While caffeine reigns as the supreme drug of the professoriate, some university faculty members have started popping “smart” pills to enhance their mental energy and ability to work long hours, according to two University of Cambridge scientists who polled some of their colleagues about their use of cognitive-enhancing drugs.
In a commentary published in Nature on Thursday, Barbara Sahakian and Sharon Morein-Zamir revealed the results of an informal survey they conducted of a handful of colleagues who are all involved in studying drugs that help people perform better mentally.
Ms. Morein-Zamir said they asked “fewer than 10" colleagues in different fields who have done research on cognitive-enhancing drugs, such as Provigil, which is approved in the United States to treat narcolepsy and other severe sleep disorders. “We know that some people—academics—they could be philosophers or ethicists or people who do neuroscience, they chose to take some of these drugs,” said Ms. Morein-Zamir.
The notion raises hackles in some parts of academe. “It smells to me a lot like taking steroids for physical prowess,” said Barbara Prudhomme White, an associate professor of occupational therapy at the University of New Hampshire, who has studied the abuse of Ritalin by college students. Revelations about the use of performance-enhancing drugs in professional baseball have stirred public interest recently, and she sees parallels between athletes and assistant professors. “You’re expected to publish and teach, and the stakes are high. So young professors have to work their tails off to get that golden nugget of tenure.”
Perceived Benefits
The poll was not meant to be a comprehensive study, said Ms. Morein-Zamir, a neurocognitive scientist and research associate at Cambridge. Rather, the essay, “Professor’s Little Helper,” is intended to provoke a public discussion of whether society in general, and universities in particular, should regulate the use of available compounds and the more-effective medications that might be developed in the future. “If a drug helps you be more alert but also make better decisions, how does society feel about that?” she asked.
The colleagues they contacted had not used stimulants such as Ritalin or Adderall but had used Provigil, known generically as modafinil. Although it is approved only to treat sleep-related disorders, researchers have found evidence that modafinil can also improve the cognitive performance of Alzheimer’s patients, people with attention-deficit hyperactivity disorder (ADHD), and several other syndromes.
In 2003, Ms. Sahakian and colleagues reported that normal subjects perform better on certain types of cognitive tests and felt more alert after taking modafinil, compared with people who had taken a placebo. Soldiers in Iraq, according to reports, have used modafinil to stay awake and to improve their abilities in combat.
When the Cambridge researchers asked their colleagues why they used modafinil, the answers included “to stay awake, to stay focused, to be on the ball, for sustained hard thinking, to stay focused for extended amounts of time,” said Ms. Morein-Zamir. One academic in the United States obtained the drug from a primary-care doctor and uses it to combat jet lag. A British researcher, who obtained modafinil via an Internet site, said he used it fortnightly to enhance productivity and for important intellectual challenges, wrote the researchers.
When asked whether she uses modafinil, Ms. Morein-Zamir said she “informally tried it.” She felt she was quite productive but said, “I don’t know if I would have been productive otherwise. Personally, I’m not going to be knocking them back every day. But I’m perfectly fine with other people who want to take it.”
Although the drug is not approved to treat jet lag, many doctors are apparently willing to prescribe it for that purpose. Neuroscientists may be the early adopters in academe because they know more about the drug than people in other fields.
“I would say it’s fairly common, by which I mean that I know several people who use it occasionally for purposes of counteracting jet lag,” said Martha J. Farah, a professor of psychology at the University of Pennsylvania. “Many academics do take it for that purpose, often after getting a prescription from their physician.”
But some go beyond using it for jet lag. After Ms. Farah gave a talk on cognitive-enhancing drugs, a graduate student approached her to say that he takes modafinil at the end of each week in order to finish all the work that he was unable to complete. The drug enables him to work all night. “He takes another modafinil to get through the next day, and voila! He’s all caught up,” she said.
Worries About Side Effects
Ms. Farah said she has used modafinil, under a prescription, on two overseas trips and was amazed by its ability to counteract jet lag. “I found myself marveling at just how clearheaded and comfortable I felt,” she said. Given that experience, she said, she was tempted to use it regularly to counteract her normal tendency to get tired in the early evening.
“I have decided not to do it because I have a lingering mistrust of ‘free lunches,’” she said. “This is a little too good to be true. I think as society becomes more experienced with these medications, we’ll have a better sense of what are their hidden downsides.”
For example, she notes, cheating the body of sleep suppresses the immune system and impairs brain functions. “There’s no reason to believe that modafinil is protecting you from these really bad effects of long-term sleep deprivation,” she said.
In fact, although cognitive-enhancing drugs have been on the market for decades (The Chronicle, June 25, 2004), it sometimes takes that long for side effects to become apparent. A major study published in August by the Journal of the American Academy of Child & Adolescent Psychiatry showed that children with ADHD who had taken stimulants grew less than did children with ADHD who did not take the drugs.
Modafinil is widely regarded as having fewer side effects than stimulants like Ritalin, but the Food and Drug Administration in October warned doctors about some rare but potentially serious conditions associated with the drug. modafinil had been linked to skin rashes and hypersensitivity that extends to multiple organs, according to the FDA and to Cephalon, the company that makes the drug. The conditions associated with modafinil can be serious or life-threatening, said the warning. One person died of multiorgan hypersensitivity after taking it. The drug has also caused adverse psychiatric reactions, including anxiety, mania, hallucinations, and the development of suicidal thoughts.
Unfair Advantage?
Even with such warnings, the allure of chemicals that confer an advantage may be hard to resist for academics, given the pressures they face. If there were a cognitive-enhancing drug that did not have side effects, said Ms. Prudhomme White, “would I be tempted? Damn right I would. ... Who wouldn’t be?”
In their Nature commentary, Ms. Sahakian and Ms. Morein-Zamir asked people to consider whether and when cognitive-enhancing drugs are acceptable. While many people might agree that students should not be allowed to use such compounds during, say, a college-entrance exam, society might decide that it was worthwhile for surgeons or air-traffic controllers to use them.
The present suite of cognitive-enhancing drugs confer only minor or moderate benefits, which some say are not much better than caffeine. But researchers will very likely develop more-effective drugs, and then the drive to use them will grow, suggest the Cambridge researchers. “The drive for self-enhancement of cognition is likely to be as strong if not stronger than in the realms of ‘enhancement’ of beauty and sexual function,” they wrote in Nature.
And if that happens, there would be nothing wrong with academics taking such drugs, said John Harris, a professor of bioethics at the University of Manchester School of Law, in England. “If there are effective and safe cognitive enhancers, I see no reason in principle why people should not use them any more than I shouldn’t go to my desk with a cup of coffee.”
The drive to improve performance is nothing new, said Mr. Harris, author of Enhancing Evolution: The Ethical Case for Making People Better, published in October by Princeton University Press. “What are candles and electric light?” he asked. “They’re enabling us to stay up and work. I don’t know if people said this is an illicit form of enhancement.”
But Ms. Farah draws a distinction between coffee and modafinil. “Sometimes a difference in degree is as good as a difference in kind,” she said. “Something that helps you stay awake and functioning for an extra four or five hours is just very different from something that helps you stay awake for an extra day. Even the biggest coffee fiend is not going to be losing a night’s sleep on a regular basis. You just can’t do that comfortably with coffee, whereas with modafinil its frighteningly easy.”