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Friday, May 23, 2008

Every now and then an article comes out praising Provigil for helping you concentrate and get things done. (It also apparently helps you lose weight. I know I would go to the fridge a lot less often if I could only concentrate.)

Many of the writers I know are terrible procrastinators. I'm considered prolific, and I waste heaps of time. So a drug that would help me sit down and get things written, instead of surfing, without making me less creative, or turning me into an newt, etc., sounds pretty magical.

On the other hand, I try to avoid taking drugs on general principle. The human body is an incredibly complex mechanism, and drugs that actually change your personality sound kind of threatening. They could make you a more effective person but would you still be, you know, you?

So this is (as they say on DailyKos, my current time suck) an open thread. What are the facts on smart drugs? Has anyone found them effective? Ineffective? Side effects? Moral issues? Are we all mad not to be taking them?

Labels:

42 Comments:

I don't know about Provowhatever, but Guinness is a miracle drug.

So is Redbreast Irish Whiskey.

By Blogger DMc, at 3:39 PM  

Yeah, but Guinness makes you strong. I want to be smart!

By Blogger Alex Epstein, at 3:47 PM  

Solid sleep on a consistent basis is the best "drug," hands down. Plus, it doesn't cost money or require a script from a doc.

By Blogger Christina Shaver, at 4:29 PM  

I'm actually going to be asking my doctor about Provigil next week. I'd love to be able to get that "solid sleep on a consistent basis" that Christina mentions, but I suffer from pretty severe apnea. Amongst its reputed side-effects, modafinil is approved for apnea.

So: sleep through the night with proper O2 levels-> have energy enough for the gym-> lose weight-> have less need for modafinil.

Assuming my doctor thinks it's the right course of treatment, I'll let you know my take on it. Since the ABC-Disney deadline is fast approaching, I would certainly benefit from the reported side-effects.

By Blogger R.A. Porter, at 5:30 PM  

Christina has the best advice, so far.

Nonetheless, the stuff you're talking about sounds like just any other amphetamine or drug that triggers your "stress" system (based on my knowledge, most diet drugs are just amphetamines). You'd accomplish the same thing, possibly save money and avoid strange complications if you just drink a little more caffeine (but even then, unless you have ADHD or something, the substantial amount of caffeine needed for provide real help, and then that could be inconvenient).

To ad to Christina's advice, though, there's meditation (very effective, since it's main point is to focus your attention), warm baths, time management tips, organization tips, etc. etc. that would probably help a lot more. . .but require more sustained effort on your part.

Some other things that you can eat/take for immediate help with focus: vinegar. Watch out that you don't have A LOT of vinegar or caffeine, though, as they can make the heart go too fast.

Getting a good amount of niacin in your diet will help a lot, too. That one requires a steady effort of making sure you get niacin and that you educate yourself about what has niacin in it. Having a good amount of niacin in your diet will also help you fall asleep at night, too.

So, yeah, those are my tips. I'm not a doctor, dietitian or anything of that sort, but those are some things that I've picked up over the years.

By Blogger The_Lex, at 5:37 PM  

I don't know about Provigil, but Ritalin is a highly addictive drug physically and mentally (i believe it's related to speed) and I know several people who were addicted to it through high school and university. I took it myself for a while and it gave me horrible mood swings, so I dropped it and just forced myself to concentrate. It's too easy to fall back on a drug. I think it's better to just use your will power and develop a schedule that you can follow.

One thing I can say about concentration drugs, is that they don't help you prioritize. Sure you'll be concentrating better, but if you start paying attention to your desk lamp, for instance, then you will really, really be thinking hard about that lamp.

By Blogger Trevor, at 6:03 PM  

I haven't put the required effort into acquiring Provigil, but I'm planning to quite soon.

For the past two weeks I've been taking high doses of B-vitamins. 2000% of the recommended daily amount of B6 and B12, namely. It could just be the placebo effect, but dammit, I've gotten more things done during this time than during pretty much any other two-week time period of my life.

B6 and B12 are also major components of most competently-made energy drinks.

By Blogger Elver, at 6:05 PM  

Oh yeah, another couple things that could help:

Iodine (via iodized salt or seafood) - You would probably know if you're not getting enough of this one (you don't have a goiter, do you?). Iodine again is less of a supplement to give you extra concentration and more of a "if you don't have enough it, your concentration will suffer."

Coconut - One of the fatty acids in coconut also works as a good necessary part of the diet that most people don't address (mainly because the useful necessary fatty acid is a saturated fat!). The fatty acid in coconuts works with the iodine in your body for all types of useful hormone balancing, which can help with concentration.

R.A., thanks for reminding me about iodine and coconut by mentioning B vitamins!

By Blogger The_Lex, at 6:20 PM  

Edit: Elvor mentioned B-vitamins. Thanks, Elvor!

By Blogger The_Lex, at 6:21 PM  

try gingko biloba and ginseng. there have been trials as to its effect on concentration. but i prefer a good nights sleep too. and you sleep better if you cut out all stimulants inc coffee.
but what you really need to do is self discipline yourself. i'm struggling with that, but i am getting better.

By Blogger iabanon, at 7:09 PM  

I'd sa stay away from the concentration drugs. Just sounds like it would cut down on your day dreaming and thinking off topic. But aren't the tangents and connected ideas worth keeping in your life? I mean you could get more done but might miss out on a fantastic direction that you just weren't aware of because of focusing on your task at hand.

By Blogger Kevin, at 7:39 PM  

About 10 years ago, I did quite a bit of research into smart drugs, otherwise known as nootropics.

The major one at the time, and I believe still the #1 drug mentioned in this category, is called Piracetam. Another is Vasopressin, which is a brain chemical used to "imprint" memories.

I spoke to a forensic psychologist who specialized in brain chemistry while researching these drugs, and while she didn't see much harm in Piracetam (although the effect isn't quite as pronounced as many nootropic enthusiasts would claim), the case with Vasopressin was different.

Vasopressin, ingested through a nasal spray, would be very effective in increasing memory, but the problem is akin to body builders or atheletes using steroids. When you ingest these foreign hormones, your natural production of them tends to dry up and you'd end up with worse memory than when you started.

By Blogger Mikey Mo, at 8:06 PM  

Additional useful tips:

Eat more nuts (peanuts, cashews, etc.), beans, vegetables and fruit. More brown pasta and wheat/grain pastas can probably help, too.

The more complex carbohydrates will also help to get vasopressin in the brain and some other natural stuff that will help steady the emotions and increase cognitive abilities.

Also getting out of your usual workspace can help, too, to shock the mind out of your usual routine.

By Blogger The_Lex, at 8:21 PM  

From the current issue of the Economist... [http://www.economist.com/science/displaystory.cfm?story_id=11402761]

"Provigil and Ritalin really do enhance cognition in healthy people. Provigil, for example, adds the ability to remember an extra digit or so to an individual's working memory (most people can hold seven random digits in their memory, but have difficulty with eight). It also improves people's performance in tests of their ability to plan. Because of such positive effects on normal people, says the report, there is growing use of these drugs to stave off fatigue, help shift-workers, boost exam performance and aid recovery from the effects of long-distance flights.

"Earlier this year, Nature, one of the world's leading scientific journals, carried out an informal survey of its (mostly scientific) readers. One in five of the 1,400 people who responded said they had taken Ritalin, Provigil or beta blockers (drugs that can have an anti-anxiety effect) for non-medical reasons. They used them to stimulate focus, concentration or memory. Of that one in five, 62% had taken Ritalin and 44% Provigil. Most users had somehow obtained their drugs on prescription or else bought them over the internet."

By Blogger Jason, at 8:49 PM  

I agree with Alex. I try to avoid taking unnecessary drugs. But, if I have a headache or cold I’ll take a paracitemol, if I’m sick and the doctor prescribes something I’ll take it. I’m not going to start popping vitamin pills or herbal remedies anytime soon though. A friend of mine recently turned his face orange because the vitamin c pills and the face cream he was using reacted with each other!

By Blogger George, at 10:11 PM  

I'd take them if I was writing and had to go through and check for errors fifty-two times before I turn something in. But never during the more creative parts. I'd rather take longer than fry my brain.

By Blogger BoCoPoCo, at 10:56 PM  

http://www.slate.com/id/2118315/

Those drugs are just speed repackaged so big pharm can make a buck. Look at the great writers who used speed. Sure, you'd love to write like them, but do you want their tragic lives too?

By Blogger probability, at 9:11 AM  

"Speed repackaged"?

Um. No.

Basic knowledge of chemistry should be enough to understand that.

By Blogger Elver, at 9:18 AM  

Sorry, Professor Frink, but Adderall is simply a repackaging of a dextroamphetamine, i.e. diet pills, speed, amphetamines. Got that, doc?

By Blogger probability, at 9:32 AM  

I think we were talking about IQ-enhancing drugs in general and mostly Provigil in particular.

Speed-based IQ-drugs are a small minority and Provigil has nothing to do with amphetamines.

By Blogger Elver, at 9:37 AM  

Modafinil not "speed repackaged"; it has been prescribed for narcolepsy for over 30 years. Its off-label uses have been studied for quite some time with some interesting, though qualified, results.

By Blogger R.A. Porter, at 1:30 PM  

I've never tried the prescription smart drugs. In college, I did try gingko biloba (sp?) during my overload semester. After three days, I had to stop it because I couldn't concentrate on a single thing. It gave me a bit of energy, but my god, it also gave me ADD.

I'll stick to caffiene, thank you very much. And that in mild doses since it likes to heighten my anxiety. stupid side effects.

By Blogger Stacey, at 1:59 PM  

Granted, Provigil/Modafinil may not be classified as an amphetamine, but it has many similar effects and packaged marketing (e.g. diet drug and increasing focus/attention), but it also has similar bad side effects (like increasing the blood pressure, which cause issues people with HBP, the crash afterward, some bits of euphoria, etc. etc.). Why not try another prescription ADHD drug for increasing attention and focus, like Strattera, a drug that affects the brain similarly yet differently with the same risks. And to slightly return to TV, there's amantadine, the drug mentioned on the last episode of House, which can probably help with focus and so forth.

I'm not saying that drugs shouldn't be taken when they can significantly increase a person's quality of life or needed to keep someone alive, but they should be taken with a lot of caution.

Then there's really the fact that our modern lifestyles contribute a lot to lack of focus. Even people who aren't clinically ADHD probably face a lot of similar "symptoms," simply because they're not taking the best care of themselves and have trouble doing so because of the high expectations on the modern human to perform. And beyond taking care of ourselves, a lot of us probably don't engage in the full range of activities that can enhance the performance of our minds and bodies. In the long run, getting exercise, meditating, eating better, getting enough sleep, engaging in various activities that require cognition, etc. etc. can all lead to better focus and quality of mind.

Unfortunately, our lives don't lead to easily engage in such activities and it can be very difficult to change our lives and habits to make it a better. And from what Alex has mentioned in past entries (i.e. children, a career in television writer, working for himself in many capacities [creative writer, marketer to some degree, etc. etc.]), it's no wonder you have trouble working at 150% peak performance, Alex!

A few months ago, after being very disappointed and frustrated with my performance on a big LIFE project that I have going on, I came to the realization that I'm taking on a lot more projects than a "typical" person (full time job, big LIFE project that I'd like done yesterday, keeping up with the volume of good TV out there, keeping up a good relationship with my wife, taking care of a cat with some medical problems and its sister, having a social life, etc. etc.) and that the reason I'm getting easily distracted is because my body is saying, "Hey, dude, calm down, rest and have a good time! You're working too hard and not really enjoying life. Life isn't about working all the time and accomplishing everything that you can. Sometimes it's about rest and recreation."

By Blogger The_Lex, at 2:01 PM  

I suspect that Provigil isn't a good idea for frequent use. If I recall correctly from reading about the subject (I'm not a doc), people who habitually get fewer than 6 hours per night put themselves at risk of cardiovascular problems, namely hypertension, heart failure, and stroke.

Obesity and diabetes are linked with shorting one's self on sleep, and people who are habitual short sleepers also have a higher overall mortality rate than those with good sleep hygiene. Disrupted sleep is also linked with disturbed immune system function and with decreased resistance to infection.

Sleep also plays an important role in learning new information and skills. Harvard researchers have been doing some fascinating work in this area (see http://www.news.harvard.edu/gazette/2007/05.03/05-sleep.html).

In other words, sleep deprivation is not good as a regular thing... Provigil may make you feel okay and maybe even better than okay (I've never tried it), but IMO, the sleep piper must be paid.

By Blogger the third coast, at 2:11 PM  

R. A. -- can you elaborate on the "interesting, but qualified" results achieved with Provigil?

By Blogger Alex Epstein, at 2:11 PM  

Alex, wikipedia does its usual decent (not perfect) job with pharma articles. I'm sure that will change in the next couple of years as the spammers start to realize they can boost sales by putting their false claims in the wiki articles to grant them more "authority", but they don't seem to have figured that out yet.

The first para on Modafinil's off-label uses includes links to five studies which are equivocal in their results. Modafinil appears to improve performance - by improving concentration and short-term memory - on "relatively difficult and monotonous working memory tasks." One of the linked studies also found a negative correlation between IQ and performance enhancement.

Personally, I would not consider trying more than a few days' trial of modafinil if otherwise healthy. It's just not clear from the research - although the anecdotes are compelling - that it has much of an impact on complex, non-memory related tasks. Especially when you consider the reduced impact it seems to have even on those, for subjects with higher IQs.

I'm more willing to try it because of its FDA approved use for apnea. If the side-effects really are pronounced, that's just icing on the cake.

By Blogger R.A. Porter, at 2:44 PM  

Who said anything about not sleeping? I get plenty of sleep. (That's a benefit of commuting from the bedroom to the living room.)

By Blogger Alex Epstein, at 3:31 PM  

My guess is, if the drug really works, anyone who is on it isn't procrastinating enough to visit your blog and leave a comment. They're too busy doing whatever it is they are supposed to be doing.

Christina, apparently you're not a mother of young children. Sleep is a luxury in this household, and we simply can't afford luxuries at the moment. All our money goes towards renovations.

I did hear that the company, Devon McGregor had switched samples and that Provasik damages your liver. There was a controversy about that years ago, if I recall.

By Blogger Tim W., at 2:35 PM  

Probably I'm responsible for your attention being diverted during the day. Aren't I?

By Blogger Lisa Hunter, at 3:48 PM  

I recommend Yerba Mate. It's an herbal tea from South America that has a caffeine stimulant in it, but instead of the jittery feeling of coffee, it's more of a focus buzz. It's great stuff, especially with a bit of milk and sugar. And not a packaged drug, either. Just a tea.

By Blogger Monsterbeard, at 5:11 PM  

C'mon, Lisa, this is a family blog. Naughty!

By Blogger Alex Epstein, at 6:25 PM  

To all the commenters who think it's safer to self-medicate with ginseng, or ginkgo biloba, or eating a lot of coconut, or drinking yerba mate or whatever, please don't think that "natural" means "safe". At least with a drug that's been around a long time, there are studies of efficacy and safety. There are also, usually, some safeguards in place ensuring that when you buy a 200mg dose of Provigil, you're getting a 200mg dose of 2-benzhydrylsulfinylethanamide.

I'm not opposed to homeopathic and alternative medical treatments and have used some herbal treatments myself, but get deeply concerned by people who seem to think that "natural" = "safe".

Statements like @Monsterbeard's are very worrisome, defending yerba mate by saying it's "not a packaged drug, either. Just a tea." That's true, and some studies indicate that its chemical cohort lead to a better overall experience than the caffeine cohort of coffee, but the research is inconclusive. To be a bit more snarky, hemlock can be brewed into "just a tea" as well, but I wouldn't recommend it for concentration.

Sorry to be such a downer, but I find too many people taking too many herbal treatments without any concern about their impact. These are often the same people who think drugs are inherently bad and western medicine a scam perpetuated by big pharma and insurance companies to extract money from people.

By Blogger R.A. Porter, at 7:46 PM  

Hey, RA, I didn't say eat A LOT of coconut. I just said eat coconut.

I make the assumption that very few people (unless you live where coconut is one of the main food staples) actually eat coconut on a regular basis. In all honesty, a lot of my suggestions have been based on the idea of plain eating healthy and adding food to someone's normal diet as stuff that tastes good and will help benefit their focus and peace of mind. . .and I'm under the assumption a lot of people in this world don't generally eat super healthy.

Me, I eat a spoonful of shredded coconut a night before bedtime. . . if I remember to do it in the first place. Frankly, it's probably a bad idea to chow down on tons of coconut, since it has a lot of calories in it. No need to eat it to the extent of gaining tons of weight, increasing cholesterol, increasing blood pressure, etc. etc.

All things in moderation. No need to over consume any of my suggestions for the "benefits" of them.

By Blogger The_Lex, at 8:45 PM  

@the_lex: I had assumed you were talking about balancing out the diet and not truly self-medicating with any particular food, but there are far too many people who do think herbs/"superfoods" are curealls.

I wasn't picking on you, but "coconut" is such an inherently funny word I needed it to fill out my list.

By Blogger R.A. Porter, at 9:23 PM  

Oh. Cool. =D

By Blogger The_Lex, at 9:43 PM  

The best advice I ever got was this:

No matter what, get 30 mins of consistent physical activity 3 days a week at minimum. Drink 5-8 glasses of water a day (yes, you can drink too much water) and sleep when you're tired.

Basically: listen to your body.

I've been trying to master the power of the quick midday nap and I find that it's been quite helpful in keeping my mind and body alert.

By Blogger Brandon Laraby, at 2:49 PM  

I have trouble concentrating too, and have been researching various ways to help me focus.

Lots of good info on this thread. Thanks to all who contributed.

:-)

By Blogger Laura Reyna, at 12:00 AM  

I'll pipe up for ENADA. a 5mg pill of NADH. I pop one in the morning when I first wake up with some water, then wait about 20 minutes before going for coffee or food. It's a vitamin B3 variant(Co-Enzyme 1). It lets me be more alert, and thus often more focused. If you don't get enough sleep, you may be mentally alert, but you'll still be physically tired.

By Blogger Hugo Fuchs, at 8:17 PM  

I use Provigil (also known as Modafinil) or at least I used to be on it for about a year for a sleep disorder (it's originally meant to treat narcolepsy, but one of its off-label uses is to treat other sleep disorders). Anyway, it works a little differently than say Ritalin or Dex (you would have to look up the details elsewhere), wired.com recently had a series of articles on smart drugs. Anyway, I'm no longer on modafinil because it's lost it's effect, but at least it wasn't too addictive as I was able to go on drug holidays quite frequently...
at the end of the day, creating a distraction free workspace is important (I still majorly suck at it). Setting a doable task list of some sort can help.

oh and also, be careful of rashes caused by modafinil. Health Canada released a warning in the fall about the risks of a potentially deadly rash.

I wish I could just drink coffee, but it gives me stomach aches.

I was given tyrosine supplements prior to being diagnosed with a sleep disorder which I think was a little useful. Might work for some.

By Blogger buzzkill, at 2:18 AM  

Great little book on art and procrastination (it can apply to any profession really)

"The Art of War" by Steven Pressfield

http://www.amazon.ca/War-Art-Through-Creative-Battles/dp/0446691437/ref=sr_1_2?ie=UTF8&s=books&qid=1214288603&sr=8-2

By Blogger buzzkill, at 2:25 AM  

Here's an interesting recap of some recent research into the use of amphetamines to improve learning: http://languagelog.ldc.upenn.edu/nll/?p=389

That, of course, doesn't make them *safe*. Just efficacious.

By Blogger R.A. Porter, at 11:00 AM  

Somewhat going against the grain of "common sense" health, I figured out I was actually not getting enough sodium in my diet (nothing like humid days that make me tired to show me the problem).

Upping my sodium, I grew more attentive and efficient. Today, I haven't even needed caffeine (and have actually chosen not to have any because my heartrate was a little high last night).

Going against the grain, I don't blanket advise having lots of sodium (especially if you're not very active), but if you find yourself during hot, humid summer days, maybe you should talk to your doctor, a trainer, dietition/nutritionist or whatever that could give a much more professional and educated view on how sodium intake can affect attention and focus.

I know I was surprised.

By Blogger The_Lex, at 11:22 AM  

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