Study suggests smart drugs are used for optimization, not self-medication

A study of people using cognition-enhancing drugs without a prescription (conducted in London) found that these individuals had faster reaction and error-correction times with equally accurate automatic responses on cognitive tests compared to their peers not using these drugs. This indicates that users of cognition-enhancing drugs might be using them to enhance their already healthy cognitive function rather than to alleviate deficiencies in cognitive function. The paper was published in the Journal of Cognitive Enhancement.

Cognition-enhancing drugs, also known as nootropics or smart drugs, are substances that aim to improve mental functions such as memory, attention, creativity, or motivation. Some of these drugs are prescribed for medical conditions that impair cognition, like ADHD, Alzheimer’s disease, or narcolepsy.

Common examples include stimulants such as methylphenidate and modafinil, which can enhance alertness and concentration. Others, like donepezil or memantine, target neurotransmitter systems involved in memory and learning in dementia patients. There are also over-the-counter supplements, such as caffeine, ginkgo biloba, and omega-3 fatty acids, that are sometimes marketed as natural cognitive enhancers.

While these substances can provide short-term benefits, their long-term effects on healthy individuals are less clear. Misuse or overuse of prescription cognition-enhancing drugs can lead to side effects such as anxiety, insomnia, or dependence.

Study author Rachel D. Teodorini and her colleagues wanted to investigate whether the cognitive functions of individuals who use modafinil or methylphenidate differ from those of non-users. They also wanted to see whether individuals who use these drugs without a prescription do so to compensate for a cognitive deficit or to enhance their otherwise healthy cognition.

Study participants were recruited through two online forums—Bluelight and Reddit—and via advertisements placed at the London South Bank University campus in Elephant and Castle in Central London.

A total of 90 participants completed the study. Of these, 47 used cognition-enhancing drugs without a prescription. More specifically, 28 reported using only modafinil, 6 reported using only methylphenidate, and 13 reported using both. Seventy-seven percent of participants were male. Their average age was 30. Sixty-eight percent had a university education. Fifty-one percent of cognition-enhancing drug users reported that they were currently studying for a qualification, compared to 88% of participants not using these drugs.

Study participants completed a questionnaire that asked about their demographic data, mental health, and drug use habits. They also completed two cognitive tasks—the Antisaccade task and the Arrow Flanker Task—and self-reported their executive functioning quality (using the BRIEF-A questionnaire). The Antisaccade Task measures inhibitory control and the ability to suppress automatic eye movements, while the Arrow Flanker Task measures attention and cognitive control by assessing how well a person can ignore distracting stimuli.

Results showed that participants who used cognition-enhancing drugs tended to be faster to respond and correct errors in the cognitive tasks, while being as equally accurate as their non-using peers. Also, the use of cognition-enhancing drugs was not associated with any self-reported measures of cognitive functioning.

The study authors state that this suggests users of (unprescribed) cognition-enhancing drugs are not individuals with poorer cognitive functions who are self-medicating. Rather, they seem to be individuals with healthy cognitive functions who wish to enhance them through the use of drugs.

“The data reported here suggest that some CED [cognition-enhancing drug] use may be motivated by optimization of function and not self-medication of problems, perceived or otherwise, with the endogenous control of attention,” the study authors concluded.

The study contributes to the scientific understanding of the psychological characteristics of individuals using cognition-enhancing drugs without a prescription. However, it should be noted that the study was conducted on a relatively small sample of participants from a single, relatively small geographical area (London). Results from larger groups and groups from other cultural and geographical regions may differ.

The paper, “The Cognitive Performance of Unmedicated Off‑Prescription Users of Modafinil and Methylphenidate,” was authored by Rachel D. Teodorini, James H. Smith‑Spark, and Nicola Rycroft.