Substances used and prevalence rates of pharmacological cognitive enhancement among healthy subjects

Abstract

Pharmacological "cognitive enhancement" (CE) is defined as the use of any psychoactive drug with the purpose of enhancing cognition, e.g. regarding attention, concentration or memory by healthy subjects. Substances commonly used as CE drugs can be categorized into three groups of drugs: (1) over-the-counter (OTC) drugs such as coffee, caffeinated drinks/energy drinks, caffeine tablets or Ginkgo biloba; (2) drugs being approved for the treatment of certain disorders and being misused for CE: drugs to treat attention-deficit/hyperactivity disorder (ADHD) such as the stimulants methylphenidate (MPH, e.g. Ritalin(®)) or amphetamines (AMPH, e.g. Attentin(®) or Adderall(®)), to treat sleep disorders such as modafinil or to treat Alzheimer's disease such as acetylcholinesterase inhibitors; (3) illicit drugs such as illicit AMPH, e.g. "speed", ecstasy, methamphetamine (crystal meth) or others. Evidence from randomized placebo-controlled trials shows that the abovementioned substances have limited pro-cognitive effects as demonstrated, e.g. regarding increased attention, increased cognitive speed or shortening of reaction times, but on the same time poses considerable safety risks on the consumers. Prevalence rates for the use of CE drugs among healthy subjects show a broad range from less than 1 % up to more than 20 %. The range in prevalence rates estimates results from several factors which are chosen differently in the available survey studies: type of subjects (students, pupils, special professions, etc.), degree of anonymity in the survey (online, face-to-face, etc.), definition of CE and substances used/misused for CE, which are assessed (OTC drugs, prescription, illicit drugs) as well as time periods of use (e.g. ever, during the past year/month/week, etc.). A clear and comprehensive picture of the drugs used for CE by healthy subjects and their adverse events and safety risks as well as comprehensive and comparable international data on the prevalence rates of CE among healthy subjects are of paramount importance for informing policy makers and healthcare professionals about CE.

(Mis)use of prescribed stimulants in the medical student community: Motives and behaviors. A population-based cross-sectional study

“…6 A clear and comprehensive picture of the psychostimulants used by college students, in the light of available international data on their prevalence, is of great importance for informing policy makers and healthcare professionals about psychostimulant consumption. 7 However, 85% of the world's research within the field of drug abuse and dependence is carried out in the United States, and little is known about psychostimulant use in other countries. 8 Medical school in France has one of the longest study paths within French higher education.…”

Evaluation of nonmedical use of prescription stimulants by college students at three northeastern pharmacy schools

“…However, several studies have examined their nonmedical use, defined as taking a prescription drug without a prescription or in a way other than prescribed. Literature has shown evidence of nonmedical use by students and young professionals of ADHD medications including amphetamine (Adderall), dextroamphetamine (Dexedrine), lisdexamfetamine (Vyvanse), methylphenidate (Ritalin, Concerta, and Daytrana), and dexmethylphenidate (Focalin), as well as the wakefulness‐promoting drug, modafinil (Provigil) . Data suggest that nonmedical use at individual colleges ranges between 0% and 25%, with a 6.9% average prevalence during students' time in college .…”

Brain Stimulation for Cognitive Enhancement in the Older Person: State of the Art and Future Directions

“…All of these are sensible and attainable strategies for maintaining good cognitive performance, and possess a quality of 'naturalness' that make them ethically untroubling compared to means such as pharmacological enhancement (Caviola and Faber 2015). Several pharmacological agents are thought to provide modest benefits to cognitive performance in otherwise healthy people, many of which were originally intended for use in neurological disorders (Franke et al 2014). For example, modafinil was developed for narcolepsy, and methylphenidate is commonly used to treat attention-deficit hyperactivity disorder.…”