Physicians should not prescribe cognitive enhancers to healthy individuals, states a report being published today in the Canadian Medical Association Journal (CMAJ). Dr. Eric Racine and his research team at the IRCM, the study's authors, provide their recommendation based on the professional integrity of physicians, the drugs' uncertain benefits and harms, and limited health care resources.
Prescription stimulants and other neuropharmaceuticals, generally prescribed to treat attention deficit disorder (ADD), are often used by healthy people to enhance concentration, memory, alertness and mood, a phenomenon described as cognitive enhancement.
"Individuals take prescription stimulants to perform better in school or at work," says Dr. Racine, a Montréal neuroethics specialist and Director of the Neuroethics research unit at the IRCM. "However, because these drugs are available in Canada by prescription only, people must request them from their doctors. Physicians are thus important stakeholders in this debate, given the risks and regulations of prescription drugs and the potential for requests from patients for such cognitive enhancers."
The prevalence of cognitive enhancers used by students on university campuses ranges from 1 per cent to 11 per cent. Taking such stimulants is associated with risks of dependence, cardiovascular problems, and psychosis.
"Current evidence has not shown that the desired benefits of enhanced mental performance are achieved with these substances," explains Cynthia Forlini, first author of the study and doctoral student in Dr. Racine's research unit. "With uncertain benefits and clear harms, it is difficult to support the notion that physicians should prescribe a medication to a healthy individual for enhancement purposes."
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