Thursday, May 22, 2008

On the mind

In laboratories around the world, scientists are hard at work at making drugs to treat diseases based in the brain such as Parkinson's, Alzheimers and schizophrenia. Many of the drugs they are creating are specific to the disease, others are not and these offer to enhance cognitive abilities such as memory and learning. The fascinating thing about these drugs is that if taken by normal people, they may offer cognitive enhancement.

This is the lesson we have already learnt from drugs such as Ritalin and Provigil. Many people with no form of disease or disorder are now taking them as cognitive enhancers. In the case of Ritalin, it is reasonable to state that the drug is possibly one in which the risks of off-label use outweigh the benefits. It is an amphetamine-like drug that can be addictive. In the case of Provigil (also known as modafinil) the side effects are smaller, and people using it to maintain alertness when they are working late are likely to report far fewer side-effects than drinking a lot of coffee.

The comparison of coffee is worth bearing in mind. It is a drug that practically everyone takes, and it does have side effects. Just because it comes from nature doesn't make it any better than something out of a laboratory.

This brings us to the question of whether we should welcome or fear the new generations of cognitive enhancing drugs that are likely to arrive? And as they arrive, so will the potential for use "off label" by people who are not sick. People worry about a society where everyone is doing drugs but they forget or choose to ignore the various stimulants already used from caffeine to ginseng. While it is true that there are potentially medical risks of a new generation of cognition-enhancing drugs (as well as ethical issues), it be wrong to fear their arrival and legislate against them as a whole.

Policies need to be based on the each drug's potential for harm. If these new drugs are generally safe, and people want to take them, it would be wrong to criminalise this behaviour or even set up punitive measures. Some of these drugs may be a good thing, offering us real benefits—particularly as we age. Mental acuity starts to fail when we get older. Just because such mental failings are not given (at present) any specific medical label, doesn't mean that they don't have a legitimate use for cognition enhancing drugs.

Even if you hate the idea of a society where lots of people are taking cognitive enhancing drugs or one where many people feel obliged to take them, there is very little that can be done to eradicate it. People need to be realistic about what government legislation can, in any case, do about off-label drug use.

Taking a punitive approach to cognition enhancers pre-judges who has a legitimate use for them. In twenty or thirty years from now, many impairments of the brain will be recognised as legitimate reasons for the use of cognitive enhancers. Wouldn't it be a shame if the first generation of people who found a use for them were punished.

Cognitive enhancement: All on the mind
Prepare for drugs that will improve memory, concentration and learning May 22nd 2008

Leaders: Smart drugs