Modafinil is being hailed as the ‘world’s first safe smart drug’. Be wary of the hype

    28 August 2015

    Most students will have heard of it, and some will have taken it. Last week, scientists at Oxford University caused a media furore with their work on modafinil. ‘Smart drug taken by one in four students really does boost performance,’ said the Telegraph. ‘Narcolepsy medication modafinil is world’s first safe “smart drug”,’ claimed the Guardian.

    With the big headlines and bold claims, I couldn’t wait to read the article. In fact I found that many of the assertions were dodgy at best. Firstly, it was not a new study, but a review of 24 older studies examining the effects of modafinil on various cognitive functions. Second, the authors were very critical, and quite non-committal. They did conclude that preliminary evidence supports modafinil as a cognitive enhancer:

    When more complex tasks are considered, modafinil appears to enhance attention, higher executive functions, and learning and memory

    However, they also noted:

    It appears that within research on modafinil, any consensus about cognitive benefits has to this point been limited by the use of simplistic testing paradigms

    The use of ‘appear’ in any scientific paper should raise an eyebrow; it sounds like there just isn’t enough evidence to say anything conclusive yet.

    In light of the limited evidence, the authors’ recommendations for improved cognitive tests are sensible. Many of the original studies chose tests used to assess cognitive deficiency, rather than enhancement. Therefore, many have a ‘ceiling effect’; they aren’t good at discriminating cognitive enhancement from people with already high cognitive function. Hopefully, this will shape better research into the cognitive effects of modafinil, leading to more confident conclusions.

    When it comes to ‘safety’, the review itself mentions the word once (note our friend ‘appear’, again): ‘The FDA-approved eugeroic modafinil … appears safe for widespread use.’ This is not a criticism of the authors; the review did not aim to analyse safety data.

    At the moment, we can only speculate on the number of casual modafinil users. The assertion that ‘one in four students at Oxford University’ take modafinil, quoted in the Telegraph article, actually comes from a student newspaper survey with little scientific credibility. Another survey, conducted in 2008 by the journal Nature, found that roughly nine per cent of readers reported taking modafinil at some point. Simply, we don’t really know exact figures, but a significant number of academics and students ‘appear’ to be users.

    Last year, I had the pleasure of hearing Professor Barbara Sahakian from Cambridge University discuss cognitive enhancing drugs, or ‘nootropics’. Towards the end, someone asked: ‘So, if a friend asked me where to get some modafinil, what should I say?’ After the laughter faded, Professor Sahakian made clear the risk. As modafinil is a prescription drug, licensed only for narcolepsy in Britain, most casual users source it online. And you just can’t trust drugs bought online.

    As she told Sky News:

    [It] is a very unsafe way to get these drugs because you don’t really know what you’re getting and you don’t know if it’s safe for you as an individual.

    In the film Limitless, Bradley Cooper’s character Eddie describes NZT-48, the fictional nootrope, as ‘some unknown, untested, possibly dangerous drug scammed out of some unidentified lab somewhere’. This sums up precisely the situation with modafinil bought online. For now, I’d stick to coffee.