Pharmacological Cognitive Enhancement in Healthy Individuals: A Compensation for Cognitive Deficits or a Question of Personality?

Abstract

The ongoing bioethical debate on pharmacological cognitive enhancement (PCE) in healthy individuals is often legitimated by the assumption that PCE will widely spread and become desirable for the general public in the near future. This assumption was questioned as PCE is not equally save and effective in everyone. Additionally, it was supposed that the willingness to use PCE is strongly personality-dependent likely preventing a broad PCE epidemic. Thus, we investigated whether the cognitive performance and personality of healthy individuals with regular nonmedical methylphenidate (MPH) use for PCE differ from stimulant-naïve controls. Twenty-five healthy individuals using MPH for PCE were compared with 39 age-, sex-, and education-matched healthy controls regarding cognitive performance and personality assessed by a comprehensive neuropsychological test battery including social cognition, prosocial behavior, decision-making, impulsivity, and personality questionnaires. Substance use was assessed through self-report in an interview and quantitative hair and urine analyses. Recently abstinent PCE users showed no cognitive impairment but superior strategic thinking and decision-making. Furthermore, PCE users displayed higher levels of trait impulsivity, novelty seeking, and Machiavellianism combined with lower levels of social reward dependence and cognitive empathy. Finally, PCE users reported a smaller social network and exhibited less prosocial behavior in social interaction tasks. In conclusion, the assumption that PCE use will soon become epidemic is not supported by the present findings as PCE users showed a highly specific personality profile that shares a number of features with illegal stimulant users. Lastly, regular MPH use for PCE is not necessarily associated with cognitive deficits.

Nonmedical use of prescription drugs for cognitive enhancement as response to chronic stress especially when social support is lacking

“…Social support, which was assumed to be another external resource to achieve valued goals, to deal with problems, or increase well‐being, had no main effect on self‐reported CE‐drug use. Prior studies seem inconclusive with respect to the relation of substance use and support (Maier et al, ; Peck et al, ; Schröder et al, ; Wiegel et al, ), as well as with regard to stress‐buffering effects of support (Peirce et al, ; Steptoe et al, ; Wiegel et al, ).…”

The Use of Prescription Drugs, Recreational Drugs, and “Soft Enhancers” for Cognitive Enhancement among Swiss Secondary School Students

“…It is unlikely that everyone will benefit equally from CE. A recent study suggested that regular users of substances for CE present a personality profile that might explain substance use and efficacy [ 28 ].…”

Drugs, games, and devices for enhancing cognition: implications for work and society

“…25,41 One study reported that people with subclinical traits related to attention deficit hyperactivity disorder (ADHD), impulsivity, and novelty seeking were more prone to using cognitive enhancers. 62 However, it is possible that people self-medicate or at least try to self-medicate for undiagnosed ADHD traits or subjective cognitive deficits, 63 as well as for motivational problems 45,64 and diminished inhibitory control resulting in increased impulsivity. 65 Another study reported similar subjective attention impairments/ADHD symptoms, but also increased omission errors in an attention test in users of (unprescribed) stimulants.…”