̽��ֱ�� of Cambridge - smart drugs

‘Smart’ drugs can decrease productivity in people who don’t have ADHD, study finds

fpjl2 — Fri, 09 Jun 2023 15:58:04 +0000

New research from the ̽��ֱ�� of Cambridge and the ̽��ֱ�� of Melbourne, published in Science Advances, shows neurotypical workers and students taking cognitive enhancers, or ‘smart’ drugs, may actually be inhibiting their performance and productivity.

Drugs such as methylphenidate, sold under the brand name Ritalin among others, are commonly prescribed for attention deficit hyperactivity disorder (ADHD), but are also taken by those without a diagnosis, in the belief that the drugs will enhance focus and cognitive performance.

In four double-blinded, randomised trials in Melbourne, each a week apart, the same 40 healthy participants took one of three popular ‘smart’ drugs (methylphenidate, modafinil or dextroamphetamine) or a placebo. They were assessed on how they performed in a test designed to model the complex decision-making and problem-solving present in our everyday lives.

While previous studies into the effects of smart drugs have used simpler cognitive tasks targeting memory or attention, the Melbourne trial involved more computationally complex activities that better simulate the difficult nature of tasks people encounter in daily life.

Participants were asked to complete an exercise known as the Knapsack Optimisation Problem – or ‘knapsack task’ – in which they were given a virtual knapsack with a set capacity, and a selection of items of different weights and values. ̽��ֱ��participants had to figure out how to best allocate items to the bag, to maximise the overall value of its contents.

Overall, participants taking the drugs saw small decreases in accuracy and efficiency, along with large increases in time and effort, relative to their results when not taking the drugs.

For example, when given methylphenidate – often used to treat ADHD in children, but increasingly taken by college students cramming for exams – participants took around 50% longer on average to complete the knapsack problem as when they were given a placebo.

In addition, participants who performed at a higher level in the placebo condition compared to the rest of the group tended to show a bigger decrease in performance and productivity after receiving a drug.

In terms of 'productivity', for example – the level of progress per item moved in or out of the knapsack – the participants in the top 25% under a placebo regularly ended up in the bottom 25% under methylphenidate.

By contrast, participants who had a lower performance in a placebo condition only very occasionally exhibited a slight improvement after taking a drug.

Professor Peter Bossaerts, Leverhulme International Professor of Neuroeonomics at the ̽��ֱ�� of Cambridge, believes more research needs to be conducted to find out what effects the drugs are having on users without ADHD.

“Our results suggest that these drugs don’t actually make you ‘smarter’,” said Bossaerts. “Because of the dopamine the drugs induce, we expected to see increased motivation, and they do motivate one to try harder. However, we discovered that this exertion caused more erratic thinking — in ways that we could make precise because the knapsack task had been widely studied in computer science.

“Performance did not generally increase, so questions remain about how the drugs are affecting people’s minds and their decision making.”

Dr Elizabeth Bowman researcher at the Centre for Brain, Mind and Markets at the ̽��ֱ�� of Melbourne and lead author of the study said the results show we have yet to establish the effectiveness of pharmaceutical enhancers on our performance, when used by neurotypical people to perform everyday complex tasks.

“Our research shows drugs that are expected to improve cognitive performance in patients may actually be leading to healthy users working harder while producing a lower quality of work in a longer amount of time,” said Bowman.

Smart drugs do motivate people, but the added effort can lead to “erratic thinking”, adversely affecting above-average performers, according to researchers.

Our results suggest that these drugs don’t actually make you ‘smarter’

Peter Bossaerts

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Opinion: ̽��ֱ��science, drugs and tech pushing our brains to new limits

cjb250 — Thu, 06 Oct 2016 08:27:40 +0000

A recent explosion of neuroscience techniques is driving substantial advances in our understanding of the brain. Combined with developments in engineering, machine learning and computing this flowering has helped us enhance our cognitive abilities and potential. In fact, new research into the extraordinary machine in our skulls is helping us keep pace with the rapid rise of artificial intelligence.

Exciting new advances are everywhere, but worth putting front and centre are findings made in the relatively new area of social neuroscience. Research by Molly Crockett at Oxford ̽��ֱ�� has demonstrated how we might influence the social brain and examine the effects of neurotransmitters, such as serotonin, and hormones, such as oxytocin, on social cognition and social interactions. This includes the most fundamental aspects of our daily lives: trust, punishment, moral judgement, conformity and empathy.

Crockett and colleagues used experiments looking at cooperation, and moral dilemmas such as the “trolley problem” where participants must decide who to save from an onrushing railway cart (a similar puzzle was posed in the 2015 Helen Mirren film Eye in the Sky). Among their findings was evidence that serotonin increased an aversion to harming others. This clearly suggests that this brain chemical can promote positive social behaviour.

Does serotonin make you a better person? Xavier Béjar/Flickr, CC BY-SA

Recently developed computerised tests, such as EMOTICOM, which assesses a range of cognitive functions, will also make it easier to combine state-of-the-art neuroscience techniques with objective measurement of social and emotional concepts.

Shared knowledge

One amazing feat of combined neuroscience, engineering and computing was achieved by Edda Bilek, Andreas Myer-Lindenberg and colleagues from the Mannheim Central Institute of Mental Health in Germany. They invented a way to study information flow between human pairs during real-time social interaction, using functional magnetic resonance imaging (fMRI), which measures changes in blood flow in the brain. They were particularly interested in studying joint attention because it arises in early development and is important for social learning.

Their study allowed immersive, audio-visual interaction of two people in linked fMRI scanners, and identified the flow of information between the sender’s and receiver’s temporoparietal junction, a key brain region for social interaction. Not only did the study show that specific social brain systems are drivers of interaction in humans, it demonstrated the strength of integrated research across biological and physical sciences.

In future, this will allow us to study in real time the neural networks involved in other forms of joint social interaction, such as defeat, trust and mutual attraction.

Understanding attraction. codin.g/Flickr, CC BY-NC-ND

Rapid development of these fMRI techniques, and of neuroimaging, will continue to transform the field of neuroscience. Experiments have tackled topics such as unconscious racial bias, “mind reading” and lying. It is work which helps to pull back the curtain on our understanding of the human mind – and might make us wonder if this glimpse into our thoughts crosses an ethical line in terms of privacy and profiling.

To see the power of fMRI techniques, look to the futuristic experiments by Jack Gallant and colleagues at the ̽��ֱ�� of California. They have developed a method for reconstructing movie segments that a person is watching purely based on fMRI recordings, which track brain activation patterns. More recently, the Gallant laboratory mapped the semantic atlas of the brain. These semantic networks are a sum of our verbal knowledge and how we understand the relationship between words and concepts.

̽��ֱ��drugs might work

Outside of the lab and academia, there is an increasing use of so-called lifestyle drugs to enhance cognition, creativity and motivation in the workplace. Drugs such as modafinil, which has effects on noradrenaline, dopamine and GABA/glutamate in the brain, can boost cognitive functions, especially in flexibility of thinking and complex planning.

Such drugs are used to seek a competitive edge at university or work. ̽��ֱ��Care Quality Commission reported that over a six-year period from 2007 to 2013, there had been a 56% rise in prescriptions for methylphenidate in the UK. London City workers and traders use them to stay awake and alert for long periods of time. German workers use them in jobs where small mistakes might have large consequences. American academics travelling to international meetings use them to counteract jet lag.

Modafinil has been known to reduce accidents in shift workers, thereby increasing safety. In a similar fashion, aniracetam is used by Silicon Valley entrepreneurs to boost cognition. One of the original drugs in the same class is piracetam, which increases brain metabolism, while aniracetam has been shown to modulate the receptors in the brain that are thought to enhance cognition.

Pills and thrills. Geoff Greer/Flickr, CC BY-SA

In parallel, there is a boom in demand for nootropics. These “microdosed” psychdedelics are increasingly a phenomenon in which small amounts of psilocybin mushrooms, LSD or mescaline are taken to enhance perception and creativity. Cognitive processes, including attention, learning and memory, have also been targeted through evidence-based games such as the brain training programme and the Wizard memory game developed by ̽��ֱ�� of Cambridge and Peak. These academia-industry collaborations help to translate neuroscience discoveries into the real world.

AI, AI, Go

At present, the magnificent human brain is superior to artificial intelligence (AI). Computers have to dedicate themselves to playing chess or Go in order to beat us humans. In contrast, we can play chess or Go or perform many other activities and behaviours, often multi-tasking, and we can create new ideas and inventions. We are also social beings and our social and emotional cognition allows us to have “theory of mind”. In other words we can understand and empathise with the thoughts and emotions of others.

However, with the rapid advances in machine learning and computing technology – including face and voice recognition – the potential for artificial intelligence may be limitless. By contrast, there will likely remain limits to the extent to which we can enhance human intelligence.

Nonetheless, the amazing achievements made by basic and clinical neuroscientists will not only help us understand the healthy brain but also improve brain health for everyone, including those with neuropsychiatric disorders, such as Alzheimer’s disease, and brain injury.

This piece is co-published with the World Economic Forum as part of its Final Frontier series. You can read more here.

Barbara Sahakian, Professor of Clinical Neuropsychology, ̽��ֱ�� of Cambridge

This article was originally published on ̽��ֱ��Conversation. Read the original article.

Rapid advances in neuroscience are driving a huge shift in our understanding of how the brain works and could improve both our cognitive abilities and our brain health, writes Professor Barbara Sahakian (Department of Psychiatry) on ̽��ֱ��Conversation website.

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Opinion: Fair play? How ‘smart drugs’ are making workplaces more competitive

Anonymous — Wed, 06 Jul 2016 10:42:08 +0000

We live in an increasingly competitive world where we are always looking to gain an advantage over our rivals, sometimes even our own colleagues. In some cases, it can push people to extreme, unethical and illegitimate methods – something we’ve seen recently in the doping scandal that has hit the athletics world.

In a recent review paper, we found that people are increasingly using performance-enhancing drugs for common tasks ranging from sitting examinations to giving presentations and conducting important negotiations. These “cognitive enhancers” – such as antidepressants, beta blockers (used to treat heart conditions or anxiety) or “smart drugs” – can boost energy and mood, helping us to perform better with less sleep. But is it safe for healthy individuals to take such drugs? And is it right?

Smart drugs include modafinil (commonly used to treat sleep disorders) and methylphenidate, also known as Ritalin (used to treat ADHD). These drugs make us more attentive, focused and awake – so it’s easy to see why they are so popular. In today’s knowledge economy, we need dynamic and flexible brains to excel in the workplace. Demanding jobs require us to be adaptable and able to make decisions under time pressure or high levels of risk. We need to be attentive, have good memory and great planning and problem-solving skills, but also the ability to read and understand others’ views. Maintaining motivation and resilience in difficult situations and under stress are also key.

We are only starting to understand how widespread the use of smart drugs is. In a 2008 online poll by the journal Nature of 1,400 people in 60 countries, one in five reported they were using cognitive-enhancing drugs to stimulate their focus, concentration or memory. This study looked specifically at the use of beta blockers, Ritalin and modafinil.

Meanwhile, a 2015 survey of some 5,000 workers at a German health insurance company estimated that about 6.7% were using drugs to enhance their performance or cope with anxiety, up from 4.7% in 2009. However the real number could be much higher, as some people may be reluctant to report such use. Studies have also estimated that some 10%-15% of students worldwide use cognitive enhancers including Ritalin and modafinil.

Promising effects

̽��ֱ�� students and academics typically say they use cognitive enhancers for three main reasons: to gain the competitive edge; to overcome the effects of jet lag or insufficient sleep in order to stay awake and alert and to perform at peak level; and to increase work-related motivation. We know that if tasks are boring, it is difficult to get into the flow – and much easier to procrastinate and surf our favourite websites instead.

In my own laboratory, we have assessed the effects of both modafinil and methylphenidate (Ritalin). We saw improvements in a wide variety of cognitive functions, including sustained attention or concentration, memory, planning and problem solving. In addition, modafinil enhanced task-related pleasure or motivation.

But it’s not just about improving performance at “everyday jobs”. For certain members of our society, such as doctors or those in the the military and air traffic control, cognitive enhancing drugs such as modafinil could turn out to be lifesavers. Indeed, we have found that sleep-deprived doctors might benefit from modafinil in situations that require efficient information processing, flexible thinking and decision making under time pressure.

In these studies with modafinil, side effects are relatively low. But while this all sounds positive, these are early studies on a limited number of people. Given the increasing use of such drugs, we urgently need long-term studies of their safety and efficacy for use by healthy people.

Games and brain stimulation

Of course, drugs are not the only way to boost our cognitive abilities. There has also been a proliferation of “brain training” games, many of which make claims that are difficult to substantiate. Last year, my colleagues and I showed how a game, based on scientific data, could be used to improve memory in patients with schizophrenia. With a games developer, we created ̽��ֱ��Wizard Memory Game, which runs as an app on tablets or mobile phones.

Non-invasive brain stimulation devices are also now being used by healthy people, for example “transcranial direct current stimulation”, which uses electrodes placed on the scalp to pass a low electrical current. This may be able to accelerate the learning process – we’re even seeing video gamers using this technology to gain the competitive edge.

If none of this sounds appealing, there is a low-tech solution to artificially boosting your “intelligence”: exercise. This stimulates the production of new brain cells and improves cognition, mood and physical health – and hence better overall well-being.

While there is reason that we should promote improvements in brain health and mental well-being globally, the use of cognitive enhancers that can only be purchased or accessed illegitimately, such as Ritalin, is dangerous and controversial. Some students feel forced to use cognitive enhancing drugs, because they see other students using them and they do not want to fall behind.

In response to concerned students, Duke ̽��ֱ�� amended its honour code in 2011 to state that “the unauthorised use of prescription medication to enhance academic performance” was a form of cheating. Until these cognitive enhancing drugs are approved for use by healthy people, it is best to use other means to boost cognition. Maybe it is also time to consider how we can best promote mental well-being for a more flourishing society.

Barbara Sahakian, Professor of Clinical Neuropsychology, ̽��ֱ�� of Cambridge

This article was originally published on ̽��ֱ��Conversation. Read the original article.

̽��ֱ��opinions expressed in this article are those of the individual author(s) and do not represent the views of the ̽��ֱ�� of Cambridge.

Barbara Sahakian (Department of Psychiatry) discusses 'smart drugs' and other ways to boost our cognitive abilities.

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̽��ֱ��ethics of smart drugs

gm349 — Mon, 31 Oct 2011 10:04:02 +0000

There is an increasing lifestyle use of cognitive enhancing drugs, or smart drugs by healthy people. Why might this be? And how will it change our society? Are people using these drugs just realize their potential, or is it that pressures to perform in a globally competitive environment means that individuals’ feel that they cannot afford an ‘off day’ due to lack of sleep or stress? This is perhaps particularly true of certain professions, where there are issues of safety to oneself or others, such as the military, doctors, etc.

Caffeine is the current stimulant of use for many people, as it is widely available, and effective: however, its wakefulness-promoting effects are transient. For doctors there is the undesirable side-effect of tremors at the dose required for maximum effects (600mg), which is common.

Therefore, it is useful to examine whether there are more effective cognitive enhancers, with fewer detrimental side effects, for those whose failures in attention, concentration and problem solving may lead to deleterious effects, including jeopardy of safety in the military arena, or serious adverse events during operations.

Although measures to reduce doctors’ working hours have been implemented in both the United Sates and Europe, surgeons performing long, arduous operations remain susceptible to the effects of fatigue, and frequent transitions from day to night work expose junior doctors to the risk of impaired psychomotor performance.

Indeed, fatigued doctors risk making poor judgements and committing serious medical errors. Given the continued need for innovation in this area, pharmacological methods could conceivably be used to combat fatigue at some time in the future.

In an exciting collaboration between the ̽��ֱ�� of Cambridge, Department of Psychiatry and the Imperial College London, Division of Surgery, it has recently been discovered that the ‘smart drug’ Modafinil improves cognitive flexibility and reduces impulsivity in sleep deprived doctors. These results have just been published in the journal Annals of Surgery.

In a proof of concept randomized placebo controlled study, run by Charlotte Housden (Cambridge) and Dr Colin Sugden (Imperial), 39 doctors were deprived of sleep overnight and given a dose of 200mg of Modafinil or placebo. ̽��ֱ��doctors taking Modafinil had cognitive improvements, including flexibility of thinking, and reduced impulsivity.

These executive functions are clearly important for conducting surgical operations under stress and time pressure. However, there was no change on their clinical psychomotor performance on a laparoscopic task, which mimics and measures the dexterity necessary to perform surgery.

While a chronic Modafinil study is required to determine the long term effects of the drug as a safe and effective means of improving cognitive impairment due to sleep deprivation, this acute study has demonstrated that benefits are obvious on at least the first occasion.

Given these important findings, it is possible to speculate that doctors who take these drugs may be able to plan an intervention more effectively or show greater cognitive flexibility when approaching a challenging clinical problem. However, it is critical that the long-term safety of the use of these drugs in healthy people remains to be determined.

̽��ֱ��many ethical discussions that I and Charlotte Housden have had with the public on the use of cognitive enhancing drugs by healthy people have been revealing. A variety of views have emerged, ranging from ‘These drugs should only be used by people with neuropsychiatric disorders such as Attention Deficit Hyperactivity disorder, or Alzheimer’s Disease’, to ‘If they are safe, why not use them, to make up for fatigue, to improve memory or other forms of cognition?’, and ‘Why not use them to get in an especially productive working day?’.

This increasing lifestyle use has to be balanced against other important facets of life, such as a good work/life balance. ̽��ֱ��possibility to accelerate into a 24/7 society for many people is a serious concern, as are issues of cheating and coercion.

As a society, we certainly need to be concerned about the use of these drugs by healthy children and adolescents where their brains are still in development. Furthermore, the purchasing of prescription medication over the internet is dangerous. However, if long-term safety and efficacy are proven in healthy people, it may well be, at least for certain segments of the population, these drugs will prove life-savers.

Professor Barbara Sahakian, Professor of Clinical Neuropsychology at the ̽��ֱ�� of Cambridge, has been researching cognitive enhancers for over a decade. Here she discusses the emergence of ‘smart drugs’ and the ethical and practical issues they raise.

If long-term safety and efficacy are proven in healthy people, it may well be, at least for certain segments of the population, these drugs will prove life-savers.

Professor Barbara Sahakian, Professor of Clinical Neuropsychology at the ̽��ֱ�� of Cambridge

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