et al, 2001).
In addition, in a double-blind study of healthy volunteers undertaking simulated day and night shift work, a 4-day regimen of 200 mg modafinil significantly reduced errors on the WCST and Hayling sentence completion task compared to placebo (Hart et al, 2006). This is probably due to the dopamine-related enhancement of the ability to engage in control processes measured by fMRI activation of the dorsolateral PFC and anterior cingulate cortex. Interestingly, modafinil did not enhance motivation measured by self-report measures on the Visual Analogue Scale.
A more recent randomized double-blind study comparing 400 mg modafinil to placebo in patients with remitted depression found that modafinil reduced errors on the WCST, but not on other neurocognitive test battery measures including planning, attention, and episodic memory (Bennett et al, 2008). However, modafinil did not have any effect on subjective feelings of fatigue, as measured by visual analog scales. This suggests that the motivating effects of modafinil are not related to arousal per se, but rather primarily to its effects on catecholamine-dependent systems.