How Fighter Pilots Stay Sharp: Provigil

I might as well tell you up front: this story is being written under the influence of drugs. I'm not high. Nor am I feeling the least bit euphoric, jittery, or spaced out. Still, my brain is not acting entirely under its own power, because a few hours ago I took 200 milligrams of the anti-tiredness drug Provigil. With the assistance of this stalwart pharmaceutical sidekick, I've been able to spend the last couple of hours poring over a stack of scientific papers without distraction. Even now, it's enabling me to crank out these lines with atypical focus and mental dexterity – at least it feels that way.

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Provigil is the American brand name for the compound modafinil, the latest in a long and mostly undistinguished line of substances ranging from cocaine (commended by Freud) to amphetamines (assistant to Kerouac for 'On the Road') to Ritalin (long a college student favorite) to good old caffeine, consumed to fuel binges of productivity. Originally designed to treat narcolepsy, a disorder that leaves people perpetually sleepy, Provigil is also prescribed for those suffering from sleep apnea or for shift workers who can't get proper shut-eye during the day yet must stay alert enough at night so as not to kill people with heavy machinery. The air force, meanwhile, dispenses it as a "go pill," used by pilots to stay sharp. In July, the technology news site TechCrunch speculated that Provigil was becoming the "entrepreneur's drug of choice around Silicon Valley," powering 20-hour workdays. In other words, Provigil is already renowned for its ability to keep people awake. Lately, however, the drug is getting attention for doing more than that. It seems that a lot of people are taking Provigil to make themselves smarter.

If the limited research on the drug's cognitive enhancement properties is to be believed, the benefits are real. In a 2002 study by Cambridge University neuropsychologists, non–sleep deprived students given modafinil performed better than a control group on a number of standard cognitive tests. After being shown a series of visual patterns on a computer screen, for example, the modafinil crowd could better pick out which ones they'd seen before. Modafinil users also won in the "Tower of London" competition, a logic puzzle that measures problem-solving ability.

At least a few subsequent reports have backed up those results. A 2006 study of doctors taking modafinil, by researchers at California's Loma Linda University School of Medicine, concluded that it facilitated "sustained attention, cognitive control, and working memory" on the job.

Oddly, no one understands exactly how the drug promotes cognitive enhancement. What researchers do know is that it operates in a different fashion than amphetamines and other stimulants, and current speculation focuses on how it alters a set of neurotransmitters (chemicals that relay signals in your brain) in the frontal cortex, the center of high-level thinking.

The difference between the drug's wakefulness effects and its brain-enhancing ones is also blurry, but there are plenty of people who are happy to take advantage of both. This past April the scientific journal 'Nature' published a survey of its readership – most of whom are doctors and scientists – and found that one in five respondents had "used drugs for nonmedical reasons to stimulate their focus, concentration, or memory." The top brain-doping drug of choice was methylphenidate, a.k.a. Ritalin, followed closely by Provigil. "I'm amazed at how frequent the usage is, when you start to ask," says Cambridge professor of clinical neuropsychology Barbara Sahakian, who co-authored a 2007 'Nature' paper arguing that society needs to confront ethical questions raised by cognitive enhancement. "Most people are taking it to perform well as a healthy human. Whether it's because of jet lag or a neighbor blasting music all night, there are lots of times when we are not at our top performance." She describes colleagues who take it after long flights to help word recall for lectures or to concentrate on a piano piece; one even "took it once every two weeks in order to have a really intensive workday."

That squared with tales I'd heard from medical student friends about peers routinely popping Provigil and its companions like candy. Then there's the story a colleague told me of a famous author he'd met who disclosed that he took it to work nights. That was all the information I needed to start feeding my brain regular helpings of Provigil.