Pills or Push-Ups? Effectiveness and Public Perception of Pharmacological and Non-Pharmacological Cognitive Enhancement

Abstract

We review work on the effectiveness of different forms of cognitive enhancement, both pharmacological and non-pharmacological. We consider caffeine, methylphenidate, and modafinil for pharmacological cognitive enhancement (PCE) and computer training, physical exercise, and sleep for non-pharmacological cognitive enhancement (NPCE). We find that all of the techniques described can produce significant beneficial effects on cognitive performance. However, effect sizes are moderate, and consistently dependent on individual and situational factors as well as the cognitive domain in question. Although meta-analyses allowing a quantitative comparison of effectiveness across techniques are lacking to date, we can conclude that PCE is not more effective than NPCE. We discuss the physiological reasons for this limited effectiveness. We then propose that even though their actual effectiveness seems similar, in the general public PCE is perceived as fundamentally different from NPCE, in terms of effectiveness, but also in terms of acceptability. We illustrate the potential consequences such a misperception of PCE can have.

Why is Cognitive Enhancement Deemed Unacceptable? The Role of Fairness, Deservingness, and Hollow Achievements

“…Research has demonstrated that these substances can have performance-enhancing effects in healthy individuals, for example by improving memory or attention (for reviews, see Repantis et al, 2010 ; Battleday and Brem, 2015 ; Ilieva et al, 2015 ). However, current PCE cannot enhance performance to more than modest degrees at best, depending on individual baseline performance ( Husain and Mehta, 2011 ; Caviola and Faber, 2015 ). Some societies have witnessed a rise in the use of PCE ( Care Quality Commission, 2013 ).…”

Social Policy and Cognitive Enhancement: Lessons from Chess

“…Further relevant evidence could be gathered by comparing thresholds between traditional and pharmacological enhancers, not only between currently permitted and prohibited substances. In one recent overview, non-pharmacological enhancement practices, such as naps, were found to be as effective as pharmacological enhancers such as Modafinil, methylphenidate and caffeine [ 57 ].…”

Pharmakologisches kognitives Neuroenhancement und Neurotransmittersysteme

“…Demzufolge gilt Dopamin als der zentrale und entscheidende Neuromodulator von Belohnungsverhalten und frontalhirnassoziierten Leistungen wie Emotionsverarbeitung, Arbeitsgedächtnis und kognitive, exekutive Kontrolle (22)(23)(24). In Metaanalysen konnten positive Effekte von MPH auf Gedächtnisleistungen und Lernen bei Gesunden nachgewiesen werden (25,26). Weiterhin scheint MPH zu einer Verbesserung der Verarbeitungsgeschwindigkeit und Inhibitionskontrolle (26,27) zu führen.…”

“…In Metaanalysen konnten positive Effekte von MPH auf Gedächtnisleistungen und Lernen bei Gesunden nachgewiesen werden (25,26). Weiterhin scheint MPH zu einer Verbesserung der Verarbeitungsgeschwindigkeit und Inhibitionskontrolle (26,27) zu führen. Interessanterweise zeigen Metaanalysen jedoch keine Verbesserung von Aufmerksamkeitsleistungen (25,26) oder sogar eine Verschlechterung dieser kognitiven Funktion bei Gesunden (28).…”