Brain boosters?

Emma Dixon explores cognitive enhancers

Cognitive enhancers – which are also called neuroenhancers, smart drugs and nootropics – are drugs that are intended to increase ‘mental performance’. This may include memory, learning capacity, attention span and mental energy.

Many of these drugs were originally intended for medical use, for conditions such as attention deficit hyperactivity disorder (ADHD) and fatigue, but have since gained popularity outside of the medical world.

Who uses them?

Some drugs in this group have been approved for medical use in some countries – for example, Ritalin for ADHD and donepezil for Alzheimer’s disease. There are further clinical trials looking into using some of these drugs for other neurodegenerative or neuropsychiatric conditions that result in cognitive impairments. With the increasing occurrence of these conditions, especially in an ageing population, it has been suggested that any medication that can aid cognitive ability may increase the quality of life for those patients.

But what about healthy individuals using these drugs? Some people who do not have neuropsychiatric conditions have started using these products to boost their cognitive performance at university or at work.

But no medication is without risk, and researchers are concerned that healthy people may suffer side-effects from using these drugs. In the case of medical use, the potential side-effects are often seen as justified in comparison to the cognitive improvements that the drugs may bring, but for healthy individuals these risks may not offset the benefits.

Do they work?

Although we don’t fully understand how these drugs work, some clinical trials are being carried out to investigate their usefulness, both for people with reduced cognitive abilities and for healthy individuals, with mixed results.

One study investigated the effects of a cognitive enhancer called modafinil, which was originally used for wakefulness and sleeping disorders. Healthy participants reported improvements in their ability to complete visual, memory and problem-solving tasks. These effects may be short-lived. Other studies have shown no long-term benefits for healthy individuals, or for those with only mild cognitive impairment. Some studies have even reported negative side-effects of these drugs, including nausea, diarrhoea and anxiety.

Researchers are particularly concerned about young people using these drugs. The brain doesn’t fully develop until around 25, and using some drugs before your brain is fully developed may increase the risk of altering this development.

Should cognitive enhancers be available to everyone?

Most cognitive enhancers are legal, even if they’re not available at pharmacies. Given that there’s mixed evidence for their benefits and side-effects, should these drugs be available without prescription?

Some scientists think that drugs such as these should be used not just to combat neurodegenerative diseases, but to improve everyone’s cognitive ability. Professor Julian Savulescu from the Wellcome Centre for Neuroethics suggests that “more research could focus directly on enhancement – on making things better as opposed to preventing them from being bad. We’re talking about positive biology, positive pharmacology. Things that will improve people’s lives, not just treat diseases.”

Some researchers have raised concerns over the legal status of these drugs, suggesting that more effort needs to be focused on why seemingly healthy individuals are using them. At present there is very little definitive data on which people use these drugs and why. If they are being used to overcome stressful environments, then taking them would be only treating the symptoms, not the cause.

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Questions for discussion

  • What would you say if one of your friends wanted to try cognitive enhancers?
  • Do you think there should be an age restriction for use of neuroenhancers?

Further reading

About this resource

This resource was first published in ‘Addiction’ in August 2015.

Psychology, Health, infection and disease
Education levels:
16–19, Continuing professional development