Supplements vs. Prescription Modafinil: Which Makes You Smarter?

Published on Apr 28, 2018

Let’s face it, we MDs can be pretty smug sometimes. We often believe that with our universities and research, we know it all. Hence, I love studies that show that sometimes all of what we think we know isn’t enough. The most fun “naked in Times Square” moments for modern pharmaceutical-based medicine are when a cheap and widely available supplement beats or holds its own versus an expensive drug. This morning’s blog is on how common memory supplements did just that. Let me explain.

Modafinil: the ‘Smart’ Drug

Modafinil is a stimulant or “upper,” which means it promotes alertness and wakefulness, so it is often used to treat sleep disorders in those who have severe problems staying awake. In the U.S., modafinil is a pharmaceutical drug that requires a prescription. This drug has also managed to carve out a reputation as a ‘smart’ drug, or an aid to greatly enhance mental focus and concentration.

Modafinil is in the same US-regulated controlled substance category (schedule IV) as benzodiazepines, such as Xanax, Librium, Valium; barbiturates, such as phenobarbital; and so on. Hence, it should be prescribed with caution due to its side effects. These can include all of the common issues with other stimulants, like not being able to get to sleep, hallucinations, changes in mood, and so on.

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Bacopa and Ginseng: the ‘Smart’ Supplements

Commonly known as waterhyssop and found growing in wetland environments, Bacopa monnieri, is a common herb used in Ayurvedic medicine, a holistic and ancient medicine that originated in India and focuses on a mind, body, and spirit balance to promote healing and maintain health.

Photo of Waterhyssop plant with leaves and white flowers

Mr. Meijer/Shutterstock

Bacopa could be called the ‘smart’ herb as for thousands of years, it, too, has been used to improve memory and other cognitive conditions. And many swear it makes them smarter by enhancing their mental focus and concentration. Its benefits don’t stop there. Bacopa monnieri is not only known as one of the ‘smart’ supplements, it’s also known for reducing stress, anxiety, and depression; possibly treating Alzheimer’s and reducing seizures in epilepsy; relieving chronic pain; and much more.

Ginseng is a root herb that has also been associated with improved mental focus and concentration. Ginseng has been a staple of natural herbal medicine for centuries, and, again, many swear by its benefits. There are many types of ginseng; a couple of the more common are Asian (Korean) ginseng and American ginseng. Ginseng is also known for reducing stress, lifting mood, reducing inflammation, suppressing appetite, increasing sex drive, and much more.

Jiangdi/Shutterstock

While Bacopa seems to have a more chronic long-term effect on concentration improvement, ginseng’s effect seems to be more acute, or short term. In other words, taking Bacopa regularly (like a daily vitamin) may keep mental focus sharp long-term, but if you just need a quick mental pick-me-up, ginseng may do the trick. A new study set out to determine if Bacopa monneiri and ginseng could hold their own against the prescription drug modafinil in their ability to enhance mental focus and concentration. The results were interesting. Let’s take a look.

‘Smart’ Drug vs. ‘Smart’ Supplements for Mental Focus

The new study pitted both ginseng and Bacopa against the prescription drug modafinil. The new study aggregated results from prior double-blind randomized controlled trials (a meta-analysis). This means that in these studies both participants and investigators didn’t know which group was the test group and which was the control group (given a placebo). All of the studies provided data on modafinil, Bacopa, or ginseng and their cognitive outcomes. What did the researchers discover?

The cognitive effects varied depending on the treatment. For fast mental processing, modafinil was the winner. For enhancing memory and focus on learning, Bacopa, taken regularly, took first place here. For boosting secondary memory (or stored memories) and performing quick-reaction-based tasks, ginseng was the clear victor.

So which makes you smarter depends on the kind of “smarts” you’re looking for, but according to the researchers, the natural herbs (i.e., nutraceuticals) ginseng and Bacopa had comparable cognitive effects to the controlled-substance pharmaceutical modafinil.

Other Ways to Get a Memory Boost

While Bacopa and ginseng may be a good natural alternative to the pharmaceutical modafinil, I’ve also covered a few other studies that provide possible tips to boosting memory. The first one is easy. All you have to do is sleep. The harder part here for some, however, is that it must be a good night’s sleep. Sleep may strengthen important memories by purging out the weaker memories we don’t need.

Green tea has been all the rage for its many potential health benefits, and one of those appears to be its ability to enhance memory. Taking a turmeric/curcumin supplement may also aid memory by regenerating nerve stem cells and keeping the brain healthy. Finally, the negative anesthesia effects following surgery include a memory decline, cognitive changes and a postoperative dementia risk that increases with each surgery. In this case, it’s not about boosting memory but retaining the memory you have by avoiding big surgeries.

The upshot? It’s always amazing to me that an herb or root that’s been thought to help memory for thousands of years really works in a modern randomized controlled trial. Even more amazing is that you can get these supplements for pennies on the dollar compared to Modafinil and without the crazy side effects of that drug. Turns out the ancients actually did know a thing or two!