Cognitive enhancement with methylphenidate and modafinil: conceptual advances and societal implications

摘要

Abstract: “Cognition enhancement” (CE) drugs are pharmaceuticals taken by healthy people with the aim of sustaining attention, augmenting memory, or improving other cognitive capacities. This paper focuses on two CE drugs – methylphenidate and modafinil. It analyzes their mechanism of action, the evidence for their efficacy in nonsleep deprived individuals, and reviews their adverse effects. It then addresses the normative stances and social issues surrounding CE drug use. Currently, there is little evidence that either methylphenidate or modafinil provide any useful cognitive enhancement to well-rested users. However, it is very possible that future research may reveal cognitive benefits for these agents or for other pharmaceuticals. Public attitudes on CE mirror those evident in academic debate. Even though the majority seem to be opposed to enhancement based on issues of authenticity, utility, and fairness, a steady minority take the view that cognitive enhancer usage is both acceptable and fair. Current legal regimes do not adequately address the social phenomenon of CE use. While the United Nations Convention on Psychotropic Substances defines limits of methylphenidate use across the globe, no such guide exists for modafinil.