The purpose of this study was to shed light on the topic of performance enhancing drugs used and abused by young adults.  Their ability to alter cognitive functioning is discussed for the performance enhancing qualities, and the possibility of neural plasticity in a developing prefrontal cortex is also discussed with concern shown to the long term effects of these drugs. Three different classes of drugs were studied for their abilities to improve executive functioning, working memory and increase long term potentiation in the various neural pathways. The first class of drugs used in this study is psycho-stimulants, (Methylphenidate and amphetamine) which are commonly prescribed to alleviate the core symptoms of ADHD in adolescents. At optimal therapeutic dosages stimulants have proven effective in increasing attentiveness and working memory, while decreasing drowsiness and hyperactivity. It is known that stimulants such a methylphenidate have become extremely popular on the black market and are used to enhance mental performance in healthy individuals. It is important to mention that healthy individuals in this case are characterized as not suffering from dopamine and norepinephrine deficiencies that would otherwise allow doctors to prescribe a stimulant for pharmacological therapy.

Currently, the military uses these drug to aid soldiers who suffer from extreme sleep deprivation while in combat or operating heavy machinery (i.e. air planes, tanks, etc.). The use of stimulants in this particular field is most certainly not for the treatment of ADHD but rather as a performance enhancing drug. Meanwhile the second drug that was used in this study was Modafinil, which was originally approved by the FDA for the treatment of narcolepsy because of its ability to promote wakefulness. Recently, it has been used by the military in the same way that stimulants are used. Its use as a cognitive enhancing drug is currently being studied, but its effectiveness in increasing attentiveness and decreasing drowsiness is nearly congruent with stimulants like methylphenidate.

Lastly, the class of drugs called Ampakines were studied for their ability to increase the formation of long term memories out of short term memories thus allowing them to be used as a cognitive enhancing drug. The initial purpose of these drugs was to treat Alzheimer’s disease in older individuals. Now, they are being tested in the military for their ability to increase memory without having negative effects on the central nervous system as seen with stimulants and modafinil.

The findings of this study were that both stimulants and modafinil produced cognitive enhancement in healthy individuals. Not surprisingly though, the presence of negative side effects in healthy individuals versus non-healthy individuals (those prescribed the medication to treat an actual condition) were significantly higher. It seemed that in the case of stimulants, individuals who had normal baseline levels of dopamine and norepinephrine were more susceptible to accumulating abnormally high levels of DA and NE thus reversing desired “therapeutic” outcomes. The misuse and abuse of these drugs is extremely common in high school and college aged students that wish to perform better on exams or other areas of academia. In addition to accidental overdoses and illegal exchange of these drugs researchers are strongly concerned with the long term effects that these drugs have on developing brains of their particularly young users and how it relates to long term executive functioning in the prefrontal cortex. It was found that these drugs have a higher affinity to the neural plasticity in the cortical regions of the brain that are responsible for decision making and other adaptive behavior. This area of the brain is host to the receptors AMPA and NMDA which function successfully due to neural plasticity. It was found that increased levels of dopamine (which is the byproduct of these stimulant drugs) causes a disruption of the ion channels associated with these receptors and an internalization of the subunit receptor NR2B located within the NMDA receptor. As a result neural plasticity is diminished and the effects on working memory and long term potentiation are reversed.

Future areas of research are needed on Ampakines in particular because so little information is known about the possible therapeutic usage of these drugs as a cognitive enhancer. In addition to research on the safety of Ampakines, it would be especially helpful to study the possibilities of substance use disorders and addiction with modafinil. One aspect that was mentioned but not covered as part of study itself is the ethical limitations of these drugs for use in healthy individuals. Traditionally, the use of pharmaceuticals is reserved for the treatment of diagnosable conditions and disorders. In light of this study, it is clear that certain pharmaceuticals are being used outside of their intended purpose in order or gain an advantage over other individuals in the same field.

The ethical discussion over cognitive enhancing drugs is quite similar to the discussion of performance enhancing drugs used by professional athletes. The ultimate purpose of an individual using a cognitive or performance enhancing drug is to gain an advantage over another athlete in competition or a student taking the same test. If the National Olympic Committee requires athletes to undergo drug tests for anabolic steroids, why should Universities or Committees of national exams such as the SAT and ACT not require drug testing for illegal stimulant use?

Urban, K., & Gao, W. (2014). Performance enhancement at the cost of potential brain plasticity: Neural ramifications of nootropic drugs in the healthy developing brain. Frontiers in Systems Neuroscience, 8(38). Retrieved October 9, 2014.

 

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