Cognition-Boosting 'Smart Drugs' Not So Smart for Healthy People

Cognitive enhancers, often dubbed as “smart” drugs, might impair performance and productivity in individuals without attention-deficit/hyperactivity disorder (ADHD), according to new research from the University of Cambridge and the University of Melbourne, published in Science Advances.

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.

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In four double-blinded, randomized 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.

‘Smart Drugs’ May Diminish Performance in Those Without ADHD

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.

The participants had to figure out how to best allocate items to the bag, to maximize 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.

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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.

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In terms of “productivity”, 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 (). More research needs to be conducted to find out what effects the drugs are having on users without ADHD.

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These results suggest that these drugs don’t make you ‘smarter’. Because of the dopamine the drugs induce, we expected to see increased motivation, and they do motivate one to try harder. However, they discovered that this exertion caused more erratic thinking.

Performance did not generally increase, so questions remain about how the drugs are affecting people’s minds and their decision-making. The results show researchers have yet to establish the effectiveness of pharmaceutical enhancers on our performance when used by neurotypical people to perform everyday complex tasks.

Hence, drugs that are expected to improve cognitive performance in patients may be leading to healthy users working harder while producing a lower quality of work in a longer amount of time.

References:

Cognitive Enhancement Drug Use Among Future Physicians: Findings from a Multi-Institutional Census of Medical Students - (https://link.springer.com/article/10.1007/s11606-012-2249-4)
Are prescription stimulants “smart pills”? The epidemiology and cognitive neuroscience of prescription stimulant use by normal healthy individuals - (https://psycnet.apa.org/record/2011-18633-001)
Not so smart? “Smart” drugs increase the level but decrease the quality of cognitive effort - (https://www.science.org/doi/10.1126/sciadv.add4165)

Source-Eurekalert