performance enhancing drugs: cognitive enhancement

within the defined set of performance enhancing drugs, we have to consider the subset of cognition enhancement drugs. first suggested by dr. cornelio giurgea, these so-called “smart pills” can be synthetic or natural substances aimed at enhancing neural physiology, and can include ubiquitous substances like caffeine and nicotine (smith & farah, 2011). most prevalent of these pharmaceuticals are those prescription stimulants that aid in the treatment of attention deficit hyperactive disorder, such as ritalin and adderall.

in 2011, dr. elizabeth smith and dr. martha farah published a review in psychological bulletin addressing a number of questions around the use of these smart-drugs for non-medical purposes (i.e. performance enhancement), and came to some interesting conclusions. the use of these drugs, particularly the amphetamines ritalin and concerta and the dextroamphetamine adderall was extremely prevalent among readers of the science journal nature (20%) and among high school and college students, with one study indicating over half of the students surveyed had used these drugs for nonmedical reasons (desantis et. al 2009). as the authors noted, the access to these class ii substances was through other students with legal prescriptions, with over half of the college students with a prescription having been approached to sell or give their pills to another student (mccabe et al. 2006).

the bradley cooper film “limitless” portrays an unorganized and disheveled, but otherwise intelligent author who discovers a wonder-drug called “nzt”. the similarities to adderall are not subtle, yet the effects of the drug significantly exaggerated, transforming eddie morrra into a super-intelligent, productive, and successful investment banker. but how effective are these substances for enhancing cognitive performance in healthy individuals?

“man is not going to wait passively for millions of years before evolution offers him a better brain” - gazzaniga, 2007

the same review looked at a variety of markers of “intelligence” and “cognitive performance” and was able to evaluate several subsets, including learning, memory, working memory, and cognitive control. as you might imagine, as is common in double-blind studies, the results were somewhat equivocal. as always, a full reading of the article is recommended and warranted to understand the intricacies of potential effects of these drugs. however, some conclusions can and were reached. firstly, it appears as if these drugs may be beneficial for enhancing memory - but only for longer-term memory tasks where subjects are asked to recall details several hours or days after the event.

in terms of working memory, oft used as a surrogate for general intelligence, it seems that the evidence, taken as a whole, points to these drugs having a moderate effect, but only for some individuals under certain conditions. this seems like more of a limitation of the current research methodology within psychology than a failing on the part of the drug. the most fascinating study reviewed in this context was by mattay et al. (2003) who demonstrated a genotype dependance on the efficacy of the drug. those researchers showed that those subjects who were homozygous for a polymorphism coding for valine as opposed to methionine in a gene responsible for the synthesis of the enzyme catechol-o-methyltransferase, performed better when administered dextroamphetamine.

lastly, studies that investigated cognitive control, that is, the ability to guide thought and behavior in accordance with internally generated goals or plans (e.g. “staying on task”) were considered. since this is not a tightly controlled term, the actual tests employed are varied. nonetheless, the results show that there was no real effect of these drugs on cognitive control, except in the cases where subjects self-reported impulsivity.

overall, this article identified the intense short-comings of research into the effectiveness of non-prescribed cognition enhancement drugs. it is likely that these drugs do have significant cognitive enhancing abilities, hence the high-prevalence of their use by academics and students. as is often the case, public use and abuse of peds exceeds the capacity of the scientific process to accurately characterize the effectiveness. even so, the current state of science funding means that many of the unanswered questions we have about these substances will continue to go unanswered. the author’s concluding statement however sheds light on why this research is so important:

“greater public support of nonmedical neuroscience research, including methods of cognitive enhancement, will encourage greater knowledge and transparency concerning the efficacy and safety of these products and will encourage the development of products based on social value rather than profit value.” - smith & farah, 2011

references

deSantis, alan, seth m. noar, and elizabeth m. webb. “nonmedical adhd stimulant use in fraternities." journal of studies on alcohol and drugs 70.6 (2009): 952-954.

gazzaniga, m. s. (2005). the ethical brain. new york, ny: dana press.

mattay, v. s., goldberg, t. e., fera, f., hariri, a. r., tessitore, a., egan, m. f., weinberger, d. r. (2003). catechol o-methyltransferase val158-met genotype and individual variation in the brain response to amphetamine. proceedings of the national academy of sciences, usa, 100, 6186–6191.

mccabe, s. e., teter, c. j., & boyd, c. j. (2006). medical use, illicit use, and diversion of prescription stimulant medication. journal of psycho-

active drugs, 38, 43–56.

smith, m., & farah, m. j. 2011 are prescription stimulants “smart pills"? the epidemiology and cognitive neuroscience of prescription stimulant use by normal healthy individuals. psychological bulletin, 137, 5, 717.