Pharmacological Neuroenhancement Research Articles

On pharmacological neuroenhancement as part of the new neurorights' pioneering legislation in Chile: a perspective.

The so-called neurorights are emerging human rights, or rather reconfigurations of already existing human rights, seeking to address the impact of the possible misuse of neurotechnologies, which have the potential to become more invasive and harmful in the future if not regulated. The aim of specifying neurorights is to protect the dignity and autonomy of the individual in the face of neurotechnological advances. Recently, Chile proposed a Constitutional reform inspired by the neurorights, opening a debate. One of the proposed neurorights is fair and equitable access to cognitive enhancement, which will be the specific object of this perspective article. Starting from the legal proposal, we analyse and discuss some perspectives on cognitive enhancement, or "neuroenhancement", which could be considered as part of enhancement neurotechnologies, pointing out that pharmacological enhancers, or "smart drugs", might be considered as part of these enhancers. We present a classification of the different types of cognitive enhancements as it has been proposed in the literature, into which pharmacological cognitive enhancement can be included, concluding that there is currently no agreement amongst scholars and lawyers about the ethical consideration of pharmacological cognitive enhancement. We therefore argue that it is necessary for the legislator to explicitly address the issue in the proposed regulations, in order to take a clear position on the topic, as it has been done in the United Kingdom, where the pharmacological neuroenhancers have been explicitly excluded from the regulation. If pharmacological neuroenhancers are going to be considered neurotechnologies, then new law proposals should seek harmonization with the already existing legislation regulating pharmacological health and consumer rights (both globally, taking into account international drug laws, and locally, according to each country's internal regulations) and of course, with the whole system of fundamental rights. Finally, we briefly discuss the ethical problem of equitable access to this new type of neurotechnologies (as part of the neurorights) and leave the debate open for new insights from the scientific community on the possible consequences of including (or not) pharmacological neuroenhancers as neurotechnologies for cognitive enhancement in the framework of the ethical and legal debate.

The relevance of pharmacological neuroenhancement for stress and resilience-A multistudy report.

Pharmacological neuroenhancement (PNE) is discussed as coping strategy in academic and work-related contexts. Depending on the definition of PNE and sample population, different prevalence rates for various groups have been reported. In the three parts of the study, prevalence rates for work and student populations in Germany are detected and the reasons for PNE and possible causal associations between PNE, stress and resilience are investigated. In part 1 of the study, 152 occupational physicians (OPs) were surveyed about prevalence rates and reasons for PNE. In part 2 of the study, 1,077 German students reported on their PNE behavior. 704 students were then longitudinally considered to draw conclusions on causal associations between PNE, stress, and resilience. The OPs' estimated prevalence rate of 10.9% in a working population is higher than the prevalence rate of 5.4% for prescription and illicit substances found in the student sample in part 2 of the study. The reason suspected by OPs to be most important for PNE with prescription drugs were performance pressure and long working hours. Using soft enhancers, such as caffeine, is most common with a prevalence rate of 76.8% in the student sample. Stress predicts a higher (β = 0.179, p < 0.001) and resilience a lower use of PNE (β = -0.13, p = 0.001). Resilience predicts a lower (β = -0.35, p < 0.001) and PNE a higher level of stress (β = 0.11, p < 0.001). OPs suspect a prevalence rate of 10.9% among the working population, while we found a prevalence rate of 5.4% among students. Caffeine is the most used substance for PNE, while the use of prescription and illicit substances remains low. Higher levels of stress and lower levels of resilience result in a higher use of PNE. Universities should therefore include the promotion of resilience and methods for dealing with study stress in health programs to reduce PNE.

Focus on neuroenhancement: a systematic review and its ethical implications

IntroductionPharmacological and cognitive neuroenhancement refer to the non-medical use of prescription drugs, alcohol, illegal drugs, or the so-called soft enhancers, to enhance cognition, mood, work or school performance, or to promote pro-social behaviour. Literature on the topic is meagre, and available data only partially enlightens their use.ObjectivesThe aim of this paper is to review and comment on the available literature on pharmacological neuroenhancement and, secondary, on emotional enhancement.MethodsA systematic review was conducted according to the PRISMA guidelines. Pubmed, Scopus, Embase, PsychInfo and Google Scholar databases were accessed to select English language articles, published from 1980 to April 2020. 11746 papers were initially selected and 123 papers were finally included.ResultsAvailable literature indicates a widespread and increasing use of different kinds of substances, drugs and food supplements mainly with neuroenhancing purposes, especially amongst specific populations of young healthy subjects. The evidence regarding their efficacy is controversial. Further, a limited or no awareness regarding the possible consequences of their abuse/misuse emerges amongst users.ConclusionsDespite the limited evidence that some substances may improve cognitive functions in healthy subjects and neglecting their detrimental side effects and potential risk of misuse, abuse and addiction, there is an increasing worldwide use of the so-called neuroenhancers, especially in some categories of individuals, such as university students. Further studies are needed to collect reliable data on the effects of neuroenhancers in healthy subjects. Neuroenhancement puts into question the concept of authenticity, so that the problem requires to be analyzed within a complex ethical conceptual frame.DisclosureNo significant relationships.

The Prevalence of Pharmacological Neuroenhancement Among University Students Before and During the COVID-19-Pandemic: Results of Three Consecutive Cross-Sectional Survey Studies in Germany.

BackgroundAccording to the literature, the conditions of studying and living as well as the psychological, social and health behavior-related variables, which were strongly related to pharmacological neuroenhancement (PN) before the pandemic, significantly changed during the pandemic. For this reason, it is expected that the prevalence of PN among university students is higher during the pandemic compared to before the pandemic. Therefore, the present study aimed to investigate and compare the prevalence of PN among university students before and during the COVID-19-pandemic.MethodsThree online surveys assessing the 12-month prevalence of PN were conducted among university students at the University of Mainz, Germany. The first survey took place in summer term 2019 (before the pandemic), the second in summer term 2020 (during the first German lockdown), and the third in summer term 2021 (after the second German lockdown). Pearson's chi-square test was used to test whether the 12-month prevalence of PN differed significantly between the three surveys.ResultsThe 12-month prevalence of PN was 10.4% in 2019, 11.3% in 2020, and 8.0% in 2021. Chi-square tests revealed no statistical difference in the prevalence of PN between 2019 and 2020. Overall, the use of PN was lower in 2021 compared to 2019 (p < 0.0001) as well as in comparison to 2020 (p = 0.001). Only the use of cannabis slightly increased from 2019 to 2020 (7.1 vs. 8.3%) and decreased in 2021 (5.4%). At all three time points, cannabis was the most commonly used substance for the purpose of PN. Consequently, the results suggest that the prevalence of PN was highly intertwined with the prevalence of cannabis use for PN.DiscussionThe decrease in the prevalence of PN of around three percentage points in 2021 compared to the previous years was a surprising finding. It may be mainly due to the decrease in the prevalence of cannabis for the purpose of PN. However, the fairly high prevalence of PN of around 8% in 2021 is still an important finding that demonstrates that there is still an urgent need for prevention initiatives among university students to combat the use of PN.

Potential risk groups and psychological, psychosocial, and health behavioral predictors of pharmacological neuroenhancement among university students in Germany

Aiming to develop and implement intervention strategies targeting pharmacological neuroenhancement (PN) among university students more specifically, we (1) assessed the prevalence of PN among German university students, (2) identified potential sociodemographic and study-related risk groups, and (3) investigated sociodemographic, psychological, study-related psychosocial, general psychosocial and health behavior related factors predicting the 12-month prevalence of PN. Therefore, a cross-sectional online survey was administered to students of the University of Mainz, Germany. A binary logistic regression with stepwise inclusion of the five variable groups was performed to predict PN. A total number of 4351 students out of 31,213 registered students (13.9%) participated in the survey, of which N = 3984 answered the question concerning PN. Of these, 10.4% had used one substance for PN at least once in the past 12 months. The regression analysis revealed 13 variables that were significantly related to the 12-month prevalence of PN. Specifically, the group of health behavior related variables showed the strongest relationship with PN. Therefore, an approach to the prevention of PN should be multifactorial so that it addresses social conditions, as well as education on substance use and healthy behaviors in terms of non-pharmacological strategies as alternatives of PN.

Psychiatric Comorbidity and Stress in Medical Students Using Neuroenhancers.

Background: Pharmacological neuroenhancement (PN) is a common healthcare problem at least among students. PN seems to be associated with stressful situations. There is a lack of data about personal characteristics, comorbidities, and coping strategies regarding stress and factors of resilience in students and medical staff.Methods: A web-based survey about the non-medical use of PN drugs with a focus on neuroenhancement was developed and distributed among medical students throughout Germany; the questionnaire was open in April and May of 2020. The survey contained questions about the use of well-known PN drugs, frequency, special purposes, reasons for the use, psychiatric disorders, use of psychotropic drugs apart from PN purposes, and factors of resilience using the brief resilience scale.Results: Data of 1,159 students of medicine were analyzed. The most frequently used substances for PN were coffee (78.8% lifetime prevalence rate), energy drinks (45.7%), caffeine tablets (24.3%), methylphenidate (5.2%), illicit amphetamines (2.0%), and cocaine (1.7%). 98.4% suspected that PN drug use could lead to addiction. PN drug use specifically for PN was significantly associated with the use of (a) any psychotropic drug (other than neuroenhancers), (b) any psychiatric disorder, and (c) higher values of feeling pressure to perform in professional/students' life and in private life as well as (d) the subjective feeling of pressure to perform to be burdening and (e) harmful to one's own health. PN drug use in general was significantly associated with being less resilient. The use of illicit PN drugs, over the counter drugs and prescription drugs was associated with being less resilient.Conclusion: This study indicates that PN with legal and illegal drugs is a widespread phenomenon among German medical students. Users seem to be more often burdened by psychiatric disorders, especially addictive disorders, the perception of stress, pressure to perform and low levels of resilience. These aspects should be considered in further investigation of PN drug use.

Pharmacological Neuroenhancement, Perceived Stress, and Resilience in Spine Surgeons–A Cross-Sectional Survey

Spine surgeons are usually exposed to high workload and demanding work conditions. Although the relationship between pharmacological neuroenhancement (PNE) and resilience (i.e., the ability to recover from stress), as well as perceived stress and resilience-enhancing factors, has been investigated in the general population, less is known about the impact of those factors in spine surgeons. This study aimed to close that gap by investigating the relationship between PNE use and resilience, perceived stress, or resilience-enhancing factors in spine surgeons. We conducted a cross-sectional survey in a sample of 582 spine surgeons in German-speaking countries (Austria, Germany, and Switzerland). Potentially predictive variables as well as the use of PNE were assessed by self-report questionnaires. We conducted stepwise logistic regression with backward elimination to assess the relationship among PNE use, perceived stress, resilience, and resilience-enhancing factors. Lifetime prevalence for PNE use was 5.7%, with highest prevalence rates for antidepressants (2.6%). Each additional unit on the Perceived Stress Scale increased the risk for PNE use (odds ratio, 2.271; 95% confidence interval, 0.1.363-3.785; P= 0.002). No statistically significant results were found for the individual ability to recover from stress or resilience-enhancing factors. Spine surgeons with higher levels of stress seem to be more prone to nonmedical use of PNE. Tailored interventions may improve the ability to cope with high perceived stress and prevent the use of PNE. Further research should examine the efficacy of those interventions on the prevention of PNE in spine surgeons.

Just "Like Coffee" or Neuroenhancement by Stimulants?

Introduction: Pharmacological neuroenhancement (PN) is a topic of increasing importance and prevalence among students. However, there is a lack of differentiating PN substances, according to their psychoactive effects. In particular, there is a lack of data about PN by caffeinated drinks, even if coffee is a common and broadly used Neuroenhancer because of its cognitively enhancing effects regarding wakefulness, alertness and concentration.Materials and Methods: A web-survey was developed for German students and alumni about the non-medical use of caffeine for PN contained questions about coffee, caffeinated drinks and energy drinks, caffeine pills and methylxanthine tea regarding frequency and further contextual factors.Results: Six hundred and eighty-three participants completed the survey. Nearly all participants knew about PN (97.7%). 88.1% admitted using some over-the-counter substances. For PN purposes, coffee was used by 72.9% followed by energy drinks (68.2%) and cola drinks (62.4%). Methylxanthine containing tea was used for PN purposes, too (black tea 52.3%, green tea 51.7%). 1.8% admitted using illegal substances or prescription drugs, too.Discussion: Using legal methylxanthine containing drinks for PN seems to be extremely common with coffee and energy drinks being the preferred substances, while illegal and prescription drugs are only minimally used. Further studies should investigate the awareness of methylxanthine containing drinks as well as its character to be a flavoring drink or a neuroenhancer.

Neuroenhancement: State of the Art and Future Perspectives.

Pharmacological neuroenhancement refers to the non-medical use of prescription drugs, alcohol, illegal drugs, or the so-called soft enhancers for the purpose of improving cognition, mood, pro-social behavior, or work and academic performance. This phenomenon is undoubtedly more frequent than previously supposed especially amongst university students.The aim of the present paper was to carefully review and comment on the available literature on neuroenhancement, according to Prisma guidelines.The results showed a great use of all prescribed drugs (benzodiazepines, antidepressants, antipsychotics, nootropic compounds, and especially stimulants) as neuroenhancers amongst healthy subjects, although probably the real prevalence is underestimated. The use of illicit drugs and soft enhancers is similarly quite common. Data on the improvement of cognition by other compounds, such as oxytocin and pheromones, or non-pharmacological techniques, specifically deep brain stimulation and transcranial magnetic stimulation, are still limited.In any case, if it is true that human beings are embedded by the desire to overcome the limits of their intrinsic nature, neuroenhancement practices put into question the concept of authenticity. Therefore, the problem appears quite complex and requires to be deepened and analyzed with no prejudice, although within an ethical conceptual frame.

Eine Längsschnittstudie zur Kausalität zwischen Belastung im Studium, Depressivität und kognitivem Neuroenhancement bei Medizinstudierenden in NRW

A longitudinal study on the causal relationship between study-related stress, depressive symptoms and cognitive neuroenhancement among medical students in NRW Objectives: Medical students report high levels of study-related stress. They are also subject to an increased risk of depression. Study-related stress may lead to the consumption of a range of different substances in order to meet study requirements (pharmacological neuroenhancement = PN). This study therefore investigates the causal links between study-related stress, depression and PN. Methods: In total, 204 medical students in NRW (North Rhine-Westphalia) participated in the online survey [age: M(SD) = 24.1 (3.6); 20.1% male]. A longitudinal design with two measuring points was used with a 4-week interval. In order to measure PN, we asked how often different substances were consumed in the last four weeks to improve performance or reduce stress. The substances in question were divided and weighted according to soft enhancers, prescription drugs and illegal substances. Depressive symptoms were measured with the PHQ9 and study-related stress with the “Higher Education Stress Inventory”. Cross-lagged regression analysis (CLA) was used in order to determine causality. Results: The prevalence rates of depression were very high at 22.5% (t1) and 15.4% (t2). With regard to the causal relationship, study-related stress is a predictor of depressive symptoms but depression is not a predictor of study-related stress. Study-related stress is also a predictor of PN, but PN is not a predictor of stress. Both CLA effects were equally significant for depressive symptoms and PN. Conclusions: Study-related stress is a predictor of depressive symptoms and performance-enhancing PN. No clear causality could be found for depressive symptoms and PN, as they influence each other. Lecturers and university medical institutions should be made aware of the effects of study-related stress and be given appropriate advice in order to prevent depression and PN. Keywords: cognitive neuroenhancement – study-related stressors – medical students – depressive symptoms

Pharmacological Neuroenhancement: Current Aspects of Categorization, Epidemiology, Pharmacology, Drug Development, Ethics, and Future Perspectives.

Recent pharmacoepidemiologic studies suggest that pharmacological neuroenhancement (pNE) and mood enhancement are globally expanding phenomena with distinctly different regional characteristics. Sociocultural and regulatory aspects, as well as health policies, play a central role in addition to medical care and prescription practices. The users mainly display self-involved motivations related to cognitive enhancement, emotional stability, and adaptivity. Natural stimulants, as well as drugs, represent substance abuse groups. The latter comprise purines, methylxanthines, phenylethylamines, modafinil, nootropics, antidepressants but also benzodiazepines, β-adrenoceptor antagonists, and cannabis. Predominant pharmacodynamic target structures of these substances are the noradrenergic/dopaminergic and cholinergic receptor/transporter systems. Further targets comprise adenosine, serotonin, and glutamate receptors. Meta-analyses of randomized-controlled studies in healthy individuals show no or very limited verifiability of positive effects of pNE on attention, vigilance, learning, and memory. Only some members of the substance abuse groups, i.e., phenylethylamines and modafinil, display positive effects on attention and vigilance that are comparable to caffeinated drinks. However, the development of new antidementia drugs will increase the availability and the potential abuse of pNE. Social education, restrictive regulatory measures, and consistent medical prescription practices are essential to restrict the phenomenon of neuroenhancement with its social, medical, and ethical implications. This review provides a comprehensive overview of the highly dynamic field of pharmacological neuroenhancement and elaborates the dramatic challenges for the medical, sociocultural, and ethical fundaments of society.

Beyond Treatment Versus Enhancement: A Qualitative Study of Pharmacological Neuro-Enhancement Among Dutch and Lithuanian University Students

This article examines the ambiguous relationship between treating illness and enhancing normalcy through the use of “cognitive enhancement” drugs. Although the literature on pharmacological neuro-enhancement generally differentiates between the “licit/therapeutic” and “illicit/enhancement” use of substances, in-depth interviews with 35 university students in the Netherlands and Lithuania—both with and without formal medical diagnoses of (mainly) Attention Deficit Disorder and Attention Deficit Hyperactivity Disorder—reveal the fluidity of these categories. Our study of the perceptions and experiences of people who use such drugs further suggests a much broader range of substances, motives, and sought-after effects than are commonly acknowledged in the “cognitive enhancement” literature. We need a more inclusive and context-sensitive approach to study pharmacological neuro-enhancement, for instance, by approaching both licit and illicit drugs as tools or instruments.

Neuroenhancement in four occupations in Germany

The aim of this study was to assess the prevalence of pharmacological neuroenhancement in 4 occupations and to investigate its association with psychosocial working conditions and mental health. In the study on "Neuroenhancement Behaviour in the Context of Stressful Workload - empirical Studies on Employees", 4166 employed physicians, advertising experts, publishers and software developers were surveyed with computer-assisted personal interviews. Lifetime, 12 months and 4 weeks prevalence rates with corresponding confidence intervals were calculated. The association of neuroenhancement with psychosocial working conditions and mental health were estimated in Poisson regression models. The lifetime prevalence of pharmacological neuroenhancement was 8.4%, the 12 months prevalence 2.9% and the 4 weeks prevalence 1.3%. Advertising experts and female software developers showed elevated prevalence rates for neuroenhancement. Psychosocial working conditions, such as support from colleagues, role clarity, emotional demands and job insecurity were associated with neuroenhancement in men. Burnout and depressive symptoms were related to an increase in neuroenhancement. Compared to samples from the general population or the overall working population, the estimated prevalence rates among the investigated occupations were slightly elevated. Burnout and depressive symptoms might operate as potential risk factors or consequences of pharmacological neuroenhancement.

Descriptive assemblage of psychedelic microdosing: Netnographic study of Youtube™ videos and on-going research projects

BackgroundDespite increasing clinical and neuroscientific research, pharmacological neuroenhancement literature rarely discusses psychedelic drugs. However, psychedelic microdosing, the ingestion of sub-perceptual doses of psychedelics like psilocybin, has gained increasing public and scientific attention. Published research on the topic is scarce and systematic studies of the digital milieus surrounding psychedelic microdosing are currently non-existent. MethodsIn this netnographic study, we explore psychedelic microdosing by focusing on Youtube™ and listing current research projects as a descriptive assemblage. We used the Youtube Data Tool (YDT) for data extraction from the YouTube™ platform. We selected videos that specifically focused on microdosing with a psychoactive substance and descriptively analysed the ecology of practices of the six most viewed videos focusing on definitions, dosages per substance and claimed effects. ResultsOur initial data extraction, completed in 2016, resulted in total of 115 Youtube™ videos. Additional data extractions done in 2017 and 2018 showed a 290% increase of “microdosing” videos between 2016 and 2018, indicating that the phenomenon is growing, at least online. The digital milieu of microdosing in 2016 included 48 videos (41,7%) which mentioned a psychoactive substance. The six most viewed videos comprised 92% (N = 934,819) of the total view count and the ecology of practices depicted psychedelic microdosing as beneficial, but the claimed effects and dosing require critical evaluation. Contrary to how typical users of illicit drugs are often portrayed in the media and science, these videos revolved around themes like research, experiments, self-monitoring and the imperative of sharing results. As our descriptive assemblage demonstrates several psychedelic microdosing research projects are under way, potentially influencing user practices and knowledge. ConclusionThis type of online drug research can be used to gather knowledge of under-researched topics, like psychedelic microdosing. However, further digital and non-digital drug research is needed to investigate this potentially rising phenomenon.

Pharmacological neuroenhancement and the ability to recover from stress \u2013 a representative cross-sectional survey among the German population

BackgroundPharmacological neuroenhancement (PNE) refers to the use of psychoactive substances without doctor’s prescription to enhance cognitive performance or to improve mood. Although some studies have reported that drugs for PNE are also being used to cope with stressful life situations, nothing is known about the relationship of PNE and resilience, i.e. the ability to recover from stress. This study aimed at investigating the relationship of PNE and resilience in the first representative population sample.MethodsA cross-sectional survey in a representative sample of 1128 adults (age ≥ 18 yrs.) living in Germany was conducted. The use of PNE and related attitudes, perceptions and behaviours were assessed by structured interviews and self-report questionnaires. Stepwise logistic regression with backward elimination was conducted to identify potential risk factors for PNE use.ResultsLifetime prevalence for the use of stimulating prescription drugs without medical indication was 4.3%, 10.2% for stimulating illicit drugs, 20.3% for mood modulating prescription drugs, and 23.4% for cannabis. Coping with stressful situations was more frequently reported as underlying motive for using stimulant or mood modulating prescription drugs than stimulating illicit drugs or cannabis. The individual perceived stress increased the risk of using stimulating prescription drugs (OR: 2.86; 95% Cl: 1.49–5.46) and the individual ability to recover from stress decreased the risk of using any substance for PNE and especially mood modulating prescription drugs (OR: .62; 95% Cl: .47–.81).ConclusionsThe non-medical use of prescription drugs for PNE appears to be more prevalent in subjects who are less resilient to stress. Tailored resilience interventions that improve the ability to adapt to and recover from stressors may prevent the use of prescription medication for PNE. Further research should disentangle the association between psychological resilience and PNE as well as examine the efficacy of resilience interventions in the prevention of PNE.

Prevalence Estimates for Pharmacological Neuroenhancement in Austrian University Students: Its Relation to Health-Related Risk Attitude and the Framing Effect of Caffeine Tablets.

Background: Pharmacological neuroenhancement (PN) is defined as the use of illicit or prescription drugs by healthy individuals for cognitive-enhancing purposes. The present study aimed (i) to investigate whether including caffeine tablets in the definition of PN within a questionnaire increases the PN prevalence estimate (framing effect), (ii) to investigate whether the health-related risk attitude is increased in students who use PN.Materials and methods: Two versions of a paper-and-pencil questionnaire (first version included caffeine tablets in the definition of PN, the second excluded caffeine tablets) were distributed among university students at the University of Graz, Austria. The unrelated question model (UQM) was used to estimate the 12-month PN prevalence and the German version of the 30-item Domain-Specific Risk-Taking (DOSPERT) scale to assess the health-related risk attitude. Moreover, large-sample z-tests (α = 0.05) were performed for comparing the PN prevalence estimates of two groups.Results: Two thousand four hundred and eighty-nine questionnaires were distributed and 2,284 (91.8%) questionnaires were included in analysis. The overall PN prevalence estimate for all students was 11.9%. One-tailed large-sample z-tests revealed that the PN estimate for students with higher health-related risk attitude was significantly higher compared to students with lower health-related risk attitude (15.6 vs. 8.5%; z = 2.65, p = 0.004). Furthermore, when caffeine tablets were included into the example of PN, the prevalence estimate of PN was significantly higher compared to the version without caffeine tablets (14.9 vs. 9.0%; z = 2.20, p = 0.014).Discussion: This study revealed that the PN prevalence estimate increases when caffeine tablets are included in the definition of PN. Therefore, future studies investigating the prevalence of, and predictors for, PN should be performed and interpreted with respect to potential framing effects. This study further revealed that the PN prevalence estimate is increased in students with a higher health-related risk attitude compared to students with a lower one. Therefore, future education and prevention programs addressing PN in the collective of students should not only inform about potential side effects of its use but also address the limited effects on cognition and potential alternatives of PN.

Doping for the brain

The enhancement of physical and cognitive abilities (i. e. concentration, vigilance, memory) has always been desirable for humans. The term pharmacological neuroenhancement refers to the use of legal or nonprescription psychoactive substances by healthy subjects with the intention of cognitive enhancement. To give the most prominent example, caffeine serves worldwide as anatural stimulant. Brain doping, however, specifies the use of illegal substances or prescription drugs beyond approval with the purpose of cognitive enhancement. Only amphetamines, methylphenidate and modafinil have significant effects on attentiveness, concentration and alertness, whereas other substances, such as anti-dementia drugs or anti-depressants failed to demonstrate cognitive enhancement in healthy subjects.

Sensitivity of Quantitative Signal Detection in Regards to Pharmacological Neuroenhancement

Pharmacological neuroenhancement (PNE) is a form of abuse and has not yet been addressed by methods of pharmacovigilance. In the present study, we tested if quantitative signal detection may be sensitive in regards to PNE. We evaluated the risk of drug abuse and dependence (DAAD) related to substances that are known to be used for PNE and divided this group into agents with (methylphenidate) and without a known abuse potential outside the field of PNE (atomoxetine, modafinil, acetylcholine esterase inhibitors, and memantine). Reporting odds ratios (RORs) were calculated using a case/non-case approach based on global and country-specific drug safety data from the Uppsala Monitoring Centre (UMC). Both control substances (diazepam and lorazepam) and methylphenidate were statistically associated with DAAD in all datasets (except methylphenidate in Italy). Modafinil was associated with DAAD in the total dataset (ROR, 2.7 (95% confidence interval (CI), 2.2–3.3)), Germany (ROR, 4.6 (95% CI, 1.8–11.5)), and the USA (ROR, 2.0 (95% CI, 1.6–2.5)). Atomoxetine was associated with DAAD in the total dataset (ROR, 1.3 (95% CI, 1.2–1.5)) and in the UK (ROR, 3.3 (95% CI, 1.8–6.1)). Apart from memantine, which was associated with DAAD in Germany (ROR, 1.8 (95% CI, 1.0–3.2)), no other antidementia drug was associated with DAAD. Quantitative signal detection is suitable to detect agents with a risk for DAAD. Its sensitivity regarding PNE is limited, although atomoxetine and modafinil, which do not have a known abuse potential outside PNE, and no antidementia drugs, whose use in PNE is presumably low, were associated with DAAD in our analysis.

Pharmacological Neuroenhancement: teachers' knowledge and attitudes-Results from a survey study among teachers in Germany.

BackgroundPharmacological neuroenhancement (PN) is a topic of increasing importance. Its prevalence rates range from 1 % to more than 20 %. Students are a group that shows exceptionally high prevalence rates. However, little is known about teachers’ knowledge, management, attitudes and ethical judgements regarding PN.MethodsA web-based survey containing 40 closed questions was developed. All teachers working at all private and public schools in Mecklenburg-Vorpommern, a state in northeastern Germany, were invited to participate after their respective school offices were contacted by telephone, email and mail.ResultsIn total, 255 teachers participated in the survey. Of those, 73.3 % had already heard about PN in general, and 68.2 % had heard about PN in students. Their sources of knowledge were digital media such as TV (73.8 %) and the internet (40.6 %) and print media (64.7 %); their own students informed 29.9 % of the teachers about PN in general and 35.6 % of them about PN among students. Furthermore, 34.9 % of the surveyed teachers were convinced that PN substance use was ineffective in general, and 51.8 % of the surveyed teachers believed that PN substances were ineffective in achieving better grades. Only 1.2 % thought that none of the so-called PN substances could lead to addiction, and 37.6 % would classify PN substance use as general drug misuse. The highest values regarding risk of addiction were observed for illicit drugs. The prevalence of PN substance use was evaluated to be very low and to be significantly higher in male, highly skilled and college/university students. In total, 1.6 school lessons per year were used to discuss PN. Finally, 55.7 % of the surveyed teachers believed that performance-enhancing substances should be forbidden at schools.ConclusionTeachers, as an integral part of the education of children and adolescents, often know about PN substances and mostly refuse their use being afraid about the risk of addiction. However, regarding effects as well as side effects of PN substances, teachers have very different opinions. Furthermore, they seem to underestimate the prevalence among their students and broach the topic infrequently. Teachers should be sensitized for high prevalence rates and should broach the topic of PN more frequently to their students to prevent potential misuse of PN substances.

Pharmacological Neuroenhancement in the Field of Economics-Poll Results from an Online Survey.

Introduction: The use of over-the-counter, prescription, and illicit drugs to increase attention, concentration, or memory—often called (pharmacological) neuroenhancement—shows a broad range of prevalence rates among students. However, very little data is available on neuroenhancement among employed persons. The aim of this study was to provide first data on substance use for neuroenhancement among readers of the German “Handelsblatt” coming from the field of economics.Methods: Readers of the online edition of the Handelsblatt, a leading print and online medium for the field of economics, were invited to participate in a survey via a link on the journal homepage to complete a web-based questionnaire. Within the questionnaire, participants were asked for their gender, current age, current professional status, hours of work per week, prevalence rates of substance use for the purpose of neuroenhancement as well as for reasons of its use. Binary regression analyses with stepwise forward selection were used to predict the dependent variables “use of illicit and prescription drugs for neuroenhancement” (yes/no), “use of over-the-counter drugs for neuroenhancement” (yes/no), and “use of any drug for neuroenhancement” (yes/no).Results: A total of 1021 participants completed the anonymous survey. Lifetime prevalence for the use of any drug for neuroenhancement was 88.0% and for the use of illicit and prescription drugs for neuroenhancement 19.0%. Reasons and situations that predicted neuroenhancement with illicit and prescription drugs were “curiosity,” “to enhance mood,” ”for a confident appearance,” “stress/pressure to perform,” and “deadline pressure.”Discussion: The study shows that neuroenhancement with drugs is a widespread and frequent phenomenon among people belonging to the professional field of economics. Given in the literature that the use of drugs, especially prescription, and illicit drugs, may be associated with side effects, the high epidemic of drug use for neuroenhancement also shown in the present paper underlines the new public health concern of neuroenhancement.