Comment by Construct | Hacker News Reader

Comment by Construct | Hacker News Reader

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Taking Modafinil will not make you smarter, but it will heavily diminish the negative effects of sleep deprivation. Remember, the primary indications for this medication are narcolepsy, sleep apnea, and excessive daytime sleepiness.

It also increases dopamine and norepinephrine activity in certain areas of the brain, similar to Adderall and Ritalin, so it will boost your concentration. It actually showed a positive effect on concentration in ADHD treatment trials, but the FDA declined to approve it for that purpose due to some concerns over a rare skin-rash disorder. Many people are under the misconception that it is not a stimulant, but it most certainly is.

As for controlled, double-blind trials, the results are not promising in non-sleep-deprived individuals. Controlled tests tend to show self-reported increases in restlessness, aggression, and anxiety, but the standardized cognitive and memory tests show very little, if any, improvement in the Modafinil groups. (See http://www.ncbi.nlm.nih.gov/pubmed/12672167 and http://www.ncbi.nlm.nih.gov/pubmed/15738750 for more).

Finally, don't try to import Modafinil (Provigil) into the US without a prescription. It is a Schedule IV controlled substance and the legal ramifications for importing a controlled substance can be serious. If you're still eager to try it outside of a doctor's supervision, which I definitely do not recommend, then know that Adrafinil is metabolized (partly) to Modafinil within the body but is not a controlled substance. Importing it is a still a gray area, though.

Bottom line: Getting a healthy amount of sleep should be your #1 goal for cognitive improvement. If that isn't actually possible, then Modafinil could be helpful for reversing the effects of sleep deprivation. If concentration is your problem, Modafinil may help you, but you'd probably be better off pursuing proper ADHD treatment with a medication approved for ADHD.

One important thing that's worth noting: Just because you have trouble concentrating doesn't mean you have ADHD. There are a lot of other things that could cause that.

Excellent point, and definitely worth pointing out.

It's amazing how many people are quick to self-diagnose ADHD, but have no problem spending hours on their hobbies or interesting projects. In fact, you'd be hard-pressed to find anyone in the coding community who never has problems concentrating on uninteresting projects.

> It's amazing how many people are quick to self-diagnose ADHD, but have no problem spending hours on their hobbies or interesting projects.

Having ADHD doesn't mean you can't focus, it means you can't control what you're able to focus on. Non ADHD people can make themselves focus on boring things when they have to, ADHD people find this anywhere from extremely difficult to impossible.

There's a weird thing that can happen to ADHD individuals, and its actually considered a symptom: the ability to 'hyperfocus' on certain tasks. It's very similar to The Zone, but it's random and difficult to predict when it will manifest: http://en.m.wikipedia.org/wiki/Hyperfocus

The term hyperfocus doesn't appear in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, the gold standard by which all mental disorders, including ADHD, are officially defined) at all.

The term shows 0 results on PubMed, a repository for studies, journals, and other biomedical literature. (Note: If you search for 'hyperfocus' it will give you results for 'hypertonus' because the original term returned no results)

And finally, the Wikipedia article is heavily flagged with 'Original Research' and 'Unverifiable/Biased Information' tags, and is also flagged for not having any real sources or citations.

I know the term 'hyperfocus' has worked its way into pop-psychology lately, but I've never been able to find reliable research supporting the claim. I am a bit wary of how easily it stretches the definition of ADHD to encompass just about every person I've ever worked with. After all, who wouldn't identify with the idea that they can 'hyperfocus' on video games or fun projects, but have difficulty concentrating on difficult or uninteresting work? Very slippery slope here.

I have ADHD and hyperfocus. Sometimes I go for hours and forget to eat or drink anything. Two things:

1. The DSM only defines mental illness so that it can be diagnosed. For instance, it doesn't say "prescribe drugs x, y, and z for ADHD". If the DSM doesn't include hyperfocus, it doesn't mean it doesn't happen. It just means it isn't a diagnostic criteria.

2. How much research can you find proving that depression makes people sad or that ADHD makes people unable to pay attention? Do chemists do research on how wet water is? Remember, ADHD is one of the most well-known mental disorders out there. Doctors have been treating it with stimulants for over 70 years. If you can't find research on the subject, it doesn't mean that it doesn't exist. It just means that there's not really any new ground to be broken in the area.

That said, hyperfocus is well known among Psychiatrists and Psychologists. It's just like the other symptoms: pathological versions of normal behaviors. A normal person can put down video games long enough to go to school or work. I can't without medication.

I agree with the sentiment of your post, and I have no opinion on the 'hyperfocus' issue, but I'd like to point out that the DSM embodies the state of the art and as such lags behind new insights. Only after those insights are accepted by the psychiatry community they are worked into the next version of the DSM; DSM V is (as it looks now) going to contain a lot of updates on ADHD in children, and progressive insights on adult-onset ADHD are probably going to be too cutting edge to be included (now this is of course something fairly new and I agree with the methods used to compose the DSM - better to be conservative here; my point is that the DSM is not the most up to date 'standard' to follow).

Exactly. Attention deficit is a misnomer; inappropriate attention, or poor attention control, is the issue.

Some additional "been there, done that" comments: if you try drugs, give them time to work. If you trying different drugs, give them time to leave your system. Know that some side-effects are temporary, but each person may respond differently. You may need to try a few different drugs.

If you honestly think you have a real cognitive or neurological problem, keep pushing for help and don't give up.

Link to the non-mobile version of Wikipedia:

http://en.wikipedia.org/wiki/Hyperfocus

I met a good number of people who have problems in concentration. They can't focus even in the smallest tasks, especially if it is new and difficult (complicated). May be it's just fears that disturb their concentration.

I suppose the claim of "make you smarter" depends a lot on your definition of "smart". If it includes the ability to concentrate then perhaps it does make you "smarter".

I remember Adrafinil having rather nasty side effects with long term use. Something to do with liver damage.

It is supposedly hard on the liver. I'd strongly recommend not dosing any medication without a doctor's supervision no matter what, and this is one more reason to avoid going that route.

is this true? its not uncommon to see an early 20something drink a decent amount regularly on weekends for years and still end up okay. I find it hard to believe adrafinil could do more damage than that.

this is a bit of a dumb comment I think; it's a bit like saying you've known people who've headed a soccer ball repeatedly every weekend for years, so you find it hard to believe that heading a cement block could be harmful. It's a different chemical, with different effects. The best way to determine those effects is through properly controlled trials.

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