Tuesday, November 22, 2011

Brain Doping

MOST of us want to reach our full potential. We might drink a cup of coffee to stay alert, or go for a run to feel on top of the job. So where's the harm in taking a pill that can do the same thing?
So-called cognitive-enhancing drugs are usually prescribed to treat medical conditions, but they are also known for their ability to improve memory or focus. Many people buy them over the internet, which is risky because they don't know what they are getting. We also know next to nothing about their long-term effects on the brains of healthy people, particularly the young. But some scientists believe they could have a beneficial role to play in society, if properly regulated.
So who's taking what? The BBC's flagship current affairs show Newsnight and New Scientist ran an anonymous online questionnaire to find out. I also decided to try a cognitive enhancer for myself.
 The questionnaire was completed by 761 people, with 38 per cent saying they had taken a cognitive-enhancing drug at least once. Of these, nearly 40 per cent said they had bought the drug online and 92 per cent said they would try it again. Though not representative of society, the survey is an interesting, anecdotal snapshot of a world for which there is little data.
 The drugs people said they had taken included modafinil, normally prescribed for sleep disorders, and Ritalin and Adderall, taken for ADHD. The range of experiences is striking. One respondent wrote: "It helps me extend my concentration. I can study a topic for six hours, for example, that would have me bored to tears in two." Another wrote: "Did not help me do anything but feel anxious and excited, could not sit still even 15 hours later."
 When asked about the drugs' potential impact on society, people reported concerns beyond safety, for example warning that the drugs might create a two-tier education system in which some can afford the drugs and others can't. They voiced wider concerns too, such as: "If society has come to the point that we have to take cognitive enhancers to function or perform to certain expected levels, then it is a society that has placed performance over happiness and health."
Laurie Pycroft, a student at the University of Oxford, talked to Newsnight about his experiences with modafinil. "I've taken it a few times, primarily for its ability to increase wakefulness and allow me to concentrate and stay awake for very extended periods of time. I don't take it very often but if I want to stay awake for zo or 30 hours working on an essay it's very useful," he said.
Keen to learn more, I contacted Barbara Sahakian, a neuroscientist at the University of Cambridge. She and her team work with people who have conditions such as Alzheimer's and Parkinson's disease. One area of their research is testing whether cognitive-enhancing drugs such as modafinil help. Sahakian thinks these drugs could play a wider role in society.
Her most recent research showed that sleep-deprived surgeons performed better on modafinil. "I do think we've undervalued [the drugs]. As a society we could perhaps move fonvard if we all had a form of cognitive enhancement that was safe," she told me. Before I could self-experiment with the drug! had to satisfy Sahakian's colleague James Rowe that there were no risks. We also had trained medical staff nearby. I took a tablet on two separate days without knowing which one was modafinil and which was a placebo. I then did an hour or so of tests involving memory, strategy, planning and tests of impulsiveness.
On the second day I felt more focused and in control and thought I performed better in the tests. That was the day I had been given modafinil. Rowe summed up my performance: "What we've seen today is some very striking improvements.., in memory and, for example, your planning abilities and on impulsivity." It's human nature to want to push against our limitations, but what about the risks? Before sanctioning a drug as a cognitive enhancer for healthy people, regulators would require long-term safety studies so they could weigh up the risks and benefits.
Pharmaceutical companies are not rushing to carry out such studies, but Sahakian is calling for such work to be done before someone comes to harm. Some cognitive enhancers, such as Ritalin, are controlled drugs. Modafinil is not, so it is legal to buy it online, though it is illegal to supply it without a prescription. The UK government, through the Medicines and Healthcare products Regulatory Agency, told Newsnight that tackling the illegal sale and supply of medicines over the Internet is a priority. It's not just students who claim to find the drug beneficial.
Anders Sandberg of the Future of Humanity Institute at the University of Oxford talks openly about using cognitive-enhancing drugs. He is about to start a study in Germany to compare the effects of a range of cognitive enhancers, including two hormones —ghrelin, which promotes hunger, and oxytocin, which is associated with empathy—to test their powers at what he calls "moral enhancement".
"Once we have figured out how morality works as an emotional and mental system there might be ways of improving it," he told me. The bottom line is that cognitive-enhancing pills are a reality and people are using them. But how comfortable are we with the knowledge that some of our children's classmates might be taking such drugs to perform better at school, or that one candidate for a job interview might use modafin i I to outshine the others? And who was the real me, the one on modafinil, or the one not? Perhaps we should start thinking these questions through, before a drug offering far more than a few percentage points of enhancement comes our way.


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