Would you boost your brain power?
Sarah Tomlin
Wednesday, 12 December 2007 18:35 UTC
Credit: PHOTOTAKE / Alamy
UPDATE JAN 31ST: This week, Nature is publishing two pages of correspondence responding to the Sahakian and Morein-Zamir Commentary. We’re also launching an anonymous online survey to build on the informal questionnaire that the Commentary authors sent to academics on the usage of brain boosting drugs. In aggregate, the survey results will guide future editorial content on this topic. Check back here for more updates.*
Two scientists writing a commentary article in the December 20 issue of Nature want to stimulate your brains – in more ways than one.
Barbara Sahakian and Sharon Morein-Zamir from the Department of Psychiatry at Cambridge University argue that the increased usage of brain-boosting drugs by ill and healthy individuals raises ethical questions that cannot be ignored. An informal questionnaire Sahakian and Morein-Zamir sent to some of their scientific colleagues in the US and UK revealed fairly casual use by academics, and we now want to hear your views on the topic..
The authors arguments can be read in more detail here. An earlier Nature editorial also discussed some of the ethical issues surrounding drug-based enhancement in healthy individuals inspired by a longer discussion paper from the British Medical Association.
To trigger broader discussion of these issues Sahakian and Morein-Zamir propose the following questions:
> Should adults with severe memory and concentration problems be given cognitive enhancing drugs?
> If such drugs have only mild side effects, should they be prescribed more widely for other psychiatric disorders?
> Do the same arguments apply for young children and adolescents with neuropsychiatric disorders, such as those suffering from ADHD?
> Would you boost your own brain power?
> How would you react if you knew your colleagues – or your students – were taking cognitive enhancers?
> How should society react?
Please contribute to this online discussion. 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?
For the next two weeks the authors of the Nature commentary will be joining in the conversation here. Barbara Sahakian also discusses cognitive enchancers on Nature’s podcast, extract posted here
Get ready to expand your mind..
Updated 30 January 2008 18:46 UTC
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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 BarbaraPS: 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.
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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!…
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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. -
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?
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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.
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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
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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.
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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).
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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. -
Anonymous
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.
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