Saturday, May 8, 2010

Tweaking to Get Smart: Cosmetic neurology

Recreated :File:Neuron-no labels2.png in Inksc...Image via Wikipedia
The future is now.  You can see it in seniors wanting to keep what they got as sharp as they can; college students are cadging their ADHD classmates' Alderall.  There's an article in the Wall Street Journal about traders trying to enhance their sharpness so that they don't drown the world in a bathtub of risky securities.   It's already happening: there's an underground world of neuroenhancing drugs.  People are using all kinds of pharmaceuticals to enhance their memory and sharpen their focus and concentration.

 Zack Lynch, who has a book being published this summer, called “The Neuro Revolution,” said, “We live in an information society. What’s the next form of human society? The neuro-society.” In coming years, he said, scientists will understand the brain better, and we’ll have improved neuroenhancers that some people will use therapeutically, others because they are “on the borderline of needing them therapeutically,” and others purely “for competitive advantage.”"

The American Academy of Neurology has recently released some guidelines for the practitioner on how to handle otherwise healthy people who are asking to ingesting substances for the purpose of improving attention, memory, and/or cognition.  Although the AAN states that prescribing such substances are outside the traditional goals of medicine, it notes that it considers the use of neuroenhancements acceptable since the goal is the improvement of patient well-being and that the use of neuroenhancement doesn't violate medical ethics of medicine such as beneficence, autonomy, etc.  The AAN compares the use of neuroenhancements to that of cosmetic surgery:  a practice that enhances the patient's sense of well being without harming the person.

Arthur Caplan, head of the University of Pennsylvania's Bioethics Department, notes that "technologically, we can't even build a dam that doesn't break", ie, that there have been major failures even with drugs that have received FDA approval (note that neuroenhancements are "off label" uses of drugs).  "The most relevant forerunner may be reproductive technologies, and what's happened there is an absolute lack of oversight," Caplan says. "We've got no rules about counseling, about describing the risks of side effects. We have no agreement about who can use these services. The whole thing has been treated as a Wild West free market."

The underground world of neuroenhancing drugs : The New Yorker:

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