How Fighter Pilots Stay Sharp

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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.

For a prescription drug classified as a schedule IV narcotic by the Drug Enforcement Administration, Provigil is relatively easy to obtain. (Unlike Ritalin, a highly addictive schedule II drug, modafinil is not habit forming and has shown no long-term negative side effects.) You can get it on the Internet, of course, but I decided to try the more legitimate route of consulting a doctor.

After briefly considering feigning narcolepsy, I played it straight, telling my M.D. that I'd heard people were using Provigil for sleep problems stemming from their unnatural schedules. Since I often write all night on deadline or fly all night on reporting trips, and must work the next day, well, maybe . . . "It sounds to me like you are doing something very similar to shift work," he said, with a hint of a smile. "Which Provigil is indicated for." Two hours later, the pharmacist handed over 30 pills, leaving my wallet $135 lighter, even after insurance. Brain enhancement doesn't come cheap.

A few days later, I popped 200 milligrams as I sat down at my desk after about five hours' sleep. I experienced no rush, lowered inhibitions, or enhanced feelings of self-worth. In fact it was hard to tell I was on anything at all (Provigil has few, and rare, side effects), except for the utter evaporation of my desire to return to sleep. One thing was certain: I was definitely more productive. A normal sleep-deprived work morning finds me discovering at noon that I've done nothing but click around online, reading blogs and sports news. On my first Provigil morning, I looked up to realize that I'd completed three hours of sustained work, burning through e-mails and pages of story notes without a moment's distraction.

Over the next few weeks, I tried Provigil in a variety of situations (while fighting off requests from friends to dish them a few pills), both sleep-deprived and not. The side effects were minimal (an occasional oddly intense sensation behind my eyes or a very mild nervous feeling) but nothing like those I experience after three cups of coffee. With a 100-mg dose I could dissolve any afternoon sleepiness, but I didn't necessarily feel much sharper at work. On 200 mg, however, my brain just seemed to lock in on the task at hand. While the drug was less a source of sudden insights than consistent, reliable comprehension, my productivity kept me riding smoothly over typical speed bumps, such as choosing the right word or grasping thorny scientific concepts. I couldn't help feeling that Provigil was earning back its price tag in the leg up it gave me in my work.

"You don't get something for nothing," warned James Swanson, a psychologist at the University of California–Irvine. If you want to postpone jet lag you can. But eventually it's going to catch up to you. If you use coffee to stay up on deadline all night, what do you think is going to happen? You crash. Modafinil is no different. There aren't magical properties." Swanson pointed out that whether it's Provigil or Ritalin, there are no "residual" effects. "You are not going to be smarter when the drug wears off." Indeed, I didn't feel any IQ boost when not on Provigil, and I couldn't say that the quality of my work was any better than normal.

Of course, Provigil wasn't intended to make me smarter in the first place; its cognitive effects on healthy people are serendipitous. With pharmaceutical companies cranking out promising new compounds to treat brain disorders like Alzheimer's, the next incidental cognitive enhancers may be more powerful, and more tempting to off-label users. "You can compare it to steroids in sports, where none of those were developed to enhance bodies," says Roger Stoll, executive chairman of Cortex Pharmaceuticals, a company working on a new class of potent ADHD meds. "The way this is developing, you aren't going to be able to stop it." Bioethicists worry that this coming flood of smart drugs will hasten our plunge into a 24/7, work-­obsessed society or devalue intellectual achievement in a brave new world of synthetic brain enhancement.

After my own experiment, I am not terribly concerned about becoming a brain-boosted automaton, any more than I would be after a diet of triple soy lattes. But while I may keep a little Provigil around for the occasional all-nighter, I found it doesn't enhance the qualities I really want more of: creativity, inspiration, passion for my work. For those I'll have to look elsewhere, and I think I'll start with a full night's sleep.

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