The Age [thanks to acm] takes an in-depth look at modafinil — the first eugeroic (“good wakefulness”) drug, which puts us on a new threshold in psychopharmacology. This drug promotes quiet wakefulness and seems to allow the body to get away with prolonged sleep deprivation seemingly without paying the price, and its enormous popularity makes the intended recipients — patients with medical conditions disturbing wakefulness, such as narcolepsy — a minute proportion of its actual users.

Although the ‘balance’ in the article consists of the comments of only one nay-sayer, I agree in finding it hard to understand how such a core biological necessity as restorative sleep, which has been rigidly conserved in evolution, can be cheated substantially without any biological or psychological consequences.

We think this medication is a dopamine reuptake blocker, but why it does not appear to induce the jangly tension that other dopaminergic stimulants such as the amphetamines do, why it does not induce tolerance (the need for larger and larger doses to produce the same effect over time) and dependency (a withdrawal reaction and rebound symptoms after it is stopped) with prolonged use, as do other dopaminergic drugs, is not at all clear. Of course, it has not been used long enough by a large enough number of people for us to be confident that its long term effects are already apparent. Yet, as the author puts it, we are too far down the path to the “24-hour society”, in which wakefulness is cool and sleep is not, to stop this juggernaut, its coming competitors and its flipside companions, the newer better sleep aids.