BACKGROUND: Schizophrenia is associated with widespread cognitive deficits that 
have an impact on social function. Modafinil promotes wakefulness and is 
reported to enhance cognition.
AIMS: To study the acute effects of modafinil administration upon brain activity 
and cognitive performance in people with chronic schizophrenia.
METHOD: In a randomised double-blind placebo-controlled crossover design, 19 
patients received either modafinil (100 mg) or placebo prior to undertaking a 
working memory task with functional magnetic resonance imaging.
RESULTS: Seventeen patients completed the study and another underwent acute 
relapse 4 days post-drug. Modafinil administration was associated with 
significantly greater activation in the anterior cingulate cortex during the 
working memory task. The anterior cingulate cortex signal correlated with 
cognitive performance, although only a subset of patients exhibited 
'enhancement'.
CONCLUSIONS: Modafinil modulates anterior cingulate cortex function in chronic 
schizophrenia but its beneficial cognitive effects may be restricted to a subset 
of patients requiring further characterisation.