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Post by Admin on Sept 14, 2015 18:03:55 GMT -4
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Post by Ramin Ahmad on Sept 15, 2015 9:57:40 GMT -4
A drug that increases cognition in normal people sounds great but there's a great potential for abuse. I don't think it's a great idea to add medication to normal healthy people. Many college students and even high school students abuse amphetamines. It is known that there is a increase patient encounter in the ER due to amphetamines and caffeinated beverages overdose. I think patient's who have had a decrease in cognition that interferes with daily function should be prescribed Modafinil. The study should be done again with a larger amount of patients with emphasis on side effects and long term effects. Modafinil is approved for somnolence/narcolepsy and should remain that way.
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Post by James Paul Moody on Sept 15, 2015 14:58:26 GMT -4
From the beginning of humanity, there has been a constant search for improvement. From the discovery of fire to the practice of modern medicine. There have been many improvements in the area of physical performance enhancers. Many of these improvements have been achieved with many experiments and long term research. There is now a chance for the same determination in discovering performance enhancers for the mind. My humble opinion is that this is an outstanding use of resources. I do however believe it should be done with extreme caution. There is great potential for many things to go wrong and cause more trouble for society. Although there is no true way of knowing the long term effects of anything until the long term becomes the present. There is not a reason to abandon the search for something better that has the potential to help everyone.
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Post by Mario F Vigil on Sept 16, 2015 13:15:44 GMT -4
Interesting article! First we need to keep in mind that most of the studies were done in controlled environments and only looked at the effects of a single dose. It would be hard to argue against promoting the use of a cognitive enhancer like Modafinil, Adderall, or Ritalin if it were risk-free and available to everyone. How many times we had hear that humans only use about 10% of our brain capacity? I think using medication without a medical need may be wrong not because it is physically risky or because it creates an unlevel playing field among other people but because it redefines the nature of human achievement itself.
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Post by Daman Pannu on Sept 16, 2015 17:22:55 GMT -4
Saying that taking cognitive enhancers is cheating seems hypocritical, when 3/4ths of adults in the United States drink coffee. You can say “Sorry I’m a little slow this morning, because I haven’t had my coffee this morning” and you might get a few word of understanding, but if you say something similar about adderall or modafinil, you’ll be judged more harshly. Doping is illegal for athletes because there is a lot of money on the line for the winners; and it’s considered cheating because its gives an advantage to one player that their opponent doesn’t have. The workplace isn’t a sporting event and if someone feels like they need to use modafinil that should be their choice to make.
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Post by Peter Nowd on Sept 16, 2015 20:14:18 GMT -4
The question regarding “smart drugs,” such as Modafnil, Adderall, Ritalin, and Concerta is not only a medical problem but also an ethical quandary. Over the last decade the usage of “smart drugs” has increased dramatically. For instance, according to the article “The Rise of Work Doping in the Atlantic” asserts, “Just 1.5 percent of adults aged 26 to 34 were taking ADHD medications in 2008, but that number had almost doubled to 2.8 percent in 2013…” (Khazan, 2015). Not only have providers increased the dosages the number of non-prescribed usage has also increased.
Medically, this arises many questions. The most significant question is the long term side effects of these stimulants. Although rare, researchers have concluded that these stimulants may have harmful side effects, “ Some research has shown that the long-term use of modafinil can affect sleep patterns. In rare cases and at high doses, stimulants like Adderall have been shown to induce psychosis…”(Khazan, 2015). Thus in many instances, these medications can have positive outcomes, there are instances of poor side effects and more importantly, abuse.
The use of “smart drugs” also has social implications. As the work days increase and competitiveness of many occupations, many seek for an advantage. As a result, more of the population are turning to smart drugs to improve performance. The major dilemma is if or when long-term studies show now long time side effects will it be acceptable upon the population to use these stimulants over the counter.
Reference
Khazan, O. (2015, August 27). The Rise of Work-Doping. Retrieved September 17, 2015.
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Post by Tanzina Nowrin on Sept 16, 2015 22:22:20 GMT -4
The article makes me think, is it possible to improve one's performance by the help of medication, also known as "Smart Drugs". I loved the article but one specific line caught my attention, "Essentially, it can help normal people think better". How do we define "Normal", if it is known as smart drug, it should work equally for everyone, otherwise why should we call it smart drug? Also if a person is normal, he/she should have the highest level of performance without help of any drugs. If someone requires medication to think better or enhance their performance, then I strongly disagree that the person is normal.
I’m not really in favor or against smart drugs but I believe all medication comes with adverse effects and consequences. In my opinion medications should be reserved for the required needs. We should keep the smart drugs reserved for the recommended medical use; we should not use or prescribe it off-label.
Reference: Khazan, O. (2015, August 27). The Rise of Work-Doping. Retrieved September 17, 2015.
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Post by Alicia Capilla on Sept 16, 2015 22:31:42 GMT -4
It was such an interesting article because it talks about a topic I have been concerned since I started my rotations in psychiatry in US. I am so surprised about how many adult people diagnosed with ADHD/ADD seek treatment. I don’t doubt that this is a disorder that affect a vast amount of people. However, I believe that the line that separates “healthy people” from people with the disorder is very diffuse and flexible. I totally disagree with the fact that taking a medication only because it improves your performance, as it is said in the article “the FDA doesn't prioritize approving drugs for healthy people who want to become superheroes.” I would consider doing it like “cheating” or even worse like “losing our own nature.” It is said that the side effects of Modafinil are really low, but I see it more like an ethic issue. I also think that the lifestyle in America regarding intense competition and stress among workers may exacerbate the search for a “miracle” pill that can improve our work. In any case, this is a really fascinating topic to discuss at length.
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Post by Nicole Tipton MS3 on Sept 16, 2015 22:32:51 GMT -4
Stimulant medications are one of the most commonly misused prescriptions among young adults. Like any medications there are certain risk factors associated with such misuse. These include the most common side effect profile of decrease of appetite. Other, less common side effects are addiction to the medication and induction of psychosis. In an academic and health professional world to use these drugs to “get ahead of the game” is unethical. Cognition can be fostered in a way that does not include the use of prescription medication. The question that I pose is; if these medications are used by students during studies to perform at a certain level, what happens when they no longer take these medications? Will their patients suffer? Have they created a sort of dependence of performance based on these drugs? One final thought, how are medical professionals going to teach non-dependence to medications, yet be dependent themselves?
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Post by Ibtesam Haider on Sept 16, 2015 23:15:14 GMT -4
In the fast paced and tech savvy world that we live in now, any edge or advantage is always welcomed when it comes to performance enhancement. I believe that if adults do take a cognitive enhancing drug such as modafinil, within the recommended therapeutic dosage, it will benefit not only the employees of a company to perform at a higher level, but also the company as a whole. Since there are no known serious risk factors/side effects associated with increased usage as of yet, it will only make an individual much more productive and efficient in the work environment. I don’t think its necessarily “cheating” because what about other over the counter or prescribed medications which are being misused by patients because of addiction and why aren’t these medicines being strictly monitored by the FDA? There are a lot of loop holes and contradictions that go against the ethics of medicine and they are constantly brushed aside to concentrate on the business aspect of it. I support this notion of the usage of this drug, within acceptable dosage, for cognitive and performance enhancement.
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Post by Ramez Ghanbari on Sept 17, 2015 0:36:23 GMT -4
Clinical curiosity is the driving force behind the advances in medicine. The article by Khazan O., (2015) clearly demonstrates that we tend to push the frontiers of medicine, even in healthy subjects. The article states that individuals who have taken “smart drugs” such as Adderall and Modafinil showed significant improvement in flexible thinking and cognitive benefits. What’s interesting is that “the longer and the more complex the task, … the more consistently modafinil showed cognitive benefits”. I am, although cautiously, in favor of improving the state of mind and cognitive functioning – even in healthy subjects. After all, these agents enhance neurotransmission by acting on dopamine, norepinephrine and serotonin. We tend to enhance these neurotransmitters in diseased states such as ADHD or even mood disorders. So, why not try it in healthy subjects if it is, indeed, beneficial?! One has to keep in mind the long-term adverse effects of such “smart drugs”. And, this of course requires long-term studies to assess side effects. Another important concern is the issue of abuse, when people tend to overdose the “smart drugs” for a better response; or use these agents in combination with other substances such as alcohol or controlled substances. More studies are definitely needed.
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Post by Jennifer Banarez on Sept 17, 2015 6:36:51 GMT -4
A cognition enhancing drug sounds like every overworked, unmotivated employee or student's dream. In this particular case the main focus is on modafinil. This drug has been approved by the FDA since 1998 to treat excessive sleepiness associated with narcolepsy, obstructive sleep apnea, and shift work disorder. However recently it has gained popularity as being a "cognitive enhancer."
After looking into some studies, in addition to the one stated by the article, a majority of them claim that it helps with decision making and planning. It's effect on memory and learning have not been consistent with the studies I have read. Although the study upon which this article is based on do claim that it enhances memory, learning, decision making and planning there aren't enough studies out yet that are consistent in all those fields. More importantly there is hardly any information on its long term effects. I think someone interested in taking modafinil as an "off-label" drug should read about its effects on the FDA website. Those people most likely aren't highly motivated, procrastinate excessively or are under a lot of pressure to perform well. According to the FDA website, modafinil would wake them up, make them euphoric and alter their perception. Wouldn't an unmotivated student or over worked employee then achieve their goals faster and/or more easily if they were put into that state of mind. They would see work as more enjoyable, be happier doing the work and want to stay awake to complete it. If we look at it that way then did it really improve their cognition or just improve their willpower which could be achieved without drugs.
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Post by Princess Aleke on Sept 17, 2015 7:09:23 GMT -4
Hmmm nice topic, performance enhancer is great but not showing improvement in creativity it is poor. Even without an enhancer people still finish their tasks at work with being stressed all day but rests afterward. If modafinil and Adderall are almost the same then we should consider their side effects as almost alike, in my own opinion, I would rather prescribe these medications to people who are unhealthy with decrease potential of abuse.
Modafinil, Adderall, or amphetamines are taken to improve concentration and alertness to people who have none and are good at therapeutic doses, not bad but One interesting thing about humans is wanting to take risks and more steps, if a healthy person is given modenafil and it helps him in his performance he would want to take more doses to increase his performance more and to see if it would enhance his creativity thus increasing the potential for Abuse exponentially.
For example what if the individual want to keep staying alert at the job to impress the boss or company, which is more common in white collar workers (or Extremists) who want to gain more respect and feel like celebrities at what they do, since they are highly competitive, this predisposes them to be Dependent on the drugs by stating oh I have to keep taking this wonderful pill it helps me focus, determined and makes me good at my job, that makes them to feel impressed by themselves and would not want to run off the “miracle pill” and the day it is not available, they start thinking negative OMG how can I focus and do this job? I can’t do this without it, then Depression, feeling hopeless and worthless without the pill comes in and would want to take a substitute like Amphetamines thus predisposing them to more Abusive potentials.
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Post by Ajay Varughese MS3 on Sept 17, 2015 7:42:25 GMT -4
After reading this article, two things come to mind. How a vast majority of people are taking stimulants in the workplace or at schools without knowing the long term potential side effects and how many of those people have been taking said stimulants without a prescription and not under the watchful eye of a medical professional. It my opinion I'm sure that the demographic using and abusing modafinil is so large and wide that simply studying the long term side effects would be insufficient because a mind in the mid to late "teens" would have a different neurochemistry than that of one that has fully matured, beyond the age of 25. Another question that arises is what is a therapeutic level? If the neurochemistry of two minds in two different age groups is different and not being able to fully know because modern medicine has not yet reached that realm of discovery, shouldn't a therapeutic dose be different for different "minds"? The use of this drug as a "off label" use in my opinion is quite dangerous because so much has to be researched before we can endorse its positive effects. Another point that comes to mind is if this drug improves decision making, planning, flexible thinking and combining information only if the person is in a a "certain state of mind". Will the drug have all these positive effects, like this article mentioned, say in a person who is focused and understands what tasks need to be done before taking the medication and also in a person who was leisurely watching the television, expecting this drug to magically help them finish tasks they've been procrastinating. I'm sure both persons would describe the medication effect differently. In conclusion this article brings to light a silent epidemic of people taking medications that are not prescribed to them and it will hopefully shed light on how much there is to learn about modafinil and its "off label" uses.
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Post by arijanasabic on Sept 17, 2015 10:07:56 GMT -4
As mentioned in the article, the use of stimulant medication has increased greatly in the last few years, mostly due to misuse of these types of medications. I believe that some people do need it for medical reasons such as ADHD, but it is also very common to see perfectly healthy people using it just to improve their performance or get ahead in the field they are in. Furthermore, it is dangerous to use any type of drug especially new drugs on the market. I believe it is too early to say whether Modafinil has any dangerous/ life threatening side effects or not, as there are not many researches done on that specific drug or its mode of action. While using the drug may be an individual/autonomic choice, the long term effects are not known and although those individuals may “get ahead” now, later on in life they might develop side effects which would impair their health long term. It seems that society is teaching younger generations that “shortcuts/ enhancers” are needed to succeed in life, instead of working hard and succeeding at their careers by using the skills they already have. We live in a world where "good enough" is never enough therefore increasing the need for drugs like Modafinil which we do not really need. We create more problems and health issues instead of solving them.
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