title: Non-medical use of prescription stimulants among US college students: prevalence and correlates from a national survey. Cognitive performance following modafinil versus placebo in sleep-deprived emergency physicians: a double-blind randomized crossover study. The effect of modafinil on counter-regulatory and cognitive responses to hypoglycaemia Modafinil Attenuates Disruptions in Cognitive Performance During Simulated Night-Shift Work Comparison of acute behavioral effects of sustained-release and immediate-release methylphenidate. Reinforcing and subjective effects of methylphenidate: dose and time in bed. Methylphenidate Enhances Working Memory by Modulating Discrete Frontal and Parietal Lobe Regions in the Human Brain Relative lack of cognitive effects of methylphenidate in elderly male volunteers Effects of methylphenidate on spatial working memory and planning in healthy young adults Pharmacodynamic effects on alertness of single doses of armodafinil in healthy subjects during a nocturnal period of acute sleep loss* Self-monitoring cognitive performance during sleep deprivation: effects of modafinil, d-amphetamine and placebo. Neurochemical and Psychotropic Effects of Bupropion in Healthy Male Subjects Sleepiness and the reinforcing and subjective effects of methylphenidate. Effects of methylphenidate on stimulus evaluation and response processes: evidence from performance and event-related potentials. Methylphenidate Does Not Improve Cognitive Function in Healthy Sleep-Deprived Young Adults Role of monoamine pathways in attention and effort: Effects of clonidine and methylphenidate in normal adult humans A Randomized, Double-Blind, Crossover Trial of Modafinil on Mood Effect of Magnesium Pemoline and Methylphenidate on Memory Improvement and Mood in Normal Aging Subjects Interest of modafinil, a new psychostimulant, during a sixty‐hour sleep deprivation experiment Methylphenidate's effects on paired-associate learning and event-related potentials of young adults.
abstract: AIMS To examine the prevalence rates and correlates of non-medical use of prescription stimulants ( Ritalin , Dexedrine or Adderall ) among US college students in terms of student and college characteristics . DESIGN A self-administered mail survey . SETTING One hundred and nineteen nationally representative 4-year colleges in the United States . PARTICIPANTS A representative sample of 10 904 r and omly selected college students in 2001 . MEASUREMENTS Self-reports of non-medical use of prescription stimulants and other substance use behaviors . FINDINGS The life-time prevalence of non-medical prescription stimulant use was 6.9 % , past year prevalence was 4.1 % and past month prevalence was 2.1 % . Past year rates of non-medical use ranged from zero to 25 % at individual colleges . Multivariate regression analyses indicated non-medical use was higher among college students who were male , white , members of fraternities and sororities and earned lower grade point averages . Rates were higher at colleges located in the north-eastern region of the US and colleges with more competitive admission st and ards . Non-medical prescription stimulant users were more likely to report use of alcohol , cigarettes , marijuana , ecstasy , cocaine and other risky behaviors . CONCLUSIONS The findings of the present study provide evidence that non-medical use of prescription stimulants is more prevalent among particular subgroups of US college students and types of colleges . The non-medical use of prescription stimulants represents a high-risk behavior that should be monitored further and intervention efforts are needed to curb this form of drug use OBJECTIVES Modafinil has recently been approved for the treatment of shift work sleep disorder , making it potentially available for shift-working emergency physicians . The authors ' objectives were to determine whether modafinil improved cognitive performance of emergency physicians following overnight shifts and to record symptoms and subjective evaluations of the effect of modafinil on the participants . METHODS This was a r and omized , double-blind , placebo-controlled crossover study that followed CONSORT guidelines . Participants were assigned to one of two study groups , with study sessions occurring at least seven weeks apart , and received either modafinil or placebo depending on their r and om allocation . Testing after night shifts included a coding task and an AX version of the Continuous Performance Task , both of which test cognitive function . Participants also completed visual analog scales for three subjective outcomes , and symptoms were elicited . RESULTS Modafinil facilitated performance on long interstimulus-interval AX trials ( F [ 1 , 23 ] = 6.65 , p = 0.1 ) and marginally reduced errors on AY trials in the Continuous Performance Task ( F [ 1 , 23 ] = 3.59 , p = 0.07 ) , suggesting facilitation of sustained attention , cognitive control , and working memory . Additionally , modafinil , compared with placebo , facilitated performance on the coding task at the first session . Subjective data from visual analog scales confirmed that modafinil increased perceived alertness during the simulated patient care sessions but worsened sleep onset when opportunities for sleep arose . CONCLUSIONS Modafinil increased certain aspects of cognitive function and subjectively improved participants ' ability to attend post-night-shift didactic sessions but made it more difficult for participants to fall asleep when opportunities for sleep arose Aims /hypothesisOur hypothesis is that reducing release of the inhibitory neurotransmitter gamma-aminobutyric acid ( GABA ) with modafinil will enhance symptomatic and hormonal responses to hypoglycaemia . Methods Nine healthy men received , in r and om order , two 100-mg doses of modafinil or placebo , followed by an insulin clamp in which plasma glucose was either reduced stepwise to 2.4 mmol/l or was sustained at euglycaemia ( four studies ) . Catecholamines , symptom scores and cognitive function were measured . Results Modafinil had no effect on the measured parameters during euglycaemia . During hypoglycaemia , autonomic symptom scores were significantly higher with modafinil ( increase at lowest plasma glucose concentration 271.3±118.9 vs 211.2±80.4/40 min , p=0.019 ) , and the heart rate response was increased ( 12,928±184 vs 6773±148 bpm/140 min , p=0.016 ) . Deterioration in performance of two cognitive tasks was reduced : Stroop colour – word test ( 613±204 vs 2375±161/65 min , p=0.009 ) and accuracy of a simple reaction task ( 11.3±1.8 vs 9.4±3.7 , p=0.039 ) . Conclusions /interpretationWe conclude that modafinil improves adrenergic sensitivity and some aspects of cognitive function at hypoglycaemia , possibly by reducing neuronal central GABA concentrations Common complaints among shift workers are sleep disruptions and increased sleepiness while working , which may contribute to shift workers being more susceptible to diminished performance and work-related accidents . The purpose of this double-blind , within-participant study was to examine the effects of the alerting agent modafinil on cognitive/psychomotor performance , mood , and measures of sleep during simulated shift work . In all , 11 participants completed this 23-day residential laboratory study . They received a single oral modafinil dose ( 0 , 200 , 400 mg ) 1 h after waking for three consecutive days under two shift conditions : day shift and night shift . Shifts alternated three times during the study , and shift conditions were separated by an ‘ off ’ day . When participants received placebo , cognitive performance and subjective ratings of mood were disrupted during the night shift , relative to the day shift . Objective and subjective measures of sleep were also disrupted , but to a lesser extent . Modafinil reversed disruptions in cognitive performance and mood during the night shift . While modafinil produced few effects on sleep measures during the night shift , the largest dose produced several sleep alterations during the day shift . These data demonstrate that abrupt shift changes produced cognitive performance impairments and mood disruptions during night shift work . Therapeutic doses of modafinil attenuated night-shift-associated disruptions , but the larger dose produced some sleep impairments when administered during day-shift work The rate of onset of a drug 's effect is an important determinant of its abuse potential . This experiment examined the acute behavioral effects of orally administered sustained-release methylpheni date ( SR ; 20 - 40 mg ) , immediate-release methylpheni date ( IR ; 20 - 40 mg ) , and placebo in 10 healthy volunteers .  Drug effects were assessed before drug administration and periodically afterwards for 6 hr using drug-effect question naires and performance measures that are sensitive to the acute effects of stimulants . The IR formulation produced stimulant-like drug effects ( e.g. , increased ratings of " good effects " ) that generally varied as a function of dose and time . The SR formulation produced only transient effects on these measures . These findings are consistent with previous research on the influence of rate of onset using other drugs and suggest that the abuse potential of IR methylpheni date may be greater than that of SR methylpheni date So that reinforcing and subjective effects of methylpheni date as a function of dose and level of sleepiness could be evaluated , 21 volunteers received methylpheni date ( 5 , 10 , or 20 mg ) or placebo on 2 sampling days . After 4 and 8 hr time in bed ( TIB ) , they chose their preferred capsule on 5 days . Methylpheni date was chosen more frequently after 4 hr TIB ( 60 % ) than it was after 8 hr TIB ( 33 % ) . The strongest preference ( 68 % ) was seen in the 10-mg group . At 10 and 20 mg , stimulant-like subjective effects were reported . The 10-mg group was more adversely affected by the restricted bedtime and showed more pronounced drug effects with methylpheni date . These results indicate that sleepiness modulates the reinforcing and subjective effects of methylpheni date The indirect catecholamine agonist methylpheni date ( Ritalin ) is the drug treatment of choice in attention deficit/hyperactivity disorder ( AD/HD ) , one of the most common behavioral disorders of childhood ( DSM-IV ) , although symptoms may persist into adulthood . Methylpheni date can enhance cognitive performance in adults and children diagnosed with AD/HD ( Kempton et al. , 1999 ; Riordan et al. , 1999 ) and also in normal human volunteers on tasks sensitive to frontal lobe damage , including aspects of spatial working memory ( SWM ) performance ( Elliott et al. , 1997 ) . The present study investigated changes in regional cerebral blood flow ( rCBF ) induced by methylpheni date during performance of a self-ordered SWM task to define the neuroanatomical loci of the beneficial effect of the drug . The results show that the methylpheni date -induced improvements in working memory performance occur with task-related reductions in rCBF in the dorsolateral prefrontal cortex and posterior parietal cortex . The beneficial effects of methylpheni date on working memory were greatest in the subjects with lower baseline working memory capacity . This is to our knowledge the first demonstration of a localization of a drug-induced improvement in SWM performance in humans and has relevance for underst and ing the treatment of AD/HD Rationale Methylpheni date , a dopaminergic and noradrenergic reuptake inhibitor , has been shown in young , healthy adult volunteers to produce pronounced effects on working memory and sustained attention . We were interested in assessing whether similar improvements could be conferred upon elderly volunteers in order to gain a more complete underst and ing of the effects of age on monoaminergic manipulations of working memory and attention , as well as to explore the potential for pharmacological intervention in attention and executive dysfunction disorders in this age group . Objectives The main aim of the study was to characterise the dose-related effects of methylpheni date on a range of neuropsychological functions in elderly healthy volunteers . Methods Sixty healthy elderly adult male volunteers received either a single oral dose of placebo , 20 mg or 40 mg methylpheni date prior to performing a variety of tasks design ed to assess memory , attention and executive function . A r and omised double-blind , between-subjects design was used . Results Methylpheni date had significant cardiovascular and subjective effects . However , unlike in younger volunteers , no significant effects of drug on working memory ( spatial span and spatial working memory ) , response inhibition ( stop-signal ) or sustained attention ( rapid visual information processing ) were seen . Subtle effects on latency similar to those in younger volunteers were identified : both doses of methylpheni date result ed in a slowing in response time during set-shifting and decision-making . Conclusions The results of this study demonstrate that , in elderly subjects , the cognitive effects of methylpheni date are grossly attenuated and distinct from the profile previously described in younger volunteers . It is suggested that methylpheni date may not be appropriate as a pharmacological intervention in elderly patient groups , such as those reporting age-related cognitive decline Abstract Previous studies of the effects of the psychomotor stimulant , methylpheni date , have concentrated on vigilance and reaction time tasks . In this study , the effects of methylpheni date on more complex aspects of cognition were studied using tasks from the CANTAB battery and related tests which have been shown to be sensitive to frontal lobe dysfunction . Twenty-eight young healthy men participated in a counterbalanced , double-blind , placebo-controlled study of the effects of methylpheni date .  Cognitive assessment included tests of spatial working memory , planning , verbal fluency , attentional set-shifting and sustained attention .  Methylpheni date had significant effects on performance of the tests of spatial working memory and planning but not on the attentional and fluency tests . When the drug was taken on the first test session , performance on the spatial tests was enhanced by the drug compared to placebo . However , when the drug was taken second , performance accuracy was impaired whereas response latencies were decreased . These results are consistent with a hypothesis that methylpheni date influences performance in two conflicting ways ; enhancing executive aspects of spatial function on novel tasks but impairing previously established performance . This pattern of effects is discussed within the framework of dual , interacting arousal mechanisms ABSTRACT Objective : To assess the pharmacodynamics of armodafinil compared with modafinil and placebo on measures of alertness in healthy volunteers undergoing sleep loss . Research design and methods : In a double-blind , active- and placebo-controlled , parallel-group study , 107 healthy male volunteers ( aged 18–40 years ) were r and omized to receive a single oral dose of armodafinil ( 100 , 150 , 200 , or 300 mg ) , modafinil ( 200 mg ) , or placebo administered at 19:25 h. Main outcome measures : The primary outcome was the Maintenance of Wakefulness Test ( MWT ) , administered every 2 hours from 22:00–08:00 h. Secondary outcomes included the Psychomotor Vigilance Task ( PVT ) and the Karolinska Sleepiness Scale . Blood sample s for pharmacokinetic analysis were collected hourly . Adverse events were evaluated throughout the 2‐day laboratory stay and by telephone on day 9 . Results : All four doses of armodafinil , and the dose of 200 mg modafinil , improved wakefulness as measured by increased MWT latencies ( treatment effect , p < 0.0001 ) and reduced PVT lapses of attention ( treatment effect , p < 0.0001 ) . The magnitude and duration of these effects at the later time points appeared to be dose and concentration dependent . Armodafinil at 200 mg result ed in comparable Cmax , a later tmax , and higher plasma concentrations 6–14 hours post-drug administration than with 200 mg modafinil . Following armodafinil , longer MWT latencies and fewer PVT lapses 6 to ≈ 14 hours post-drug administration were observed compared with modafinil . Armodafinil doses were well tolerated , with the most common adverse events including abdominal pain , nausea , and headache . There were reports of tachycardia/palpitations . Decreased mean sleep efficiency and increased mean blood pressure were also observed . Conclusion : Armodafinil  improved alertness at all doses studied . Relative to modafinil 200 mg , armodafinil 200 mg showed a comparable peak plasma concentration with higher concentrations 6–14 hours post-drug , and improved wakefulness and sustained attention for a longer time post-dose . Both drugs were well tolerated ; however , further research on the efficacy , safety , and tolerability of armodafinil in patients with disorders of excessive sleepiness ( ES ) is required Self-monitoring refers to the ability to assess accurately one 's own performance in a specific environment . The present study investigated the effects of the stimulating drugs modafinil ( 300 mg ) and d-amphetamine ( 20 mg ) on the ability to self-monitor cognitive performance during 64 h of sleep deprivation ( SD ) and sustained mental work . Two cognitive tasks were investigated : a visual ( perceptual ) judgement task and a complex mental addition task . Subjects in the placebo  condition displayed marked circadian and SD effects on cognitive task performance but their self-monitoring was substantively undisturbed by SD . Subjects performing under the influence of d-amphetamine likewise displayed highly proficient self-monitoring throughout the SD period . In contrast , modafinil had a disruptive effect on self-monitoring , inducing a reliable ' overconfidence ' effect ( i.e. an overestimation of actual cognitive performance ) , which was particularly marked 2 - 4 h post-dose . Although modafinil has proven to be a safe and effective countermeasure to the effects of extensive SD on cognitive task performance , we encourage a more comprehensive underst and ing of the relation between its subjective and performance enhancing effects before the drug is recommended as a viable fatigue countermeasure Bupropion is a weak inhibitor of noradrenaline ( NE ) and dopamine ( DA ) reuptake and has no direct action on serotonin ( 5-HT ) neuronal elements . In the rat brain , bupropion suppresses NE neuron firing activity via the activation of α2-adrenoceptors and increases that of 5-HT neurons through an indirect action on NE neurons . Twenty-five healthy young male volunteers , with no previous history of psychiatric disorders , were r and omized to one of four 7-day regimens : placebo , bupropion ( 150 mg ) once daily , bupropion ( 150 mg ) twice a day , and methylpheni date SR ( 20 mg daily ) . To assess the activity of the NE reuptake process , the blood pressure response to intravenous tyramine was determined . A decrease in the systolic pressure response to tyramine was considered evidence of NE reuptake inhibition . Effects on 5-HT reuptake were assessed by measuring whole blood 5-HT concentration , with a decrease serving as an index of 5-HT reuptake blockade . The Profile of Mood States ( POMS ) scale was used to assess behavioral and psychological changes . Neither bupropion nor methylpheni date altered the tyramine pressor response , in contrast to previous data that demonstrated decreases were obtained with NE reuptake inhibitors . Neither drug modified 5-HT concentrations . However , POMS scores revealed that bupropion at a dosage of 150 mg/day increased composedness , agreeability , and energy , whereas 300 mg/day improved only attention . In contrast , methylpheni date improved only energy . These data provide no evidence that bupropion acts as an inhibitor of NE or 5-HT reuptake in healthy humans . Presumably it enhances synaptic availability of NE by increasing release . Yet , because its behavioral profile is different from that of methylpheni date , it may not share all the biochemical properties of psychostimulants On 4 days , 6 volunteers received 10 mg methylpheni date or placebo at 0900 after 4 or 8 hr time in bed ( TIB ) and then on 4 days after 4 or 8 hr TIB chose their preferred capsule . On sampling days , 4 hr TIB increased multiple sleep latency test ( MSLT ) scores and Fatigue scale scores on the Profile of Mood States ( POMS ) . In both TIBs , the drug increased the MSLT and POMS Vigor and Tension scale scores . It reduced POMS Fatigue scores and improved divided attention performance to a greater extent after 4 versus 8 hr . Drug was chosen on 88 % of days after 4 hr , but only 29 % of days after 8 hr . Preference for the drug depends on sleepiness and is mediated by performance-enhancing and fatigue-altering effects This study investigated the effects of methylpheni date in a memory scanning task with two levels of high cognitive load ( memory set sizes 2 and 4 presented in displays of size 4 ) and two response requirements ( simple mapping or rotation ) . Twenty young adults were tested under placebo and methylpheni date ( 0.3 mg/Kg ) in a double-blind protocol . As expected , memory load increased misses , false alarms , confusions , and failures to respond by the deadline . In turn , the rotation requirement increased confusions and nonresponses . Reaction time ( RT ) was slowed by both factors . P3b latency also was increased by memory load and , to some extent , by the rotation requirement . These results are consistent with the proposition that P3b latency reflects largely evaluation , rather than response processes . Misses and reaction time were decreased in response to targets presented in the center vs. the periphery of the display . Confusions , however , showed the opposite trend . The display position did not affect P3b latency . These results can be explained by assuming that the subject was focusing on the center of the display and that accuracy diminished when stimuli were presented toward the periphery of the display . The stimulant challenge speeded up reaction times overall and specifically reduced the slowing effect of rotation . However , P3b latency was not affected by methylpheni date , so that the speeding of reaction time by the stimulant can be attributed to post-evaluation processes Background Abuse of methylpheni date , a treatment of attentiondeficit/hyperactivity disorder , is reported to be increasing among students for the purpose of improving cognition . Methods A single capsule , containing methylpheni date ( 20 mg ) or placebo , was administered to healthy young adults orally following 24 hours of sleep deprivation . Measurements included percent change in score from sleep-deprived baseline on four st and ardized tests of cognitive function : Hopkins Verbal Learning , Digit Span , Modified Stroop , and Trail Making tests . Measurements also included percent changes in blood pressure and heart rate from sleepdeprived baseline and plasma methylpheni date concentration . Results Differences in cognitive test performance were not observed between intervention groups . In subjects receiving methylpheni date , mean percent changes from baseline for systolic blood pressure and heart rate were increased relative to placebo between 90 and 210 minutes following capsule administration ( maximum increases of 9.45 % and 11.03 % , respectively ) . The timing of peak differences in physiologic measures did not correlate with peak serum methylpheni date concentrations . Exit question naire ratings of “ capsule effect ” and perceived performance on the postcapsule administration of the most challenging cognitive test were both higher ( p = .044 and p = .009 , respectively ) for the methylpheni date group than for the placebo group . Conclusions Cognitive improvement among sleep-deprived young adults was not observed following methylpheni date administration . Benefits perceived by abusers may relate to increased confidence and sense of well-being , as well as to sympathetic nervous system stimulation . Moreover , methylpheni date administration results in physiologic effects that could be harmful to certain individuals Methylpheni date ( 0.65 mg/kg ) , clonidine ( 200 μg ) or placebo were administered to normal adult males undertaking a dichotic monitoring task in which they were required to detect nominated target words and discriminate them from phonemic distractors . Following placebo , performance was better when attention was focused than when divided . Following clonidine , subjects were poorer and slower at discriminating targets during both divided and focused attention and subjectively were withdrawn and reported difficulties with concentration . Methylpheni date had no effect on target discrimination or response time but raised the rate of response and had marked effects on spontaneous behaviour in which an increased attention capacity was generally reported . The effects on attention of the pharmacological agents employed in this study are attributed to their effects on central monoamines . The disparity noted between objective and subjective assessment s of attention is discussed in terms of the voluntary allocation of effort Modafinil , a medication for the excessive sleepiness associated with narcolepsy , has been hypothesized to improve not just alertness but mood as well . The purpose of this study was to determine how treatment with modafinil affects mood in healthy volunteers . Normal healthy volunteers ( n = 12 , 10 men and 2 women ; 30 - 44 years ) underwent a 3-day , counterbalanced , r and omized , crossover , inpatient trial of modafinil ( 400 mg daily ) versus placebo with 4-day washout period between 2 treatments . Mood was assessed daily using both the Positive and Negative Affect Schedule and a general mood scale , which consisted of 10 bipolar adjective ratings based on a severity scale ranging from 1 to 10 . Modafinil increased general mood and Negative Affect scales relative to placebo and had a significant effect on Positive Affect scales . These results suggest that modafinil may have general mood-elevating effects accompanied by increased negative affect ( anxiety ) . The findings may have implication s for clinical practice , in particular for the adjunctive use of modafinil in treatment-resistant depression The purpose of this study was to determine the effects of magnesium pemoline ( Cylert ) and methylpheni date ( Ritalin ) on the memory and mood of normal aging persons . Seventy-eight subjects , aged 60 and over , were r and omly assigned in double blind fashion to one of the two drug conditions or to a placebo . Subjects were administered the WAIS vocabulary subtest , the Guild Memory Test , and a mood scale at the beginning of the study and the mood scale and alternate forms of the memory test in the middle and at the end of the experiment . Laboratory examinations were conducted at the beginning and end of the six week period and physical examinations were given weekly . Results showed no differential drug effects between the three groups on any of the six memory functions measured or between sub-groups of differing intellectual levels . There were , however , tentative indications that Cylert increased depression and worrisomeness and that Ritalin reduced fatigue . No physical side effects or significant changes in laboratory examinations were found on all but two subjects . These two individuals , apparently hypersensitive to Cylert , showed hepatic toxicity , but the result ant elevations on some tests quickly subsided when the drug was withdrawn Summary — Modafinil , a new psychostimulant , was evaluated in eight healthy volunteers subjected to 60 hours of sleep deprivation . During continued wakefulness , vigilance was evaluated by self‐ assessment question naires , analogue visual scales , multiple sleep latency tests ( MSLT ) , sleep logs , and continuous ambulatory electroencephalographic recordings ( EEG ) .  Modafinil ( 200 mg ) or a placebo was given every 8 hours for three days ; the sessions were separated by a 15 day wash out period . Results indicated a satisfactory level of vigilance , both subjective and objective , after the administration of modafinil , characterised by the quasi total absence of microsleep episodes which gradually occurred under placebo conditions . The confirmed wakening potency of modafinil makes this substance suitable for therapeutic use in patients with sleep disorders such as Gelineau 's syndrome and hypersomnia The effects of methylpheni date ( 0.3 mg/kg ) on young adults  paired-associate learning ( PAL ) of consonant-vowel-consonant ( CVC ) pairs and concomitant event-related potentials were assessed . The stimulant elevated mood and heart rate but did not affect PAL performance . For the first CVC , there were amplitude increases with learning for P3b at Pz , P2 at midline sites , and for a negative slow wave at Cz . For the second CVC , P3b and positive slow wave amplitude declined with learning . Increases in P3b amplitude to the first CVC were attributed to increments in stimulus meaningfulness . Decreases in P3b amplitude to the second CVC were interpreted as result ing from fewer disconfirmed expectations of feedback . The negative slow wave following the first CVC was viewed as a contingent negative variation . Methylpheni date increased parietal P3b amplitude for CVC 2 , averaged over learning phases
target: Based on a systematic review and meta- analysis we show that expectations regarding the effectiveness of these drugs exceed their actual effects , as has been demonstrated in single- or double-blind r and omised controlled trials .
  For methylpheni date an improvement of memory was found , but no consistent evidence for other enhancing effects was uncovered .
  Modafinil on the other h and , was found to improve attention for well-rested individuals , while maintaining wakefulness , memory and executive functions to a significantly higher degree in sleep deprived individuals than did a placebo .
  However , repeated doses of modafinil were unable to prevent deterioration of cognitive performance over a longer period of sleep deprivation though maintaining wakefulness and possibly even inducing overconfidence in a person 's own cognitive performance
background: The term neuroenhancement refers to improvement in the cognitive , emotional and motivational functions of healthy individuals through , inter alia , the use of drugs .
  Of known interventions , psychopharmacology provides readily available options , such as methylpheni date and modafinil .
  Both drugs are presumed to be in widespread use as cognitive enhancers for non-medical reasons .