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Modafinil does enhance cognition, review finds

BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h4573 (Published 21 August 2015) Cite this as: BMJ 2015;351:h4573

Rapid Response:

Re: Modafinil does enhance cognitoon

It is provocative to read the news:
Modafinil does enhance cognition, review finds.(1)

Modafinil is a first-line wake-promoting medication and useful therapeutic alternative to psycho-stimulant medications for excessive daytime sleepiness (EDS). It is approved in USA and in many European countries to improve wakefulness in adult patients with EDS associated with narcolepsy, obstructive sleep apnea syndrome ( CPAP resistant EDS ), and shift-work disorders.

The use of Modafinil for normal individuals to increase cognition to supra-physiological levels must be based on firm and high-quality (using the consistent and fool-proof parameters to assess cognition) clinical trials/ meta-analysis.

In fact, the assessment tools of cognition needs to be standardized and to be reviewed before making definite conclusions as erroneous conclusions may lead to serious misleading and counterproductive conclusions; particularly for the high-profile decision makers, students and scientists in the society (common targets to misuse modafinil).(2)(3)

The cognition gets easily impaired because of some degree of stress, a common factor in day-to-day life and work. The better approach is to relieve the stress factor by lifestyle measures like regular physical exercises and relaxation techniques like meditation ( transcendental meditation), tai chai, sudarshan kriya ( taught by art of living) etc.(4).

Once the stress factor is relieved the cognition and performance improves easily and physiologically without any side-effects or any nonphysiological effects in the body and mind.

Rightfully, no country in the world has approved modafinil to improve cognition in normal individuals hitherto; while every organisation has approved lifestyle measures to improve physical and mental health.

References;

1. BMJ ; 351:h 4573

2.Maher B. Poll results: look who’s doping. Nature 2008 ; 452 : 674 -5

3.Battleday R, Brem AK. Modafinil for cognitive neuroenhancement in healthy non-sleep-deprived subjects: a systematic review. Eur Neuropsychopharmacol 2015 , doi: 10.1016/j.euroneuro.2015.07.028 .

4. Zope SA, Zope RA. Sudarshan kriya: Breathing for health. Int J Yoga.2013 ;6(1):4-10 doi: 10.4103/0973-6131-105935

Competing interests: No competing interests

22 August 2015
Neelesh Gupta
Medical Student (Intern)
University College of Medical Sciences & GTB Hospital (University of Delhi)
Dilshad Garden, New Delhi, India