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Spreitzer I, Keife J, Strasser T, Kalaba P, Lubec J, Neuhaus W, Lubec G, Langer T, Wackerlig J, Loryan I. Pharmacokinetics of Novel Dopamine Transporter Inhibitor CE-123 and Modafinil with a Focus on Central Nervous System Distribution. Int J Mol Sci 2023; 24:16956. [PMID: 38069277 PMCID: PMC10707468 DOI: 10.3390/ijms242316956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
S-CE-123, a novel dopamine transporter inhibitor, has emerged as a potential candidate for cognitive enhancement. The objective of this study was to compare the tissue distribution profiles, with a specific focus on central nervous system distribution and metabolism, of S-CE-123 and R-modafinil. To address this objective, a precise liquid chromatography-high resolution mass spectrometry method was developed and partially validated. Neuropharmacokinetic parameters were assessed using the Combinatory Mapping Approach. Our findings reveal distinct differences between the two compounds. Notably, S-CE-123 demonstrates a significantly superior extent of transport across the blood-brain barrier (BBB), with an unbound brain-to-plasma concentration ratio (Kp,uu,brain) of 0.5, compared to R-modafinil's Kp,uu,brain of 0.1. A similar pattern was observed for the transport across the blood-spinal cord barrier. Concerning the drug transport across cellular membranes, we observed that S-CE-123 primarily localizes in the brain interstitial space, whereas R-modafinil distributes more evenly across both sides of the plasma membrane of the brain's parenchymal cells (Kp,uu,cell). Furthermore, our study highlights the substantial differences in hepatic metabolic stability, with S-CE-123 having a 9.3-fold faster metabolism compared to R-modafinil. In summary, the combination of improved BBB transport and higher affinity of S-CE-123 to dopamine transporters in comparison to R-modafinil makes S-CE-123 a promising candidate for further testing for the treatment of cognitive decline.
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Affiliation(s)
- Iva Spreitzer
- Department of Pharmaceutical Sciences, University of Vienna, 1090 Vienna, Austria; (I.S.); (T.L.)
- Vienna Doctoral School of Pharmaceutical, Nutritional and Sport Sciences, University of Vienna, 1090 Vienna, Austria
| | - Josefin Keife
- Translational Pharmacokinetics/Pharmacodynamics Group, Department of Pharmacy, Uppsala University, 75123 Uppsala, Sweden
| | - Tobias Strasser
- Department of Pharmaceutical Sciences, University of Vienna, 1090 Vienna, Austria; (I.S.); (T.L.)
| | - Predrag Kalaba
- Department of Pharmaceutical Sciences, University of Vienna, 1090 Vienna, Austria; (I.S.); (T.L.)
| | - Jana Lubec
- Programme for Proteomics, Paracelsus Medical University, 5020 Salzburg, Austria (G.L.)
| | - Winfried Neuhaus
- Competence Unit Molecular Diagnostics, Center Health and Bioresources, AIT Austrian Institute of Technology GmbH, 1210 Vienna, Austria;
- Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, 3500 Krems, Austria
| | - Gert Lubec
- Programme for Proteomics, Paracelsus Medical University, 5020 Salzburg, Austria (G.L.)
| | - Thierry Langer
- Department of Pharmaceutical Sciences, University of Vienna, 1090 Vienna, Austria; (I.S.); (T.L.)
| | - Judith Wackerlig
- Department of Pharmaceutical Sciences, University of Vienna, 1090 Vienna, Austria; (I.S.); (T.L.)
| | - Irena Loryan
- Translational Pharmacokinetics/Pharmacodynamics Group, Department of Pharmacy, Uppsala University, 75123 Uppsala, Sweden
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2
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Cornejo-Plaza MI, Saracini C. On pharmacological neuroenhancement as part of the new neurorights' pioneering legislation in Chile: a perspective. Front Psychol 2023; 14:1177720. [PMID: 37533709 PMCID: PMC10393253 DOI: 10.3389/fpsyg.2023.1177720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/29/2023] [Indexed: 08/04/2023] Open
Abstract
The so-called neurorights are emerging human rights, or rather reconfigurations of already existing human rights, seeking to address the impact of the possible misuse of neurotechnologies, which have the potential to become more invasive and harmful in the future if not regulated. The aim of specifying neurorights is to protect the dignity and autonomy of the individual in the face of neurotechnological advances. Recently, Chile proposed a Constitutional reform inspired by the neurorights, opening a debate. One of the proposed neurorights is fair and equitable access to cognitive enhancement, which will be the specific object of this perspective article. Starting from the legal proposal, we analyse and discuss some perspectives on cognitive enhancement, or "neuroenhancement", which could be considered as part of enhancement neurotechnologies, pointing out that pharmacological enhancers, or "smart drugs", might be considered as part of these enhancers. We present a classification of the different types of cognitive enhancements as it has been proposed in the literature, into which pharmacological cognitive enhancement can be included, concluding that there is currently no agreement amongst scholars and lawyers about the ethical consideration of pharmacological cognitive enhancement. We therefore argue that it is necessary for the legislator to explicitly address the issue in the proposed regulations, in order to take a clear position on the topic, as it has been done in the United Kingdom, where the pharmacological neuroenhancers have been explicitly excluded from the regulation. If pharmacological neuroenhancers are going to be considered neurotechnologies, then new law proposals should seek harmonization with the already existing legislation regulating pharmacological health and consumer rights (both globally, taking into account international drug laws, and locally, according to each country's internal regulations) and of course, with the whole system of fundamental rights. Finally, we briefly discuss the ethical problem of equitable access to this new type of neurotechnologies (as part of the neurorights) and leave the debate open for new insights from the scientific community on the possible consequences of including (or not) pharmacological neuroenhancers as neurotechnologies for cognitive enhancement in the framework of the ethical and legal debate.
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Affiliation(s)
- María Isabel Cornejo-Plaza
- Neurometa Research Center in Neurorights, Neuroethics, Metaverse, Behavioural Economics and Artificial Intelligence, School of Law, Universidad Autónoma de Chile, Santiago, Chile
| | - Chiara Saracini
- The Neuropsychology and Cognitive Neurosciences Research Center (CINPSI Neurocog), Faculty of Health Sciences, Universidad Católica del Maule, Talca, Chile
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Dominik P, Waßmer MP, Soyka M, Franke AG. Stimulant abuse as a coping strategy-Forensic and criminal consequences of stimulant abuse for neuroenhancement. Front Public Health 2022; 10:1028654. [PMID: 36388290 PMCID: PMC9650539 DOI: 10.3389/fpubh.2022.1028654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/12/2022] [Indexed: 01/29/2023] Open
Abstract
Pharmacological neuroenhancement (PN) describes the use of divergent psychoactive substances to enhance mental performance (cognition) without medical need. This kind of substance abuse takes place predominantly in stressful situations. Users implicitly-or even explicitly-describe this kind of drug abuse to be a coping strategy. Regarding the decision making process whether to use PN drugs or not, users indicate that legal aspects to be decisive. However, the legal situation has been neglected so far. To elucidate the German legal situation, PN substances have to be divided into over-the-counter drugs, prescription drugs and illegal drugs. Amphetamines have the highest cognition-enhancing potential, followed by modafinil and caffeine-containing substances. It is pointed out that the use of both freely available and prescription PN substances and narcotics without medical indication have so far been largely exempt from punishment under German law. However, individuals (physicians, bus and truck drivers, etc.) taking PN substances may expose others at risk due to wrong decisions (driving or treatment), errors based on side effects of the used substances. Therefore, the protection of life and health of others could legitimize criminal regulation.
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Affiliation(s)
- Philipp Dominik
- Institute for Criminal Law and Criminal Procedure Law, University of Cologne (UoC), Cologne, Germany
| | - Martin P. Waßmer
- Institute for Criminal Law and Criminal Procedure Law, University of Cologne (UoC), Cologne, Germany,*Correspondence: Martin P. Waßmer
| | - Michael Soyka
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University (LMU), Munich, Germany
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Schönthaler EMD, Hofer G, Grinschgl S, Neubauer AC. Super-Men and Wonder-Women: the Relationship Between the Acceptance of Self-enhancement, Personality, and Values. JOURNAL OF COGNITIVE ENHANCEMENT 2022. [DOI: 10.1007/s41465-022-00244-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractDue to ongoing technological innovations, self-enhancement methods are publicly discussed, researched from different perspectives, and part of ethical debates. However, only few studies investigated the acceptance of these methods and its relationship with personality traits and values. The present study investigated to what extent people accept different enhancement methods and whether acceptance can be predicted by Big Five and Dark Triad traits, vulnerable narcissism, and values. In an online survey (N = 450), we measured personality traits and values. Additionally, participants read scenarios about enhancement methods and answered questions about their acceptance of these scenarios. Factor analysis indicated a general factor of acceptance across scenarios. Correlation analyses showed that high agreeableness, agreeableness-compassion, conscientiousness, conscientiousness-industriousness, and conservation- and self-transcendence values are related to less acceptance of self-enhancement. Moreover, individuals high on Dark Triad traits, vulnerable narcissism, and self-enhancement values exhibit more acceptance. Hierarchical regression analysis revealed that said values and Big Five traits explained unique variance in the acceptance of self-enhancement. These findings highlight the importance of considering personality and values when investigating self-enhancement—a topic that is receiving increasing attention by the public, politicians, and scientists.
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Schifano F, Catalani V, Sharif S, Napoletano F, Corkery JM, Arillotta D, Fergus S, Vento A, Guirguis A. Benefits and Harms of 'Smart Drugs' (Nootropics) in Healthy Individuals. Drugs 2022; 82:633-647. [PMID: 35366192 DOI: 10.1007/s40265-022-01701-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2022] [Indexed: 12/14/2022]
Abstract
'Smart drugs' (also known as 'nootropics' and 'cognitive enhancers' [CEs]) are being used by healthy subjects (i.e. students and workers) typically to improve memory, attention, learning, executive functions and vigilance, hence the reference to a 'pharmaceutical cognitive doping behaviour'. While the efficacy of known CEs in individuals with memory or learning deficits is well known, their effect on non-impaired brains is still to be fully assessed. This paper aims to provide an overview on the prevalence of use; putative neuroenhancement benefits and possible harms relating to the intake of the most popular CEs (e.g. amphetamine-type stimulants, methylphenidate, donepezil, selegiline, modafinil, piracetam, benzodiazepine inverse agonists, and unifiram analogues) in healthy individuals. CEs are generally perceived by the users as effective, with related enthusiastic anecdotal reports; however, their efficacy in healthy individuals is uncertain and any reported improvement temporary. Conversely, since most CEs are stimulants, the related modulation of central noradrenaline, glutamate, and dopamine levels may lead to cardiovascular, neurological and psychopathological complications. Furthermore, use of CEs can be associated with paradoxical short- and long-term cognitive decline; decreased potential for plastic learning; and addictive behaviour. Finally, the non-medical use of any potent psychotropic raises serious ethical and legal issues, with nootropics having the potential to become a major public health concern. Further studies investigating CE-associated social, psychological, and biological outcomes are urgently needed to allow firm conclusions to be drawn on the appropriateness of CE use in healthy individuals.
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Affiliation(s)
- Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK.
| | - Valeria Catalani
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
| | - Safia Sharif
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
| | - Flavia Napoletano
- East London Foundation Trust (ELFT), Newham Early Intervention Service, London, UK
| | - John Martin Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
| | - Davide Arillotta
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
| | - Suzanne Fergus
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
| | - Alessandro Vento
- Department of Mental Health, ASL Roma 2, Rome, Italy
- Addictions' Observatory (ODDPSS), Rome, Italy
- Department of Psychology, Guglielmo Marconi University, Rome, Italy
| | - Amira Guirguis
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
- Swansea University Medical School, Institute of Life Sciences 2, Swansea University, Singleton Park, Swansea, UK
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Xu L, Yang X, Peng Z, Song T, Wang L, Dai C, Xu M, Shao Y, Lv J. Modafinil ameliorates the decline in pronunciation-related working memory caused by 36-h acute total sleep deprivation: an ERP study. Neurobiol Learn Mem 2022; 192:107625. [DOI: 10.1016/j.nlm.2022.107625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 04/08/2022] [Accepted: 04/25/2022] [Indexed: 01/08/2023]
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Radhakrishnan RK, Ravichandran S, Sukesh A, Kadalmani B, Kandasamy M. Single injection of very mild dose botulinum toxin in the vastus lateralis improves testicular spermatogenesis and sperm motility in ageing experimental mice. Lab Anim Res 2022; 38:7. [PMID: 35246277 PMCID: PMC8895922 DOI: 10.1186/s42826-022-00117-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/23/2022] [Indexed: 12/13/2022] Open
Abstract
Background Botulinum toxin (BoNT) is a widely used therapeutic agent that blocks the excessive release of acetylcholine at the neuromuscular junction. Previously, repeated intracremasteric injections and slight overdose of BoNT have been reported to induce adverse effects in the testicular parameter of experimental rodents. However, a mild dose of BoNT is highly beneficial against skin ageing, neuromuscular deficits, overactive urinary bladder problems, testicular pain and erectile dysfunctions. Considering the facts, the possible therapeutic benefits of BoNT on the testis might be achieved at a very minimal dosage and via a distal route of action. Therefore, we revisited the effect of BoNT, but with a trace amount injected into the vastus lateralis of the thigh muscle, and analyzed histological parameters of the testis, levels of key antioxidants and sperm parameters in ageing experimental mice. Results Experimental animals injected with 1 U/kg bodyweight of BoNT showed enhanced spermatogenesis in association with increased activities of key antioxidants in the testis, leading to enhanced amount of the total sperm count and progressive motility. Conclusions This study signifies that a mild intramuscular dose of BoNT can be considered as a potent treatment strategy to manage and prevent male infertility.
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Affiliation(s)
- Risna Kanjirassery Radhakrishnan
- Laboratory of Stem Cells and Neuroregeneration, Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India
| | - Sowbarnika Ravichandran
- Laboratory of Stem Cells and Neuroregeneration, Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India
| | - Aishwarya Sukesh
- Laboratory of Stem Cells and Neuroregeneration, Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India
| | - Balamuthu Kadalmani
- Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India
| | - Mahesh Kandasamy
- Laboratory of Stem Cells and Neuroregeneration, Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India. .,Department of Animal Science, School of Life Sciences, Bharathidasan University, Tiruchirappalli, Tamil Nadu, 620024, India. .,Faculty Recharge Programme, University Grants Commission (UGC-FRP), New Delhi, 110002, India.
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8
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Adam LC, Repantis D, Konrad BN, Dresler M, Kühn S. Memory enhancement with stimulants: Differential neural effects of methylphenidate, modafinil, and caffeine. A pilot study. Brain Cogn 2021; 154:105802. [PMID: 34592684 DOI: 10.1016/j.bandc.2021.105802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/19/2021] [Accepted: 09/19/2021] [Indexed: 11/18/2022]
Abstract
Human memory is susceptible to manipulation in many respects. While consolidation is well known to be prone to disruption, there is also growing evidence for the enhancement of memory function. Beside cognitive strategies and mnemonic training, the use of stimulants may improve memory processing in healthy adults. In this single-dose, double-blind, within-subject, randomized, placebo-controlled pilot study, 20 mg methylphenidate (N = 13) or 200 mg modafinil (N = 12) or 200 mg caffeine (N = 14) were administrated to in total 39 healthy participants while performing a declarative memory task. Each participant received only one substance and functional magnetic resonance imaging (fMRI) was used to assess drug-dependent memory effects of the substance for encoding and recognition compared to task-related activation under placebo. While methylphenidate showed some behavioral effect regarding memory recall performance, on the neural level, methylphenidate-dependent deactivations were found in fronto-parietal and temporal regions during recognition of previously learned words. No BOLD alterations were seen during encoding. Caffeine led to deactivations in the precentral gyrus during encoding whereas modafinil did not show any BOLD signal alterations at all. These results should be interpreted with caution since this a pilot study with several limitations, most importantly the small number of participants per group. However, our main finding of task-related deactivations may point to a drug-dependent increase of efficiency in physiological response to memory processing.
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Affiliation(s)
- Lucas C Adam
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
| | - Dimitris Repantis
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Berlin, Germany.
| | - Boris N Konrad
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Martin Dresler
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Simone Kühn
- Lise Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany; University Medical Center Hamburg-Eppendorf (UKE), Department of Psychiatry and Psychotherapy, Hamburg, Germany
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Schmied A, Varma S, Dubinsky JM. Acceptability of Neuroscientific Interventions in Education. SCIENCE AND ENGINEERING ETHICS 2021; 27:52. [PMID: 34351520 DOI: 10.1007/s11948-021-00328-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 07/06/2021] [Indexed: 06/13/2023]
Abstract
Researchers are increasingly applying neuroscience technologies that probe or manipulate the brain to improve educational outcomes. However, their use remains fraught with ethical controversies. Here, we investigate the acceptability of neuroscience applications to educational practice in two groups of young adults: those studying bioscience who will be driving future basic neuroscience research and technology transfer, and those studying education who will be choosing among neuroscience-derived applications for their students. Respondents rated the acceptability of six scenarios describing neuroscience applications to education spanning multiple methodologies, from neuroimaging to neuroactive drugs to brain stimulation. They did so from two perspectives (student, teacher) and for three recipient populations (low-achieving, high-achieving students, students with learning disabilities). Overall, the biosciences students were more favorable to all neuroscience applications than the education students. Scenarios that measured brain activity (i.e., EEG or fMRI) to assess or predict intellectual abilities were deemed more acceptable than manipulations of mental activity by drug use or stimulation techniques, which may violate body integrity. Enhancement up to the norm for low-achieving students and especially students with learning disabilities was more favorably viewed than enhancement beyond the norm for high-achieving students. Finally, respondents rated neuroscientific applications to be less acceptable when adopting the perspective of a teacher than that of a student. Future studies should go beyond the acceptability ratings collected here to delineate the role that concepts of access, equity, authenticity, agency and personal choice play in guiding respondents' reasoning.
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Affiliation(s)
- A Schmied
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, USA
| | - S Varma
- School of Interactive Computing, College of Computing & School of Psychology, College of Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - J M Dubinsky
- Department of Neuroscience, University of Minnesota, 6-145 Jackson Hall, 321 Church St SE, Minneapolis, MN, 55455, USA.
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Franke AG, Koller G, Krause D, Proebstl L, Kamp F, Pogarell O, Jebrini T, Manz K, Chrobok AI, Soyka M. Just "Like Coffee" or Neuroenhancement by Stimulants? Front Public Health 2021; 9:640154. [PMID: 34164365 PMCID: PMC8215262 DOI: 10.3389/fpubh.2021.640154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/05/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Pharmacological neuroenhancement (PN) is a topic of increasing importance and prevalence among students. However, there is a lack of differentiating PN substances, according to their psychoactive effects. In particular, there is a lack of data about PN by caffeinated drinks, even if coffee is a common and broadly used Neuroenhancer because of its cognitively enhancing effects regarding wakefulness, alertness and concentration. Materials and Methods: A web-survey was developed for German students and alumni about the non-medical use of caffeine for PN contained questions about coffee, caffeinated drinks and energy drinks, caffeine pills and methylxanthine tea regarding frequency and further contextual factors. Results: Six hundred and eighty-three participants completed the survey. Nearly all participants knew about PN (97.7%). 88.1% admitted using some over-the-counter substances. For PN purposes, coffee was used by 72.9% followed by energy drinks (68.2%) and cola drinks (62.4%). Methylxanthine containing tea was used for PN purposes, too (black tea 52.3%, green tea 51.7%). 1.8% admitted using illegal substances or prescription drugs, too. Discussion: Using legal methylxanthine containing drinks for PN seems to be extremely common with coffee and energy drinks being the preferred substances, while illegal and prescription drugs are only minimally used. Further studies should investigate the awareness of methylxanthine containing drinks as well as its character to be a flavoring drink or a neuroenhancer.
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Affiliation(s)
- Andreas G Franke
- Hochschule der Bundesagentur für Arbeit/University of Applied Labour Studies, Mannheim, Germany
| | - Gabriele Koller
- Department of Psychiatry and Psychotherapy, Hospital of the Ludwig Maximilian University, Munich, Germany
| | - Daniela Krause
- Department of Psychiatry and Psychotherapy, Hospital of the Ludwig Maximilian University, Munich, Germany
| | - Lisa Proebstl
- Department of Psychiatry and Psychotherapy, Hospital of the Ludwig Maximilian University, Munich, Germany
| | - Felicia Kamp
- Department of Psychiatry and Psychotherapy, Hospital of the Ludwig Maximilian University, Munich, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, Hospital of the Ludwig Maximilian University, Munich, Germany
| | - Tarek Jebrini
- Department of Psychiatry and Psychotherapy, Hospital of the Ludwig Maximilian University, Munich, Germany
| | - Kirsi Manz
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig Maximilian University, Munich, Germany
| | - Agnieszka I Chrobok
- Department of Psychiatry and Psychotherapy, Hospital of the Ludwig Maximilian University, Munich, Germany
| | - Michael Soyka
- Department of Psychiatry and Psychotherapy, Hospital of the Ludwig Maximilian University, Munich, Germany
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Marazziti D, Avella MT, Ivaldi T, Palermo S, Massa L, Vecchia AD, Basile L, Mucci F. Neuroenhancement: State of the Art and Future Perspectives. CLINICAL NEUROPSYCHIATRY 2021; 18:137-169. [PMID: 34909030 PMCID: PMC8629054 DOI: 10.36131/cnfioritieditore20210303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Pharmacological neuroenhancement refers to the non-medical use of prescription drugs, alcohol, illegal drugs, or the so-called soft enhancers for the purpose of improving cognition, mood, pro-social behavior, or work and academic performance. This phenomenon is undoubtedly more frequent than previously supposed especially amongst university students. The aim of the present paper was to carefully review and comment on the available literature on neuroenhancement, according to Prisma guidelines. The results showed a great use of all prescribed drugs (benzodiazepines, antidepressants, antipsychotics, nootropic compounds, and especially stimulants) as neuroenhancers amongst healthy subjects, although probably the real prevalence is underestimated. The use of illicit drugs and soft enhancers is similarly quite common. Data on the improvement of cognition by other compounds, such as oxytocin and pheromones, or non-pharmacological techniques, specifically deep brain stimulation and transcranial magnetic stimulation, are still limited. In any case, if it is true that human beings are embedded by the desire to overcome the limits of their intrinsic nature, neuroenhancement practices put into question the concept of authenticity. Therefore, the problem appears quite complex and requires to be deepened and analyzed with no prejudice, although within an ethical conceptual frame.
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Affiliation(s)
- Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
- Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Maria Teresa Avella
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Tea Ivaldi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Stefania Palermo
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Lucia Massa
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Alessandra Della Vecchia
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Lucia Basile
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Federico Mucci
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Italy
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Elfferich AM. Social Justice Theories as the Basis for Public Policy on Psychopharmacological
Cognitive Enhancement. CANADIAN JOURNAL OF BIOETHICS 2021. [DOI: 10.7202/1077629ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Psychopharmacological cognitive enhancements could lead to a higher quality of life
of healthy individuals with lower cognitive capacities, but the current regulatory framework
does not seem to enable access to this group. This article discusses why Sen’s Capability
Approach could open up such access, while two other modern social justice theories –
utilitarianism and Rawls’ Justice as Fairness – could not. In short, the utilitarian
approach is proven to be inadequate, due to practical reasons and having a low chance of
real-world success. Rawls’ Justice as Fairness seems to be problematic because of
conflicting stances that follow from his First Principle of Justice. The Capability Approach
has the greatest chance of success in the context of these substances, because of arguments
that can be identified under the banners of agency/self-respect and the way the public views
those who take the capability path out of their poor situation. The article also discusses
general and practical problems with psychopharmacological cognitive enhancement that should
be addressed when writing new policy on this topic.
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Mayor E, Daehne M, Bianchi R. The Dark Triad of personality and attitudes toward cognitive enhancement. BMC Psychol 2020; 8:119. [PMID: 33160397 PMCID: PMC7648998 DOI: 10.1186/s40359-020-00486-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/28/2020] [Indexed: 11/10/2022] Open
Abstract
Background Cognitive enhancement (CE) refers to the voluntary improvement of human cognitive capabilities. Few studies have examined the general attitude of the public towards CE. Such studies have suggested that the use of CE is considered largely unacceptable by the public. In parallel, past research indicates that individuals scoring high on the Dark Triad of personality (Machiavellianism, narcissism, and psychopathy) and competitiveness have atypical views of ethical questions. In this study, we examined (a) whether attitudes towards CE are associated with individual differences in the Dark Triad of personality as well as in trait and contextual competitiveness and (b) whether the Dark Triad moderates the effect of trait and contextual competitiveness on attitudes towards CE.
Method US employees (N = 326) were recruited using Mechanical Turk. Participants completed a web survey. Data were analyzed by means of (robust) hierarchical regression and (robust) ANCOVAs. Results The Dark Triad of personality and one of its subscales, Machiavellianism, predicted positive attitudes towards CE. Neither trait competitiveness nor contextual competitiveness were linked to general attitudes towards CE, but the DT was a positive moderator of the association between contextual competitiveness and positive attitudes. Conclusion Our findings extend the incipient knowledge about the factors relating to favourable views of CE by highlighting the role of dark personality traits in shaping such views. Our study further shows contextual factors can play a differentiated role with respect to such attitudes depending upon dark personality traits. Implications for policy-making are discussed.
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Affiliation(s)
- Eric Mayor
- Department of Clinical Psychology and Epidemiology, University of Basel, 4055, Basel, Switzerland.
| | - Maxime Daehne
- Institute of Work and Organizational Psychology, University of Neuchâtel, 2000 Neuchâtel, Switzerland
| | - Renzo Bianchi
- Institute of Work and Organizational Psychology, University of Neuchâtel, 2000 Neuchâtel, Switzerland
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Napoletano F, Schifano F, Corkery JM, Guirguis A, Arillotta D, Zangani C, Vento A. The Psychonauts' World of Cognitive Enhancers. Front Psychiatry 2020; 11:546796. [PMID: 33024436 PMCID: PMC7516264 DOI: 10.3389/fpsyt.2020.546796] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 08/17/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND There is growing availability of novel psychoactive substances (NPS), including cognitive enhancers (CEs) which can be used in the treatment of certain mental health disorders. While treating cognitive deficit symptoms in neuropsychiatric or neurodegenerative disorders using CEs might have significant benefits for patients, the increasing recreational use of these substances by healthy individuals raises many clinical, medico-legal, and ethical issues. Moreover, it has become very challenging for clinicians to keep up-to-date with CEs currently available as comprehensive official lists do not exist. METHODS Using a web crawler (NPSfinder®), the present study aimed at assessing psychonaut fora/platforms to better understand the online situation regarding CEs. We compared NPSfinder® entries with those from the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and from the United Nations Office on Drugs and Crime (UNODC) NPS databases up to spring 2019. Any substance that was identified by NPSfinder® was considered a CE if it was either described as having nootropic abilities by psychonauts or if it was listed among the known CEs by Froestl and colleagues. RESULTS A total of 142 unique CEs were identified by NPSfinder®. They were divided into 10 categories, including plants/herbs/products (29%), prescribed drugs (17%), image and performance enhancing drugs (IPEDs) (15%), psychostimulants (15%), miscellaneous (8%), Phenethylamines (6%), GABAergic drugs (5%), cannabimimetic (4%), tryptamines derivatives (0.5%), and piperazine derivatives (0.5%). A total of 105 chemically different substances were uniquely identified by NPSfinder®. Only one CE was uniquely identified by the EMCDDA; no CE was uniquely identified by the UNODC. CONCLUSIONS These results show that NPSfinder® is helpful as part of an Early Warning System, which could update clinicians with the growing numbers and types of nootropics in the increasingly difficult-to-follow internet world. Improving clinicians' knowledge of NPS could promote more effective prevention and harm reduction measures in clinical settings.
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Affiliation(s)
- Flavia Napoletano
- Department of Mental Health, Homerton University Hospital, East London Foundation Trust, London, United Kingdom
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - John Martin Corkery
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Amira Guirguis
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Swansea University Medical School, Institute of Life Sciences 2, Swansea University, Swansea, United Kingdom
| | - Davide Arillotta
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Caroline Zangani
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Alessandro Vento
- Department of Mental Health, Addictions’ Observatory (ODDPSS), Rome, Italy
- Department of Mental Health, Guglielmo Marconi” University, Rome, Italy
- Department of Mental Health, ASL Roma 2, Rome, Italy
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Brühl AB, d'Angelo C, Sahakian BJ. Neuroethical issues in cognitive enhancement: Modafinil as the example of a workplace drug? Brain Neurosci Adv 2020; 3:2398212818816018. [PMID: 32166175 PMCID: PMC7058249 DOI: 10.1177/2398212818816018] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Indexed: 12/01/2022] Open
Abstract
The use of cognitive-enhancing drugs by healthy individuals has been a feature for much of recorded history. Cocaine and amphetamine are modern cases of drugs initially enthusiastically acclaimed for enhancing cognition and mood. Today, an increasing number of healthy people are reported to use cognitive-enhancing drugs, as well as other interventions, such as non-invasive brain stimulation, to maintain or improve work performance. Cognitive-enhancing drugs, such as methylphenidate and modafinil, which were developed as treatments, are increasingly being used by healthy people. Modafinil not only affects ‘cold’ cognition, but also improves ‘hot’ cognition, such as emotion recognition and task-related motivation. The lifestyle use of ‘smart drugs’ raises both safety concerns as well as ethical issues, including coercion and increasing disparity in society. As a society, we need to consider which forms of cognitive enhancement (e.g. pharmacological, exercise, lifelong learning) are acceptable and for which groups under what conditions and by what methods we would wish to improve and flourish.
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Affiliation(s)
- Annette B Brühl
- Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK.,Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Camilla d'Angelo
- Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
| | - Barbara J Sahakian
- Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, UK
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Hupli A. Cognitive enhancement with licit and illicit stimulants in the Netherlands and Finland: what is the evidence? DRUGS AND ALCOHOL TODAY 2020. [DOI: 10.1108/dat-07-2019-0028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
European studies have shown lower prevalence rates of prescription stimulant use for cognitive enhancement, especially among student populations, compared to North America. This difference requires more cross-country research of the various factors involved. To find out whether other parts of the globe are witnessing similar increases in extra-medical stimulant use, and how this might relate to cognitive enhancement, requires empirical study of local contexts. This paper aims to argue that the academic and public discussion on cognitive enhancement should consider the specific country context of drug policy and research and rethink which drugs are included under the term cognitive enhancement drugs.
Design/methodology/approach
This paper offers a general review and a sociological country comparison between the Netherlands and Finland, focusing not only on prescription stimulants used to treat attention deficit hyperactivity disorder but also illicit amphetamines among young adults and methylphenidate use among Dutch and Finnish participants of the Global Drug Survey. This paper emphasises sociocultural perspectives and the importance of context in cognitive enhancement in general as the line between therapeutic and enhancement use can often be blurred. Data is drawn from global, European and national sources, including the International Narcotics Control Board, European Monitoring Centre for Drugs and Drug Addiction and Global Drug Survey.
Findings
There are hardly any national empirical studies done on cognitive enhancement drug use in Finland. On the other hand, there have been studies in the Netherlands showcasing that the use of prescription stimulants and other drugs for enhancement purposes is something that is happening among young people, albeit yet in a relatively small scale. Illicit and licit stimulant use and drug policy action in relation to cognitive enhancement drugs in the two countries varies, emphasising the importance of country context.
Originality/value
Given that cross-country research is scarce, this general review provides one of the first glimpses into cognitive enhancement drug use by comparing the country context and research in Finland, where the phenomenon has not been studied, with the Netherlands, where the topic has received more research and public attention. Further research areas are suggested.
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17
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Ricci G. Pharmacological Human Enhancement: An Overview of the Looming Bioethical and Regulatory Challenges. Front Psychiatry 2020; 11:53. [PMID: 32127792 PMCID: PMC7037021 DOI: 10.3389/fpsyt.2020.00053] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 01/21/2020] [Indexed: 12/12/2022] Open
Abstract
Cognitive enhancement, a rather broad-ranging principle, can be achieved in various ways: healthy eating and consistent physical exercise can lead to long-term improvements in many cognitive domains; commonplace stimulants such as caffeine, on the other hand, temporarily raise levels of alertness, attentiveness, and concentration; sedative substances are also used as an indirect form of enhancement to relax before an exam or an important meeting. Such approaches raise no ethical issue. Nonetheless, clinical research has led to the off-label use of drugs called nootropics or "smart drugs", which can, under certain conditions, elicit some degree of cognition-improving effects: methylphenidate and modafinil can enhance working memory and concentration in healthy individuals, although the significance and effectiveness of such applications are dubious. Such "cognitive enhancement" methods, however, do raise multiple ethical issues, and their contentious nature has caused bioethical authorities to lay out opinions and recommendations meant to regulate their use. Most notably, the Italian Committee on Bioethics has extensively dealt with the spread of nootropics, which resulted in the Italian Code of Medical Ethics including "cognitive enhancement" drugs and their prescription by doctors as critical points, along with cosmetic surgery (the latest version of the Code, updated in December 2017, deals with the two separately, in Article 76 and 76 BIS). The United States Presidential Commission for the Study of Bioethical Issues broadened the scope of cognitive enhancement techniques so as to include neural modifiers, i.e. mechanisms of brain and nervous system change: a much wider array of interventions, technologies, behaviors, and environmental conditions that may potentially affect several aspects of the human brain and nervous system. The potential of neuroscience to profoundly reshape society is nothing short of mind-blowing.
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Affiliation(s)
- Giovanna Ricci
- Section of Forensic Medicine, School of Law, University of Camerino, Camerino, Italy
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18
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Abstract
Sporting authorities and policy makers have warned of a radical increase in the availability and use of so-called 'smart' drugs, which putatively deliver cognitive enhancements in the form of improved focus, concentration, alertness, and rapid decision-making. Although the potential for health risks is well documented when it comes to performance enhancing drugs in sport, the health implications of cognitive enhancing drugs (CEDs) remain unclear. Objectives: This article aims to provide a foundational understanding about CEDs and their application in sport. It considers what little is known about the types, nature, impact, and implications of their use for athletes and sport policy. Method: A narrative literature review was undertaken to ascertain the emerging role of CEDs beyond their clinical use to treat prescribed disorders, including the limited studies in the sporting domain. This review also considered literature pertinent to the impact of CEDs in sport and the challenges for sport policy. Results: Given the prospects of negative health impacts, policy-makers interested in preventing and controlling the use of CEDs, as well as reducing harm to athletes at all levels of performance, need guidance. This article highlights multi-faceted concerns and shines a spotlight on key issues for sporting bodies to consider regarding the critical impact that widespread use and adoption of these substances might entail. Conclusion: While the World Anti-Doping Agency (WADA) is seemingly awake to the threat posed, actions to circumvent the spread of CEDs throughout sport are nascent and require greater understanding and attention.
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Affiliation(s)
- Aaron C T Smith
- Institute for Sport Business, Loughborough University London, London, United Kingdom
| | - Constantino Stavros
- School of Economics, Finance & Marketing, RMIT University, Melbourne, Australia
| | - Kate Westberg
- School of Economics, Finance & Marketing, RMIT University, Melbourne, Australia
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19
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Baas M, Boot N, van Gaal S, de Dreu CK, Cools R. Methylphenidate does not affect convergent and divergent creative processes in healthy adults. Neuroimage 2020; 205:116279. [DOI: 10.1016/j.neuroimage.2019.116279] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 10/09/2019] [Accepted: 10/13/2019] [Indexed: 01/24/2023] Open
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20
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Kexel AK, Vonmoos M, Preller KH, Hulka LM, Seifritz E, Quednow BB. Social and Non-Social Cognitive Enhancement in Cocaine Users-A Closer Look on Enhancement Motives for Cocaine Consumption. Front Psychiatry 2020; 11:618. [PMID: 32695032 PMCID: PMC7338788 DOI: 10.3389/fpsyt.2020.00618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/15/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cognitive disturbances of chronic cocaine users (CU) have been repeatedly investigated. However, it is yet unknown how CU using cocaine for cognitive or social enhancement differ from stimulant-naïve controls and CU that do not have these motives. More precisely, we assumed that CU with an enhancement motive self-medicate deficits in specific cognitive abilities, i.e., they use cocaine to enhance their performance in either social (social motive) or non-social cognitive situations (cognitive motive). METHODS Forty-two CU were categorized according to their motives for cocaine consumption into social and non-social motive groups as well as cognitive and non-cognitive motive groups, respectively. Subsequently, CU motive groups were compared to 48 stimulant-naïve controls in their social and non-social cognitive functioning applying a comprehensive neuropsychological test battery. RESULTS The social motive group showed deficits in cognitive empathy compared to controls (Cohen's d = 0.65) and the non-social motive group (d = 0.60). No mentionable effects were found for emotional empathy and Theory-of-Mind. Cognitive and non-cognitive motive groups both showed general cognitive deficits but with different patterns of impairments compared to controls: the cognitive motive group had deficits mainly in working memory (d = 0.84) and declarative memory (d = 0.60), whereas the non-cognitive motive group also had deficits in working memory (d = 0.61) but additionally in executive functions (d = 0.67). For the domains declarative memory and executive functions, the respective other CU group displayed intermediate performance. CONCLUSIONS This study demonstrates that cocaine is partially instrumentalized by CU with specific enhancement motives to counteract related cognitive impairments.
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Affiliation(s)
- Ann-Kathrin Kexel
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Matthias Vonmoos
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Katrin H Preller
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Lea M Hulka
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
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21
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Hupli A, Didžiokaitė G, Ydema M. Beyond Treatment Versus Enhancement: A Qualitative Study of Pharmacological Neuro-Enhancement Among Dutch and Lithuanian University Students. ACTA ACUST UNITED AC 2019. [DOI: 10.1177/0091450919884777] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This article examines the ambiguous relationship between treating illness and enhancing normalcy through the use of “cognitive enhancement” drugs. Although the literature on pharmacological neuro-enhancement generally differentiates between the “licit/therapeutic” and “illicit/enhancement” use of substances, in-depth interviews with 35 university students in the Netherlands and Lithuania—both with and without formal medical diagnoses of (mainly) Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder—reveal the fluidity of these categories. Our study of the perceptions and experiences of people who use such drugs further suggests a much broader range of substances, motives, and sought-after effects than are commonly acknowledged in the “cognitive enhancement” literature. We need a more inclusive and context-sensitive approach to study pharmacological neuro-enhancement, for instance, by approaching both licit and illicit drugs as tools or instruments.
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Affiliation(s)
- Aleksi Hupli
- School of Social Science and Humanities, University of Tampere, Finland
| | | | - Marte Ydema
- Amsterdam Institute for Social Science Research, University of Amsterdam, the Netherlands
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22
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Wilms W, Woźniak-Karczewska M, Corvini PFX, Chrzanowski Ł. Nootropic drugs: Methylphenidate, modafinil and piracetam - Population use trends, occurrence in the environment, ecotoxicity and removal methods - A review. CHEMOSPHERE 2019; 233:771-785. [PMID: 31200137 DOI: 10.1016/j.chemosphere.2019.06.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/28/2019] [Accepted: 06/02/2019] [Indexed: 06/09/2023]
Abstract
Pharmaceuticals which originally were designed to treat people with neurological and psychiatric conditions, e.g. Alzheimer's disease or attention deficit hyperactivity disorder (ADHD), are nowadays often misused by students as a 'brain doping' substances. These substances are known as nootropic drugs, smart drugs or cognitive enhancers, as they increase memory, attention and concentration of healthy individuals. Since they are easily available illicitly, their consumption is observed to be growing. Currently, these pharmaceuticals started gaining researchers' attention, especially since they have been recently detected in wastewater, surface water and even drinking water. This review summarises the current state of knowledge on nootropic drugs in terms of their population use trends and ethics, occurrence in the environment and detection techniques, toxicity and removal methods, in example of methylphenidate, modafinil and piracetam - three most popular nootropics. It points out that the main sources of knowledge on cognitive enhancers illicit use are often inconsistent questionnaires, which are not supported by wastewater analysis to become more veracious. Simultaneously, the studies concerning toxicity and removal methods of nootropic drugs are still limited and in many cases environmentally irrelevant. Although the prescription rules has been subjected to more strict control in developed countries, regulatory frameworks with regard to their ecosystem occurrence are still lacking and should be introduced. Moreover, the use of environmentally relevant concentrations in toxicity studies should be a standard, leading to proper ecotoxicity risk assessment. Based on this review, it is recommended to routinely monitor nootropics and their metabolites in waste- and surface waters.
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Affiliation(s)
- Wiktoria Wilms
- Faculty of Chemical Technology, Poznan University of Technology, Berdychowo 4, 60-965, Poznań, Poland
| | - Marta Woźniak-Karczewska
- Faculty of Chemical Technology, Poznan University of Technology, Berdychowo 4, 60-965, Poznań, Poland
| | - Philippe F-X Corvini
- Institute for Ecopreneurship, School of Life Sciences, University of Applied Sciences and Arts Northwestern Switzerland, Gründenstrasse 40, 4132, Muttenz, Switzerland
| | - Łukasz Chrzanowski
- Faculty of Chemical Technology, Poznan University of Technology, Berdychowo 4, 60-965, Poznań, Poland.
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23
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Heyes AR, Boardley ID. Psychosocial factors facilitating use of cognitive enhancing drugs in education: a qualitative investigation of moral disengagement and associated processes. DRUGS: EDUCATION, PREVENTION AND POLICY 2019. [DOI: 10.1080/09687637.2019.1586831] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Andrew Robert Heyes
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - Ian David Boardley
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
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24
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Hupli A, Berning M, Zhuparris A, Fadiman J. Descriptive assemblage of psychedelic microdosing: Netnographic study of Youtube™ videos and on-going research projects. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.peh.2019.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Effect of ADHD medication in male C57BL/6J mice performing the rodent Continuous Performance Test. Psychopharmacology (Berl) 2019; 236:1839-1851. [PMID: 30656365 DOI: 10.1007/s00213-019-5167-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 01/07/2019] [Indexed: 12/15/2022]
Abstract
RATIONALE The rodent Continuous Performance Test (rCPT) is a novel rodent paradigm to assess attention and impulsivity that resembles the human CPT. This task measures the rodents' ability to discriminate between target and non-target stimuli. The effect of attention-deficit/hyperactivity disorder (ADHD) medication on rCPT performance in mice remains to be fully characterized. OBJECTIVE To investigate the predictive validity of the mouse rCPT by studying the effects of ADHD medication methylphenidate, atomoxetine, amphetamine, guanfacine, and modafinil in four behavioral subgroups based on performance and impulsivity levels. METHODS Two cohorts of male C57BL/6J mice were used, and the effect of treatment was tested in a variable stimulus duration probe. Performance and impulsive subgroups were made based on discriminability and percentage premature responses, respectively. RESULTS Methylphenidate, atomoxetine, and amphetamine improved performance in the low-performing animals, with no effect in the high-performers. These improvements were a result of increased hit rate and/or decreased false-alarm rate. Furthermore, these drugs decreased percentage premature responses in the high-impulsive group. Methylphenidate, guanfacine, and modafinil increased premature responses in the low-impulsive group. Modafinil impaired performance in the high-performers by increasing false-alarm rate. CONCLUSION The effect of ADHD treatment was dependent on baseline, as seen by increases in performance for the low-performers and decreases in impulsivity for the high-impulsive animals. These results agree with clinical data and may support the inverted U-shaped arousal-performance theory. The rCPT combined with behavioral separation into subgroups has high predictive validity, and our study is a step forward towards establishing the clinical translatability of the rCPT.
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Dresler M, Sandberg A, Bublitz C, Ohla K, Trenado C, Mroczko-Wąsowicz A, Kühn S, Repantis D. Hacking the Brain: Dimensions of Cognitive Enhancement. ACS Chem Neurosci 2019; 10:1137-1148. [PMID: 30550256 PMCID: PMC6429408 DOI: 10.1021/acschemneuro.8b00571] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 12/14/2018] [Indexed: 12/11/2022] Open
Abstract
In an increasingly complex information society, demands for cognitive functioning are growing steadily. In recent years, numerous strategies to augment brain function have been proposed. Evidence for their efficacy (or lack thereof) and side effects has prompted discussions about ethical, societal, and medical implications. In the public debate, cognitive enhancement is often seen as a monolithic phenomenon. On a closer look, however, cognitive enhancement turns out to be a multifaceted concept: There is not one cognitive enhancer that augments brain function per se, but a great variety of interventions that can be clustered into biochemical, physical, and behavioral enhancement strategies. These cognitive enhancers differ in their mode of action, the cognitive domain they target, the time scale they work on, their availability and side effects, and how they differentially affect different groups of subjects. Here we disentangle the dimensions of cognitive enhancement, review prominent examples of cognitive enhancers that differ across these dimensions, and thereby provide a framework for both theoretical discussions and empirical research.
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Affiliation(s)
- Martin Dresler
- Donders Institute for Brain, Cognition and Behaviour , Radboud University Medical Centre , Nijmegen 6525 EN , The Netherlands
| | - Anders Sandberg
- Future of Humanity Institute , Oxford University , Oxford OX1 1PT , United Kingdom
| | | | - Kathrin Ohla
- Institute of Neuroscience and Medicine, Cognitive Neuroscience (INM3) , Forschungszentrum Jülich , Jülich 52428 , Germany
| | - Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology , Heinrich Heine University Düsseldorf , Düsseldorf 40225 , Germany
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors , TU Dortmund , Dortmund 44139 , Germany
| | | | - Simone Kühn
- Max Planck Institute for Human Development , Berlin 14195 , Germany
- Department of Psychiatry and Psychotherapy , University Clinic Hamburg Eppendorf , Hamburg 20246 , Germany
| | - Dimitris Repantis
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin 12203 , Germany
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Zaami S, Tagliabracci A, Berretta P, Busardò FP, Marinelli E. Use of Methylphenidate Analogues as Cognitive Enhancers: The Prelude to Cosmetic Neurology and an Ethical Issue. Front Psychiatry 2019; 10:1006. [PMID: 32038333 PMCID: PMC6989549 DOI: 10.3389/fpsyt.2019.01006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 12/20/2019] [Indexed: 01/01/2023] Open
Affiliation(s)
- Simona Zaami
- Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University, Rome, Italy
| | - Adriano Tagliabracci
- Section of Legal Medicine, Department of Excellence-Biomedical Sciences and Public Health, Ancona, Italy
| | - Paolo Berretta
- National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
| | - Francesco Paolo Busardò
- Section of Legal Medicine, Department of Excellence-Biomedical Sciences and Public Health, Ancona, Italy
| | - Enrico Marinelli
- Department of Anatomical, Histological, Forensic, and Orthopedic Sciences, Sapienza University, Rome, Italy
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Carton L, Cabé N, Ménard O, Deheul S, Caous AS, Devos D, Cottencin O, Bordet R. Pharmaceutical cognitive doping in students: A chimeric way to get-a-head? Therapie 2018; 73:331-339. [PMID: 29625706 DOI: 10.1016/j.therap.2018.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 02/23/2018] [Indexed: 10/17/2022]
Abstract
For students, the pressing demands for memorization, top-level performance, and peer competition create an environment favorable for pharmaceutical cognitive doping behavior. We aimed to describe recent practices and the benefit/risk ratio of such behavior and to discuss the issues at stake. The prevalence of pharmaceutical cognitive doping among students has been reported from 1.3% to 33% across studies, with variations depending on country and definition of pharmaceutical cognitive doping. The therapeutic classes most frequently cited as being diverted for doping purposes are psychostimulants and nootropics (methylphenidate, modafinil, piracetam), corticosteroids, sedative drugs and beta-blockers. Some illegal substances such as cannabis, amphetamines and cocaine are also consumed in order to boost mental function. Finally, over-the-counter products, such as caffeine-based tablets or energy drinks, or alcohol, are also widely used by students whose motivations involve enhanced performance, concentration, memory, and staying awake during the revision and exam period. However, the expected (often fantasized) effectiveness of these products does not correspond to the reality of a modest controversial impact on cognitive performance. There appears to be an emerging profile of the student more inclined to doping behavior. Cognitive doping thus raises the question of its regulation, opening a debate opposing, on one hand, individual freedom and supposed collective benefits and, on the other hand, health consequences, educational (in)equality, and the risk of tarnished academic success. Strengthening school and university medicine, through prevention campaigns and the identification of subjects at risk, is essential to limit the extent, risk, and damages associated with such practices.
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Affiliation(s)
- Louise Carton
- Inserm, UMR S1171, service de pharmacologie médicale, CHU de Lille, université de Lille, 59000 Lille, France; CEIP-addictovigilance, service de pharmacologie médicale, CHRU de Lille, 59045 Lille cedex, France; Service d'addictologie et de psychiatrie, CHU de Lille, 59037 Lille, France.
| | - Nicolas Cabé
- Inserm, U1077, Unicaen, EPHE, neuropsychologie et imagerie de la mémoire humaine, PSL research university, CHU de Caen, Normandie université, 14000 Caen, France; Service universitaire d'addictologie, CHU de Caen, 14000 Caen, France
| | - Olivier Ménard
- Service d'addictologie et de psychiatrie, CHU de Lille, 59037 Lille, France
| | - Sylvie Deheul
- Inserm, UMR S1171, service de pharmacologie médicale, CHU de Lille, université de Lille, 59000 Lille, France; CEIP-addictovigilance, service de pharmacologie médicale, CHRU de Lille, 59045 Lille cedex, France
| | - Anne-Sylvie Caous
- CEIP-addictovigilance, service de pharmacologie médicale, CHRU de Lille, 59045 Lille cedex, France
| | - David Devos
- Inserm, UMR S1171, service de pharmacologie médicale, CHU de Lille, université de Lille, 59000 Lille, France; Licend Coen Center Lille, 59045 Lille, France
| | - Olivier Cottencin
- CNRS UMR 9193 SCALab PsyCHIC Team, université de Lille, 59045 Lille, France; Service d'addictologie et de psychiatrie, CHU de Lille, 59037 Lille, France
| | - Régis Bordet
- Inserm, UMR S1171, service de pharmacologie médicale, CHU de Lille, université de Lille, 59000 Lille, France; CEIP-addictovigilance, service de pharmacologie médicale, CHRU de Lille, 59045 Lille cedex, France
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Dolder PC, Strajhar P, Vizeli P, Odermatt A, Liechti ME. Acute effects of lisdexamfetamine and D-amphetamine on social cognition and cognitive performance in a placebo-controlled study in healthy subjects. Psychopharmacology (Berl) 2018; 235:1389-1402. [PMID: 29511807 DOI: 10.1007/s00213-018-4849-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 01/31/2018] [Indexed: 01/26/2023]
Abstract
RATIONALE Amphetamines are used as medications but are also misused as cognitive enhancers by healthy subjects and may have additional effects on social cognition. METHODS We investigated the acute effects of single, high, equimolar doses of D-amphetamine (40 mg) and lisdexamfetamine (100 mg) on social cognition and cognitive performance using a randomized, placebo-controlled, double-blind, cross-over design in 24 healthy volunteers. Effects on social cognition were assessed using the Facial Emotion Recognition Task (FERT), Multifaceted Empathy Test (MET), and Sexual Arousal Task (SAT). Cognitive performance was measured using the Digit Symbol Substitution Test (DSST), Digit Span (DS), Stop-Signal Task (SST), and Mackworth Clock Test (MCT). RESULTS D-Amphetamine and lisdexamfetamine had small effects on measures of social cognition. There were no effects on emotion recognition on the FERT. D-Amphetamine increased direct empathy on the MET, but only for positive stimuli. Both amphetamines increased ratings of pleasantness and attractiveness on the SAT in response to sexual but also to neutral stimuli. D-Amphetamine and lisdexamfetamine increased cognitive performance (go-accuracy and vigilance on the SST and MCT, respectively). Lisdexamfetamine increased processing speed on the DSST. Neither drug had an effect on the DS. CONCLUSION Single, high, equimolar doses of D-amphetamine and lisdexamfetamine enhanced certain aspects of cognitive performance in healthy non-sleep-deprived subjects. Both amphetamines also slightly altered aspects of social cognition. Whether these small effects also influence social interaction behavior in amphetamine users remains to be investigated. TRIAL REGISTRATION The study was registered at ClinicalTrials.gov (NCT02668926).
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Affiliation(s)
- Patrick C Dolder
- Psychopharmacology Research, Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Schanzenstrasse 55, 4056, Basel, CH, Switzerland
| | - Petra Strajhar
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Patrick Vizeli
- Psychopharmacology Research, Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Schanzenstrasse 55, 4056, Basel, CH, Switzerland
| | - Alex Odermatt
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Matthias E Liechti
- Psychopharmacology Research, Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Schanzenstrasse 55, 4056, Basel, CH, Switzerland.
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31
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Schleim S, Quednow BB. How Realistic Are the Scientific Assumptions of the Neuroenhancement Debate? Assessing the Pharmacological Optimism and Neuroenhancement Prevalence Hypotheses. Front Pharmacol 2018; 9:3. [PMID: 29403383 PMCID: PMC5786508 DOI: 10.3389/fphar.2018.00003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 01/03/2018] [Indexed: 11/30/2022] Open
Abstract
Since two decades, neuroenhancement is a major topic in neuroethics and still receives much attention in the scholarly literature as well as in public media. In contrast to high hopes at the beginning of the “Decade of the Brain” in the United States and Europe that we subsume under the “pharmacological optimism hypothesis,” recent evidence from clinical neuroscience suggests that developing drugs that make healthy people smarter is even more difficult than finding new treatments for patients with mental disorders. However, cognitive enhancing drugs even for patients with impaired intellectual performance have not been successfully developed yet and new drugs that might have a disruptive impact on this field are unlikely to be developed in the near future. Additionally, we discuss theoretical, empirical, and historical evidence to assess whether cognitive enhancement of the healthy is common or even epidemic and if its application will further increase in the near future, as suggested by the “neuroenhancement prevalence hypothesis.” Reports, surveys, and reviews from the 1930s until today indicate that psychopharmacological neuroenhancement is a fact but less common than often stated, particularly in the public media. Non-medical use of psychostimulants for the purpose of cognitive enhancement exists since at least 80 years and it might actually have been more common in the past than today. Therefore, we conclude that the pharmacological optimism hypothesis and neuroenhancement prevalence hypotheses have to be rejected and argue that the neuroenhancement debate should take the available evidence more into account.
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Affiliation(s)
- Stephan Schleim
- Theory and History of Psychology, Faculty of Behavioral and Social Sciences, Heymans Institute for Psychological Research, University of Groningen, Groningen, Netherlands
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
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32
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Carton L, Cabé N, Ménard O, Deheul S, Caous AS, Devos D, Cottencin O, Bordet R. [Pharmaceutical cognitive doping in students: a chimeric way to get-a-head?]. Therapie 2017; 73:319-329. [PMID: 29224920 DOI: 10.1016/j.therap.2017.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 07/04/2017] [Accepted: 10/24/2017] [Indexed: 11/27/2022]
Abstract
For students, the pressing demands for memorization, top-level performance, and peer competition create an environment favorable for pharmaceutical cognitive doping behavior. We aimed to describe recent practices and the benefit / risk ratio of such behavior and to discuss the issues at stake. The prevalence of pharmaceutical cognitive doping among students has been reported from 1.3% to 33% across studies, with variations depending on country and definition of pharmaceutical cognitive doping. The therapeutic classes most frequently cited as being diverted for doping purposes are psychostimulants and nootropics (methylphenidate, modafinil, piracetam), corticosteroids, sedative drugs and beta-blockers. Some illegal substances such as cannabis, amphetamines and cocaine are also consumed in order to boost mental function. Finally, over-the-counter products, such as caffeine-based tablets or energy drinks, or alcohol, are also widely used by students whose motivations involve enhanced performance, concentration, memory, and staying awake during the revision and exam period. However, the expected (often fantasized) effectiveness of these products does not correspond to the reality of a modest controversial impact on cognitive performance. There appears to be an emerging profile of the student more inclined to doping behavior. Cognitive doping thus raises the question of its regulation, opening a debate opposing, on one hand, individual freedom and supposed collective benefits and, on the other hand, health consequences, educational (in)equality, and the risk of tarnished academic success. Strengthening school and university medicine, through prevention campaigns and the identification of subjects at risk, is essential to limit the extent, risk, and damages associated with such practices.
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Affiliation(s)
- Louise Carton
- Inserm, UMR S1171, service de pharmacologie médicale, université de Lille, CHU de Lille, 59000 Lille, France; CEIP-addictovigilance, service de pharmacologie médicale, CHRU de Lille, 59045 Lille cedex, France; Service d'addictologie et de psychiatrie, CHU de Lille, 59037 Lille, France.
| | - Nicolas Cabé
- Inserm, U1077, Unicaen, EPHE, neuropsychologie et imagerie de la mémoire humaine, PSL research university, Normandie université, CHU de Caen, 14000 Caen, France; Service universitaire d'addictologie, CHU de Caen, 14000 Caen, France
| | - Olivier Ménard
- Service d'addictologie et de psychiatrie, CHU de Lille, 59037 Lille, France
| | - Sylvie Deheul
- Inserm, UMR S1171, service de pharmacologie médicale, université de Lille, CHU de Lille, 59000 Lille, France; CEIP-addictovigilance, service de pharmacologie médicale, CHRU de Lille, 59045 Lille cedex, France
| | - Anne-Sylvie Caous
- CEIP-addictovigilance, service de pharmacologie médicale, CHRU de Lille, 59045 Lille cedex, France
| | - David Devos
- Inserm, UMR S1171, service de pharmacologie médicale, université de Lille, CHU de Lille, 59000 Lille, France; Licend Coen Center Lille, 59045 Lille, France
| | - Olivier Cottencin
- CNRS UMR 9193 SCALab PsyCHIC Team, université de Lille, 59045 Lille, France; Service d'addictologie et de psychiatrie, CHU de Lille, 59037 Lille, France
| | - Régis Bordet
- Inserm, UMR S1171, service de pharmacologie médicale, université de Lille, CHU de Lille, 59000 Lille, France; CEIP-addictovigilance, service de pharmacologie médicale, CHRU de Lille, 59045 Lille cedex, France
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33
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Commentary: Just Say "No". Camb Q Healthc Ethics 2017; 26:701-704. [PMID: 28937352 DOI: 10.1017/s0963180117000251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Why Enhancing Autonomy Is Not a Question of Improving Single Aspects of Reasoning Abilities through Neuroenhancement. NEUROETHICS-NETH 2017. [DOI: 10.1007/s12152-016-9299-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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35
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Franke AG, Gränsmark P, Agricola A, Schühle K, Rommel T, Sebastian A, Balló HE, Gorbulev S, Gerdes C, Frank B, Ruckes C, Tüscher O, Lieb K. Methylphenidate, modafinil, and caffeine for cognitive enhancement in chess: A double-blind, randomised controlled trial. Eur Neuropsychopharmacol 2017; 27:248-260. [PMID: 28119083 DOI: 10.1016/j.euroneuro.2017.01.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 12/14/2016] [Accepted: 01/05/2017] [Indexed: 10/20/2022]
Abstract
Stimulants and caffeine have been proposed for cognitive enhancement by healthy subjects. This study investigated whether performance in chess - a competitive mind game requiring highly complex cognitive skills - can be enhanced by methylphenidate, modafinil or caffeine. In a phase IV, randomized, double-blind, placebo-controlled trial, 39 male chess players received 2×200mg modafinil, 2×20mg methylphenidate, and 2×200mg caffeine or placebo in a 4×4 crossover design. They played twenty 15-minute games during two sessions against a chess program (Fritz 12; adapted to players' strength) and completed several neuropsychological tests. Marked substance effects were observed since all three substances significantly increased average reflection time per game compared to placebo resulting in a significantly increased number of games lost on time with all three treatments. Treatment effects on chess performance were not seen if all games (n=3059) were analysed. Only when controlling for game duration as well as when excluding those games lost on time, both modafinil and methylphenidate enhanced chess performance as demonstrated by significantly higher scores in the remaining 2876 games compared to placebo. In conjunction with results from neuropsychological testing we conclude that modifying effects of stimulants on complex cognitive tasks may in particular result from more reflective decision making processes. When not under time pressure, such effects may result in enhanced performance. Yet, under time constraints more reflective decision making may not improve or even have detrimental effects on complex task performance.
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Affiliation(s)
- Andreas G Franke
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, D-55131 Mainz, Germany; University of Neubrandenburg, University of Applied Sciences, Department of Social Work and Education, Brodaer Str. 2, 17033 Neubrandenburg, Germany.
| | - Patrik Gränsmark
- SOFI, Stockholm University, Swedish Institute for Social Research, Stockholm University, SE - 10691 Stockholm, Sweden.
| | - Alexandra Agricola
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, D-55131 Mainz, Germany.
| | - Kai Schühle
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, D-55131 Mainz, Germany.
| | - Thilo Rommel
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, D-55131 Mainz, Germany; Department of Psychology, Section for Clinical Psychology and Psychotherapy, University of Mainz, Wallstr. 3, 55122 Mainz, Germany.
| | - Alexandra Sebastian
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, D-55131 Mainz, Germany.
| | - Harald E Balló
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, D-55131 Mainz, Germany; Internistisch-onkologische Gemeinschaftspraxis, Marktplatz 11, 63065 Offenbach am Main, Germany.
| | - Stanislav Gorbulev
- Interdisciplinary Center for Clinical Trials (IZKS), University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany.
| | - Christer Gerdes
- SOFI, Stockholm University, Swedish Institute for Social Research, Stockholm University, SE - 10691 Stockholm, Sweden.
| | - Björn Frank
- University of Kassel, Department of Economics, Nora-Platiel-Str. 4, 34127 Kassel, Germany.
| | - Christian Ruckes
- Interdisciplinary Center for Clinical Trials (IZKS), University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany.
| | - Oliver Tüscher
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, D-55131 Mainz, Germany.
| | - Klaus Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Untere Zahlbacher Str. 8, D-55131 Mainz, Germany.
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Franke AG, Lehmberg S, Soyka M. Pharmacological Neuroenhancement: teachers' knowledge and attitudes-Results from a survey study among teachers in Germany. Subst Abuse Treat Prev Policy 2016; 11:32. [PMID: 27646845 PMCID: PMC5029003 DOI: 10.1186/s13011-016-0077-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Accepted: 09/13/2016] [Indexed: 11/10/2022] Open
Abstract
Background Pharmacological neuroenhancement (PN) is a topic of increasing importance. Its prevalence rates range from 1 % to more than 20 %. Students are a group that shows exceptionally high prevalence rates. However, little is known about teachers’ knowledge, management, attitudes and ethical judgements regarding PN. Methods A web-based survey containing 40 closed questions was developed. All teachers working at all private and public schools in Mecklenburg-Vorpommern, a state in northeastern Germany, were invited to participate after their respective school offices were contacted by telephone, email and mail. Results In total, 255 teachers participated in the survey. Of those, 73.3 % had already heard about PN in general, and 68.2 % had heard about PN in students. Their sources of knowledge were digital media such as TV (73.8 %) and the internet (40.6 %) and print media (64.7 %); their own students informed 29.9 % of the teachers about PN in general and 35.6 % of them about PN among students. Furthermore, 34.9 % of the surveyed teachers were convinced that PN substance use was ineffective in general, and 51.8 % of the surveyed teachers believed that PN substances were ineffective in achieving better grades. Only 1.2 % thought that none of the so-called PN substances could lead to addiction, and 37.6 % would classify PN substance use as general drug misuse. The highest values regarding risk of addiction were observed for illicit drugs. The prevalence of PN substance use was evaluated to be very low and to be significantly higher in male, highly skilled and college/university students. In total, 1.6 school lessons per year were used to discuss PN. Finally, 55.7 % of the surveyed teachers believed that performance-enhancing substances should be forbidden at schools. Conclusion Teachers, as an integral part of the education of children and adolescents, often know about PN substances and mostly refuse their use being afraid about the risk of addiction. However, regarding effects as well as side effects of PN substances, teachers have very different opinions. Furthermore, they seem to underestimate the prevalence among their students and broach the topic infrequently. Teachers should be sensitized for high prevalence rates and should broach the topic of PN more frequently to their students to prevent potential misuse of PN substances.
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Affiliation(s)
- Andreas G Franke
- Department of Social Work and Education, University of Neubrandenburg (University of Applied Sciences), Brodaer Str. 2, 17033, Neubrandenburg, Germany.
| | - Sophie Lehmberg
- Private Clinic Meiringen, Clinic for Psychiatry and Psychotherapy, 3860 Meiringen, Switzerland
| | - Michael Soyka
- Private Clinic Meiringen, Clinic for Psychiatry and Psychotherapy, 3860 Meiringen, Switzerland.,Ludwig Maximilian University (LMU), Nussbaumstr. 7, 80336, Munich, Germany
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Maier LJ, Haug S, Schaub MP. Author's response on Arria (2016): Intention matters--using the terminology 'pharmacological neuroenhancement' as a behavioural definition based on the assumed functionality. Addiction 2016; 111:938-9. [PMID: 26956687 DOI: 10.1111/add.13331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 02/01/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Larissa J Maier
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
| | - Severin Haug
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
| | - Michael P Schaub
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
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38
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Dietz P, Soyka M, Franke AG. Pharmacological Neuroenhancement in the Field of Economics-Poll Results from an Online Survey. Front Psychol 2016; 7:520. [PMID: 27148128 PMCID: PMC4835716 DOI: 10.3389/fpsyg.2016.00520] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 03/29/2016] [Indexed: 12/16/2022] Open
Abstract
Introduction: The use of over-the-counter, prescription, and illicit drugs to increase attention, concentration, or memory—often called (pharmacological) neuroenhancement—shows a broad range of prevalence rates among students. However, very little data is available on neuroenhancement among employed persons. The aim of this study was to provide first data on substance use for neuroenhancement among readers of the German “Handelsblatt” coming from the field of economics. Methods: Readers of the online edition of the Handelsblatt, a leading print and online medium for the field of economics, were invited to participate in a survey via a link on the journal homepage to complete a web-based questionnaire. Within the questionnaire, participants were asked for their gender, current age, current professional status, hours of work per week, prevalence rates of substance use for the purpose of neuroenhancement as well as for reasons of its use. Binary regression analyses with stepwise forward selection were used to predict the dependent variables “use of illicit and prescription drugs for neuroenhancement” (yes/no), “use of over-the-counter drugs for neuroenhancement” (yes/no), and “use of any drug for neuroenhancement” (yes/no). Results: A total of 1021 participants completed the anonymous survey. Lifetime prevalence for the use of any drug for neuroenhancement was 88.0% and for the use of illicit and prescription drugs for neuroenhancement 19.0%. Reasons and situations that predicted neuroenhancement with illicit and prescription drugs were “curiosity,” “to enhance mood,” ”for a confident appearance,” “stress/pressure to perform,” and “deadline pressure.” Discussion: The study shows that neuroenhancement with drugs is a widespread and frequent phenomenon among people belonging to the professional field of economics. Given in the literature that the use of drugs, especially prescription, and illicit drugs, may be associated with side effects, the high epidemic of drug use for neuroenhancement also shown in the present paper underlines the new public health concern of neuroenhancement.
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Affiliation(s)
- Pavel Dietz
- Department of Physical Activity and Public Health, Institute of Sport Science, University of Graz Graz, Austria
| | - Michael Soyka
- Private Clinic Meiringen, Clinic for Psychiatry and PsychotherapyMeiringen, Switzerland; Department of Psychiatry and Psychotherapy, Ludwig Maximilian UniversityMunich, Germany
| | - Andreas G Franke
- Department of Social Work and Education, University of Neubrandenburg Neubrandenburg, Germany
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39
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Repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex enhances working memory. Exp Brain Res 2016; 234:1807-1818. [DOI: 10.1007/s00221-016-4580-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 01/30/2016] [Indexed: 11/26/2022]
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40
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Brand R, Koch H. Using Caffeine Pills for Performance Enhancement. An Experimental Study on University Students' Willingness and Their Intention to Try Neuroenhancements. Front Psychol 2016; 7:101. [PMID: 26903909 PMCID: PMC4746440 DOI: 10.3389/fpsyg.2016.00101] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 01/19/2016] [Indexed: 11/26/2022] Open
Abstract
Recent research has indicated that university students sometimes use caffeine pills for neuroenhancement (NE; non-medical use of psychoactive substances or technology to produce a subjective enhancement in psychological functioning and experience), especially during exam preparation. In our factorial survey experiment, we manipulated the evidence participants were given about the prevalence of NE amongst peers and measured the resulting effects on the psychological predictors included in the Prototype-Willingness Model of risk behavior. Two hundred and thirty-one university students were randomized to a high prevalence condition (read faked research results overstating usage of caffeine pills amongst peers by a factor of 5; 50%), low prevalence condition (half the estimated prevalence; 5%) or control condition (no information about peer prevalence). Structural equation modeling confirmed that our participants’ willingness and intention to use caffeine pills in the next exam period could be explained by their past use of neuroenhancers, attitude to NE and subjective norm about use of caffeine pills whilst image of the typical user was a much less important factor. Provision of inaccurate information about prevalence reduced the predictive power of attitude with respect to willingness by 40-45%. This may be because receiving information about peer prevalence which does not fit with their perception of the social norm causes people to question their attitude. Prevalence information might exert a deterrent effect on NE via the attitude-willingness association. We argue that research into NE and deterrence of associated risk behaviors should be informed by psychological theory.
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Affiliation(s)
- Ralf Brand
- Sport and Exercise Psychology, University of Potsdam Potsdam, Germany
| | - Helen Koch
- Sport and Exercise Psychology, University of Potsdam Potsdam, Germany
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41
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Maier LJ, Haug S, Schaub MP. Prevalence of and motives for pharmacological neuroenhancement in Switzerland--results from a national Internet panel. Addiction 2016; 111:280-95. [PMID: 26189457 DOI: 10.1111/add.13059] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 04/02/2015] [Accepted: 07/13/2015] [Indexed: 11/30/2022]
Abstract
AIMS To estimate the prevalence of self-reported pharmacological neuroenhancement (PNE) with prescription or recreational drugs among the Swiss general population and correlates of PNE. DESIGN A population-based cross-sectional study using a self-administered online survey. SETTING A telephone-recruited highly representative internet panel in Switzerland. PARTICIPANTS A total of 10,171 Swiss employees and students (unweighted n = 10,084) aged 15-74 years (mean age: 39.1 ± 13.3; 46.6% female). MEASUREMENTS Self-reported life-time, past-year and past-month use of prescription or recreational drugs for PNE, motives for use and correlates of PNE, including socio-demographic, health and recreational drug use characteristics. FINDINGS The life-time prevalence of PNE was 4.0% [95% confidence interval (CI) = 3.62, 4.38], and the past-year prevalence was 2.1% (95% CI = 1.82, 2.38). Life-time pharmacological mood enhancement (3.1%; 95% CI = 2.76, 3.44) was more prevalent than pharmacological cognitive enhancement (1.4%; 95% CI = 1.17, 1.63). Fifty-four participants reported both (0.5%; 95% CI = 0.36, 0.64). PNE was associated with studying rather than full-time [odds ratio (OR) = 0.35; 95% CI = 0.21, 0.57] or part-time employment (OR = 0.39; 95% CI = 0.23, 0.67), stress (OR = 1.51 95% CI = 1.31, 1.75), cocaine (OR = 2.40; 95% CI = 1.51, 3.82) and amphetamine use (OR = 2.44; CI 95% = 1.37, 4.33), diagnosis of a mental disorder (OR = 4.26; 95% CI = 3.14, 5.80), and perceived poor health (OR = 0.76; 95% CI = 0.64, 0.90). CONCLUSIONS Taking prescription or recreational drugs for pharmacological neuroenhancement is rare among Swiss employees and students (4.0%). Pharmacological mood enhancement (3.1%) is more prevalent than direct pharmacological cognitive enhancement (1.4%).
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Affiliation(s)
- Larissa J Maier
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
| | - Severin Haug
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
| | - Michael P Schaub
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
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Hayward A, Tomlinson A, Neill JC. Low attentive and high impulsive rats: A translational animal model of ADHD and disorders of attention and impulse control. Pharmacol Ther 2016; 158:41-51. [DOI: 10.1016/j.pharmthera.2015.11.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Cognitive enhancers versus addictive psychostimulants: The good and bad side of dopamine on prefrontal cortical circuits. Pharmacol Res 2016; 109:108-18. [PMID: 26826399 DOI: 10.1016/j.phrs.2016.01.013] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 01/14/2016] [Accepted: 01/15/2016] [Indexed: 12/19/2022]
Abstract
In this review we describe how highly addictive psychostimulants such as cocaine and methamphetamine actions might underlie hypoexcitabilty in frontal cortical areas observed in clinical and preclinical models of psychostimulant abuse. We discuss new mechanisms that describe how increments on synaptic dopamine release are linked to reduce calcium influx in both pre and postsynaptic compartments on medial PFC networks, therefore modulating synaptic integration and information. Sustained DA neuromodulation by addictive psychostimulants can "lock" frontal cortical networks in deficient states. On the other hand, other psychostimulants such as modafinil and methylphenidate are considered pharmacological neuroenhancement agents that are popular among healthy people seeking neuroenhancement. More clinical and preclinical research is needed to further clarify mechanisms of actions and physiological effects of cognitive enhancers which show an opposite pattern compared to chronic effect of addictive psychostimulants: they appear to increase cortical excitability. In conclusion, studies summarized here suggest that there is frontal cortex hypoactivity and deficient inhibitory control in drug-addicted individuals. Thus, additional research on physiological effects of cognitive enhancers like modafinil and methylphenidate seems necessary in order to expand current knowledge on mechanisms behind their therapeutic role in the treatment of addiction and other neuropsychiatric disorders.
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Maier LJ, Liakoni E, Schildmann J, Schaub MP, Liechti ME. Swiss University Students' Attitudes toward Pharmacological Cognitive Enhancement. PLoS One 2015; 10:e0144402. [PMID: 26657300 PMCID: PMC4675521 DOI: 10.1371/journal.pone.0144402] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 11/17/2015] [Indexed: 11/18/2022] Open
Abstract
Pharmacological cognitive enhancement (PCE) refers to the nonmedical use of prescription or recreational drugs to enhance cognitive performance. Several concerns about PCE have been raised in the public. The aim of the present study was to investigate students' attitudes toward PCE. Students at three Swiss universities were invited by e-mail to participate in a web-based survey. Of the 29,282 students who were contacted, 3,056 participated. Of these students, 22% indicated that they had used prescription drugs (12%) or recreational substances including alcohol (14%) at least once for PCE. The use of prescription drugs or recreational substances including alcohol prior to the last exam was reported by 16%. Users of pharmacological cognitive enhancers were more likely to consider PCE fair (24%) compared with nonusers (11%). Only a minority of the participants agreed with the nonmedical use of prescription drugs by fellow students when assuming weak (7%) or hypothetically strong efficacy and availability to everyone (14%). Two-thirds (68%) considered performance that is obtained with PCE less worthy of recognition. Additionally, 80% disagreed that PCE is acceptable in a competitive environment. More than half (64%) agreed that PCE in academia is similar to doping in sports. Nearly half (48%) claimed that unregulated access to pharmacological cognitive enhancers increases the pressure to engage in PCE and educational inequality (55%). In conclusion, Swiss students' main concerns regarding PCE were related to coercion and fairness. As expected, these concerns were more prevalent among nonusers than among users of pharmacological cognitive enhancers. More balanced information on PCE should be shared with students, and future monitoring of PCE is recommended.
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Affiliation(s)
- Larissa J. Maier
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
| | - Evangelia Liakoni
- Division of Clinical Pharmacology and Toxicology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Jan Schildmann
- Institut für Medizinische Ethik und Geschichte der Medizin, Ruhr-Universität Bochum, Bochum, Deutschland
| | - Michael P. Schaub
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
| | - Matthias E. Liechti
- Division of Clinical Pharmacology and Toxicology, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
- * E-mail:
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Petersen MA, Nørgaard LS, Traulsen JM. Pursuing Pleasures of Productivity: University Students' Use of Prescription Stimulants for Enhancement and the Moral Uncertainty of Making Work Fun. Cult Med Psychiatry 2015; 39:665-79. [PMID: 25956594 DOI: 10.1007/s11013-015-9457-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article presents ethnographic data on the use of prescription stimulants for enhancement purposes by university students in New York City. The study shows that students find stimulants a helpful tool in preventing procrastination, particularly in relation to feeling disinterested, overloaded, or insecure. Using stimulants, students seek pleasure in the study situation, for example, to get rid of unpleasant states of mind or intensify an already existing excitement. The article illustrates the notion that enhancement strategies do not only concern productivity in the quantitative sense of bettering results, performances, and opportunities. Students also measure their own success in terms of the qualitative experience of working hard. The article further argues that taking an ethnographic approach facilitates the study of norms in the making, as students experience moral uncertainty-not because they improve study skills and results-but because they enhance the study experience, making work fun. The article thereby seeks to nuance simplistic neoliberal ideas of personhood.
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Affiliation(s)
- Margit Anne Petersen
- Section for Social and Clinical Pharmacy, Department of Pharmacy, University of Copenhagen, Universitetsparken 2, 2100, Copenhagen Ø, Denmark.
| | - Lotte Stig Nørgaard
- Section for Social and Clinical Pharmacy, Department of Pharmacy, University of Copenhagen, Universitetsparken 2, 2100, Copenhagen Ø, Denmark
| | - Janine M Traulsen
- Section for Social and Clinical Pharmacy, Department of Pharmacy, University of Copenhagen, Universitetsparken 2, 2100, Copenhagen Ø, Denmark
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The importance of stress, self-efficacy, and self-medication for pharmacological neuroenhancement among employees and students. Drug Alcohol Depend 2015; 156:221-227. [PMID: 26455555 DOI: 10.1016/j.drugalcdep.2015.09.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Revised: 09/10/2015] [Accepted: 09/14/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVES This study examined the relationship between stress, self-efficacy, self-medication, and pharmacological neuroenhancement (PNE) in the Swiss general population. METHODS Using the largest Swiss Internet panel, a sample of 10,171 employees and students (unweighted N=10,084) aged 15-74 years was recruited and asked to complete a self-administered online survey. The data were weighted for age, sex, and language region to provide results that were representative of the Swiss population. Multinomial logistic regression models were conducted to identify predictors of pharmacological cognitive enhancement (PCE) and pharmacological mood enhancement (PME) over the past year. Two self-medication models and an overall model were determined. RESULTS Current medical treatment for a mental disorder was the best predictor of both PCE and PME use as serious self-medication. The overall model revealed that cannabis use, frequent stress, and long-term stress were predictors of both PCE and PME, whereas negative stressors and time pressure at work did not remain in the final model. Furthermore, past-year PCE with and without PME was associated with being male, being a student, and using illegal drugs other than cannabis, whereas being female and having low self-efficacy predicted past-year PME only. CONCLUSIONS Consideration of the predictor variables identified in this study may help to identify the potential PCE and PME users for whom measures to prevent drug abuse and manage stress are most appropriate. More specifically, the use of PCE and PME as self-medication to enhance performance at work or while studying needs further consideration in the neuroenhancement debate.
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The Use of Prescription Drugs, Recreational Drugs, and "Soft Enhancers" for Cognitive Enhancement among Swiss Secondary School Students. PLoS One 2015; 10:e0141289. [PMID: 26505633 PMCID: PMC4624689 DOI: 10.1371/journal.pone.0141289] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 10/05/2015] [Indexed: 11/19/2022] Open
Abstract
The use of prescription or recreational drugs for cognitive enhancement (CE) is prevalent among students. However, the prevalence of CE among Swiss school students is unknown. We therefore performed a cross-sectional online survey including ≥ 16-year-old students from bridge-year schools (10th grade), vocational schools, and upper secondary schools (10th-12th grade) in the Canton of Zurich to investigate the prevalence of and motives for the use of prescription drugs, recreational drugs, and/or freely available soft enhancers for CE. A total of 1,139 students were included. Of these, 54.5% reported the use of prescription drugs (9.2%), recreational drugs including alcohol (6.2%), or soft enhancers (51.3%) explicitly for CE at least once in their lives. The last-year and last-month prevalence for CE considering all substances was 45.5% and 39.5%, respectively. Soft enhancers were the substances that were most commonly used (ever, last-year, and last-month, respectively), including energy drinks (33.3%, 28.4%, and 24.6%), coffee (29.8%, 25.1%, and 21.9%), and tobacco (12.6%, 9.3%, and 8.3%). CE with methylphenidate was less prevalent (4.0%, 2.8%, and 2.0%). However, the use of prescription drugs, alcohol, or illegal drugs for CE was reported by 13.3% of the participants. The most common motives for use were to stay awake and improve concentration. CE was more prevalent among students who reported higher levels of stress or performance pressure and students with psychiatric disorders. In conclusion, half of the school students had used a substance at least once in their lives to improve school performance. Soft enhancers were most commonly used. Prevalence rates were similar to those reported by Swiss university students, indicating that the use of prescription or recreational drugs for CE already occurs before starting higher education. Performance pressure, stress, and psychiatric disorders may be associated with CE.
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Fond G, Micoulaud-Franchi JA, Brunel L, Macgregor A, Miot S, Lopez R, Richieri R, Abbar M, Lancon C, Repantis D. Innovative mechanisms of action for pharmaceutical cognitive enhancement: A systematic review. Psychiatry Res 2015; 229:12-20. [PMID: 26187342 DOI: 10.1016/j.psychres.2015.07.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2014] [Revised: 05/31/2015] [Accepted: 07/05/2015] [Indexed: 12/21/2022]
Abstract
Pharmacological cognitive enhancement refers to improvement in cognitive functions after drug use in healthy individuals. This popular topic attracts attention both from the general public and the scientific community. The objective was to explore innovative mechanisms of psychostimulant's action, whose potential effectiveness was assessed in randomized placebo-controlled trials (RCTs). A systematic review was carried out, using the words "attention", "memory", "learning", "executive functions", and "vigilance/wakefulness" combined to "cognitive enhancer" or "smart drug". Methylphenidate, amphetamines, modafinil, nicotine, acetylcholine esterase inhibitors and antidepressants were extensively studied in previous meta-analyses and were not included in the present work. Drugs were classified according to their primary mode of action, namely catecholaminergic drugs (tolcapone, pramipexole, guanfacine), cholinergic drugs (anticholinergics), glutamatergic drugs (ampakines), histaminergic drugs, and non-specified (glucocorticoids). Overall, 50 RCTs were included in the present review. In conclusion, a number of new active drugs were found to improve some cognitive functions, in particular verbal episodic memory. However the number of RCTs was limited, and most of the studies found negative results. Future studies should assess both effectiveness and tolerance of repeated doses administration, and individual variability in dose response (including baseline characteristics and potential genetic polymorphisms). One explanation for the limited number of recent RCTs with new psychostimulants seems to be the ethical debate surrounding pharmaceutical cognitive enhancement in healthy subjects.
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Affiliation(s)
- Guillaume Fond
- Université Paris EST-Créteil, AP-HP, Pôle de Psychiatrie ET d'addictologie des Hopitaux Universitaires Henri Mondor, INSERM U955, Eq 15 Psychiatrie Génétique, DHU PE-psy, Fondation Fondamental Fondation de Coopération Scientifique en Santé Mentale, F-94000 France.
| | | | - Lore Brunel
- Université Paris EST-Créteil, AP-HP, Pôle de Psychiatrie ET d'addictologie des Hopitaux Universitaires Henri Mondor, INSERM U955, Eq 15 Psychiatrie Génétique, DHU PE-psy, Fondation Fondamental Fondation de Coopération Scientifique en Santé Mentale, F-94000 France
| | - Alexandra Macgregor
- Université Montpellier 1, INSERM 1061, Service Universitaire de Psychiatrie, CHU Montpellier F-34000, France
| | - Stéphanie Miot
- INSERM U952, CNRS UMR 7224, UMPC Univ Paris 06, F-75000 Paris, France
| | - Régis Lopez
- Université Montpellier 1, INSERM 1061, Centre de Référence National Narcolepsie Hypersomnie Idiopathique, Unité des Troubles du Sommeil, CHU Montpellier F-34000, France
| | - Raphaëlle Richieri
- Pôle Psychiatrie Universitaire, CHU Sainte-marguerite, F-13274 Marseille Cedex 09, France; Faculté de Médecine, EA 3279, Laboratoire de Santé Publique, F-13385 Marseille Cedex 05, France
| | - Mocrane Abbar
- CHU Carémeau, Université de Nîmes, Nîmes F-31000, France
| | - Christophe Lancon
- Pôle Psychiatrie Universitaire, CHU Sainte-marguerite, F-13274 Marseille Cedex 09, France
| | - Dimitris Repantis
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin franklin, Eschenallee 3, 14050 Berlin, Germany
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Maier LJ, Schaub MP. The Use of Prescription Drugs and Drugs of Abuse for Neuroenhancement in Europe. EUROPEAN PSYCHOLOGIST 2015. [DOI: 10.1027/1016-9040/a000228] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Pharmacological neuroenhancement, defined as the misuse of prescription drugs, illicit drugs, or alcohol for the purpose of enhancing cognition, mood, or prosocial behavior, is not widespread in Europe – nevertheless, it does occur. Thus far, no drug has been proven as safe and effective for cognitive enhancement in otherwise healthy individuals. European studies have investigated the misuse of prescription and illicit stimulants to increase cognitive performance as well as the use of tranquilizers, alcohol, and cannabis to cope with stress related to work or education. Young people in educational settings report pharmacological neuroenhancement more frequently than those in other settings. Although the regular use of drugs for neuroenhancement is not common in Europe, the irregular and low-dose usage of neuroenhancers might cause adverse reactions. Previous studies have revealed that obtaining adequate amounts of sleep and using successful learning techniques effectively improve mental performance, whereas pharmacological neuroenhancement is associated with ambiguous effects. Therefore, non-substance-related alternatives should be promoted to cope with stressful situations. This paper reviews the recent research on pharmacological neuroenhancement in Europe, develops a clear definition of the substances used, and formulates recommendations for practitioners regarding how to react to requests for neuroenhancement drug prescriptions. We conclude that monitoring the future development of pharmacological neuroenhancement in Europe is important to provide effective preventive measures when required. Furthermore, substance use to cope with stress related to work or education should be studied in depth because it is likely more prevalent and dangerous than direct neuroenhancement.
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Affiliation(s)
- Larissa J. Maier
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
| | - Michael P. Schaub
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
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Maier LJ, Wunderli MD, Vonmoos M, Römmelt AT, Baumgartner MR, Seifritz E, Schaub MP, Quednow BB. Pharmacological Cognitive Enhancement in Healthy Individuals: A Compensation for Cognitive Deficits or a Question of Personality? PLoS One 2015; 10:e0129805. [PMID: 26107846 PMCID: PMC4479570 DOI: 10.1371/journal.pone.0129805] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 05/12/2015] [Indexed: 11/26/2022] Open
Abstract
The ongoing bioethical debate on pharmacological cognitive enhancement (PCE) in healthy individuals is often legitimated by the assumption that PCE will widely spread and become desirable for the general public in the near future. This assumption was questioned as PCE is not equally save and effective in everyone. Additionally, it was supposed that the willingness to use PCE is strongly personality-dependent likely preventing a broad PCE epidemic. Thus, we investigated whether the cognitive performance and personality of healthy individuals with regular nonmedical methylphenidate (MPH) use for PCE differ from stimulant-naïve controls. Twenty-five healthy individuals using MPH for PCE were compared with 39 age-, sex-, and education-matched healthy controls regarding cognitive performance and personality assessed by a comprehensive neuropsychological test battery including social cognition, prosocial behavior, decision-making, impulsivity, and personality questionnaires. Substance use was assessed through self-report in an interview and quantitative hair and urine analyses. Recently abstinent PCE users showed no cognitive impairment but superior strategic thinking and decision-making. Furthermore, PCE users displayed higher levels of trait impulsivity, novelty seeking, and Machiavellianism combined with lower levels of social reward dependence and cognitive empathy. Finally, PCE users reported a smaller social network and exhibited less prosocial behavior in social interaction tasks. In conclusion, the assumption that PCE use will soon become epidemic is not supported by the present findings as PCE users showed a highly specific personality profile that shares a number of features with illegal stimulant users. Lastly, regular MPH use for PCE is not necessarily associated with cognitive deficits.
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Affiliation(s)
- Larissa J. Maier
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
| | - Michael D. Wunderli
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Matthias Vonmoos
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
| | - Andreas T. Römmelt
- Center of Forensic Hairanalytics, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Markus R. Baumgartner
- Center of Forensic Hairanalytics, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Erich Seifritz
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric Hospital University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Michael P. Schaub
- Swiss Research Institute for Public Health and Addiction (ISGF), Associated Institute at the University of Zurich and WHO Collaborating Centre, Zurich, Switzerland
| | - Boris B. Quednow
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology, Zurich, Switzerland
- * E-mail:
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