Clever pills

Can the new 'wonder drug' Modafinil really boost your brain power without side effects?

So much to do, so little time! We all know what it's like to be swamped by our commitments, yet too tired to approach them with energy and enthusiasm because we haven't had enough sleep.

In America, some are choosing to tackle this problem with the help of a drug called Modafinil. It is available on prescription, is being widely used as a lifestyle drug and the pills are known among its enthusiastic users as 'zombies'. Indications are that its popularity will soon spread to this country. So what is known about it?

Medical uses
Modafinil is licensed for the symptomatic treatment of excessive sleepiness associated with:

• Narcolepsy - a medical condition where the sufferer has an extreme tendency to fall asleep in quiet surroundings or if they're bored.
• Obstructive sleep apnoea - a condition where the patient stops breathing for short periods in their sleep. This interferes with sleep quality and can make them very drowsy in the day.
• Moderate to severe chronic shift work sleep disorder.

What does it do?
The exact way it acts isn't fully understood but it is known to increase brain dopamine levels. The dopamine system is the one that cocaine and amphetamines work on to produce euphoria, pleasure and addiction. Modafinil's effects on this system are much weaker, so it is thought that it affects other brain neurotransmitter systems as well.

What are the effects?
People who take it say that it can help them stay awake for hours or even days at a time. Users have described it as 'a nap in the form of a pill'. They feel 'revved up' without having the jitteriness that caffeine can cause, and without the euphoria and strong addiction potential of amphetamines.

With Modafinil, it is possible to have 48 hours of continual wakefulness with relatively few ill effects. And the 'sleep debt' from this length of wakefulness is much less than you would expect.

Normally, if you stay awake for 48 hours, you can expect to have to sleep for 16 hours as a 'pay back', but with Modafinil, eight hours catch-up seems to be enough.