Should physicians prescribe cognitive enhancers to healthy individuals?

CMAJ. Canadian Medical Association Journal

Volumn 185, Issue 12, 2013, Pages 1047-1050

  Forlini, Cynthia ^a,b   Gauthier, Serge ^c   Racine, Eric ^a,b,d  

^a MCGILL UNIVERSITY   (Canada)

^b CLIN RESEARCH INSTITUTE OF MONTREAL   (Canada)

^c MCGILL UNIVERSITY   (Canada)

^d UNIVERSITÉ DE MONTRÉAL   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIDEPRESSANT AGENT; CENTRAL STIMULANT AGENT; CHOLINESTERASE INHIBITOR; DEXAMPHETAMINE; METHYLPHENIDATE; MODAFINIL; NOOTROPIC AGENT;

ALERTNESS; COGNITION; DOCTOR PATIENT RELATION; HEALTH CARE PLANNING; HEALTH CARE SYSTEM; HUMAN; MEDICAL PRACTICE; MEDICAL PROFESSION; MEMORY; MENTAL CONCENTRATION; MOOD; PRESCRIPTION; PREVALENCE; SHORT SURVEY;

EID: 84878986055     PISSN: 08203946     EISSN: 14882329     Source Type: Journal    
DOI: 10.1503/cmaj.121508     Document Type: Article

References (30)

1. Maher B. Poll results: look who's doping. Nature 2008;452:674-5. (Pubitemid 351521058)
2. Wilens TE, Adler LA, Adams J, et al. Misuse and diversion of stimulants prescribes for ADHD: a systematic review of the literature. J Am Acad Child Adolesc Psychiatry 2008;47:21-31.
3. Racine E, Forlini C. Cognitive enhancement, lifestyle choice or misuse of prescription drugs? ethics blindspots in current debates. Neuroethics 2010;3:1-14.
4. Franke AG, Bonertz C, Christmann M, et al. Non-medical use of prescription stimulants and illicit use of stimulants for cognitive enhancement in pupils and students in Germany. Pharmacopsychiatry 2011;44:60-6.
5. Farah MJ, Illes J, Cook-Deegan R, et al. Neurocognitive enhancement: What can we do and what should we do? Nat Rev Neurosci 2004;5:421-5. (Pubitemid 38568502)
6. Babcock Q, Byrne T. Student perceptions of methylphenidate abuse at a public liberal arts college. J Am Coll Health 2000; 49: 143-5.
7. British Medical Association. Boosting your brainpower: ethical aspects of cognitive enhancement [discussion paper]. London (UK): British Medical Association; 2007.
8. Greely H, Sahakian B, Harris J, et al. Towards responsible use of cognitive-enhancing drugs by the healthy. Nature 2008;456:702-5.
9. Commission de l'éthique de la science et de la technologie. Position statement: psychotropic drugs and expanded uses: an ethical perspective. Québec (QC); 2009.
10. Larriviere D, Williams MA, Rizzo M, et al. Responding to requests from adult patients for neuroenhancements: guidance of the ethics, law and humanities committee. Neurology 2009; 73: 1406-12.
11. Rosenfield D, Hebert PC, Stanbrook MB, et al. Time to address stimulant abuse on our campuses. CMAJ 2011;183:1345.
12. Chatterjee A. Cosmetic neurology: the controversy over enhancing movement, mentation, and mood. Neurology 2004;63:968-74. (Pubitemid 39287902)
13. Synofzik M. Ethically justified, clinically applicable criteria for physician decision-making in psychopharmacological enhancement. Neureothics 2009;2:89-102.
14. McCabe SE, Teter CJ, Boyd CJ. Medical use, illicit use and diversion of prescription stimulant medication. J Psychoactive Drugs 2006;38:43-56.
15. Barrett SP, Darredeau C, Bordy LE, et al. Characteristics of methylphenidate misuse in a university student sample. Can J Psychiatry 2005;50:457-61. (Pubitemid 43161798)
16. Hotze TD, Shaw K, Anderson EE, et al. "Doctor, would you prescribe a pill to help me ... ?" A national survey of physicians on using medicine for human enhancement. Am J Bioeth 2011;11: 3-13.
17. Racine E. Pragmatic neuroethics: improving treatment and understanding of the mind-brain. Cambridge (MA): MIT Press; 2010.
18. Canadian Medical Association. CMA code of ethics. Ottawa (ON): The Association; reviewed 2012. Available: www.cma.ca/code-of-ethics (accessed 2012 Nov. 20).
19. Repantis D, Laisney O, Heuser I. Acetylcholinesterase inhibitors and memantine for neuroenhancement in healthy individuals: a systematic review. Pharmacol Res 2010;61:473-81.
20. Repantis D, Schlattmann P, Lainsey O, et al. Antidepressants for neuroenhancement in healthy individuals: a systematic review. Poiesis Prax 2009;6:139-74.
21. Repantis D, Schlattmann P, Laisney O, et al. Modafinil and methylphenidate for neuroenhancement in healthy individuals: a systematic review. Pharmacol Res 2010;62:187-206.
22. Smith ME, Farah MJ. Are prescription stimulants "smart pills"? The epidemiology and cognitive neuroscience of prescription stimulant use by normal healthy individuals. Psychol Bull 2011; 137: 717-41.
23. Godfrey J. Safety of therapeutic methylphenidate in adults: a systematic review of the evidence. J Psychopharmacol 2009; 23: 194-205.
24. Sussman S, Pentz MA, Spruijt-Metz D, et al. Misuse of "study drugs:" prevalence, consequences, and implications for policy. Subst Abuse Treat Prev Policy 2006;1:15.
25. Volkow ND. Long-term safety of stimulant use for ADHD: findings from nonhuman primates. Neuropsychopharmacology 2012; 37:2551-2.
26. Juengst E. What does enhancement mean? In: Parens E, editor. Enhancing human traits: ethical and social implications. Washington (DC): Georgetown Univerity Press; 1998. p. 29-47.
27. Bergström LS, Lynoe N. Enhancing concentration, mood and memory in healthy individuals: an empirical study of attitudes among general practitioners and the general population. Scand J Public Health 2008;36:532-7. (Pubitemid 352044557)
28. Cheshire W. Just enhancement. Ethics Med 2012;26:7-10.
29. Banjo OC, Nadler R, Reiner PB. Physician attitudes towards pharmacological cognitive enhancement: safety concerns are paramount. PLoS ONE 2010;5:e14322.
30. Asscher EC, Bolt I, Schermer M. Wish-fulfilling medicine in practice: a qualitative study of physician arguments. J Med Ethics 2012;38:327-31.