Modafinil improves cognition and response inhibition in adult attention-deficit/hyperactivity disorder Cognitive enhancing effects of modafinil in healthy volunteers Modafinil Alters Intrinsic Functional Connectivity of the Right Posterior Insula: A Pharmacological Resting State fMRI Study Modulatory Effects of Modafinil on Neural Circuits Regulating Emotion and Cognition Acute modafinil effects on attention and inhibitory control in methamphetamine-dependent humans. Effects of Modafinil on Emotional Processing in First Episode Psychosis Modafinil combined with cognitive training is associated with improved learning in healthy volunteers – A randomised controlled trial Modafinil modulates anterior cingulate function in chronic schizophrenia. Modafinil Increases the Latency of Response in the Hayling Sentence Completion Test in Healthy Volunteers: A Randomised Controlled Trial Early markers of cognitive enhancement: developing an implicit measure of cognitive performance Effect of Modafinil on Learning and Task-Related Brain Activity in Methamphetamine-Dependent and Healthy Individuals The role of the dopaminergic system in mood, motivation and cognition in Parkinson's disease: A double blind randomized placebo-controlled experimental challenge with pramipexole and methylphenidate Effects of methylphenidate on spatial working memory and planning in healthy young adults Time-response analysis of the effect of stimulant medication on the learning ability of children referred for hyperactivity. Short-term impact of cognition-motivation-emotional intelligence-resistance skills program on drug use prevention for school students in Wuhan, China Effects of modafinil on cognitive functions in first episode psychosis Does Modafinil Enhance Cognitive Performance in Young Volunteers Who Are Not Sleep-Deprived? Behavioral and subjective effects of d-amphetamine and modafinil in healthy adults. Comparing the Stimulant Effects of the H1-Antagonist Fexofenadine With 2 Psychostimulants, Modafinil and Methylphenidate Relative lack of cognitive effects of methylphenidate in elderly male volunteers
BACKGROUND Modafinil , a novel cognitive enhancer , has a clinical profile similar to conventional stimulants such as methylpheni date , despite a seemingly different mechanism of action . Modafinil selectively improves neuropsychological task performance in healthy volunteers , possibly through improved inhibitory control . We examined whether modafinil induced similar improvements in adults with attention-deficit/hyperactivity disorder . METHODS Twenty patients with a DSM-IV diagnosis of attention-deficit/hyperactivity disorder were entered into a double-blind , r and omized , placebo-controlled crossover study using a single 200 mg dose of modafinil . RESULTS Modafinil produced a similar pattern of cognitive enhancement to that observed in healthy adults , with improvements on tests of short-term memory span , visual memory , spatial planning , and stop-signal motor inhibition . On several measures , increased accuracy was accompanied by slowed response latency . This alteration in the speed-accuracy trade-off may indicate that modafinil increases the ability to " reflect " on problems coupled with decreased impulsive responding . Improvements were also seen in sustained attention , which was unaffected in healthy subjects . CONCLUSIONS If these benefits are shown to be maintained with chronic administration , modafinil may have potential as an important therapy for attention-deficit/hyperactivity disorder with a similar effect to stimulants such as methylpheni date in improving stop-signal response inhibition but without the side effects commonly experienced with amphetamine-like drugs Abstract Rationale . Modafinil , a novel wake-promoting agent , has been shown to have a similar clinical profile to that of conventional stimulants such as methylpheni date . We were therefore interested in assessing whether modafinil , with its unique pharmacological mode of action , might offer similar potential as a cognitive enhancer , without the side effects commonly experienced with amphetamine-like drugs . Objectives . The main aim of this study was to evaluate the cognitive enhancing potential of this novel agent using a comprehensive battery of neuropsychological tests . Methods . Sixty healthy young adult male volunteers received either a single oral dose of placebo , or 100 mg or 200 mg modafinil prior to performing a variety of tasks design ed to test memory and attention . A r and omised double-blind , between-subjects design was used . Results . Modafinil significantly enhanced performance on tests of digit span , visual pattern recognition memory , spatial planning and stop-signal reaction time . These performance improvements were complemented by a slowing in latency on three tests : delayed matching to sample , a decision-making task and the spatial planning task . Subjects reported feeling more alert , attentive and energetic on drug . The effects were not clearly dose dependent , except for those seen with the stop-signal paradigm . In contrast to previous findings with methylpheni date , there were no significant effects of drug on spatial memory span , spatial working memory , rapid visual information processing or attentional set-shifting . Additionally , no effects on paired associates learning were identified . Conclusions . These data indicate that modafinil selectively improves neuropsychological task performance . This improvement may be attributable to an enhanced ability to inhibit pre-potent responses . This effect appears to reduce impulsive responding , suggesting that modafinil may be of benefit in the treatment of attention deficit hyperactivity disorder Background Modafinil is employed for the treatment of narcolepsy and has also been , off-label , used to treat cognitive dysfunction in neuropsychiatric disorders . In a previous study , we have reported that single dose administration of modafinil in healthy young subjects enhances fluid reasoning and affects resting state activity in the Fronto Parietal Control ( FPC ) and Dorsal Attention ( DAN ) networks . No changes were found in the Salience Network ( SN ) , a surprising result as the network is involved in the modulation of emotional and fluid reasoning . The insula is crucial hub of the SN and functionally divided in anterior and posterior subregions . Methodology Using a seed-based approach , we have now analyzed effects of modafinil on the functional connectivity ( FC ) of insular subregions . Principal Findings Analysis of FC with resting state fMRI ( rs-FMRI ) revealed increased FC between the right posterior insula and the putamen , the superior frontal gyrus and the anterior cingulate cortex in the modafinil-treated group . Conclusions Modafinil is considered a putative cognitive enhancer . The rs-fMRI modifications that we have found are consistent with the drug cognitive enhancing properties and indicate subregional targets of action . Trial Registration Clinical Trials.gov Modafinil differs from other arousal-enhancing agents in chemical structure , neurochemical profile , and behavioral effects . Most functional neuroimaging studies to date examined the effect of modafinil only on information processing underlying executive cognition , but cognitive enhancers in general have been shown to have pronounced effects on emotional behavior , too . We examined the effect of modafinil on neural circuits underlying affective processing and cognitive functions . Healthy volunteers were enrolled in this double-blinded placebo-controlled trial ( 100 mg/day for 7 days ) . They underwent BOLD fMRI while performing an emotion information-processing task that activates the amygdala and two prefrontally dependent cognitive tasks — a working memory ( WM ) task and a variable attentional control ( VAC ) task . A clinical assessment that included measurement of blood pressure , heart rate , the Hamilton anxiety scale , and the profile of mood state ( POMS ) question naire was also performed on each test day . BOLD fMRI revealed significantly decreased amygdala reactivity to fearful stimuli on modafinil compared with the placebo condition . During executive cognition tasks , a WM task and a VAC task , modafinil reduced BOLD signal in the prefrontal cortex and anterior cingulate . Although not statistically significant , there were trends for reduced anxiety , for decreased fatigue-inertia and increased vigor-activity , as well as decreased anger-hostility on modafinil . Modafinil in low doses has a unique physiologic profile compared with stimulant drugs : it enhances the efficiency of prefrontal cortical cognitive information processing , while dampening reactivity to threatening stimuli in the amygdala , a brain region implicated in anxiety OBJECTIVE Individuals who are methamphetamine dependent exhibit higher rates of cognitive dysfunction than healthy people who do not use methamphetamine  , and this dysfunction may have a negative effect on the success of behavioral treatments for the disorder . Therefore , a medication that improves cognition , such as modafinil ( Provigil ) , may serve as a useful adjunct to behavioral treatments for methamphetamine dependence . Although cognitive-enhancing effects of modafinil have been reported in several population s , little is known about the effects of modafinil in methamphetamine-dependent individuals . We thus sought to evaluate the effects of modafinil on the cognitive performance of methamphetamine-dependent and healthy individuals . METHOD Seventeen healthy subjects and 24 methamphetamine- dependent subjects participated in this r and omized , double-blind , placebo-controlled , crossover study . Effects of modafinil ( 200 mg , single oral dose ) were assessed on participants ' performance on tests of inhibitory control , working memory , and processing speed/attention . RESULTS Across subjects , modafinil improved performance on a test of sustained attention , with no significant improvement on any other cognitive tests . However , within the methamphetamine-dependent group only , participants with a high baseline frequency of methamphetamine use demonstrated a greater effect of modafinil on tests of inhibitory control and processing speed than those participants with low baseline use of methamphetamine . CONCLUSIONS Although modafinil produced limited effects across all participants , methamphetamine-dependent participants with a high baseline use of methamphetamine demonstrated significant cognitive improvement on modafinil relative to those with low baseline methamphetamine use . These results add to the findings from a clinical trial that suggested that modafinil may be particularly useful in methamphetamine-dependent subjects who use the drug frequently BACKGROUND Emotional impairments are important determinants of functional outcome in psychosis , and current treatments are not particularly effective . Modafinil is a wake-promoting drug that has been shown to improve emotion discrimination in healthy individuals and attention and executive function in schizophrenia . We aim ed to establish whether modafinil might have a role in the adjuvant treatment of emotional impairments in the first episode of psychosis , when therapeutic endeavor is arguably most vital . METHODS Forty patients with a first episode of psychosis participated in a r and omized , double-blind , placebo-controlled crossover design study testing the effects of a single dose of 200 mg modafinil on neuropsychological performance . Emotional functions were evaluated with the  emotional face recognition test  , the  affective go-no go task  , and the  reward and punishment learning test . Visual analogue scales were used throughout the study to assess subjective mood changes . RESULTS Modafinil significantly improved the recognition of sad facial expressions ( z = 2.98 , p = .003 ) . In contrast , there was no effect of modafinil on subjective mood ratings , on tasks measuring emotional sensitivity to reward or punishment , or on interference of emotional valence on cognitive function , as measured by the affective go-no go task . CONCLUSIONS Modafinil improves the analysis of emotional face expressions . This might enhance social function in people with a first episode of psychosis Improving cognition in people with neuropsychiatric disorders remains a major clinical target . By themselves pharmacological and non-pharmacological approaches have shown only modest effects in improving cognition . In the present study we tested a recently-proposed methodology to combine CT with a ' cognitive-enhancing ' drug to improve cognitive test scores and exp and ed on previous approaches by delivering combination drug and CT , over a long intervention of repeated sessions , and used multiple tasks to reveal the cognitive processes being enhanced . We also aim ed to determine whether gains from this combination approach generalised to untrained tests . In this proof of principle r and omised-controlled trial thirty-three healthy volunteers were r and omised to receive either modafinil or placebo combined with daily cognitive training over two weeks . Volunteers were trained on tasks of new- language learning , working memory and verbal learning following 200 mg modafinil or placebo for ten days . Improvements in trained and untrained tasks were measured . Rate of new- language learning was significantly enhanced with modafinil , and effects were greatest over the first five sessions . Modafinil improved within-day learning rather than between-day retention . No enhancement of gains with modafinil was observed in working memory nor rate of verbal learning . Gains in all tasks were retained post drug-administration , but transfer effects to broad cognitive abilities were not seen . This study shows that combining CT with modafinil specifically elevates learning over early training sessions compared to CT with placebo and provides a proof of principle experimental paradigm for pharmacological enhancement of cognitive remediation BACKGROUND Schizophrenia is associated with widespread cognitive deficits that have an impact on social function . Modafinil promotes wakefulness and is reported to enhance cognition . AIMS To study the acute effects of modafinil administration upon brain activity and cognitive performance in people with chronic schizophrenia . METHOD In a r and omised double-blind placebo-controlled crossover design , 19 patients received either modafinil ( 100 mg ) or placebo prior to undertaking a working memory task with functional magnetic resonance imaging . RESULTS Seventeen patients completed the study and another underwent acute relapse 4 days post-drug . Modafinil administration was associated with significantly greater activation in the anterior cingulate cortex during the working memory task . The anterior cingulate cortex signal correlated with cognitive performance , although only a subset of patients exhibited ' enhancement ' . CONCLUSIONS Modafinil modulates anterior cingulate cortex function in chronic schizophrenia but its beneficial cognitive effects may be restricted to a subset of patients requiring further characterisation Background Modafinil is a medication licensed for the treatment of narcolepsy . However , it has been reported that healthy individuals without wakefulness disorders are using modafinil off-label to enhance cognitive functioning . Although some studies have reported that modafinil improves cognitive task performance in healthy volunteers , numerous other studies have failed to detect cognitive enhancing effects of modafinil on several well-established neuropsychological tasks . Interestingly , several clinical and pre clinical studies have found that improved cognitive task performance by modafinil is accompanied by slower response times . This observation raises the question as to whether this slowing of response time in healthy volunteers is a necessary and sufficient condition for cognitive enhancement with modafinil . The aim of the current experiment was to explore this question by investigating the effects of modafinil on the Hayling Sentence Completion Test ( HSCT ) . Methodology Sixty-four healthy volunteers received either a single dose ( 200 mg ) of modafinil ( n = 32 ) or placebo ( n = 32 ) in a r and omized , double-blind , placebo-controlled , parallel group study in which the principal outcome measures were response latencies on the response initiation and response inhibition sections of the HSCT . Principal Findings Participants dosed with modafinil had significantly longer mean response latencies on the HSCT for both the response initiation and response inhibition compared to participants dosed with placebo . However , participants in both groups made a similar number of errors on each of these measures , indicating that modafinil did not enhance the accuracy of performance of the task relative to placebo . Conclusions This study demonstrated that administration of single 200 mg doses of modafinil to healthy individuals increased the latency of responses in the performance of the HSCT , a task that is highly sensitive to prefrontal executive function , without enhancing accuracy of performance . This finding may provide important clues to defining the limitations of modafinil as a putative cognitive enhancer . Trial Registration Clinical Trials.gov There is intense interest in the development of effective cognitive enhancing drugs which would have therapeutic application across a number of neurological and psychological disorders including dementia , schizophrenia and depression . However , development in this area has been limited by the absence of sensitive biomarkers which can be used to detect and refine therapeutic-like action in phase 1 clinical studies . The aim of the present study was therefore to develop a measure of cognition relevant to the action of c and i date cognitive enhancers which might be sensitive to pharmacological manipulation in healthy volunteers . Healthy volunteers ( n = 34 ) were r and omised to receive a single dose of modafinil ( 100 mg ) or placebo . Five hours post dose , attentional flexibility in learning was assessed using a novel implicit learning task . Volunteers also completed an auditory digit span task and visual analogue scales ( VAS ) . Modafinil increased alertness as measured by the VAS . In the implicit learning task , modafinil enhanced learning rates in terms of both accuracy and reaction time , suggesting an increase in implicit rule learning . These results suggest that the novel learning task should be explored as a biomarker of early cognitive improvement which could be more sensitive than conventional measures Methamphetamine (MA)-dependent individuals exhibit deficits in cognition and prefrontal cortical function . Therefore , medications that improve cognition in these subjects may improve the success of therapy for their addiction , especially when cognitive behavioral therapies are used . Modafinil has been shown to improve cognitive performance in neuropsychiatric patients and healthy volunteers . We therefore conducted a r and omized , double-blind , placebo-controlled , cross-over study , using functional magnetic resonance imaging , to examine the effects of modafinil on learning and neural activity related to cognitive function in abstinent , MA-dependent , and healthy control participants .  Modafinil ( 200 mg ) and placebo were administered orally ( one single dose each ) , in counterbalanced fashion , 2 h before each of two testing sessions . Under placebo conditions , MA-dependent participants showed worse learning performance than control participants . Modafinil boosted learning in MA-dependent participants , bringing them to the same performance level as control subjects ; the control group did not show changes in performance with modafinil . After controlling for performance differences , MA-dependent participants showed a greater effect of modafinil on brain activation in bilateral insula/ventrolateral prefrontal cortex and anterior cingulate cortices than control participants . The findings suggest that modafinil improves learning in MA-dependent participants , possibly by enhancing neural function in regions important for learning and cognitive control . These results suggest that modafinil may be a suitable pharmacological adjunct for enhancing the efficiency of cognitive-based therapies for MA dependence In Parkinson 's disease ( PD ) reduced dopaminergic activity in the mesocorticolimbic pathway is implied in the pathophysiology of several non-motor symptoms related to mood , motivation and cognition . Insight in the pathophysiology of these syndromes may pave the way for more rational treatments . In a double-blind , r and omized , placebo controlled , crossover design with three arms , we studied the effects of a direct dopaminergic challenge with the dopamine 2 receptor agonist pramipexole , an indirect challenge with the dopamine reuptake inhibitor methylpheni date , and placebo on measures of mood , motivation and cognition in 23 agonist-naïve PD patients and 23 healthy controls . Acute challenge with pramipexole had a negative effect on mood and fatigue in both patients and controls . In addition , challenge with pramipexole led to increased anger , fatigue , vigor and tension in healthy control subjects , but not in PD patients . Challenge with methylpheni date had a positive effect on anhedonia and vigor in PD patients . Due to its side effects after a single administration , pramipexole is probably less suitable for acute challenge studies . The acute effects of a methylpheni date challenge on anhedonia and vigor in PD patients make this drug an interesting choice for further studies of the treatment of mood and motivational disorders in this population Abstract Previous studies of the effects of the psychomotor stimulant , methylpheni date , have concentrated on vigilance and reaction time tasks . In this study , the effects of methylpheni date on more complex aspects of cognition were studied using tasks from the CANTAB battery and related tests which have been shown to be sensitive to frontal lobe dysfunction . Twenty-eight young healthy men participated in a counterbalanced , double-blind , placebo-controlled study of the effects of methylpheni date .  Cognitive assessment included tests of spatial working memory , planning , verbal fluency , attentional set-shifting and sustained attention .  Methylpheni date had significant effects on performance of the tests of spatial working memory and planning but not on the attentional and fluency tests . When the drug was taken on the first test session , performance on the spatial tests was enhanced by the drug compared to placebo . However , when the drug was taken second , performance accuracy was impaired whereas response latencies were decreased . These results are consistent with a hypothesis that methylpheni date influences performance in two conflicting ways ; enhancing executive aspects of spatial function on novel tasks but impairing previously established performance . This pattern of effects is discussed within the framework of dual , interacting arousal mechanisms This report introduces a method for obtaining behavioral time-response information for a short-acting psychotropic drug ( methylpheni date [ Ritalin ] ) that is widely used to treat behaviorally hyperactive children . We used a laboratory learning task to document that between one and two hours after the administration of a single dose of methylpheni date , the drug exerts its maximum effect on performance in a learning task in the laboratory . This effect on cognitive performance dissipates within the same day . This rapid and transient effect of methylpheni date makes it possible to classify patients in a single day into those who respond favorably and those who respond adversely to the drug in terms of its effect on cognitive behavior Summary Drug abuse continues to be a serious public health threat worldwide . Most drug abuse prevention research has been conducted with predominantly American or European adolescent population s. Little is known about approaches that work best to prevent the initiation of Chinese adolescent drug use . For targeting risk factors of drug initiation in Chinese adolescents , a school-based health intervention program named “ Cognition-Motivation-Emotional Intelligence-Resistance Skills ” ( CMER ) was developed to enhance cognition upon drug use , to decrease motivation of drug use and to improve emotional adjusting and drug resistance skills in this study . A total of 798 students from 3 senior high schools in Wuhan , a city in central China , were assigned r and omly to intervention and control groups . The intervention group received the CMER program in which knowledge , development of positive attitude and motivation towards drugs and training of peer resistance skills were basic elements . The immediate impact was compared by measuring the above mentioned elements prior to and three-month after the training session . Students from both groups were asked to complete a self-administered question naire . The question naire included demographic items , self-reported drug use behavior , cognition , attitude , and motivation associated with the initiation of drug use and resistance skills . Three months after the intervention , significant effects were found on “ illegal substance use at least once ” ( P<0.05 ) between the intervention and control groups . Immediate effects of the intervention were also found on knowledge , motivation and peer resistance skills ( P<0.05 ) , but there was no clear evidence for any effects on attitude towards substance use ( P>0.05 ) . It was concluded that the CMER program , which significantly increased the knowledge of drugs and peer resistance skills , was effective in the drug abuse prevention in a sample of school students in Wuhan , China Rationale Cognitive impairments are important determinants of functional outcome in psychosis , which are inadequately treated by antipsychotic medication . Modafinil is a wake-promoting drug that has been shown to improve attention , memory and executive function in the healthy population and in patients with schizophrenia . Objectives We aim ed to establish modafinil ’s role in the adjunctive treatment of cognitive impairments in the first episode of psychosis , a time when symptoms may be more malleable than at chronic stages of the disease . Methods Forty patients with a first episode of psychosis participated in a r and omised , double-blind , placebo-controlled crossover design study assessing the effects of a single dose of 200 mg modafinil on measures of executive functioning , memory , learning , impulsivity and attention . Results Modafinil improved verbal working memory ( d = 0.24 , p = 0.04 ) , spatial working memory errors ( d = 0.30 , p = 0.0004 ) and strategy use ( d = 0.23 , p = 0.03 ) . It also reduced discrimination errors in a task testing impulsivity . Modafinil showed no effect on impulsivity measures , sustained attention , attentional set-shifting , learning or fluency . Conclusions Modafinil selectively enhances working memory in first episode psychosis patients , which could have downstream effects on patients ’ social and occupational functioning Abstract : In a double-blind , parallel groups study , 60 healthy student volunteers ( 29 men and 31 women , aged 19 - 22 years ) were r and omly allocated to receive placebo , 100 or 200 mg modafinil . Two hours later , in the early evening , they completed an extensive cognitive battery . The 3 groups did not differ in self-ratings of sleepiness or tiredness before the testing session , and there were no treatment-associated changes in these or in mood ratings during the tests . Modafinil was without effect in several tests of reaction time and attention , but the 200-mg group was faster at simple color naming of dots and performed better than placebo in the Rapid Visual Information Processing test of sustained attention . Modafinil was without effect on spatial working memory , but the 100-mg group performed better in the backward part of the digit span test . Modafinil was without effect on verbal short-term memory ( story recall ) , but 100 mg improved digit span forward , and both doses improved pattern recognition , although this was accompanied by a slowing of response latency in the 200-mg group . There were no significant effects of modafinil compared with placebo in tests of long-term memory , executive function , visuospatial and constructional ability , or category fluency . These results suggest that the benefits of modafinil are not clearly dose-related , and those from 100 mg are limited to the span of immediate verbal recall and short-term visual recognition memory , which is insufficient for it to be considered as a cognitive enhancer in non-sleep-deprived individuals Modafinil is indicated for the management of excessive daytime sleepiness ; however , recent studies have examined a broad range of potential uses . Given that clinical uses of modafinil may be exp and ing , this study compared modafinil and d-amphetamine effects on subjective and performance measures . Across 11 sessions , 11 healthy adults were tested after oral doses of placebo ( 5 sessions ) , modafinil ( 1.75 mg/kg , 3.50 mg/kg , or 7.00 mg/kg ) , and d-amphetamine ( 0.035 mg/kg , 0.070 mg/kg , 0.140 mg/kg ) under double-blind , r and omized conditions . Assessment s of cognitive performance and subjective effects were completed before drug administration , 30 min after drug administration , and at hourly intervals after drug administration for 5 hr . Modafinil increased ratings on the Amphetamine and Morphine Benzedrine Group scales of the Addiction Research Center Inventory ( ARCI ) and increased ratings on the Vigor and Total Positive scales of the Profile of Mood States .  d-Amphetamine increased visual analog ratings of feeling stimulated and liking the drug and increased ratings on the Morphine Benzedrine Group scale of the ARCI . Both medications significantly reduced visual analog scale ratings of feeling sleepy , and modafinil decreased ratings on the ARCI Pentobarbital-Chlorpromazine-Alcohol Group scale . Both medications sustained performance that deteriorated across time on the Sternberg Number Recognition Test . Modafinil also enhanced performance rate on the Digit-Symbol Substitution Task above baseline levels and increased response rate on the Repeated Acquisition of Response Sequences Task . These results suggest that modafinil engenders alerting effects and increases performance in healthy non-sleep-deprived individuals comparable with that of d-amphetamine Background Although antihistamines are known for their sedative adverse effects , fexofenadine was previously shown to have stimulating effects . These stimulant effects were rather mild in magnitude and were only demonstrated in tasks with a high workload . Aim The present study was set up to compare the magnitude of the stimulant effect of fexofenadine with those of 2 psychostimulants , modafinil and methylpheni date . Method Sixteen healthy volunteers ( 5 males and 11 females ; mean age , 21.8 years ) participated in a 4-way , placebo-controlled , crossover study . The effects of fexofenadine ( 360 mg ) , modafinil ( 200 mg ) , methylpheni date ( 20 mg ) , and placebo were compared in a critical tracking , divided attention , motor impulsivity , and vigilance task . Results In this study , no significant stimulant effects of fexofenadine were found in any of the tasks . Modafinil only improved reaction time in the vigilance task , whereas methylpheni date improved performance in the divided attention and vigilance tasks . In addition , performance after methylpheni date treatment was also better than after fexofenadine in the divided attention and vigilance tasks . Conclusion From the results , it can be concluded that the stimulating effects of methylpheni date are confirmed , whereas the stimulating effects of fexofenadine were not demonstrated in this study . It is evident that the stimulating effects of fexofenadine , which were apparent in previous studies , are not of the same magnitude as the effects of known psychostimulants such as methylpheni date Rationale Methylpheni date , a dopaminergic and noradrenergic reuptake inhibitor , has been shown in young , healthy adult volunteers to produce pronounced effects on working memory and sustained attention . We were interested in assessing whether similar improvements could be conferred upon elderly volunteers in order to gain a more complete underst and ing of the effects of age on monoaminergic manipulations of working memory and attention , as well as to explore the potential for pharmacological intervention in attention and executive dysfunction disorders in this age group . Objectives The main aim of the study was to characterise the dose-related effects of methylpheni date on a range of neuropsychological functions in elderly healthy volunteers . Methods Sixty healthy elderly adult male volunteers received either a single oral dose of placebo , 20 mg or 40 mg methylpheni date prior to performing a variety of tasks design ed to assess memory , attention and executive function . A r and omised double-blind , between-subjects design was used . Results Methylpheni date had significant cardiovascular and subjective effects . However , unlike in younger volunteers , no significant effects of drug on working memory ( spatial span and spatial working memory ) , response inhibition ( stop-signal ) or sustained attention ( rapid visual information processing ) were seen . Subtle effects on latency similar to those in younger volunteers were identified : both doses of methylpheni date result ed in a slowing in response time during set-shifting and decision-making . Conclusions The results of this study demonstrate that , in elderly subjects , the cognitive effects of methylpheni date are grossly attenuated and distinct from the profile previously described in younger volunteers . It is suggested that methylpheni date may not be appropriate as a pharmacological intervention in elderly patient groups , such as those reporting age-related cognitive decline
Based on a systematic review and meta- analysis we show that expectations regarding the effectiveness of these drugs exceed their actual effects , as has been demonstrated in single- or double-blind r and omised controlled trials .
For methylpheni date an improvement of memory was found , but no consistent evidence for other enhancing effects was uncovered .
Modafinil on the other h and , was found to improve attention for well-rested individuals , while maintaining wakefulness , memory and executive functions to a significantly higher degree in sleep deprived individuals than did a placebo .
However , repeated doses of modafinil were unable to prevent deterioration of cognitive performance over a longer period of sleep deprivation though maintaining wakefulness and possibly even inducing overconfidence in a person 's own cognitive performance
The term neuroenhancement refers to improvement in the cognitive , emotional and motivational functions of healthy individuals through , inter alia , the use of drugs .
Of known interventions , psychopharmacology provides readily available options , such as methylpheni date and modafinil .
Both drugs are presumed to be in widespread use as cognitive enhancers for non-medical reasons .