The First Real Smart Drug? Researchers Say Modafinil Works

So-called smart drugs or "nootropics" might have a roaring internet trade already, but there's still little consensus on how effective most substances actually are at enhancing cognitive function in people who are healthy but just want a bit of a brain boost.

A study published this week, however, makes bold claims on the properties of one of the most well-known smart drugs: modafinil. Modafinil is a medication prescribed for sleep conditions such as narcolepsy, but students, execs, and hacker types have documented taking the drug even when they're sleeping just fine—and getting brain enhancing effects as a result.

The new paper, published in European Neuropsychopharmacology, supports the general claims of modafinil fans. Ruairidh Battleday and Anna-Katharine Brem from the University of Oxford and Harvard Medical School reviewed studies that looked at the effect of modafinil on non-sleep-deprived people and came away stating that modafinil "may well deserve the title of the first well-validated pharmaceutical 'nootropic' agent."

What's more, they reported that they "did not observe any preponderances for side effects or mood changes." The studies they looked at reported only minor adverse effects and little effect on mood—"if anything improving it."

The authors went about their review by looking at previously published studies from January 1990 to December 2014 that investigated the cognitive effects of modafinil in healthy people (who weren't sleep deprived). They decided to do the overview, which included 24 eligible studies, because of lack of consensus on modafinil's effects and discrepancies in the methodology of studies.

One major discrepancy was how researchers tested modafinil's effects. This involves having a subject complete a task having taken modafinil and having taken a placebo, and comparing their performance. But what task do you use?

They found that in general, studies were split into two camps: simpler tasks, and more complex tasks.

A lot of methodologies developed to test cognition are more commonly applied to people with cognitive deficits. The researchers found that more recent studies that used more complex tests of cognition tended to report more consistently beneficial effects of modafinil than those using simpler tests.

This brought them to another conclusion: we need a better way to test the cognitive effects of nootropics. The kind of simple tasks used to test cognition are often targeted at people who have some sort of cognitive deficit, but they're not necessarily going to cut it when you're looking to measure the effect of drugs that may improve cognition beyond even normal levels.

This applies beyond modafinil to smart drugs in general, especially as we can imagine the future will bring even more sophisticated enhancement products: How do you measure brain power that might be off the charts?

While the researchers might have given some solid grounding for modafinil's effects, there's still the ethical debate over whether, or when, it's ok to take a pill that makes you smarter (obviously, modafinil is not yet licensed for this use). Is it OK to give yourself a drug-induced boost before an exam?

Guy Goodwin, President of the European College of Neuropsychopharmacology, suggested in a press statement that these findings underline the urgency of that discussion. "Previous ethical discussion of such agents has tended to assume extravagant effects before it was clear that there were any," he said. "If correct, the present update means the ethical debate is real: how should we classify, condone or condemn a drug that improves human performance in the absence of pre-existing cognitive impairment?"

However, not everyone agrees that modafinil is all that. Comments in the r/nootropics subreddit, full of users who report trying various alleged "smart" substances, show mixed reports. One points out that more studies are ongoing: A paper published after the period reviewed in this study concludes modafinil "does not enhance the global cognitive performance of healthy non-sleep deprived students, except regarding non-demanding tasks."

The jury might still be out on this particular substance, but one thing's clear: smart drugs are here.