The off-prescription use of modafinil: An online survey of perceived risks and benefits

Abstract

Cognitive enhancing drugs are claimed to improve cognitive functions such as learning and attention. However, little is known presently about the characteristics of off-prescription cognitive enhancing drug users or their perceived everyday experience with these drugs. As modafinil is the most commonly used off-prescription cognitive enhancing drug, the current study aimed to provide a detailed profile of modafinil users and their experiences and perceptions of this drug. To this end, an online survey, targeting cognitive enhancing drug users and students, was advertised on forum sites. Information was obtained regarding demographic data, illicit drug use, psychiatric diagnosis and experience of modafinil. Of the 404 respondents, 219 reported taking modafinil. Of these the majority were male, American or British, university-educated and currently employed, with a mean age of 27. Overall, modafinil was perceived by users as being safe. Modafinil users reported higher levels of illicit drug use and psychiatric diagnosis than would be expected from population-based data. More frequent reported modafinil use was associated with higher numbers of perceived benefits whilst reported frequency of use was not associated with the number of perceived risks. There was also a tentative link between the reported use of modafinil and the reported presence of psychiatric disorders, largely depression and anxiety. Respondents who had reported a psychiatric diagnosis declared higher subjective benefits of modafinil. This may suggest further beneficial effects of modafinil or it may reflect insufficient medical treatment for psychiatric disorders in some people. Overall, the findings of the current study should be beneficial in informing clinicians and legislative bodies about the modafinil user profile and how modafinil is perceived.

Behavioral and dopamine transporter binding properties of the modafinil analog (S, S)-CE-158: reversal of the motivational effects of tetrabenazine and enhancement of progressive ratio responding

“…The ability of (S)-CE-123 and (S, S)-CE-158 to increase motivation and ameliorate effortrelated impairments can be seen as complimentary to the known effects of their parent compound, modafinil. In addition to its prescribed indication as a treatment for narcolepsy, modafinil is frequently used by many individuals as a nootropic, for off-label effects such as cognitive enhancement (Sahakian and Morein-Zamir, 2011;Battleday and Brem, 2015;Sousa and Dinis-Oliveira, 2020;Teodorini et al 2020). Memory and cognitive flexibility have been described as effects of both the S-configuration and the racemic mixture of the thiazolecontaining modafinil analog, CE-123 (Nikiforuk et al 2017;Kristofova et al 2018;CarnatsPerna et al 2019).…”

The Dark Triad of personality and attitudes toward cognitive enhancement

“…The prevalence of use of PCE varies depending on the context (ranging from 1 to 55%), and is especially high among some professional groups and students [ 13 – 15 ]. While research shows that medical risks associated with PCE outweigh its benefits [ 5 , 6 , 16 – 18 ], the public overestimates the effectiveness of PCE and underestimates the risks of undesirable side effects [ 15 , 19 , 20 ]. A study analyzing data from 15 countries participating in the General Drug Survey, show that the use of PCE has increased multiple fold from the 2015 edition to that of 2017 in several countries and decreased in none [ 21 ].…”

Serotonin/5-hydroxytryptamine (5-HT) physiology

“…3 Modafinil is a "wake-promoting agent" licenced for treatment of excessive daytime somnolence associated with narcolepsy, sleep apnoea, shift worker sleep disorder and attention deficit and hyperactivity disorder (ADHD). 12 The mode of action is not fully understood. Modafinil inhibits noradrenaline and dopamine, and increases the release of histamine, glutamate and serotonin.…”