‘Get Smart’ Drug

Cambridge scientists have shown that modafinil, a medication which is currently used to help people stay awake, can also improve mental processing.  Their tests show that the drug enhances planning, problem solving, and memory of complex patterns.  People taking modafinil are also more accurate at discriminating between stimuli and quicker to inhibit impulsive responding. 

According to Danielle Turner, author of this research, ‘The drug appears to make people stop and think – after receiving it the volunteers were significantly better at inhibiting impulsive responding and at reflecting on the problems we set them.’

This drug could be invaluable to people who are overly impulsive or have specific kinds of cognitive deficits.  People who suffer from attention deficit disorder (ADHD), or who have impairments in certain types of memory, problem-solving, or planning, all fall into this category.  Other compounds have been used to treat these conditions in the past, but all of them have involved unfortunate side-effects such as addiction and increased anxiety.  Modafinil is not addictive and does not appear to have many side effects.

‘[Drugs such as] amphetamine and methylphenidate [Ritalin] have been used previously to help improve some aspects of people’s performance, but they often have the disadvantage of causing impairments in other functions, and are also associated with serious side effects such as addiction.  Modafinil, in contrast, has been shown to have few side effects and there is no evidence that it is  addictive’ says Turner.

So how does modafinil work and why doesn’t it have the same side effects as other cognitive enhancers?  According to Turner, that is a difficult question.  ‘The exact mechanism of action of modafinil is unknown.  [Other cognitive enhancers] cause significant changes in the transmission of dopamine and noradrenaline [chemical messengers known to be involved in keeping the brain alert, and also in sensations of pleasure, as well as in addiction].  These changes are likely to account in part for the cognitive enhancing properties associated with these drugs, but also for the associated negative side-effects.’  That modafinil uses a different mechanism is quite clear, however what this mechanism actually is remains to be determined.

When pushed to guess at the mechanism, Turner conjectures ‘[Modafinil] might act indirectly via other chemical messengers within the brain, possibly the noradrenergic system.  This would explain the enhanced cognitive effects and also the changes in physiological measures [such as increased heart rate, blood pressure] that we see.’

In her recent research, conducted together with Prof. Barbara Sahakian, also from Cambridge University, Turner tested 60 healthy male volunteers, each of whom swallowed either a dummy tablet or a dose of modafinil (200 or 400 milligrams).  To make certain that any results observed were really due to actions of the drug, rather than placebo effects or ‘faking’, neither volunteers nor experimenters were allowed to know which tablet had been taken until all the results were tabulated. 

Having swallowed their pills, volunteers performed a variety of different tasks using computer games and touch-sensitive monitors.  In one, which tested for impulsiveness, they had to respond as fast as possible to arrows requesting that right- or left-hand buttons be pressed. Occasionally, they were quite suddenly asked NOT to press either button.  People who had only swallowed a dummy pillneeded more warning time to stop than those who had taken a small dose of modafinil, and those who had taken a big dose of modafinil needed the least warning time of all.

People who took modafinil also performed better at spatial planning tasks and did better on two different tests for of memory than people who didn’t.  They were able to remember and repeat (in the order they were presented, both forwards and backwards) more numbers than people who had taken the dummy pills only, and showed an enhanced memory for visual patterns.

All of the information available to date suggests that modafinil will provide a lifeline for people who have poor memories or are uncontrollably impulsive.  But will this new medication  really work?  Turner aims to find out as soon as possible.  The next challenge on her research agenda is to determine whether modafinil works for patients as well as for healthy volunteers.  She will soon try the drug on teenagers and adults suffering from ADHD in order to find out whether it helps them in the ways she expects.  She will also use brain imaging techniques to determine which areas of the brain are involved in the tasks her patients perform, and which are influenced by modafinil.  This information will be extremely useful in determining how the drug works.

 

For more information contact:  Danielle Turner

Phone:  01223 336010

Email:  dct23@cam.ac.uk