Nootropics & Other Cognitive Enhancement

Nootropics (drugs/psychoactive substances) is a form of biological Cognitive Enhancement, i.e., any modification in the biology of a person which increases their cognitive capacities ¹. Apart from drugs (nootropics), alternative biological cognitive enhancements include, possibly, magnetic stimulation.

Note: this page was last updated in November, 2014, and was written by a single author. It does not reflect any consensus on LessWrong.

The most imminent, successful and polemic method is through the use of drugs, substances that alter the functioning of our brain's neurochemistry in order to improve certain aspects of cognition. There is an increasing trend in the use of cognitive enhancement drugs among healthy individuals in schools and colleges^{2 3}. This means this kind of enhancement technology is already in use. The overall impact of a widespread use of these kinds of drugs could be enormous ⁴. However, the whole set of ethical consequences is unknown and subject of on-going developments ^{5 6 7 8 9 10 11}

Examples

Currently, there are several drugs been used as cognitive enhancers by healthy individuals, e.g.: caffeine, ritalin, aderall, modafinil and Aricept. Academic research assessing the risks and benefits of these drugs in the healthy individual have began only recently. In addition, the results of those researches are vastly ignored by most of the concerned population. Three of the most used, promising and known cognitive enhancement drugs are listed in more detail below:

• Caffeine: Perhaps the most used and old cognitive enhancer. Caffeine has an excitatory result in the brain, by partially disabling the process that signals low availability of energy. ¹². Caffeine and its metabolites also increase the serum concentration of adrenaline, thus increasing heart rate, blood pressure and stress ¹³. Many researchers have found a vast number of beneficial cognitive effects, as improved concentration and memory retention ¹⁴. Its beneficial effects on overall health are also documented ¹⁵. However, the American adult male's average dosage^{16 17} surpasses the healthy dosage fourfold. At the average ingested dosage, caffeine has strong detrimental health effects increasing the risk of heart attacks and strokes ^{18 19} and also possess addiction potential, with severe withdrawal symptoms such as depression, irritability, pain and narcolepsy ²⁰.
• Modafinil: Modafinil effects are mediated through the neurotransmitters histamine and dopamine. Histamine regulates the state of wakefulness. Dopamine has important roles on motivation, cognition, reward, attention and working memory ²¹. There are at least 7 studies on the cognitive enhancement properties of modafinil in healthy individuals ^{22 23 24 25 26 27 28 29}. Those studies' results are:
  • Increased new-language learning ³⁰
  • Enhanced performance on tests of digit span, visual pattern recognition memory, spatial planning and stop signal reaction time ³¹.
  • Lower error rate in a visual spatial task³².
  • Improved fatigue levels, motivation, reaction time and vigilance³³.
  • Improvement on spatial working memory, planning and decision making at the most difficult levels, as well as visual pattern recognition memory following delay and subjective ratings of enjoyment of task performance ³⁴ .
  • Decreased impairment in vestibular function in 24h sleep deprived individuals³⁵.
  • Decreased impairment on performance in a flight simulation test in 30h and 40h sleep deprived individuals^{36 37}.
  • No adverse effects were reported in none of these studies, however this wasn't the target of any of them.

Many other studies in non-healthy patients have found some adverse effects³⁸, but have confirmed its safety and - so far - no addiction potential profile. However, research on its long-term safety is deeply needed.

• Aricept(Donepezil): Aricept inhibits the breakdown of acetylcholine. Acetylcholine is a neurotransmitter linked to long-term memory. There are at least two studies with healthy individuals that have found: greater retention of how to perform a set of complex tasks ³⁹ and increased visual and verbal long-term memory ⁴⁰.

Biases affecting our judgment

There are several cognitive biases affecting our judgment on the risks and efficacy of biological cognitive enhancers. Two are worth mentioning:

• Statistical format: we do not update our beliefs correctly when presented with absolute probabilities (i.e.: 10%) - when the information is presented in terms of occurrences (i.e.: one person in ten) the belief update is much more close to bayesian ⁴¹. This bias impairs our ability to use information from scientific research to update our beliefs. One can easily comprehend the risks involved with a certain drug if a friend suffered a heart attack due to its use, avoiding such drug from then on. But reading an abstract number showing the rise in blood pressure – the most important preventable risk factor for death - of caffeine users is much higher than of modafinil users is too far away from the occurrence-based savannah way our brains are accustomed to absorb information ⁴²
• Status quo: a consistent and unjustified tendency to prefer that some parameter stays in the configuration it has always been, over other possible configurations. This tendency can manifest itself by preferring to continue to use a known drug with many side effects over a new safer drug and also impair our judgment of many others technological advancements. When analyzing if a new configuration should be used, Bostrom and Ord ⁴³ suggest the following heuristic: we imagine a scenario were the parameter will naturally change to the new configuration and ask if we would intervene. If we wouldn't intervene, then we have a reason to think the new configuration should be preferred.

Relevance

Bostrom ⁴⁴ argues for the huge impact of cognitive enhancements: "Imagine a researcher invented an inexpensive drug which was completely safe and which improved all‐round cognitive performance by just 1%. The gain would hardly be noticeable in a single individual. But if the 10 million scientists in the world all benefited from the drug the inventor would increase the rate of scientific progress by roughly the same amount as adding 100,000 new scientists. Each year the invention would amount to an indirect contribution equal to 100,000 times what the average scientist contributes. Even an Einstein or a Darwin at the peak of their powers could not make such a great impact. " Even outside the academic community, imagine a drug that improves the efficiency of all employees and workers around the world by just 1%. This would roughly means adding more 1 trillion dollars of production every year to the world gross product. This would be equivalent to the addition of an entire well developed country to the world, Germany for instance.

References

1. SAVULESCU, J. & MEULEN, Rudd ter (orgs.) (2011) "Enhancing Human Capacities". Wiley-Blackwell.
2. Jump up↑ KAPNER, E. (2003) "Recreational use of Ritalin on college campuses". InfoFactsResources – The Higher Education Center for Alcohol and Other Drug Prevention. Available at: www.edc.org/hec/pubs/factsheets/ritalin.pdf (accessed 4 Jan 2006).
3. Jump up↑ TETER, C.J. et al. (2005). "Prevalence and motives for illicit use of prescription stimulants in an undergraduate student sample", J Am Coll Health 53 (2005).
4. ↑ ^Jump up to:4.0^ ^4.1 BOSTROM, NICK. (2008) "Three Ways to Advance Science" For Nature Podcast, 31 January 2008. Available at: http://www.nickbostrom.com/views/science.pdf
5. Jump up↑ SANDBERG, Anders & LIAO, S.M., (2008) "The Normativity of Memory Modification", Neuroethics (2008), (1 2) 85-99.
6. Jump up↑ SANBERG, Anders & SAVULESCU, Julian. (2008). "Neuroenhancement of Love and Marriage: The Chemicals Between Us." Neuroethics (2008) Vol. 1:31-44.
7. Jump up↑ BOSTROM, Nick & SAVULESCO, Julian. (orgs.), (2009) "Human Enhancement". Oxford University Press.
8. Jump up↑ BOSTROM, Nick & SANDBERG, Anders. (2006) "Converging Cognitive Enhancements", Annals of the New York Academy of Sciences, Vol. 1093.
9. Jump up↑ SANDBERG, Nick & SANDBERG, Anders. (2009) "The Wisdom of Nature: an Evolutionary Heuristic for Human Enhancement" in: BOSTROM, Nick & SAVULESCU, Julian(orgs.). Human Enhancement. Oxford University Press, EUA.
10. Jump up↑ BOSTROM, Nick & SANDBERG, Anders. (2009) "Cognitive Enhancement: Methods, Ethics, Regulatory Challenges", Science and Engineering Ethics, Vol. 15, No. 3.
11. ↑ ^Jump up to:11.0^ ^11.1 SQUIRE, Larry R. et al. (orgs.) (2008) "Fundamental Neuroscience." Academic Press. 3a edition.
12. Jump up↑ DEWS, P.B. (1984). "Caffeine: Perspectives from Recent Research." Berlin: Springer-Valerag
13. Jump up↑ BOLTON, Sanford (1981). "Caffeine: Psychological Effects, Use and Abuse". Orthomolecular Psychiatry 10 (3): 202–211.
14. Jump up↑ THOMPSON, Rebecca & KEENE, Karen (2004). "The pros and cons of caffeine". The Psychologist (The British Psychological Society) 17 (12): 698–701.
15. Jump up↑ NCDT (2011). Report of the 2011 National Coffee Drinking Trends (NCDT).
16. Jump up↑ ILLY, A. & VIVIANI, R. (1995) Espresso Coffee: The Chemistry of Quality. San Diego: Academic P.
17. Jump up↑ GREENBERG, J. A. Et al.(2007) "Caffeinated beverage intake and the risk of heart disease mortality in the elderly: a prospective analysis". Am J Clin Nutr 85 (2): 392–8.
18. Jump up↑ LESON. C. L. Et al. (1998) "Caffeine overdose in an adolescent male.". Journal of toxicology. Clinical toxicology Vol. 26 (5–6): 407–15.
19. JULIANO, Laura M. & GRIFFITHS, Roland R. (2004) "A critical review of caffeine withdrawal: empirical validation of symptoms and signs, incidence, severity, and associated features". Psychopharmacology 176 (1): 1–29.
20. ↑ ^Jump up to:20.0^ ^20.1 CAIDWELL, John A. et al. (1999) "The Effects of Modafinil on Aviator Performance During 40 Hours of Continuous Wakefulness: A UH-60 Helicopter Simulator Study." Army aeromedical research unit fort rucker al.
21. ↑ ^Jump up to:21.0^ ^21.1 CAIDWELL, John A. et al. (2004) "The Efficacy of Modafinil for Sustaining Alertness and Simulator Flight Performance in F-117 Pilots During 37 Hours of Continuous Wakefulness." Air Force Research lab brooks AFB TX, Human effectiveness Dir/Biodynamics and protection div.
22. ↑ ^Jump up to:22.0^ ^22.1 LI Yanfeng, ZHAN Hao, XIN Yimei, et al. (2007) "Effects of modafinil on vestibular function during 24 hour sleep deprivation". Frontiers of medicine in China, Vol. 1, Number 2, 226-229.
23. ↑ ^Jump up to:23.0^ ^23.1 BARANSKI, J. V. Et al. (2004) "Effects of modafinil on cognitive and meta-cognitive performance". Hum Psychopharmacol. 2004 Jul; Vol. 19(5):323-32.
24. ↑ ^Jump up to:24.0^ ^24.1 MÜLLER, U. Et al. (2004) "Effects of modafinil on working memory processes in humans". Psychopharmacology (Berl.) Vol. 177 (1-2): 161–9. Cite error: Invalid **<ref>** tag; name "mull1" defined multiple times with different content
25. ↑ ^Jump up to:25.0^ ^25.1 TURNER, D. C et al. (2003). "Cognitive enhancing effects of modafinil in healthy volunteers". Psychopharmacology (Berl.) Vol. 165 (3): 260–9.
26. ↑ ^Jump up to:26.0^ ^26.1 MULLER, U. et all. (2012) "Effects of modafinil on non-verbal cognition, task enjoyment and creative thinking in healthy volunteers." Neuropharmocology: 2012 (In press)
27. ↑ ^Jump up to:27.0^ ^27.1 GILLEEN, J., et al. (2014). "Modafinil combined with cognitive training is associated with improved learning in healthy volunteers--a randomised controlled trial." European Neuropsychopharmacology : The Journal of the European College of Neuropsychopharmacology, 24(4), 529–39. doi:10.1016/j.euroneuro.2014.01.001.
28. Jump up↑ http://www.rxlist.com/provigil-drug/side-effects-interactions.htm
29. Jump up↑ YESAVAGE, et al. (2002). "Donepezil and flight simulator performance Effects on retention of complex skills" NEUROLOGY 2002; 59:123–125.
30. Jump up↑ YESAVAGE, et al. (2002). "Donepezil and flight simulator performance Effects on retention of complex skills" NEUROLOGY 2002; 59:123–125.
31. Jump up↑ POHL, Rüdiger (orgs.). (2005) "Cognitive Illusions: A Handbook on Fallacies and Biases in Thinking, Judgement and Memory". Psychology Press. pp. 61-78
32. Jump up↑ BUSS, David(orgs.). (2005) "The Handbook of Evolutionary Psychology". Wiley, New Jersey. pp. 739-740.
33. Jump up↑ BOSTROM, Nick & ORD, Toby. (2006) "The Reversal Test: Eliminating Status Quo Bias in Applied Ethics". Ethics 116 (Julho 2006): 656-679.