Modafinil: A smart drug with psychiatric implications

Introduction Modafinil is approved to treat excessive somnolence but it is also off-spec used as a treatment for ADHD and as a cognitive enhancer. Research on the effects of modafinil on cognitive function have yielded mixed results. Modafinil interact with dopamine, noradrenaline, serotonin, glutamate, orexin, histamine and GABA levels. The regulation of these neurotransmitters is widely known to be implicated in most of the neuropsychiatric disorders. Methodology A review was conducted aiming to clarify the biological mechanisms of action of modafinil; its effects on attention, learning, executive functions and creative thinking; as well as possible neuropsychiatric disorders associated to its intake. The literature search was conducted in PubMed data reviewing articles dating between 2015 and 2016. Results (1) Empirical evidence for cognitive enhancing effects of one of the most frequently used substances, modafinil, is sparse. Studies suggest that with more protracted and complex testing, more benefits are associated to modafinil use. (2) Modafinil may be implicated in alterations of reward-related behaviour. Compared to placebo, modafinil leads to an enhanced tendency to make previously rewarded choices compared to the avoidance of previously punished choices. This pattern of altered choice behaviour is probably induced by an increase of the dopamine level and a potential contribution of elevated noradrenaline. Conclusions Some people share information about this drug in social network. Off-label use of this drug may be implicated in alterations of reward-related behaviour and patients with previous psychiatric disorders should be aware of its possible adverse effects.