Stimulant Usage by Medical Students for Cognitive Enhancement: A Systematic Review

Abstract

Stimulants have been used throughout human history for a variety of reasons. High levels of stress and the demanding nature of medical school make their usage among medical students particularly common. The most prevalent stimulant used by students is coffee, followed by tea and other forms of caffeine like sugary energy drinks. In addition, amphetamine-based medications for treating attention deficit hyperactivity disorder (ADHD) have been increasing in popularity, which many students take illicitly. Students report taking various forms of stimulants to promote cognitive enhancement, prolong wakefulness and retain focus for long periods of time. Moderate doses of caffeine and amphetamines would lead to enhanced alertness and concentration. However, large increases in dosage or frequency would lead to an increased risk of toxicity and adverse effects. The positive outcomes from stimulant consumption are often overshadowed by the negative side effects and incorrect dosage. Thus, it appears that usage of stimulants should be limited, in favor of a more sustainable approach to cognitive enhancement. This review analyzes the use of stimulants among the medical student community, consequences of misuse and discussed the healthy and organic approaches to lessen the stress and improve academic performance. This article also discusses the mechanisms of action, acceptable doses, additives, ingredients of stimulants commonly used by medical students for cognitive enhancement and the implications of long-term use as the stress of practicing medicine extends well beyond the medical school years.

Examination Stress During COVID-19 and Its Coping Interventions Used by Medical Students of Pakistan

“…The most prevalent stimulant used by students is coffee, followed by tea and other forms of caffeine like sugary energy drinks. 17 The results of our study reported that the consumption of tea and coffee were 94 (37.6%) and 34 (13.6%) respectively. Another study conducted among the university students of Lebanon revealed that the use of caffeine during exams was more than the required dose approved by Food and Drug Administration (FDA).…”

Do Medical Universities Students Use Cognitive Enhancers while Learning?—Conclusions from the Study in Poland

“…In our study, caffeine, in different forms, was the most often chosen CEs by our respondents (over 92%). It is estimated that about 80–85% of the adult world’s population uses caffeine because of caffeine-induced psycho-stimulation [ 31 , 32 , 33 , 34 ]. Our results are consistent with some other published data [ 33 , 35 ].…”

“…This observation is unsurprising because students (over 90%) often used caffeine as a CE. It was found that caffeine may produce rapid positive inotropic and chronotropic effects on the cardiovascular system and, in toxic doses, may cause life-threatening arrhythmias [ 34 , 48 ]. Caffeine can activate various brain areas [ 48 ], which is the reason for increased alertness but may lead to sleeping problems.…”

La calidad del sueño y su relación con el rendimiento académico en estudiantes de medicina.

“…Existen factores externos que pueden afectar directamente la calidad del sueño de las personas, como lo son: el uso de estimulantes para la mejora cognitiva, entre los que están los fármacos promotores de vigilia, sustancias psicoactivas, bebidas energéticas y productos con cafeína (1,24). Entre los efectos adversos del uso excesivo de estos productos se encuentran: el riesgo de toxicidad, la disminución de la calidad y cantidad de sueño; efectos que opacan los pros de su uso y consumo (24). Según un estudio de revisión sistemática realizado en 2021, el uso de estimulantes para la mejora cognitiva es cada vez más común en los estudiantes de medicina, pues según ellos, ayuda a prolongar la vigilia y mantener la concentración durante amplios períodos (24).…”

“…Entre los efectos adversos del uso excesivo de estos productos se encuentran: el riesgo de toxicidad, la disminución de la calidad y cantidad de sueño; efectos que opacan los pros de su uso y consumo (24). Según un estudio de revisión sistemática realizado en 2021, el uso de estimulantes para la mejora cognitiva es cada vez más común en los estudiantes de medicina, pues según ellos, ayuda a prolongar la vigilia y mantener la concentración durante amplios períodos (24). Entre las razones de los estudiantes para el uso y consumo de estas sustancias se encuentra el mejoramiento del rendimiento académico pues les permite estar alerta y concentrados en sus actividades prácticas y teóricas, además de lograr una productividad prolongada a lo largo del día; estas situaciones los lleva al aumento del consumo de estas sustancias en temporada de exámenes y culminación de año universitario (24).…”