Thursday, December 20, 2007

Good Dope, Bad Dope - All In The Mind?

When you gaze at the symphony on stage you probably don't expect to be looking into the faces of a bunch of drug users but, guess again.

In the 60's, it was all psychodelic drugs aimed at "expanding consciousness." Today what are becoming in vogue are drugs to focus consciousness and, according to the LA Times, they becoming increasingly widespread among society's movers and shakers:

Despite the potential side effects, academics, classical musicians, corporate executives, students and even professional poker players have embraced the drugs to clarify their minds, improve their concentration or control their emotions.

"There isn't any question about it -- they made me a much better player," said Paul Phillips, 35, who credited the attention deficit drug Adderall and the narcolepsy pill Provigil with helping him earn more than $2.3 million as a poker player.

The medicine cabinet of so-called cognitive enhancers also includes Ritalin, commonly given to schoolchildren for attention deficit hyperactivity disorder, and beta blockers, such as the heart drug Inderal. Researchers have been investigating the drug Aricept, which is normally used to slow the decline of Alzheimer's patients.

They are all just precursors to the blockbuster drug that labs are racing to develop."Whatever company comes out with the first memory pill is going to put Viagra to shame," said University of Pennsylvania bioethicist Paul Root Wolpe.

In the real world, there are no rules to prevent overachievers from using legally prescribed drugs to operate at peak mental performance. What patient wouldn't want their surgeon to be completely focused during a life-or-death procedure? "If there were drugs for investment bankers, journalists, teachers and scientists that made them more successful, they would use them too," said Charles E. Yesalis, a doping researcher and emeritus professor at Pennsylvania State University. "Why does anyone think this would be limited to an athlete?"

In the world of classical music, beta blockers such as Inderal have become nearly as commonplace as metronomes.

The drugs block adrenaline receptors in the heart and blood vessels, helping to control arrhythmias and high blood pressure. They also block adrenaline receptors in the brain. "You still have adrenaline flowing in your body, but you don't feel that adrenaline rush so you're not distracted by your own nervousness," said Dr. Bernd F. Remler, a neurologist at the Medical College of Wisconsin in Milwaukee.

But cosmetic neurology, as some call it, has risks. Ritalin, Adderall and other ADHD drugs can cause headaches, insomnia and loss of appetite. Provigil can make users nervous or anxious and bring on headaches, while beta blockers can cause drowsiness, fatigue and wheezing.

In an article published today in the journal Nature, Morein-Zamir and University of Cambridge neuroscientist Barbara J. Sahakian say that clear guidelines are needed to decide what's fair. It may be reasonable to ban the drugs in competitive situations, such as taking the SAT. But in other cases, they wrote, people such as airport screeners, air-traffic controllers or combat soldiers might be encouraged to take them.

With a slew of memory enhancers in development, the issues are not academic.

Memory Pharmaceuticals of Montvale, N.J., for example, is eyeing drugs to combat those pesky "senior moments" that are considered a normal part of aging."If there were drugs that actually made you smarter, good Lord, I have no doubt that their use would become epidemic," Yesalis said. "Just think what it would do to anybody's career in about any area. There are not too many occupations where it's really good to be dumb."

One thing is obvious. If "cosmetic neurology" becomes accepted it will, in reality, become all but mandatory. It will reach the point where not to use the products brings sharp, and potentially career diminishing, consequences.

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