PMH62 - Evidence for the off-label use of Methylphenidate for Cognitive Enhancement in Healthy individuals

Abstract

Legal indications for the use of methylphenidate are restricted to children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Despite its defined therapeutic indications, there is a trend in non-prescribed methylphenidate off-label use by students and professionals to improve performance. New terms related to this trend: academic doping, nootropic, cosmetic neurology or smart pill. To describe findings and consequences on methylphenidate’s off-label use for cognitive enhancement in healthy individuals. A systematized search was conducted to retrieve the best scientific evidence on the subject available in English, Portuguese or Spanish. One review evaluated nine studies on the use of methylphenidate among healthy medical students. The prevalence was 16%, with no gender difference. However, there was a higher prevalence among those with had a low academic performance. Most students (65.2%) began using the drug after starting college. The use was seasonal throughout the year - periods close to exams or at the end of the semester were associated with a higher demand for the stimulant. There is little evidence in the literature about the effect of methylphenidate on the cognition of those without ADHD. There is no evidence that the drug increases memorization or associative learning, only that it makes people more alert, but with their selective attention capacity reduced. Some studies suggest that stimulants may interfere with neural mechanisms for the consolidation of learning and long-term memory, which is a risk for intellectual performance. Also, methylphenidate increases heart rate and blood pressure, potentially more worrying in adults than children due to possible associations with other substances and reports of sudden deaths and side psychiatric effects. Although we currently live in a highly competitive environment, it’s important to adopt social interventions that focus on the misuse of methylphenidate, alerting the public and focusing on the consequences of its non-prescribed use.