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The Quest for a "Smart Pill!"

Researchers at the University of Oxford, England, recently released a white paper on their analysis of a number of studies that were done between 1990 and 2014 on Modafinil (Provigil), a drug that has been used in the U.S. since 1998 for narcolepsy, sleep apnea and shift-work disorders. What they found was a surprising enhancement of the study subjects' executive function and cognition abilities. The drug appeared to be tied to improvements in attention, learning, memory and creative thinking in a little over half the study subjects. Had the researchers found a so-called "smart pill?"

It should be noted that Provigil has been taken in the U.S. recreationally for years by those needing to stay alert and awake for long periods of time. But it's important to keep in mind that when we talk of cognition, we're actually talking about a multitude of things. It's a broad descriptive term that includes understanding, comprehension, mental processing, perception, discernment, insight and more. And there is a very rigorous science behind measuring cognition that is detail-oriented and fairly complex.

But cognition is not the same as intelligence. Just because a person may be labeled as "smart" doesn't always mean they're more insightful or perceptive. And it's difficult to measure anyone's subjective impressions of improvement in their cognitive functioning. Many study subjects may say that some drug is helping them when in reality it's not doing anything that is objectively measurable. In other words, proving that a drug such as Modafinil, or any other similar drug, actually improves cognitive functioning will be a difficult task for future researchers.

So what should we make of this latest information on a drug that might help some individuals improve their cognitive capacities? One of the more frustrating things that the elderly or their loved ones experience is the loss of that person's cognitive ability and if there were a drug that could slow or even halt that decline, it would probably be more than tempting to ask doctors or providers for a prescription.

Unfortunately, the drug is not FDA approved for cognitive help and there are a lot of warnings listed against its use. A history of heart disease, high blood pressure, liver or kidney problems, a history of substance abuse or mental health problems, or being pregnant all preclude use of this medication. And it's not known to be effective when used for a long period of time. Used for sleep disorders or shift work for short periods of time can be useful but long-term use by individuals to help prevent or delay cognitive decline is not indicated.

There have been a long list of attempts to improve cognitive capacities and turning to drugs has been increasingly tempting because we have become a society that accepts medication usage so easily. However, like so many similar substances before it, studies involving seniors using this drug have shown no real benefit. As conventional wisdom goes, perhaps sticking to a good cup of coffee in the morning to boost alertness may still be the best medicine--for all of us!

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