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Modafinil has been extensively studied as a treatment for sleep disorders, but data on its capacity for cognitive enhancement is thin. In Cambridge, England, researchers saw a spike in the short-term memory and planning ability of male volunteers who took the drug. Other researchers saw bone-tired subjects who took Provigil stay alert while using helicopter simulators; tests have also indicated that the drug can improve planning and the ability to remember long strings of numbers.

I swallow a pill at around 2:00 p.m., roughly the same time of day I was first tested in Eric Wassermann’s lab. I’m walking down Fifth Avenue in the bright spring sunshine and feel nothing. I get a cell-phone call and start talking, feeling my usual afternoon dopiness. Later I board a flight back home to San Francisco, and about three hours after popping the pill, I fall asleep.

In San Francisco, I try Provigil again at 8:00 a.m., along with my usual cup of coffee. This time, after 15 or 20 minutes, I feel an alertness that caffeine alone doesn’t usually give me; the feeling plateaus over the next three hours and resolves into a low-key but constant “up” sensation. I plunge into work and feel highly efficient and bright. For a little while, the sensation is almost too much, as if my brain has been set to fast-forward and can’t be turned off.

That morning, I talk to Jeffry Vaught, the research and development chief at Cephalon. He tells me that the pill is a mild stimulant and does not prevent sleep if people desire it. “For people with narcolepsy,” he says, “the impact is not mild; it’s life changing.” Vaught says the mechanism behind Provigil’s effect is not well understood, but scientists know what part of the brain it involves. “It’s a pathway involved with wakefulness, with waking you up and keeping you attentive,” Vaught says. “This pathway is activated by modafinil.” Major stimulants such as caffeine and amphetamines act on this part of the brain, too, but they also activate other regions, causing side effects such as jitters, loss of appetite, and that edgy feeling.

As the day wears on, my steady up-ness begins to get annoying. I’m calm, but I realize that when I write without the drug, I experience an intricate pattern of short ups interspersed with mild downs, during which I rest my brain. I’m not used to this uniform pharmaceutical lift.

Before long we might be drinking beverages laced with modafinil and other mild stimulants that have fewer side effects than coffee. It’s likely that we’ll also be slipping zappers onto the brims of our hats and flipping them on when we get spacey. But neither of these brain boosters is close to helping me, say, understand advanced quantum mechanics or write a symphony like Mozart. I’ll have to muddle along being me for a bit longer.

David Ewing Duncan is a Technology Review contributing editor. His next book is Experimental Man: A Molecular Autobiography.

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Credit: Jason Schneider

Tagged: Biomedicine

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