When should pharmacological cognitive enhancers be used?

Pharmacological cognitive enhancers (PCEs) are licensed to improve cognitive functioning in those suffering from specific medical disorders like dementia, attention deficit hyperactivity disorder (ADHD) and daytime sleepiness associated with narcolepsy, with Nicholson et al (2015) observing that ‘healthy individuals use PCEs without a prescription for non-medical purposes … [and is] ‘largely restricted to students, with very little evidence for use in working populations.’

In the largest study on PCEs conducted, Maier et al (2018) reported on data collected from over 100 000 participants in 15 countries as part of the Global Drug Survey 2015 and 2017. They found that 4.9% and 13.7% of the global samples, respectively, reported the 12-month use of prescription or illegal stimulants and/or modafinil to improve work or study performance, an average increase of 180%. Expanding on this, while Mann (2021) ascribes this trend to be associated with students in higher education, he acknowledges that accurate prevalence rates are imprecise amonst stuents, ranging from 5% to 35% of student populations. However, Sharif et al (2021) cite evidence that the lifetime prevalence rate of prescribed PCEs intake for non-medical reasons, ‘as a self-attempt to increase cognitive performances, among university students in the UK and Ireland has been estimated to be around 10%.’