The Efficacy of Modafinil as a Cognitive Enhancer: A Systematic Review and Meta-Analysis

J Clin Psychopharmacol. Sep/Oct 2019;39(5):455-461. doi: 10.1097/JCP.0000000000001085.

Abstract

Background: Animal models and human studies have identified the potential of modafinil as a cognitive enhancing agent, independent of its effects on promoting wakefulness in sleep-deprived samples. Given that single-dose applications of other putative memory enhancers (eg, D-cycloserine, yohimbine, and methylene blue) have shown success in enhancing clinical outcomes for anxiety-related disorders, we conducted a meta-analytic review examining the potential for single-dose effects for modafinil on cognitive functioning in non-sleep-deprived adults.

Methods: A total of 19 placebo-controlled trials that examined the effects of single-dose modafinil versus placebo on the cognitive domains of attention, executive functioning, memory, or processing speed were identified, allowing for the calculation of 67 cognitive domain-specific effect sizes.

Results: The overall positive effect of modafinil over placebo across all cognitive domains was small and significant (g = 0.10; 95% confidence interval, 0.05-0.15; P < 0.001). No significant differences between cognitive domains were found. Likewise, no significant moderation was found for modafinil dose (100 mg vs 200 mg) or for the populations studied (psychiatric vs nonpsychiatric).

Conclusions: In conclusion, the available evidence indicates only limited potential for modafinil to act as a cognitive enhancer outside sleep-deprived populations.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Attention / drug effects
  • Central Nervous System Stimulants / administration & dosage
  • Central Nervous System Stimulants / pharmacology
  • Cognition / drug effects*
  • Executive Function / drug effects
  • Humans
  • Modafinil / administration & dosage*
  • Modafinil / pharmacology
  • Nootropic Agents / administration & dosage*
  • Nootropic Agents / pharmacology

Substances

  • Central Nervous System Stimulants
  • Nootropic Agents
  • Modafinil