How Safe are Smart Drugs?

March 18, 2009 02:32 PM
by Shannon Firth
Medicines used for attention-deficit disorder and hyperactivity have been praised for improving brain performance; but new research on one "smart drug" draws parallels to cocaine.

How Safe are Smart Drugs?

Before doctors began prescribing modafinil for “off label” uses such as attention defecit and hyperactivity disorder (ADHD) and schizophrenia, it was used as a treatment for narcolepsy.

In time, those who needed to study or work or party for longer hours chose modafinil, "a wakefulness drug" because it appeared safe. According to Time magazine, the scientific community, without knowing the drug's specific mechanisms, believed that modafinil did not rely on dopamine, a neurochemical closely tied to addiction.

Dr. Nora Volkow, head of the National Institute on Drug Abuse was skeptical that modafinil could bypass dopamine and began studying how modafinil functioned in the brain On March 17, the Journal of American Medical Association published the report she co-authored.

Volkow divided 10 men, ages 23 to 46, into three groups. One group received a placebo pill the other received 200 mg of modafinil, and the third received 400 mg, according to the LA Times Blog.

Volkow's results confirmed her suspicions. The positron-emission tomography (PET) brain scans of men who took modafinil showed that dopamine transporters, which remove traces of dopamine from between cells, were obstructed.

According to Time writer Jeffrey Kluger, Volkow discovered that modafinil functions by "canceling the garbage trucks” and leaving behind residual dopamine, which induces pleasure and increases the potential for addiction.

Modafinil also locks into the same receptor site as cocaine, at a place called the nucleus accumbens, which is frequently linked with abuse of recreational drugs. Volkow emphasizes, "This completely negates the argument that modafinil has no dopaminergenic effect."

The LA Times Blog notes that methylphenidate (Ritalin), another medication used to treat ADHD, also boosts dopamine levels, though the prescribed dosage for modafinil is 10 times greater than methylphenidate.

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Background: Experts advocate expanded use of "smart drugs"

A group of neuroscientists, psychiatrists and ethicists have been encouraging the public to use brain-boosting drugs, and argued that medications like Ritalin and Adderall are comparable to other mind-enhancing strategies, such as sleep and coffee. According to New Scientist, the group also believes that such "inexpensive drugs may even have the potential to be a more egalitarian way to get ahead than expensive tutoring."

The assertion follows an August 2008 survey published in the journal Nature, which found that students and professionals were increasingly taking prescription drugs to stay awake, stay focused, and to improve their memories. Speculation arose over whether prescription drugs like Provigil, Adderall and Ritalin should be used to enhance productivity in addition to treating illness.

In the survey 20 percent of 1,400 international respondents, mainly academics and scientists, said that they had taken these drugs to “improve workplace performance.” Twice as many respondents reported taking the drugs for their off-label uses than for their prescribed uses, and a third of respondents would give their children medicine to help them with their schoolwork if students at a rival high school were taking the same pills. A 66-year-old respondent defended his reason for taking the pills: “As a professional, it is my duty to use my resources to the greatest benefit of humanity. If ‘enhancers’ can contribute to this humane service, it is my duty to do so.”

Science Live interviewed students and professors at the University of Cambridge Science Festival in February 2008, asking about the social and ethical implications of “smart drugs.” One student confessed, “If you want to go to the best university and you know you’re not the smartest in the whole of the country … I would take the drug.” Conversely, a University of Cambridge professor said, “If it’s going to change the innate ability of people then I’d start to get worried, because that gets into biological engineering and I think we need to debate about that.”

Zack Lynch, founder and executive director of the Neurotechnology Industry Organization, believes that the drugs will become more widely used around the globe. Lynch hypothesized, "If you're GE Capital and you have offices in 154 financial centers around the planet, and these [brain-drug] tools are available in Dubai, and your workers there are trading more effectively, 5 to 10 percent better—they'll have a neuro-competitive advantage over workers where these tools are not legalized," he told the National Journal.

Scientists in England are considering using urine tests to measure students’ smart drug intake. Les Iversen, a pharmacologist at Oxford University and a member of the Academy of Medical Sciences Panel, told The Times of London, “If and when really effective drugs become available, and only rich people can afford them, they would have a grossly unfair advantage in exams.”

In the United States, critics of “smart drugs” are concerned about the recent Neurotechnology Initiative Act [NNITV] brought to Congress this past May. The bill, if passed, would increase government funding by $200 million per year, increase the staff of the Food and Drug Administration and speed up the process of approving drugs related to brain and nervous system disorders. While the bill aims to expedite the treatment and prevention of diseases like Alzheimer’s, Parkinson’s, and schizophrenia, many of the treatments for these illnesses double as “smart drugs.”

Fleur Britten, who writes for The Times of London, decided to try Modifinil, the generic form of Provigil, which is a drug prescribed for narcolepsy, to see what the “buzz” was about. After downing the pill, Britten writes, “Streams of consciousness babble endlessly; I feel spirited and industrious … I fantasise about Thatcher-style productivity. Perhaps this is the key to the mythological 25-hour day?” Britten’s problem came later: “Wide-eyed at 2am, I reached for a sleeping pill. And another. … I ended up taking three times the normal dose.”

Related Topics: British Health Agency Discourages Ritalin Use; improving brain function without using drugs

In December 2008,findingDulcinea reported that Britain’s national health institute recommended that doctors minimize the use of drugs like Ritalin to combat ADHD, advising that psychological therapy be used instead.

New Scientist examines some of the drugs people use to enhance their cognition, but also offer ten ways to a better brain that don't include Medication. They do include diet, exercise, listening to music, sleep, and memory tricks.

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