Last week, Nature published an editorial arguing for the mainstream acceptance of “cognitive enhancing drugs”:
Today, on university campuses around the world, students are striking deals to buy and sell prescription drugs such as Adderall and Ritalin — not to get high, but to get higher grades, to provide an edge over their fellow students or to increase in some measurable way their capacity for learning. These transactions are crimes in the United States, punishable by prison.
Many people see such penalties as appropriate, and consider the use of such drugs to be cheating, unnatural or dangerous. Yet one survey estimated that almost 7% of students in US universities have used prescription stimulants in this way, and that on some campuses, up to 25% of students had used them in the past year. These students are early adopters of a trend that is likely to grow, and indications suggest that they’re not alone.
While I agree, in general, with the stance of the editorial – “enhancement” shouldn’t be a dirty word – I think there are two important qualifiers. The first is that every “enhancement” comes with unintended side-effects. The brain is a precisely equilibrated machine. In the case of the ADHD drugs cited in the editorial, the tradeoff might involve creativity. Some of my friends who relied on crushed Ritalin during college used to joke about how the drugs were great for late-night cramming sessions, but that they seemed to suppress any kind of originality. In other words, increased focus came at the expense of the imagination.
It makes perfect sense that such a cognitive trade-off would exist. Paying attention to a particular task – like writing a term paper, or cramming for an organic chemistry test – requires the brain to ignore all sorts of seemingly unrelated thoughts and stimuli bubbling up from below. (The unconscious brain is full of potential distractions.) However, the same thoughts that can be such annoying interruptions are also the engine of creativity, since they allow us to come up with new connections between previously unrelated ideas. (This might be why schizotypal subjects score higher on tests of creativity. They are less able to ignore those distracting thoughts, which largely arise from the right hemisphere.) Here’s what I wrote in my New Yorker article on the anatomy of the insight moment:
While it’s commonly assumed that the best way to solve a difficult problem is to focus, minimize distractions, and pay attention only to the relevant details, this clenched state of mind may inhibit the sort of creative connections that lead to sudden breakthroughs. We suppress the very type of brain activity that we should be encouraging. Jonathan Schooler has recently demonstrated that making people focus on the details of a visual scene, as opposed to the big picture, can significantly disrupt the insight process. “It doesn’t take much to shift the brain into left-hemisphere mode,” he said. “That’s when you stop paying attention to those more holistic associations coming in from the right-hemisphere.”
The second caveat is that modern neuroscience actually has a surprisingly mediocre record of coming up with effective drugs. Although we’ve learned an astonishing amount about how the brain works in recent decades, this basic research has rarely lead to therapeutic breakthroughs. Prozac, after all, was first invented as a treatment for high blood- pressure. (It worked in animals, but not humans.) And even though Prozac and other SSRI’s are prescribed in dizzying numbers, we still don’t know how they really work. (The over-simplified serotonin hypothesis has been largely discredited, as I explain here.) Or look at addiction, one of the most devastating mental illnesses. In recent decades, neuroscience has learned a tremendous amount about the substrate of addiction, with much of the work focusing on the dopamine reward pathway. And yet we’re still giving people methadone, which was invented in 1937. Neuroscience knows a lot about the pathways of long-term memory, having identified plenty of pertinent kinase enzymes (CREB, PKC, etc.) and yet where are the memory enhancing drugs?
The pharmacological failures of neuroscience are entirely understandable. The brain is the most complicated machine in the universe, which means that it’s very hard to fix, and even harder to enhance. Pop those pills at your own risk.