Modafinil - the time-shifting drug

The wonders of pharmacology keep appearing regularly, each new drug seemingly too good to be true. In recent times there have been several killer apps for the drug industry – chemical substances that replace depression with a happy disposition or bolster a flagging sex drive to royal command performance (with encore) levels. Prozac and Viagra provided benefits so compelling they have entered everyday language and have a global following. Now there’s another “drug-most-likely-to-succeed” – this one enables you to stay awake for 40+ hours with close to full mental capacity with few side effects

Modafinil improves memory, and enhances one's mood, alertness and cognitive powers. The drug has a smoother feel than amphetamines and enables the user to stay awake and alert for 40 hours or more. Once the drug wears off, you just have to catch up on some sleep.

Marketed as Provigil ', 'Aletec' and 'Vigicer', Modafinil is a psychostimulant approved by the US Federal Drug Administration for improving wakefulness in patients with excessive sleepiness associated with shift work sleep disorder, obstructive sleep apnea / hypopnea syndrome and narcolepsy.

Not surprisingly, a drug that enables people to stay awake for 40 hour periods at close to full mental capacity with no real side effects could quickly gain widespread usage as a time-shifting drug. Got a project to do, Particularly, when it is devoid of the jitteriness associated with most drugs commonly used in such circumstance such as dextroamphetamine, cocaine and the world's most popular drug, caffeine.

"Au natural", (without drugs) humans don't deal well with lack of sleep and thanks to our fast-paced lifestyle and ever-increasing job demands, sleep deprivation is a commonplace occurrence in modern culture.

Australian researchers recently found that people who drive after being awake for more than 17 hours performed worse than those with a blood alcohol level of .05 percent (the local blood alcohol limit). Tests the world over have found that sleep deprivation significantly reduces human performance capabilities, coordination, reaction time and judgment.

Twenty four hours without sleep is enough to reduce most humans to half their normal mental capacity and it declines rapidly from that point.

Not surprisingly, the military are showing the most interest in the drug.

A large part of battle fatigue is sleep deprivation. When the military is on the move, almost everybody is required to perform mission-critical tasks way after they should be asleep. From the personnel at command HQ to the soldiers at the front, two or three weeks of activity with just a few hours sleep per day is routine in combat situations.

For years the military has been exploring new methods to safely combat sleep deprivation and to prevent the associated degradation of performance.

A drug that can double the mental capacity and alertness of a fighting force has more than doubled its effectiveness.

On top of that, with military communications now in real-time, this is a drug that might keep a small fighting force in heavy contact going until the sky's open up and help arrives.

But likely candidates for the modafinil fan club aren't hard to find beyond the military, if the world's caffeine consumption is any indication.

Caffeine is a drug used across the planet for combating fatigue, restoring mental performance and enhancing exercise endurance. Caffeine occurs naturally in more than 60 plant species each contributing to a whopping global per capita consumption estimated at around 70 milligrams (mg.) per person per day some 20 years ago. That figure is growing.

More than half of all American adults consume 300 mg. or more of caffeine every day. Nine out of ten Americans consume caffeine every day.

The most prolific caffeine contributor is coffee, the second most valuable legally traded commodity on Earth (after oil) with annual global retail sales more than US$70 billion. Caffeine is also contained in tea, chocolate and caffeine-enhanced cold drinks such as Coca Cola, Pepsi Cola, Red Bull et al.

In recent times, the caffeine-enhanced softdrink market has burgeoned.

In 1970, the average american drank 36 gallons of coffee and 23 gallons of carbonated soft drinks. By the year 2000, coffee consumption had more than halved to 17 gallons and soft drinks had grown 130% to 53 gallons. Caffeine consumption has grown significantly and a large proportion of that caffeine was imbibed with the sole aim of performance enhancement.

Unfortunately, the benefits of caffeine are such that constant use builds immunity, leaving the jitteriness but not the enhanced performance and most of the world's habitual coffee consumption is used to stave off the effects of caffeine withdrawal. Modafinil does not appear to have such drawbacks, though users should be acutely aware that prolonged and regular use of the drug will lead to health issues.

Almost any profession requires being switched on (mentally alert) at least some of the time, and if it's good enough for the most scientifically-analysed elite warriors on the planet, we suspect it'll be good enough for all other armed forces personnel, emergency and rescue workers, police, firefighters, and doctors, who are faced with very long hours of making potential life and death decisions ... and all those who need or choose to work long hours in their profession, from truck and taxi drivers, through to computer programmers.

Sportspeople are another likely marketplace - at the June 2003 United States Track and Field Championships, a star studded field of athletes tested positive for modafinil including sprinters Kelli White, Chris Phillips, Calvin Harrison and Chryste Gaines, hurdlers Sandra Glover and Eric Thomas and hammer thrower John McEwen. Modafinil now attracts a two year ban from all elite sports, but can be expected to proliferate at any level where drug testing does not occur.

Then there will be those who will take Modafinil for recreational purposes - it just might be the ultimate party drug with the user awake, alert and balanced and no problems remembering what happened or what got said the next morning.

So how good is it? Researchers recently had the opportunity to compare a group of America's finest with and without modafinil.

The testing was done using elite F-117A Nighthawk pilots - an F117-A Nighthawk is one of those black triangular stealth attack aircraft used with surgical precision by the US airforce in all recent wars.

Just over 60 Nighthawks were built and only one F-117A unit exists - the 49th Fighter Wing, at Holloman Air Force Base, N.M. The single-seater can fly at high subsonic speeds for unlimited distances with air refuelling. On their first deployment to Kuwait in 1992, a group of F-117s flew non-stop for 18.5 hours, a record for single-seat fighters that stands today.

With the right pilot aboard, the Nighthawk is a formidable weapon - a precision-strike aircraft with exceptional combat capabilities particularly suited for penetrating high-threat airspace with its stealth and speed and hitting critical targets with surgical accuracy using laser-guided weapons.

During Operation Desert Storm the Nighthawk flew approximately 1,300 sorties scoring direct hits on 1,600 high-value targets in Iraq. At US$45 million each, the Nighthawk is one of America's most effective weapons. When the United States declares war on you, the chances are the Nighthawk will be the first to tell you hostilities have begun. It was the ONLY U.S. or coalition aircraft to strike targets in downtown Baghdad and it led the first Allied air strike on Yugoslavia in March, 1999.

Our test group was the people who fly these aircraft - people who push the limits of human performance day-today using one of the most expensive and sophisticated aircraft on the planet. For the records, the F117-A is built by Lockheed Aeronautical Systems, is powered by two General Electric F404 non-afterburning engines is 19.4 metres long, 3.9 metres high, weighs 23,625 kilograms and has a wingspan of 13.2 metres.

The Laboratory and simulator tests studied the effects of being awake for 40 hours on alertness and flight performance.

The tests were repeated every five hours to help track the pilots' level of fatigue by monitoring body and brain activities. One test is a one-hour flight simulator mission. Researchers looked at the aviators' ability to monitor flight gauges and calculate basic mathematical equations. They also monitored eye movements and changes in pupil size.

While no one crashed or even came close to crashing, researchers said flight precision most noticeably changed between 33 hours and 38 hours into the test.

Armed with this initial data, the scientists returned to Holloman a few months later for the modafinil study.

Scientists said that while the pilots were on the medication, their performance "significantly improved," especially after 25 hours without sleep. The pilots also sustained brain activity at almost normal levels despite their sleeplessness.

During the simulator tests, modafinil "significantly" reduced the effects of fatigue during flight manoeuvres, researchers said.

Under the influence of modafinil, flight performance degraded by 15 to 30 percent. Performance by pilots without the medication degraded by 60 to 100 percent compared to fully rested performance levels.

The results of the testing were heavily conclusive - modafinil was effective for reducing the impact of fatigue.

International biopharmaceutical company Cephalon owns the worldwide rights to Modafinil.

Modafinil is available in more than 20 countries and is marketed under the brand name PROVIGIL in the United States, United Kingdom, Ireland, Italy, South Korea, Belgium and Luxembourg. Modafinil is available in other countries under the brand names, ALERTEC, MODIODAL, MODASOMIL, MODAVIGIL and VIGIL.

Modafinil is listed as a Schedule IV drug under the Controlled Substances Act. Schedule IV drugs as a class have a lower abuse potential than drugs listed in Schedule II or III. Other examples of Schedule IV drugs include Ambien, Xanax and Ativan. Examples of Schedule II drugs include Actiq, morphine, methadone and methylphenidate (Ritalin). Examples of Schedule III drugs include anabolic steroids, codeine and hydrocodone with aspirin or Tylenol, and some barbiturates.

Cephalon recently announced that it has filed an application with the U.S. Food and Drug Administration (FDA) requesting marketing approval of a new proprietary form of modafinil for the treatment of attention- deficit/hyperactivity disorder (ADHD) in children and adolescents between the ages of six and 17.