Modafinil has been used to help improve cognitive functions in people who are sleep-deprived or stressed. It has been shown to enhance performance and boost moods in a number of studies, including a randomized double-blind placebo-controlled trial in sleep-deprived emergency physicians.
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1. Increases Energy Levels
Unlike traditional stimulants, modafinil does not increase heart rate or blood pressure, nor cause feelings of jitteriness. It is a wakefulness agent that also enhances cognition. It is use to treat narcoleptic patients, and research shows that it can reduce fatigue in healthy individuals, as well as improve memory, alertness, and mood. Now, It is also use to treat disease-related sleepiness, attention-deficit disorder, Alzheimer’s disease, depression, idiopathic hypersomnia, cognitive impairment in schizophrenia, myotonic dystrophy, and post-anesthesia grogginess. It is also an effective jet lag treatment.
Research into the cognition-enhancing effects of modafinil has been mix. It appears to enhance performance in healthy adults who are not sleep-deprive, but it has not consistently shown improvement in complex cognitive tasks such as planning and decision-making. A randomized placebo-controlled study found that modafinil enhances performance on digit span, visual recognition memory, and spatial planning tasks in non-sleep-deprived people. However, it does not seem to affect arithmetic, reasoning, or perceptual speed-accuracy trade-off performance (Turner et al, 2003).
Cognitive enhancement effects of modafinil
A recent study compared modafinil with placebo in healthy young people using a cognitive task designed to measure the ability to switch attention. Both drugs significantly improved performance. Interestingly, modafinil increased performance on the switch task only when participants were awake. In the same study, modafinil also attenuated the decrease in performance caused by the SSRT (Switch-Response Task) – a measure of difficulty in switching attention from one stimulus to another – when subjects were awake but not consciously focusing their attention.
It is thought that the cognitive enhancement effects of modafinil are mediate by the brain’s monoamine neurotransmitters, including hypocretin, histamine, epinephrine, and g-aminobutyric acid. Its effect on arousal is thought to be mediate by the dopamine system, although its mechanism of action is still unknown.
Although studies have shown that modafinil is safe, it may not be appropriate for everyone. It can lead to dependence, especially when taken long term. Now, It is important to get a good night’s sleep and avoid caffeine, nicotine, and alcohol before taking it. It is also better to rely on lifestyle changes, rather than take a pill, to boost energy levels and mental health.
2. Increases Focus
Cognition is a central feature of many neuropsychiatric disorders, and there is an important need for new pharmacological approaches to cognitive dysfunction. Modafinil Malaysia is an agent with a favorable profile to enhance cognition, and several studies suggest that it improves performance on a number of cognitive tasks in healthy subjects (with and without sleep deprivation).
Among children with ADHD, modafinil has been found to significantly improve parent, teacher, and clinician ratings of ADHD symptoms in an open-label study using 400 mg/day for 4.6 weeks (Rugino and Copley, 2001). A randomized placebo-controlled trial with divided doses showed comparable efficacy to conventional stimulants in improving ADHD symptoms in adolescent patients with ADHD (Biederman et al, 2005).
In animal models, Modaheal 200 increases working memory and the processing of contextual cues in a task-specific manner. Similarly, modafinil improves human performance on a variety of cognitive control tasks in a dose- and delay-dependent manner. The magnitude of these enhancements relates to the level of cognitive demand. In addition, the improvement in performance correlates with changes in fMRI activity in the prefrontal cortex and the amygdala. Modafinil appears to dampen lateral amygdala activity during fear processing, indicating that it improves mental clarity and reduces anxiety.
Other studies have also shown that modafinil improves a number of psychiatric disorders, in particular schizophrenia. However, these studies have typically involve only a small number of participants and have been conduct using a short duration of treatment. In one study of 20 clinically stable schizophrenia patients, 8 weeks of double-blind add-on modafinil therapy at 200 mg/day failed to improve behavioral cognitive measures (CPT-Identical Pairs version, oculomotor delayed response, letter-number span, and delayed match-to-sample) compared with placebo (Sevy et al, 2005).
Other studies have demonstrated that Modafinil improves IQ in students with low IQ who are taking antidepressants, but the effect is likely to be due to ceiling effects. Moreover, Modafinil has been found to improve another frontal-dependent cognitive measure, Stroop interference, in a randomize trial with flexible dosing of 400 and 600 mg/day add to existing antidepressant medication (Schwartz et al, 2004). In this study, changes in the Stroop interference score were correlate with a reduction in errors on the WCST, and these changes mirrored an increase in left BA 46 activity.
3. Reduces Stress
Studies show that modafinil reduces the negative impact of stress on mental health by increasing concentration and motivation. This increased focus and concentration makes it easier to achieve goals and tasks, even when they are stressful or difficult. It also increases the ability to cope with stress and negative emotions, making it easier to regulate moods and improve overall mental well-being. In addition, modafinil acts as an antidepressant, which can help reduce feelings of depression and anxiety. This combination of effects can be particularly useful in combating PTSD and may help military personnel to maintain vigilance and stay alert in dangerous situations.
Modafinil increases the levels of norepinephrine, epinephrine, and dopamine in the brain. This increase is thought to be the primary reason for its wake-promoting effects. Modafinil’s ability to increase norepinephrine and dopamine in the brain also helps explain its effectiveness in treating various fatigue syndromes, narcolepsy, and attention-deficit/hyperactivity disorder (ADHD).
Several studies indicate that modafinil exerts these effects by inhibiting adenosine monophosphate (AMP)–activated protein kinase (AMPK), an enzyme that breaks down adenosine triphosphate (ATP) in cells. This causes the release of the amino acid adenosine and other energy-producing molecules, leading to increased arousal and activity. It has also been show that modafinil can directly activate the adrenergic and dopaminergic systems of the brain by binding to and blocking the dopamine transporter (DAT) and increasing its sensitivity to the NMDA receptor.
Another mechanism by which modafinil increases arousal and activity is by increasing the availability of the neurotransmitter glutamate. Glutamate is require for normal arousal and cognition, and it interacts with both the adrenergic and dopaminergic pathways to produce arousal. Using 2-deoxyglucose autoradiography, Nicolaidis and colleagues found that modafinil increases glutamate availability in the prefrontal cortex of rats.
Other studies have found that modafinil decreases errors made in a WCST and Hayling sentence completion task, which requires cognitive control. This effect is associate with activation of the dorsolateral prefrontal cortex and anterior cingulate cortices. One double-blind, placebo-controlled study of narcolepsy patients showed that a 4-day course of 200 mg modafinil improved performance on the WCST and a version of the Hayling task that measures planning and decision-making.
4. Reduces Anxiety
Modafinil ((2-((diphenylmethyl)sulfinyl)acetamide), the most commonly prescribe drug for narcolepsy, is know to increase cognitive performance in sleep-deprived subjects by inhibiting dopamine and norepinephrine transporters. However, recent research suggests that it may also have antianxiety effects in healthy individuals.
In a randomized, double-blind, placebo-controlled crossover trial of 38 healthy volunteers, modafinil significantly increased the speed of mental arithmetic and verbal fluency, as well as improved reaction time and accuracy on a visual memory recall task. In addition, participants who took modafinil showed a decrease in anger and hostility scores on the POMS questionnaire and decreased levels of anxiety as measured by the HAM-A scale. There was a significant correlation between serum modafinil levels and the changes in anger-hostility score, but no other significant correlations were observe between the changes in other POMS subscales or in anxiety levels.
The researchers found that a single dose of modafinil significantly reduced the reactivity of the amygdala to a threatening stimulus, suggesting that modafinil reduces anxiety and depression. The study also showed that modafinil increases glutamate in the medial prefrontal cortex (PFC), resulting in an increase in cognitive efficiency. This increase in glutamate appears to be due to adrenergic mechanisms as it is block by the adrenergic receptor antagonist, prazosin. In addition, modafinil increased the synthesis of the amino acid, creatine-phosphocreatine, and reduced the reuptake of the amino acid, aspartate, in the PFC.
Enhance cognition and improve impulsivity
Moreover, the researchers found that modafinil decreased the reactivity of the hippocampus to a threatening stimulus. This finding is consistent with the hypothesis that the hippocampus plays an important role in anxiety and depression, as it is involve in the processing of fear and stress. In addition, the hippocampus is associate with memory functions and modulates the activity of NMDA receptors.
Modafinil’s ability to enhance cognition and improve impulsivity and response inhibition while simultaneously decreasing anxiety and depression is a novel benefit that could have therapeutic applications. These findings are the first to show that a drug can elicit cognitive enhancement in healthy individuals, and it opens up ethical discussion about how we should classify, condone, or condemn a pharmaceutical agent that enables us to work harder and faster than is reasonable.