Pharmaceutical Cognitive Enhancement Research Articles

Balancing consumption and constraint: Binge drinking, stimulant misuse, and relational capital among young adults

Peer relations inform consumption practices that shape both alcohol use and prescription drug misuse. Integrating studies on pharmaceutical cognitive enhancement with research on consumptive based edgework, this paper examines the role of psychostimulant medications in resolving contradictory aspects of contemporary peer building processes. Drawing on qualitative interviews (n = 162) from a U.S. based study on the context of young adult prescription drug misuse, we demonstrate how medical resources are incorporated into peer bonding rituals in order to enhance consumptive capacity, reduce social risks, and facilitate the accumulation of relational capital. These findings highlight the paradoxical and problematic health ramifications of consumptive based peer bonding practices as well as how psycho-stimulant medications may compound those issues in unintended ways.

Intellectual Doping and Pharmaceutical Cognitive Enhancement in Education: Some Ethical Questions

Intellectual Doping and Pharmaceutical Cognitive Enhancement in Education: Some Ethical Questions

Surveying the Use of Pharmaceutical Cognitive Enhancers in the Australian Financial Services Industry

The non-medical use of pharmaceuticals such as methylphenidate and modafinil for cognitive enhancement has been explored in college students, medical students and various professions in the US and Europe. We present results of an anonymous online survey of such use among members of the Australian financial services industry. Our hypothesis was that industry sectors would report different preferences for different drugs, reflecting different workplace task demands. The survey was advertised to industry groups, online media articles, and social media outlets between September 2016 and October 2017. Industry sector, hours worked per week, and other demographic and personal health factors were also surveyed. 372 responses were received, of which 140 were valid and complete, and 69 were variously incomplete but usable. Different sectors of the financial services industry reported significantly different rates of use among colleagues. Respondents from different industry sectors also nominated different substances as most prevalent with significantly different frequencies. There was a significant difference in reported hours slept per night between those who reported workplace use and those who did not. A number of side effects were also reported, including headaches and mood swings. This is an important first step in exploring the use of attempts at pharmaceutical cognitive enhancement in competitive professional workplaces with diverse task demands.

Enhancement imaginaries: exploring public understandings of pharmaceutical cognitive enhancing drugs

The growing use of psychoactive substances in everyday life, the increasing experimentation among users and the potential of poly drug use for non-medical, lifestyle or enhancement purposes presents an evolving policy challenge. The paper aims to build on previous research to gain a more in-depth qualitative understanding of the imaginaries around pharmaceutical cognitive enhancement (PCE). It focuses in particular on how the so-called pharmaceutical cognitive enhancing drugs (PCEDs) might be used and the social acceptability of these uses across multiple social contexts and groups. Data come from 23 focus groups (99 participants), representing a wide range of social groups, recruited in the UK. We discuss four distinct ‘enhancement practices’ where PCE use was conceptualised as a way to (1) become the best version of oneself; (2) gain a competitive edge over others; (3) for personal achievement or well-being; and (4) promote personal/public safety. The findings problematise the term ‘enhancement’ by showing the different ways in which the use of pharmaceutical ‘enhancement’ drugs can be imagined and understood. We argue for the value of policy responses that acknowledge and respond to a wider range of enhancement practices including those of prospective user groups.

Academic Carelessness, Bootstrapping, and the Cybernetic Investigator

The following discussion is concerned with certain forms of poor practice in academic publishing that give rise to “academic urban legends.” It suggests that rather than simply consider phenomena such as poor citation practices and circular reporting as mistakes, misunderstandings, and evidence of lack of rigor, we might also read them as evidence of a particular kind of creativity—for which misunderstandings, assumptions, and failures of diligence are mechanisms by which potentially influential ideas manifest. Reflecting particularly on a critique of the debate surrounding pharmaceutical cognitive enhancement and its use by university staff and students, the following will argue that investigators within the disciplines concerned with the effects or development of these technologies are themselves implicated as potential subjects. Alongside reflections from science fiction studies that offer insights into the experiential dimension of reading and misreading, this paper offers some insights regarding how we might think of mistakes and misunderstandings as a form of bootstrapping and a source of creativity in scientific and technological development.

Pharmaceutical Cognitive Enhancement in Greek University Students: Differences Between Users and Non-Users in Social Cognitive Variables, Burnout, and Engagement

ABSTRACTPharmaceutical cognitive enhancement (PCE) represents the non-medical use of prescribed medication for the improvement of cognitive functioning and academic performance. Although there are some studies about PCE prevalence, it is less clear how users and non-users of PCE substances differ with respect to their positive and negative student experiences (e.g. academic burnout and engagement with studies) and in social cognitive variables that relate to decision-making and self-regulation of PCE use. The present study assessed whether students with different experiences of PCE substance use displayed differences in academic burnout, study engagement, and social cognitive variables relevant to PCE use. Three hundred and forty-seven university students (mean age (M) = 22.15 years, SD = 1.69; 54% females) completed a battery of anonymous questionnaires on academic burnout, engagement with studies, social cognitive variables relevant to PCE use, and self-reported use of PCE substances and non-prescribed nutritional supplements. Three user groups emerged, namely non-users (51.9%, n = 180), single users of non-prescribed dietary supplements (25.4%, n = 88), and dual users of both non-prescribed dietary supplements and PCE (22.8%, n = 79). Multivariate analysis of variance indicated significant differences among the three user groups in intentions, attitudes, social norms, and anticipated regret toward PCE use. No significant differences were observed with respect to academic burnout and work engagement. The findings show that university students may engage in PCE use independent of their student experiences. Rather, a chemically assisted performance enhancement mindset seems to differentiate users from non-users of PCE substances.

Classics in Chemical Neuroscience: Methylphenidate.

As the first drug to see widespread use for the treatment of attention deficit hyperactivity disorder (ADHD), methylphenidate was the forerunner and catalyst to the modern era of rapidly increasing diagnosis, treatment, and medication development for this condition. During its often controversial history, it has variously elucidated the importance of dopamine signaling in memory and attention, provoked concerns about pharmaceutical cognitive enhancement, driven innovation in controlled-release technologies and enantiospecific therapeutics, and stimulated debate about the impact of pharmaceutical sales techniques on the practice of medicine. In this Review, we will illustrate the history and importance of methylphenidate to ADHD treatment and neuroscience in general, as well as provide key information about its synthesis, structure-activity relationship, pharmacological activity, metabolism, manufacturing, FDA-approved indications, and adverse effects.

Australian University Students' Coping Strategies and Use of Pharmaceutical Stimulants as Cognitive Enhancers.

Background: There are reports that some university students are using prescription stimulants for non-medical ‘pharmaceutical cognitive enhancement (PCE)’ to improve alertness, focus, memory, and mood in an attempt to manage the demands of study at university. Purported demand for PCEs in academic contexts have been based on incomplete understandings of student motivations, and often based on untested assumptions about the context within which stimulants are used. They may represent attempts to cope with biopsychosocial stressors in university life by offsetting students’ inadequate coping responses, which in turn may affect their cognitive performance. This study aimed to identify (a) what strategies students adopted to cope with the stress of university life and, (b) to assess whether students who have used stimulants for PCE exhibit particular stress or coping patterns.Methods: We interviewed 38 university students (with and without PCE experience) about their experience of managing student life, specifically their: educational values; study habits; achievement; stress management; getting assistance; competing activities and demands; health habits; and cognitive enhancement practices. All interview transcripts were coded into themes and analyzed.Results: Our thematic analysis revealed that, generally, self-rated coping ability decreased as students’ self-rated stress level increased. Students used emotion- and problem-focused coping for the most part and adjustment-focused coping to a lesser extent. Avoidance, an emotion-focused coping strategy, was the most common, followed by problem-focused coping strategies, the use of cognition on enhancing substances, and planning and monitoring of workload. PCE users predominantly used avoidant emotion-focused coping strategies until they no longer mitigated the distress of approaching deadlines resulting in the use of prescription stimulants as a substance-based problem-focused coping strategy.Conclusion: Our study suggests that students who choose coping responses that do not moderate stress where possible, may cause themselves additional distress and avoid learning more effective coping responses. Helping students to understand stress and coping, and develop realistic stress appraisal techniques, may assist students in general to maintain manageable distress levels and functioning. Furthermore, assisting students who may be inclined to use prescription stimulants for cognitive enhancement may reduce possible drug-related harms.

Associations Between the Big Five Personality Traits and the Non-Medical Use of Prescription Drugs for Cognitive Enhancement.

While the number of studies of the non-medical use of prescription drugs to augment cognitive functions is growing steadily, psychological factors that can potentially help explain variance in such pharmaceutical cognitive enhancement (CE) behavior are often neglected in research. This study investigates the association between the Big Five personality traits and a retrospective (prior CE-drug use) as well as a prospective (willingness to use CE drugs) measure of taking prescription drugs with the purpose of augmenting one's cognitive functions (e.g., concentration, memory, or vigilance) without medical necessity. We use data from a large representative survey of German employees (N = 6454, response rate = 29.8%). The Five Factor Model (FFM) of Personality was measured with a short version of the Big Five Personality Traits Inventory (BFI-S), which includes: openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism. Together with this, demographic variables such as gender, age, education, and income were used as potential confounders in multiple logistic regression models. Our results show a 2.96% lifetime prevalence of CE-drug use and a 10.45% willingness to (re)use such drugs in the future. We found that less conscientious and more neurotic respondents have a higher probability of prior CE-drug use and a greater willingness to use CE drugs in the future. No significant effects were found for openness, extraversion, or agreeableness. Prior CE-drug use was strongly associated with a greater willingness to take such drugs in the future. This study shows that specific personality traits are not only associated with prior enhancement behavior, but also affect the willingness to (re)use such drugs. It helps increase understanding of the risk factors of CE-drug use, which is a health-related behavior that can entail severe side-effects for consumers. The knowledge gathered can thus help improve interventions aimed at minimizing health problems.

Neuroenhancement in Healthy Adults, Part I: Pharmaceutical Cognitive Enhancement: A Systematic Review

The term neuroenhancement refers to improvement in the cognitive, emotional and motivational functions of healthy individuals through inter alia, the use of drugs. This popular topic attracts attention both from the general public and the scientific community. Our objective is to summarize in a synthetic review the data of randomized placebo-controlled trials that assessed cognitive effects of administration of neuroenhancers in non-sleep-deprived healthy adults compared to placebo. The major outcomes were attention, memory, learning, executive functions, and vigilance/wakefulness. Details on the pharmacological profile, effectiveness and safety for each drug are provided. We classify them according to their recognized major primary mode of action, namely catecholaminergics (methylphenidate, modafinil, amphetamines, tolcapone, pramipexole, guanfacine, antidepressants), cholinergics (nicotine, varenicline, acetylcholine esterase inhibitors, anticholinergics), glutamatergics (ampakines, memantine, Dcycloserine), histaminergics, and non-specified (caffeine, racetams/phosphodiesterase inhibitors and glucocorticoids).

Exploring Some Challenges of the Pharmaceutical Cognitive Enhancement Discourse: Users and Policy Recommendations

The article explores some of the issues that have arisen in the discourse on pharmaceutical cognitive enhancement (PCE), that is, the use of stimulant drugs such as methylphenidate, amphetamine and modafinil by healthy individuals of various populations with the aim of improving cognitive performance. Specifically, we explore the presumed sizes of existing PCE user populations and the policy actions that have been proposed regarding the trend of PCE. We begin with an introductory examination of the academic stances and philosophical issues involved in defining PCE. We then focus on an examination of the population sizes of presumed current PCE users that have been listed in the academic literature on PCE, on presuppositions, which have been problematized by some authors as based on anecdotal or misinterpreted survey data. We follow this with an empirical examination of a potential PCE user population in a national context (students at the University of Ljubljana in Slovenia). We then proceed to examine the regulatory options proposed in the academic literature to address PCE, finally comparing them with an empirical overview of the policy recommendations on PCE produced in the multinational context of several national ethics advisory bodies (EABs) in Europe. Our main conclusion is that there is still little debate among the national EABs on what type of public policy responses, if any, are needed to address PCE in European countries, and that the issues they do address are similar to those discussed and proposed in the academic articles on PCE.

Neuroenhancing public health

One of the most fascinating issues in the emerging field of neuroethics is pharmaceutical cognitive enhancement (CE). The three main ethical concerns around CE were identified in a Nature commentary...

Boosting brainpower? From the medicalisation of cognition to the pharmaceuticalisation of routine mental life

Sociological engagement with debates around the promise, problems and prospects of pharmaceutical cognitive enhancment is still at an early stage. In this paper we attempt to explore how the prospect of cognitive enhancement can be understood using existing sociological concepts of medicalisation, biomedicalisation and pharmaceuticalisation. Drawing on two case studies, that of Mild Cognitive Impairment (MCI) and the use of modafinil to enhance alertness, we discuss the idea of enhancement medicine and the use of cognitive enhancers outside of medical authority. We suggest that whilst all three of the above concepts shed important light on these developments, overlapping and converging as they do in various ways, pharmaceuticalisation provides a more precise sociological term of reference. We end with some suggestions for a research agenda for tracing and tracking trends in pharmaceutical cognitive enhancement over time.

Potenziamento della capacitÀ mentale? Dalla medicalizzazione della cognizione alla farmacologizzazione delle routine mental life

Sociological engagement with debates around the promise, problems and prospects of pharmaceutical cognitive enhancment is still at an early stage. In this paper we attempt to explore how the prospect of cognitive enhancement can be understood using existing sociological concepts of medicalisation, biomedicalisation and pharmaceuticalisation. Drawing on two case studies, that of Mild Cognitive Impairment (MCI) and the use of modafinil to enhance alertness, we discuss the idea of enhancement medicine and the use of cognitive enhancers outside of medical authority. We suggest that whilst all three of the above concepts shed important light on these developments, overlapping and converging as they do in various ways, pharmaceuticalisation provides a more precise sociological term of reference. We end with some suggestions for a research agenda for tracing and tracking trends in pharmaceutical cognitive enhancement over time.

Visions and Ethics in Current Discourse on Human Enhancement

Since it is now broadly acknowledged that ethics should receive early consideration in discourse on emerging technologies, ethical debates tend to flourish even while new fields of technology are still in their infancy. Such debates often liberally mix existing applications with technologies in the pipeline and far-reaching visions. This paper analyses the problems associated with this use of ethics as “preparatory” research, taking discourse on human enhancement in general and on pharmaceutical cognitive enhancement in particular as an example. The paper will outline and discuss the gap between the scientific and technological state of the art and the ethical debates, pointing out epistemic problems in this context. Furthermore, it will discuss the future role of genuine ethical reflection in discourse on human enhancement, arguing also that such discourse needs to include a technology assessment—in the broad sense of the term—which encompasses, inter alia, anthropological perspectives and aspects of social theory.

Zehn Jahre Neuroethik des pharmazeutischen kognitiven Enhancements – Aktuelle Probleme und Handlungsrichtlinien für die Praxis

An evaluating survey of the development of the neuroethics of pharmaceutical cognitive enhancement (PCE) during the last decade, focussing on the situation in Germany, has been undertaken. This article presents the most important conceptual problems, current substances and central ethical and legal issues. Very first guidelines and recommendations for policy-makers are formulated at the end of the text.