The entire psychiatric profession is built on the notion that taking prescription medications to alter thought and mood is a good idea.
Within the last few years, drug manufacturers have released a number of new medications designed to improve memory, attention, concentration, alertness, learning, and other cognitive functions.
These drugs, called cognitive enhancers, can also boost energy levels and wakefulness, and primarily affect the frontal and parietal lobes.
But in terms of improving cognition, taking pharmaceuticals can be highly problematic: The benefits are limited. The drugs often stop working after a few years or even months.
The longer you take them, the more you are at risk for side effects ranging from hallucinations to high blood pressure. You may also develop a tolerance, requiring you to take higher and higher dosages – which can exacerbate any side effects — to get the desired results. And, people can become addicted to them.
“Present cognitive-enhancing drugs have wide ranging effects and side effects and are not predictable,” warns Dr. Sharon Morein-Zamir of the University of Cambridge. “We also know next to nothing about their long-term effects in healthy people.”
The Drug Enforcement Administration (DEA) classifies Adderall, Ritalin, and other cognitive enhancers as Schedule II controlled substances, putting them in the same category as cocaine and methamphetamine, because of their high potential for abuse.
As Dr. Morein-Zamir notes, side effects are a huge issue with prescription cognitive enhancers:
- Modafinil can cause over a dozen side effects including depression, insomnia, chest pain, heart palpitations, vomiting, bruising, skin rash, blistering, fever, vomiting, anxiety, headaches – and that’s just a partial list. This stimulant drug, introduced in the late 1990s to treat narcolepsy, is currently banned by the World Anti-Doping Agency (WADA).
- Patients who take Adderall can experience painful or burning urination, uneven heartbeats, mood swings, twitching, shortness of breath, seizures, weakness, dizziness, blurred vision, diarrhea, hair loss, and many more unpleasant side effects.
- Ritalin, introduced in the 1950s to treat chronic fatigue, is favored by psychiatrists for children with ADHD. Taking Ritalin can make you feel like you might faint or even cause paranoia. Other problems include numbness or tingling in the hands and feet, sweating, vision problems, fever, stomach pain, nausea, dizziness, aggression, and restless behavior.
On top of all these problems, there is new evidence that prescription cognitive enhancers are largely ineffective at improving thinking, problem-solving ability, and memory.
According to Dr. Rick Nauert, “Efficacy of these drugs for patients with mild cognitive impairment has not been established. A review of published literature finds that cognitive enhancers did not improve cognition.”
The reviewers looked at eight randomized trials of four different prescription cognition enhancers: donepezil, rivastigmine, galantamine, and memantine.
They found that there were limited short-term cognitive benefits and no long-term benefits after about a year and a half. Psychiatrists are well aware that so many prescription drugs just stop working after a time they have a name for the phenomenon: poop-out.
As to the effectiveness of prescription cognitive enhancers even in the short term, results are mixed.
Some studies show modest benefits for mundane tasks that don’t require a high level of thinking or creativity, while others show no improvement in grades or work performance, reports Psychology Today (6/3/2013).
One of the problems is that drugs formulated to improve mental function in people with clinical cognitive impairment, such as Alzheimer’s patients, are now being taken off-label to give a mental boost to people who are not cognitively impaired.
“New drugs that enhance cognition in cognitively healthy individuals present difficult public policy challenges,” explains an article in The MilBank Quarterly. “While their use is not inherently unethical, steps must be taken to ensure that they are safe.”
And the idea that cognitive enhancers actually make you smarter, as depicted in the Bradley Cooper movie Limitless, is a myth. “They do not make people more intelligent,” notes a bulletin from the Australian Drug Foundation (ADF).
The ADF also suggests that natural brain supplements, such as extracts of Bacopa monnieri, offer a safer option to pharmaceutical drugs to enhance cognitive performance – and that the effects are reportedly much longer lasting.
 http://psychcentral.com/news/2013/09/17/cognitive-enhancers-may-do-more-harm-than-good/59619.html Psych Central citing the Canadian Medical Association Journal, undated: Cognitive Enhancers May Do More Harm than Good by Rick Nauert, Ph.D.