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Is the nootropic drug modafinil likely to work for you?

Modafinil is being used as a nootropic drug that increases alertness and gives a sense of well-being — to some users. Like most drugs, individual results seem to vary. One reason for the variation is a common genetic variation in the COMT gene.

What is Modafinil?

Modafinil is a prescription medication (in the US) for decreasing daytime drowsiness in narcolepsy patients. Off-label, it is a popular drug for neuroenhancement. Does it work? Clinical trials have shown that it is effective for cognitive enhancement, but the trials didn’t differentiate between genotypes and show a range of effectiveness.[ref][ref]

Modafinil is thought to work by increasing dopaminergic neurotransmission, which depends on the activity of the gene, COMT (catechol-O-methyltransferase). COMT is the enzyme that breaks down neurotransmitters (including dopamine, epinephrine, and norepinephrine), and the rate at which it metabolizes the neurotransmitters affects their levels in the brain.

When investigating modafinil’s effectiveness in people with different genotypes, research results showed that those with the COMT Val/Val genotype had a much better response than those with the Met/Met genotype in terms of sustained vigilant attention.[ref] In fact, the study says that modafinil “was hardly effective in subjects with the Met/Met genotype”. For both genotypes, modafinil kept the subjects from feeling sleepy, so the difference in genotype was on the cognitive benefits rather than wakefulness.


Modafinil Genotype Report:

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Check your genetic data for rs4680 (23andMe v4,v5; AncestryDNA):

  • G/G: (Val/Val) higher COMT activity, better response to modafinil
  • A/G: intermediate COMT activity
  • A/A: (Met/Met) lower COMT activity, not as much response to modafinil

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Another study looked at the effects of modafinil on REM and non-REM sleep and found that it varied by COMT genotype.[ref] This sleep deprivation study found that modafinil increased specific EEG activity in those with the Val/Val genotype during sleep recovery (after modafinil and sleep deprivation for 40 hours). The study concludes: ” in NREM sleep, the drug increased EEG activity in 3.0-6.75 and > 16.75 Hz frequencies exclusively in Val/Val allele carriers. Taken together, the data show that the promotion of wakefulness by pharmacological interference with dopaminergic and adenosinergic mechanisms differently affects sleep EEG markers of sleep homeostasis.”


Lifehacks:

If you’ve ever tried modafinil and wondered why it didn’t have much of an effect on you, perhaps the reason is in your genes.

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About the Author:
Debbie Moon is the founder of Genetic Lifehacks. Fascinated by the connections between genes, diet, and health, her goal is to help you understand how to apply genetics to your diet and lifestyle decisions. Debbie has a BS in engineering from Colorado School of Mines and an MSc in biological sciences from Clemson University. Debbie combines an engineering mindset with a biological systems approach to help you understand how genetic differences impact your optimal health.