LiveLongAgeWell

A LLAW reader several days ago mentioned that it sounded like I advocated use of “mind drugs” to enhance mental performance (post: the new drug war…move over marijuana). I told her that I didn’t either advocate or vilify their use, but the subject deserves our consideration. All of us interested in potential advances in better aging will be increasingly exposed to—perhaps seduced by—the possibility that a prescription drug might boost mental performance and diminish the need or desire to sleep. Some have exclaimed: welcome…the age of cosmetic neurology is almost here!

In a recent journal Nature, seven prominent scientists argued that these drugs should be legal and more available for otherwise normal, healthy people who simply want a mental boost (“cognitive enhancement”). They stated

cognitive enhancement has much to offer individuals and society, and a proper societal response will involve making enhancements available while managing their risks.

Among those in-the-know, the main player in this field of pharmaceutical grade cognitive enhancements is modafinil (trade name Provigil). I haven’t taken it so I can’t speak from experience, but My Experience With Smart Drugs is a London journalist’s story about his use of the medication over several weeks. His report is glowingly positive. He wrote that he accomplished significantly more focused work while taking modafinil, and seemingly without side effects. He only stopped the drug after he became concerned about potential long-term brain damage.

Until recently, most user reports about modafinil have been positive, or at least neutral, with no significant side effects noted. Lately though, there has been somewhat of a backlash against the drug, and a National Institute on Drug Abuse study published in the March 18 Journal of the American Medical Association demonstrated, by using PET brain tomography scans, that modafinil increased brain dopamine levels. The conclusion was the drug carries a significant addiction risk, similar to cocaine. The authors noted, however “reports of modafinil abuse are rare and much less frequent than those for stimulant drugs” [such as Ritalin]. They also mentioned a significant blood pressure and heart rate increase with the drug.

But the big fear with modafinil is what was voiced by the London journalist: are there long-term deleterious brain effects? No one knows, especially since researchers are uncertain how the drug actually works, making the whole adventure rather more scary. Might it increase the risk of dementia and, by making thinking “easier” in the short term, thereby making the brain lazy and less creative?  (Brain function, similar to that for muscles, improves through synapse creation which is stimulated by mental effort.)

And indeed, could use prove to be physically or psychologically addicting?  From experience with other drugs, often serious side effects, such as addiction, only show up years later. Valium, for example—passed out almost indiscriminately during the 60s—only years later was discovered to be addictive, leaving a wake of angry patients who, after years of free use, were forced (to try) to wean off.

Next post…brief wrap-up on cognitive enhancement drugs.