Modafinil: because coffee is for mugs

   With the end of the academic year looming, preparation for summer exams can prove to be a constant struggle to remain focused and refrain from engaging in the seemingly infinite number of more enjoyable things you could be doing. Constantly trying to cram your head with more information than it wishes to retain can be demoralizing, and sometimes your brain just doesn’t seem to do what you want it to. But what if there was a simple way to maintain concentration and improve your memory?

   For an increasing number of students this ‘what if’ is not simply conjecture, but a stark and understandably tempting reality. A smorgasbord of mind-enhancing prescription drugs is now available which enable whoever scoffs them to knuckle down and swot up for their imminent deadlines, more alert and awake than ever.

   The theme of cognitive-enhancing drugs was the inspiration behind the recently-released film Limitless in which Bradley Cooper plays a struggling writer who, in a desperate bid to complete his belated novel, accepts a mysterious pill that allows users to access 100% of their brain’s potential, as opposed to the meager 20% usually on offer. Unfortunately, unlike the fictional NZT-48 featured in the film, the available pharmaceuticals are unlikely to enable you to write a book in four days, transform you into an overnight Wall Street mogul and win back your ex. But the prospect of a quick and easy way to improve concentration and gain even the slightest edge for a pending exam or essay deadline may be an appealing one for many students.

   Indeed, a poll conducted by the scientific journal Nature revealed that roughly one in five readers, many of whom were students, have used so-called “smart pills” to improve concentration. In this study participants were quizzed specifically on 3 drugs: beta-blockers, which are used for heart conditions and have an anti-anxiety property; modafinil, used for treatment of narcolepsy and other sleep disorders; and methylphenidate, more commonly known as Ritalin, which is used to treat ADHD.  Of these three substances, Ritalin proved to be the most popular with 62% of readers who responded positively to the survey reporting to have taken it, followed by modafinil (44%)  and beta-blockers (15%).

   Research conducted by Barbara Sahakian, professor of clinical neuropsychology at Cambridge, revealed that in some US universities as many as 17% of students admitted to taking Ritalin as a brain-booster. The exhaustive list of available learning supplements extends far beyond these three drugs, including donepezil, Adderall, and Dexedrine to name but a few.  Each of them have the effect of improving the ability to concentrate for prolonged periods of time, and Ritalin and modafinil in particular have been shown to improve memory capacity.

   More so than Ritalin or beta-blockers, modafinil is emerging as a popular work aid amongst UK students. “I’ve used [modafinil] on a few occasions. It’s like Viagra for the mind”, said one Bristol University student who has experimented with the drug to help him study. “The first couple of times I tried it I thought it was amazing - I could work all night without getting tired or distracted”. But the student, who wished to remain anonymous, did warn of the undesirable consequences; “other times it was too much and you can’t get to sleep for hours, even when you know your body must be exhausted.”

   None of these drugs are freely available for over-the-counter consumption in the UK but some, namely modafinil, can legally be purchased online and imported from pharmacies abroad – often from China. This was also the case with the recreational “legal high” mephedrone, which could be imported, and consumed and sold within the bounds of the law until its classification as a class B drug last April.

   Modafinil, also commonly refered to by its brand name Provigil, has been authorized for use in some operations by the French Foreign Legion and the US Air Force, in preference over the traditional use of amphetamines, to keep troops focused during lengthy operations in which sleep deprivation is incurred.

The use of nootropics (cognitive enhancing substances) in academia is hardly a new trend. People have long used amphetamines to keep them working longer and harder, and the more commonly acceptable stimulants caffeine and nicotine are staples for many a student. But are there any significant differences between these old school study buddies and the new kids on the block?

   Caffeine-containing substances such as coffee, ProPlus and guarana work by indiscriminately boosting the whole nervous system for a short period of time, creating an increased sense of mental stimulation and reducing the body’s perception of fatigue, but also creating a jittery feeling after one cup too many. Despite extensive research, the precise mechanism by which modafinil works is still unclear, but it is apparently more ‘refined’ than caffeine or amphetamines, providing stimulation to targeted areas of the brain and actively improving memory retention. The effective duration of the drug is also much longer than that of caffeine, with the result of users being able to work for hours on end from a single dose before crashing.

   Some have argued that to take these drugs is a form of cheating, but it is hard to say that using them constitutes cheating when they are equally available to any student wishing to access them. As Professor Sahakian from the Nature study points out, “just as one would hardly propose that a strong cup of coffee could be the secret of academic achievement or faster career advancement, the use of such drugs does not necessarily entail cheating."

   As with all relatively new drugs, recreational or otherwise, very little has yet been determined about any negative side effects that may be incurred by using modafinil. This is purely because it has not been in circulation for a long enough period to form representative, non-clinical studies on use in healthy patients, and with time more will be known about the extent and nature of any detrimental effects. Perhaps the biggest risk to users is the uncertain purity of the chemical that you are purchasing from an unvalidated company selling you drugs from half way round the world. The most rigorous of clinical trials won’t allow you to make an informed decision on the substance you are choosing to take if that substance is not what it claims to be.

   Importantly, recognition of the growing use of cognitive enhancing medication is needed by academic institutions. They should make their stance on the use of these drugs clear, be it one of condemnation of one of indifference, and make students aware if their actions would be classed as cheating.