Smart drugs; how much of a risk are you prepared to take?

“We simply don’t know how chronic drug treatment will affect ‘healthy’ brain function in future years.” So says Professor Barbara Shahakian of the University of Cambridge, on the subject of cognition enhancing medications. The newspapers and their online equivalents have recently been full of stories about using such so called ‘smart drugs’, for example to study for exams, but we know very little about them, or about what effect they might have on us in the long term. Such drugs include both Ritalin, prescribed for ADHD and Modafinil, for narcolepsy.

New figures for drugs used to treat Attention Deficit Hyperactivity Disorder (ADHD) show that prescriptions from GPs have risen 56% in 5 years. The media and certain professionals in the mental health field have been quick to assume that GPs are therefore prescribing them less carefully, and raised concerns that such drugs might be ‘abused’ and ‘diverted or misused’. I have my own theory, which is that as the UK’s psychiatrists have become more confident in diagnosing ADHD (GPs don’t generally diagnose it, as it is such a time consuming process) and they have also relaxed the prescribing of the necessary medications from ‘red’ type (consultant only prescription) to ‘amber type’ (meaning the GP can prescribe with consultant support), this would naturally lead to an increase in numbers of GP prescriptions. GPs are not that easy to hoodwink, and no-one will receive a prescription from our GPs, unless they have a well documented consultant diagnosis. My concern therefore is not the increasing numbers of prescription drugs, but the issue of non-prescribed ‘smart drugs’ being used by students to self medicate with the aim of ‘enhancing’ their academic performance.

Some research suggests up to 1 in 10 UK students uses such drugs, and some have written about their experience online. In Oxford the verdict was that Modafinil made only subtle improvements in concentration, but it did make them poo a lot!

It doesn’t yet seem to be quite clear how these drugs work, but it is generally agreed that they stimulate a part of the brain that changes mental and behavioural reactions. Therefore using them to keep yourself working harder for longer without medical advice seems to be a significant risk with regards to potential long term effects on the brain. A recent study by Dr Nora Volkow and colleagues, based on PET scans, suggested that 400mg Modafinil had effects in brain areas known to be involved in substance abuse and dependence. There is also evidence that it will disrupt sleep patterns in the long term, and the ability to make memories.

It seems to defy logic to use drugs to get through exams/ academic work when all the good evidence- based advice is that for sustainable performance humans do best with regular breaks, planned meals, and quality sleep, and even mindfulness/ exercise.


With all these possible risks, I would strongly encourage you to think hard before taking any non prescribed psychostimulants, or cognition enhancing drugs. There might be short term benefits, but are the risks worth taking?