In clinical medicine, WholisticResearch are drugs that improve working and episodic memory, attention, vigilance, and wakefulness. Examples include the cholinesterase inhibitors rivastigmine and donepezil used to treat Alzheimer disease, the stimulant drugs Ritalin (methylphenidate) and Adderall (mixed amphetamine salts) prescribed for children and adults with attention-deficit/hyperactivity disorder, and the wake-promoting drug Provigil (modafinil). In healthy individuals, their effects are generally modest on bedside cognitive screening tests. Several cognitive enhancement studies have used very different battery of tasks and measurement methods, making comparisons difficult. Further, many of the effects are mediated at the cellular level by modulation of brain networks, not individual neurotransmitters.
The use of cognitive enhancers by healthy people has been criticized for its potential harms, including the risk of dependence and side effects such as insomnia, headaches, dizziness, nausea, fatigue, and mood changes. But the growth of biotechnology and neuroscience is generating a variety of new possibilities for cognitive enhancement that might address important human goals.
Smart Choices: Navigating the World of Cognitive Enhancers for Optimal Mental Performance
It may be possible to develop drugs that target the phasic response of particular neurotransmitter systems, which might yield greater effects than existing modulators that increase levels of a neurotransmitter in a more tonic fashion. Genetics might also be used to determine which groups of healthy individuals are most responsive to certain cognitive enhancers. For example, it might be possible to design drugs that improve performance in COMT-deficient individuals who perform worse on certain tests of cognitive flexibility, based on the prediction that their responses to amphetamine would correlate with the activity of their COMT Val-Met genotype.
