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CURATOR
A pinboard by
Simona Gulbinaitė

'Smart drug' use is increasing rapidly and as a Neuroscientist I wonder if they know at what cost.

PINBOARD SUMMARY

'Smart drugs' are becoming more popular amongst university students to improve academic performance.

In 10 seconds? Increasing number of students (in some organisations up to 25%) are using ‘smart drugs’ to enhance their performance.

Don’t believe it? Drugs that are used to enhance mental activities such as thinking, understanding, learning, and remembering are referred to as cognitive enhancers. These type of drugs are used to treat people with attention deficit hyperactivity disorder (ADHD), Alzheimer‘s disease and narcolepsy (falling asleep suddenly). These cognitive enhancers are now called ‘smart drugs’ and are used to enhance academic performance among university students. Although their use has been reported as early as 1939, they are now becoming more popular than ever amongst university students to improve concentration, organisation and prolonged alertness.

How do ‘smart drugs’ work?

The most popular drugs used to enhance cognition are amphetamines (Aderol), which act by increasing dopamine (DA), noradrenaline (NA) and serotonin concentrations in nerve terminals. Another popular drug class is methylphenidates (Ritalin), which use a different mechanism, but also increase levels of DA and NA in multiple areas of the brain. Racetams (Piracetam) are also often used as a ‘smart drug’ and they act by increasing the function of excitatory glutamate receptors in the brain.

Is using 'smart drugs' worth it?

Efficacy – Even though there are conflicting reports, most studies show no cognitive enhancement and only a very slight improvement in test scores, grades and grade retention in healthy young adults when using amphetamines.

Side-effects – One of the reasons why students do not perform significantly better on stimulant drugs may be the side-effects they are associated with. Common side-effects include anxiety, irritability, sleep problems, decreased appetite, headaches and abdominal pain. Unfortunately, these drugs have not been used long enough to establish long-term side effects which may be associated with addiction.

Safety – Cognitive enhancers are controlled drugs and usually require a prescription, however some people obtain them illicitly. There is an emerging trend for producers to augment the formula of the drug and sell it as a supplement. These substances may not be safe for consumers as they have not been approved by the food and drink administration (FDA). Furthermore, merchants avoid liability by marketing their products as cognitive enhancers but labelling them as "for research use only".

8 ITEMS PINNED

Effects of modafinil on non-verbal cognition, task enjoyment and creative thinking in healthy volunteers.

Abstract: Modafinil, a putative cognitive enhancing drug, has previously been shown to improve performance of healthy volunteers as well as patients with attention deficit disorder and schizophrenia, mainly in tests of executive functions. The aim of this study was to investigate the effects of modafinil on non-verbal cognitive functions in healthy volunteers, with a particular focus on variations of cognitive load, measures of motivational factors and the effects on creative problem-solving.A double-blind placebo-controlled parallel design study evaluated the effect of 200 mg of modafinil (N = 32) or placebo (N = 32) in non-sleep deprived healthy volunteers. Non-verbal tests of divergent and convergent thinking were used to measure creativity. A new measure of task motivation was used, together with more levels of difficulty on neuropsychological tests from the CANTAB battery.Improvements under modafinil were seen on spatial working memory, planning and decision making at the most difficult levels, as well as visual pattern recognition memory following delay. Subjective ratings of enjoyment of task performance were significantly greater under modafinil compared with placebo, but mood ratings overall were not affected. The effects of modafinil on creativity were inconsistent and did not reach statistical significance.Modafinil reliably enhanced task enjoyment and performance on several cognitive tests of planning and working memory, but did not improve paired associates learning. The findings confirm that modafinil can enhance aspects of highly demanding cognitive performance in non-sleep deprived individuals. This article is part of a Special Issue entitled 'Cognitive Enhancers'.

Pub.: 24 Jul '12, Pinned: 18 May '17

Objective and subjective cognitive enhancing effects of mixed amphetamine salts in healthy people.

Abstract: Psychostimulants such as mixed amphetamine salts (MAS, brand name Adderall) are widely used for cognitive enhancement by healthy young people, yet laboratory research on effectiveness has yielded variable results. The present study assessed the effects of MAS in healthy young adults with an adequately powered double-blind cross-over placebo-controlled trial. We examined effects in 13 measures of cognitive ability including episodic memory, working memory, inhibitory control, convergent creativity, intelligence and scholastic achievement, with the goals of determining (1) whether the drug is at least moderately enhancing (Cohen's d >= .5) to some or all cognitive abilities tested, (2) whether its effects on cognition are moderated by baseline ability or COMT genotype, and (3) whether it induces an illusory perception of cognitive enhancement. The results did not reveal enhancement of any cognitive abilities by MAS for participants in general. There was a suggestion of moderation of enhancement by baseline ability and COMT genotype in a minority of tasks, with MAS enhancing lower ability participants on word recall, embedded figures and Raven's Progressive Matrices. Despite the lack of enhancement observed for most measures and most participants, participants nevertheless believed their performance was more enhanced by the active capsule than by placebo. We conclude that MAS has no more than small effects on cognition in healthy young adults, although users may perceive the drug as enhancing their cognition. This article is part of a Special Issue entitled 'Cognitive Enhancers'.

Pub.: 14 Aug '12, Pinned: 18 May '17

Does long-term medication use improve the academic outcomes of youth with attention-deficit/hyperactivity disorder?

Abstract: Youth with Attention-Deficit/Hyperactivity Disorder (ADHD) frequently experience academic impairment, including lower grades than their peers and elevated risk for grade retention and school dropout. Medication is the most commonly used treatment for youth with ADHD, and it is therefore essential to understand the extent to which medication use improves long-term academic functioning. This paper reviews the literature on the relation between long-term medication use and the academic outcomes of youth with ADHD. A systematic literature search was conducted to identify pertinent studies published since 2000 that followed youth with ADHD for 3 or more years. Academic outcomes of interest included school grades, achievement test scores, and grade retention. Nine studies were identified reporting on eight distinct longitudinal samples (N across studies = 8,721). These studies demonstrate that long-term medication use is associated with improvements in standardized achievement scores. However, the magnitude of these improvements is small and the clinical or educational significance is questionable. Evidence for long-term improvements in school grades and grade retention is less compelling. This review highlights methodological considerations in providing directions for future research. The importance of using multiple sources to gather information about medication adherence is discussed, including use of methodologies such as electronic monitors, rather than relying solely on parent report or chart review. Future research should also examine a range of medication adherence definitions in order to determine whether age of onset, duration of use, dose, and/or consistency of use moderates the relation between long-term medication use and academic outcomes.

Pub.: 09 Jun '12, Pinned: 18 May '17

Psychostimulants and cognition: a continuum of behavioral and cognitive activation.

Abstract: Psychostimulants such as cocaine have been used as performance enhancers throughout recorded history. Although psychostimulants are commonly prescribed to improve attention and cognition, a great deal of literature has described their ability to induce cognitive deficits, as well as addiction. How can a single drug class be known to produce both cognitive enhancement and impairment? Properties of the particular stimulant drug itself and individual differences between users have both been suggested to dictate the outcome of stimulant use. A more parsimonious alternative, which we endorse, is that dose is the critical determining factor in cognitive effects of stimulant drugs. Herein, we review several popular stimulants (cocaine, amphetamine, methylphenidate, modafinil, and caffeine), outlining their history of use, mechanism of action, and use and abuse today. One common graphic depiction of the cognitive effects of psychostimulants is an inverted U-shaped dose-effect curve. Moderate arousal is beneficial to cognition, whereas too much activation leads to cognitive impairment. In parallel to this schematic, we propose a continuum of psychostimulant activation that covers the transition from one drug effect to another as stimulant intake is increased. Low doses of stimulants effect increased arousal, attention, and cognitive enhancement; moderate doses can lead to feelings of euphoria and power, as well as addiction and cognitive impairment; and very high doses lead to psychosis and circulatory collapse. This continuum helps account for the seemingly disparate effects of stimulant drugs, with the same drug being associated with cognitive enhancement and impairment.

Pub.: 18 Dec '13, Pinned: 18 May '17

Attention-deficit hyperactivity disorder (ADHD) stimulant medications as cognitive enhancers.

Abstract: Recent increases in attention deficit hyperactivity disorder (ADHD) diagnoses, and the escalation of stimulant prescriptions, has raised concern about diversion and abuse of stimulants, as well as the ethics of using these drugs as "cognitive enhancers."Such concern appears misplaced in the face of substantial evidence that stimulant drugs do not improve the academic performance of ADHD-diagnosed students. Moreover, numerous studies have found little or no benefit of stimulants on neuropsychological tests of ADHD-diagnosed as well as normal, individuals. This paper examines the apparent paradox: why don't drugs that improve "attention," produce better academic outcomes in ADHD-diagnosed students? We found that stimulant drugs significantly improved impairment of episodic memory in ADHD-diagnosed undergraduate students. Nevertheless, we also found consistent academic deficits between ADHD students and their non-ADHD counterparts, regardless of whether or not they used stimulant medications. We reviewed the current literature on the behavioral effects of stimulants, to try to find an explanation for these conflicting phenomena. Across a variety of behavioral tasks, stimulants have been shown to reduce emotional reactions to frustration, improve the ability to detect errors, and increase effortful behavior. However, all of these effects would presumably enhance academic performance. On the other hand, the drugs were also found to promote "risky behavior" and to increase susceptibility to environmental distraction. Such negative effects, including the use of drugs to promote wakefulness for last minute study, might explain the lack of academic benefit in the "real world," despite their cognitive potential. Like many drugs, stimulants influence behavior in multiple ways, depending on the environmental contingencies. Depending on the circumstances, stimulants may, or may not, enhance cognition.

Pub.: 12 Jun '13, Pinned: 16 May '17