neuroenhancers: the debate continues

July 25, 2009

Adderall (credit: www.michaelshouse.com)

Adderall (credit: http://www.michaelshouse.com)

If you aren’t familiar with the debate about neuroenhancers, you should definitely read up on it. It’s one of the most interesting contemporary debates going in the public health/education/pharmacology realm. For those of you who aren’t familiar with the debate, here’s a quick primer: the use of neuroenhancers like Ritalin, Adderall, Modafinil, and others has become more prevalent among people (often students but increasingly professionals too) wishing to squeeze a bit more of productivity out of their lives. (This discussion does not include the legal and appropriate use of these drugs for clinical learning disabilities like ADHD.) If you have a half hour, I’d highly suggest Margaret Talbot’s excellent New Yorker article on the issue.

Those of you not familiar with the debate may have the immediate and understandable reaction against the use of neuroenhancers. To those people, I urge you to consider the difference between taking a stimulant in pill form (as these come) and one in drink form, as our beloved coffee comes.

Unlike steroids, these drugs don’t yet have well documented health consequences for human use yet, which makes their use harder to damn. After all, we’ve been prescribing these stimulants (n. b. – Modafinil, a sleeping disorder drug, works differently than Ritalin and Adderall and is not an amphetamine) for years without seemingly negative consequences.

And yet, Edmund Higgens, a professor of family medicine and psychiatry, has an interesting piece in Scientific American that discusses some recent (mostly animal) studies that indicate the health consequences of stimulants like Adderall are more complicated than previously thought. Animals subjected to regimens of similar stimulants displayed some signs of anxiety, depression, and long term “cognitive defects.” While it’s important to distinguish between animal studies and clinical studies, the results of the latter often follow the former.

While the article is more directed at the over-prescription of ADHD drugs for kids, its contents certainly come to bear on (what I think is) a more interesting discussion. Once health consequences of neuroenhancers become present, the case for their recreational (academic, or professional) use becomes more difficult.

What’s still unclear is how (if at all) intermittent use affects our long term mental and cognitive health. Still, these new studies color a discussion that will only become more important in the future.

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