Recent replies to "Would you boost your brain power?"

Reply from peter savuk

peter savuk — Wed, 16 Apr 2008 01:42:50 -0000

I do not know if my answer and my question will really help anyone else, but there is always hope :)

Yes, I would boost my brain power using any means possible, if i am nearly sure that the negative side effects are controllable for me and the total value added to my life cycle is quite high and out of this I am stronger in doing my share for the development of our existence.

I would appreciate if some of my colleagues would take it, so I can save lots of time and avoid frustration.

Society should understand that there are people in this world, currently in the stage of leaders and decisionmakers, who in one hand need their maturity and experience gained in aging, on the other hand must – because of the importance of their decision – always have the maximum brain power available on request.

Reply from andreea socolov

andreea socolov — Sat, 12 Apr 2008 12:57:16 -0000

I think that a drug treatment for persons concentration problems is very good. But first everyone should know the drug very well, or at least take some advice from a specialist or the family doctor. Some drugs can have bad side effects.

Reply from Nicolau Werneck

Nicolau Werneck — Fri, 11 Apr 2008 16:26:42 -0000

(first I would like to say that before I meant “bedside conversion”.)

I thought these drugs were actual “cognitive enhancers”. I though they would enlarge our memory capacity and speed, but more then that, that they would help you to reason about more things at the same time, faster. So I was excited that they moght help me to focus on multiple things. People alway tell me I need more “focus”… What I want is more power to do multi-tasking. I believe people are often too focused, and need to deal more with different subjects, and find out bridges between different research areas.

Now that I am reading the new texts on the subject, it seems to me that it’s just the opposite: these drugs restrain your ability to focus on multiple things!... I would never take such a pill. This is not a cognitive enhancer, it might be simply a cognitive leash.

I don’t want a drug that help me to follow the model of teaching and researching that we have, with all those little tests, exams and competitions. I thought society was moving away from this, but now I see people happy with drugs that will help them to plunge into the test-grade-competition model.

We must change all of this. the tests and the competitions in science and teaching. That’s not what science is all about!... Can you imagine Socrates taking Ritalin? What would be his motivation? I bet he would drink conium before that.

I am OK with people taking drugs just as long as this don’t affect how our society works. It seems to me these drugs might help making society a worse place, with more competition and more “focus”. I want the opposite, so I might start being against these drugs after all.

Reply from Corie Lok

Corie Lok — Tue, 01 Apr 2008 15:19:49 -0000

I have fallen victim to April’s Fools. Damn! Please disregard the above message.

Reply from Corie Lok

Corie Lok — Tue, 01 Apr 2008 15:16:04 -0000

Here’s some news from one of our bloggers, Anna Kushnir. She says that there are new NIH regulations requiring people applying for R01 grants to sign an affidavit that they will not use brain-enhancing drugs.

Reply from Evets Kcep

Evets Kcep — Tue, 11 Mar 2008 19:26:47 -0000

I see no ethical issues at all with taking a cognitive enhancing drug. I do feel some restrictions should apply, such as age and general health requirements.

We have no problem with Lasik for our eyes, or appetite suppressors to curb our eating. Society doesn’t seem to abhor those who seek breast implants, liposuction, or even face lifts. Why would there be an issue for a drug that improves us as persons? I could certainly stand to be improved. LOL

If I knew where to obtain them, I would test some of these drugs to see if they really were beneficial.

Reply from Bysshebot Gearloose

Bysshebot Gearloose — Mon, 10 Mar 2008 21:40:21 -0000

Any putative cognitive enhancers will depend on the general population that the drugs actually explain their mental creativity and should they still have adverse sequelae of the world – or seizures.

The authors arguments apply for more detail here.

An earlier Nature editorial contents on a unitary phenomenon, but involves cholinergic drugs which have only mild side effects associated with my own brain power to draw an epistemological discussion to some of research regarding the possible creation of drugs that most ADHD medications with my sleeptime by various ‘experts’ under the cognitive enhancers that can ameliorate if you boost your colleagues will be bold enough to the biochemical systems are completely safe for integrating new drugs.

I view the extra coaching and Morein- Zamir’s examples, methylphenidate and policies – inevitably will agree with these people, it does it is difficult to justify serious discussion.

Reply from anonymous

anonymous — Sun, 09 Mar 2008 12:03:20 -0000

Whether or not someone chooses to be dumb is a choice everyone makes on a daily basis. Whether or not someone chooses to enhance their cognitive abilities pharmacologically should be their own choice as well. The U.S. government never penalizes someone for an overt act of stupidity unless it involves a recognized criminal action. Unfortuantely, it often penalizes someone for success or intelligence. I have no doubt our government will work over-time to find a potential danger to the situation so that they can legislate some kind of punitive control, with the help of busy-body ethicists.

Reply from christian chiamulera

christian chiamulera — Fri, 15 Feb 2008 10:49:04 -0000

The Commentary by Barbara Sahakian and Sharon Morein-Zamir “Professore’s little helper” (Nature 450, 1157–1159; 2007) triggered a long-awaited debate on cognitive enhancers. The argument has been presented within a pragmatic frame of questions that stimulate ethical answers. Among them, Volkow & Swanson correspondence remind us that it is also a matter of addiction. On this regard, we recently commented about the use of smokeless tobacco in sport as a cognitive enhancement habit (Addiction 102, 1847-1848; 2007). We think that it is not only a matter of control, prevention and/or prohibition of use, but there is also the need to generate empirical data in support of ethical considerations. In fact, cognitive enhancers are rewarding for people who use to take them in order to get a desired outcome, even if at present most of these substances (except for those with psychostimulant properties) do not fully meet the criteria to act as reinforcers, and to stimulate brain areas known to be involved in motivational processes.

There is a gap between the evidence of their protracted use and abuse, their rewarding effects and the apparent lack of reinforcing properties. We suggest developing new experimental approaches able to detect their dependence-liability within the different specific context these substances are taken (e.g., sport, intellectual tasks, etc.). We recommend bringing together ethical and empirical arguments into a research agenda that include the development of new experimental paradigms for investigations on current and novel molecules acting as cognitive enhancers.
Christian Chiamulera, Roberto Leone & Guido F. Fumagalli
Faculty of Exercise and Sport Science, University of Verona, via Casorati 43, 37100 Verona, Italy.

Reply from Robert Taylor

Robert Taylor — Mon, 21 Jan 2008 16:01:45 -0000

Quite apart from the ethical issues surrounding the taking of drugs to improve cognitive ability, there are some practical issues which need consideration.

In some countries, eg the UK, the taking of performance enhancing drugs is quite simply NOT illegal (assuming they are not Class A, B, or C drugs). I do not believe any UK employer would be able to force their employees to take tests to look for such drugs.

Even if they did carry out such tests, medical records are private and certainly cannot be shared with employer’s without the employees consent.

If people do not admit to taking such drugs, how will anyone be able to prove otherwise ?

In conclusion, I think it will be inpracticable to outlaw such drugs, and it could be argued that it is no different from drinking lots of coffee (or taking caffeine tablets).

Reply from peter freer

peter freer — Wed, 16 Jan 2008 17:06:05 -0000

In response to Joseph Milerad’s post, I am CEO of Unique Logic and Technology. The company produces an educational product that assists in cognitive development and behavioral shaping for AD/HD students. I did not mention this as it is not relevant to the statements I made and would be self-promoting. However, since Mr. Milerad thinks it relevant, I should also disclose that I am also President of Freer Logic, LLC which provides HPT (Human Performance Training) to the nuclear power industry. I was invited to speak to the International Atomic Energy Agency of the United Nations in 2007 as an expert in this field. I would maintain that ad hominem arguments needn’t be launched.

All that being disclosed, Mr. Milerad maintains that my statements regarding ADHD studies are exaggerated and distorted, creating “an impression that the outcome of these studies was just the opposite of what actually has been shown.” Pure nonsense. I actually quoted one of the authors of the longest study ever performed on an ADHD population in the US. I doubt his view is distorted.

You may view one of the most thorough, comprehensive studies performed on ADHD medicines by Oregon University’s Drug Effectiveness Review Project at http://www.ohsu.edu/drugeffectiveness/reports/documents/ADHD%20Final%20Report%20Update%201.pdf (Drug Class Review on Pharmacologic Treatments for ADHD) whose results I have clearly stated. Again it covers virtually every pharmacologic study performed on ADHD to date and quite clearly separates the wheat from the chaff.

Now, regarding my statement that Mr. Milerad opposes: “If ADHD stimulants affect neurotransmitters as doctors Barbara Sahakian and Sharon Morein-Zamir suggest, this is pure speculation.” I shall clarify. If ADHD is caused by neurotransmitter malfunction, it is pure speculation. No one knows the etiology and to suggest that ADHD is related to neurotransmission malfunctions is speculation. Can neurotransmitters be affected pharmacologically? Certainly? Do we know how this relates to ADHD? Absolutely not. It’s speculation because we DO NOT know the etiology. Could it be a malfunction of basal ganglia? Possibly. Could it be heritable and a normal trait? Possibly. Could it be due to lower brain volume resulting in a developmental delay? Possibly. Could it be a variety of factors? Possibly.

Let’s make it clear: no one knows the etiology and therefore no one knows what impact neurotransmitters play on ADHD. Pharmacologists wish to find the Holy Grail because it results in billions of dollars in sales.

The brain is neuroplastic; it will and does adapt according to the stimulation it receives. That is conclusive fact. No doubt about it. So, if we are speaking about a human being, then attention problems are not just brain based. They may take root there, but they are also directly related to and affected by one’s environment. Therefore, appropriate environmental factors play a great role in the treatment of ADHD including behavior shaping, consistent reward/consequences, structure, etc. Trying to determine whether changes in neurotransmission or physical brain structure cause ADHD always must be considered in context as we have the problem of antecedence; is ADHD caused by different brain structure or chemistry or are those issues the result of the brain’s interaction with its environment? It is facile to attempt to reduce ADHD to a simple pharmacologic cause.

Reply from joseph Milerad

joseph Milerad — Mon, 14 Jan 2008 23:10:30 -0000

I was quite amazed reading the comment of Mr. Peter Freer. It gives a totally misleading and distorted picture of the outcome of the ADHD studies. By taking bits and pieces out of context exaggerating some parts and omitting others Mr. Freer manages to create an impression that the outcome of these studies was just the opposite of what actually has been shown,

Even more surprising is his statement that it is a pure speculation that ADHD stimulants affect neurotransmitters. Either Mr. Freer lacks elementary knowledge of neuropharmacology or he has some hidden agenda.

A Google search suggests that it may be the latter explanation.
Mr. Freer is the CEO of Unique Logic + Technology, Inc.
A company sells a computer program that allegedly improves ADHD – symptoms, learning disabilities memory problems and so on. How this is achieved is not clear from the pseudo – scientific explanations on the company’s home page.

Since Mr. Freer does not reveal his address occupation or any conflicts of interest it raises the suspicion that he uses the Nature Forum to promote his computer gizmo by distorting facts about established medical treatment of ADHD

Reply from abhay sharma

abhay sharma — Fri, 11 Jan 2008 14:41:31 -0000

What about professor’s little ones?

While raising ethical issues regarding use of cognitive-enhancing drugs, the Commentary “Professor’s little helper” (Nature 450, 1157, 2007) offers a set of questions for broader discussion. Earlier also, the editorial “Enhancing, not cheating” (Nature 450, 320, 2007) emphasized that there is a need for broad debate on the issue. Here, I would like to suggest that question of possible transgenerational effect of neuroactive drugs also needs to be entertained. We may discard the experiment in which exposing mice to high doses of morphine showed persistence of damage to the nervous system in their descendants as just plain suspect (NewScientist No. 2162, pp. 27-30, 28 November 1998), but whatever little is known about the effect of human exposures in grandparents on outcomes in their grandchildren does really confront us with the possibility of epigenetic inheritance down the male line (Eur. J. Hum. Genet. 10, 669, 2002; Eur. J. Hum. Genet. 10, 682, 2002). An apt example of transgenerational inheritance in the present context of drugs affecting brain would be that related to smoking. In the Avon Longitudinal Study of Parents and Children (ALSPAC, from three districts around Bristol, UK), Pembrey et al. have reported that early paternal smoking is associated with greater body mass index (BMI) at 9 years in sons (Eur. J. Hum. Genet. 14, 159, 2006). Authors’ following remark provides us the readers with food for thought on the issue of use of pharmaceutical cognitive enhancers: “Our findings add a new, multigenerational dimension to the interplay between inheritance and environment in health and development; they provide proof of principle that sex-specific, male-line transgenerational effects exist in humans. We propose that our results, which are specific enough to allow replication, are manifestations of an evolved adaptive transgenerational response mechanism. Our study exemplifies a research approach that could, potentially, make a major contribution to public health and impact on the way we view our responsibilities towards future generations” (Eur. J. Hum. Genet. 14, 159, 2006). It is interesting to note that transgenerational potential of drug use does not find a place even in the original discussion paper “Boosting your brain power: ethical aspects of cognitive enhancements” from the British Medical Association (text to link). I think we need to worry not only about possible short- and long-term neural side-effects in drug users but also about potential disproportionately larger risks that drug exposure might impose on our unsuspecting future generations.

Reply from Martha Farah

Martha Farah — Thu, 10 Jan 2008 19:29:34 -0000

This exchange has been very interesting – but also very theoretical! One purpose of the forum was to inform each other about actual uses of modafinil and other cognition-enhancing drugs among the readers of Barbara and Sharon’s article. As they said: “We especially want to hear from you if you’re already using these drugs – or if you know people who are. What are your reasons for taking, or not taking, these drugs?” Here I will share some of my experiences and hope that others will reciprocate!

I have used modafinil a few times when traveling. In Japan (my first time), I used it my first day there, as well as a few days later when I had to give a talk. In China I used it for one day. It made a huge difference to how I felt.

I also used it on a trip closer to home. A couple of years ago I was a juror at the Sundance Film Festival – a definite break from this nerd’s routine! – and there is a big party on the final night after the awards ceremony. Unfortunately I have a tendency to want to go to sleep by 8 or 9 at night and this party would be starting well after that, in a later time zone no less. But I was not going to miss this party!! So I went to Anthropologie and got myself a cool shabby chic dress (shabby is very important at Sundance, BTW – I showed myself to be a nerdy newbie by being in a dress at all), called my doctor and got myself a modafinil tablet, and I was good to go. It was a Cinderella kind of experience, but minus the pumpkin problem!

After my Sundance experience I gave some serious thought to using modafinil more often for evening socializing. It would without question improve my quality of life. Feeling vegetative by 8 PM does very bad things for a person’s social and cultural life. But I guess I am enough of a “psycho- pharmacological Calvinist” that I have not done this.

I’d be interested in knowing who else has tried modafinil for jet lag and toyed with the idea of using it for other purposes as well! Are you using it, or thinking of using it, to enhance your cognition?

Reply from Ashok Das Mahapatra

Ashok Das Mahapatra — Wed, 09 Jan 2008 04:05:41 -0000

The authors have presented a nice article on cognitive-enhancing drugs, which helps to improve the concentration and continue to work for a prolonged period of time (hard work).
The adverse side effect cannot be ruled out. The side effect may not be visible in short term, but will make their presence in long term. In my opinion, rather than using such type of drugs, which have side effect, why don’t we focus something safer. Especially to enhance memory power, concentration, Yoga and Meditation will be a better choice, no doubt. But negative aspect is that one needs to invest enough time for the practice. Probably, we do not have either patience or time to practice such kind of things.

Reply from Nicolau Werneck

Nicolau Werneck — Mon, 07 Jan 2008 14:10:59 -0000

I don’t understand this discussion about using the drugs being “fair” or “unfair”. This idea of scientific work as a competition, if not any work, is mistaken in my opinion. (This is a Brazilian contribution to an anglo-saxon magazine…) It is more important to change this competitive characteristic of our societies then to change our opinion on drugs.

Using calculators and computers have been seen as fair or unfair when they came by, but then they became widespread, and are now just tools that everybody must have. Our brains and bodies are just tools too, answering to “the ghost” in our machinery. Is it unfair to oil your cogs in the Tour de France? I don’t think so… What about doing it to our brains?

As for doping in sports, such as the Tours de France, what will happen is that we will eventually start to have different modalities: racing with doping, and without. Using drugs is not OK in these competitions, because the rules say so, but we can create competitions without these rules. It will start to become just one more restriction, just like specifications of the equipments used by the competitors. It makes sense in sports because it is an inherently competitive activity, although you can enter a competition without caring about winning, and without caring if someone won in an “unfair” way. We must fight for a less competitive society, and try to live without caring so much about winning, or about the fairness of the winners.

Of course side effects should be taken into account for you to decide to use cognitive enhancing drugs, but let’s always remember that values such as “being healthy”, “live long” et cetera can be put by some in a lower level than to have the drug’s effects. That’s what happens to many users of the said “recreational drugs”. It’s not that they “don’t know” or “don’t understand”. If they often suffer from a bedtime conversion and decide it was a bad idea is another problem. This specific question is too old for us to be debating as something new, what changed is that we are not talking about using drugs “for fun”, but for a (said) useful reason. Whether the excuse makes it OK or not to use them is for the morality of each one to decide.

One might choose to take the advice of Poincaré to the extreme, and use such a drug in his quest for the truth in spite of the suffering it might cause to you, damaging your body.

I only hope the users never reach some form of “higher logic” and start a science unattainable by the mundane brain. They say some albums recorded by musicians using LSD can only be “understood” if you also take it. I still believe logic is not about power but, but about the way you do things (in portuguese: “não é força, é jeito”). I’m not sure those drugs halp you with the jeito, I believe it’s more related to power and efficiency. There is only one way to find out!...

Reply from Peter Khooshabeh

Peter Khooshabeh — Sat, 05 Jan 2008 15:30:35 -0000

Sahakian and Morein-Zami have done a thorough job of mentioning several types of cognitive enhancement, whether induced pharmacologically or not. At the same time, when they discuss ethical implications of taking a substance to enhance cognition, they note that that drug delivery does not really avoid the ethical dilemma—whether by pill or drink, the intended effect is often similar. However, I feel that the discussion should give more attention to non-pharmaceutical types of cognitive-enhancement that are available and not ridden with the same ethical turmoil, adding to the second issue brought up by Steven Rose’s comment. For example, preparatory courses for standardized exams and mnemonic devices already ‘boost brain power.’ As an example of non-medical uses of cognitive-enhancing drugs, Sahakian and Morein-Zami point out the fact that active military personnel take drugs to improve performance while on duty. However, even before the advent of these pharmaceutical approaches, soldiers have been trained to perform such tasks as neutralizing their fears and perceiving specific visual stimuli, e.g. landmines, aircrafts, and other objects relevant to that domain, better than the general civilian public (Staszewski, 2007). There are other examples of behavioral interventions that change cognitive ability.

Is taking an SAT prep class cheating? Not every student taking the SAT exam has access to such a resource, and some argue that it confers an unfair advantage to those students who do prepare in such a way.

Professor Michael Gazzaniga’s book ‘The Ethical Brain’ explores a lot of the ideas mentioned in the main article around which this discussion revolves.

Peter Khooshabeh
PhD Student
University of California Santa Barbara

PS: I want to acknowledge Dr. Pereira’s urging the community to make an epistemological analysis on these issues. Peter Freer’s comment also provides information from longitudinal works that seems to dispel myths that cognitive-enhancing drugs actually enhance. However, Morein-Zami’s rebuttal is a valid criticism that even some of the longitudinal studies are not necessarily conclusive to the ethical debate.

Reply from Sandy McAfee

Sandy McAfee — Fri, 04 Jan 2008 14:43:48 -0000

Regarding the suggested use of cognitive enhancers to reduce the care costs associated with an ageing population, there are a number of important ethical and moral issues which have not yet been discussed in this blog. I would like to point to a few important concerns:

1) Perhaps the most obvious issue is the medicalising and pathologising of an otherwise normal but perhaps health-vulnerable segment of society, with the attendant message that the treatment for this ‘old age pathology’ is cognitive enhancement via medication. The side-effects of some if not all cognitive enhancers (as has been already well stated in this blog) in long term use appear to be largely unknown. As older people can have altered drug metabolism it seems reasonable to expect that drug interaction effects and other iatrogenic issues due to polypharmacy are likely to be significant in some individuals, particularly if used in an unregulated way. There are other unwanted psychosocial effects, however, of medicalising the ageing process.

2) The raised expectation (without adequate evidence of efficacy and/or safety) that cognitive enhancers will significantly delay or ameliorate serious illness such as dementia might increase unwarranted demand for these drugs, leading to potential exploitation and financial abuse of older people. Without making any specific accusations of impropriety, we know that the pharmacology industry already makes a huge amount of dosh from older people, and regards anti-dementia drugs as the Holy Grail. The recent debate in the UK over the revised NICE guidelines for anti-cholinesterase drugs shows that many who have studied the evidence base remain unconvinced over the value of these substances in the care and treatment of dementia.

3) With the expectation of increasing care costs and the use of emotive phrases such as ‘burden’ and ‘demographic time-bomb’ society may induce an exaggerated sense of guilt and fear in older people which could add to the likelihood of experimentation with such substances. Scientists, drug companies, health services and commentators have a responsibility to avoid the use of inflammatory language.

4) Perhaps the most important and compelling issue is the largely overlooked evidence base pointing to the value of psychosocial and interpersonal interventions such as cognitive stimulation therapy, to improve cognitive functioning. As with children who can get a leg-up from an enhanced parental or scholastic environment (op cit), the potential environmental and interpersonal influences upon cognitive functioning with older people have been widely written about but have yet to be taken up in the health and social care services within the UK in any widespread way. Instead we see an over-prescribing of drugs and an under-investment in psychological interventions to facilitate improved cognitive and behavioural functioning, despite the existence of RCT evidenced efficacy of such approaches showing benefits on cognitive tests on a par with anti-cholinesterase inhibitors (e.g. Spector et al, British Journal of Psychiatry, 2003). Equally important to wellbeing in older age is the detrimental effect upon cognitive functioning of ‘malignant social psychology’ and isolation written about by Tom Kitwood.

Before we get too excited about the use of cognitive enhancers for ourselves or our parents we need to give serious thought to the kind of society we want to live in, even if these drugs were to deliver on their hype. I am grateful to Sahakian and Morein-Zamir for opening up this debate.

Reply from John Montgomery Rouse

John Montgomery Rouse — Wed, 02 Jan 2008 15:53:57 -0000

Firstly, thank you to the authors for their excellent article.

My question is a simple one: won’t this eventually make us all dumber rather than smarter as we’ll take a pill to save us the hard work of concentration?

Should appeal widely to students?

Reply from Sarah Tomlin

Sarah Tomlin — Wed, 02 Jan 2008 11:17:49 -0000

Posted on behalf of Nick Bostrom, Oxford University

I think the target discussion piece is a fine one. I agree with the point that that has been made by several of the commentators, that there is a need for better understanding of the long-term effects of the use of potential cognitive enhancers in an ecological setting. It is one thing to show a short-term positive effect on some artificial lab task. It is quite another to show that long-term use actually leads to sustainable performance gains on important real-world tasks (such as improved academic output). The latter is harder to demonstrate, but it is what ultimately matters.

Unfortunately, progress on developing effective cognitive enhancers, and on understanding their long-term effects, is slower that it could have been because there is a shortage of focused research in this area. In general, the potential of enhancement medicine has yet to be fully appreciated.

Prevailing patterns of medical funding and regulation are organized around the concept of disease. Every pharmaceutical on the market with alleged cognitive-enhancing effects was developed as a treatment for some pathology. The nootropic virtues in healthy adults were discovered as fortuitous side effects. This disease-centric framework impedes the development of safe and effective enhancing medicine. In particular, it has the following consequences:

First, it makes funding hard to come by; it also makes it hard to obtain regulatory approval for enhancement drugs. The result is that those who wish to research cognitive enhancement must often mask their work under the guise of addressing some “respectable” disease.

Second, in order to get access to the benefits of a cognitive enhancer, the user must first be classified as sick. This leads to the expansion of diagnostic categories and the invention of new pathological conditions – sometimes to cover cases that in earlier times would have been regarded as normal human variation.

Third, it contributes to inequity in access. The main obstacle for someone who might be interested in trying modafinil or some related drug is not cost (which is similar to a Starbucks coffee) but information: knowing that the drug exists, and how to obtain it. This discriminates against people with low social and informational capital.

With the cockcrow of enhancement medicine, we need to retool or regulatory paradigm. It is not only special occupations like military commandos and air traffic controllers who would benefit from good enhancement drugs. Many jobs are as important and intellectually taxing – including the jobs of many scientists and academics. Anything that may help our humble brains deal better with the complex challenges of the 21st century is to be not only welcomed but actively sought. But it will require substantial investment to develop interventions that are both safe and effective in long-term use.

Nick Bostrom, PhD
Future of Humanity Institute, James Martin 21st Century School, Oxford University