Enhancement… is it time yet?

February 6, 2009 at 6:25 am Leave a comment

No, I am not talking about Extenze here. I am talking about the  OTHER,  supposedly more important, erogenous zone – the brain. Nature has an uncanny tendency to talk about cognitive enhancement near the end of the year. In 2007 they ran a commentary by Barbara Sakhian and her colleague from Cambridge, and exactly a year later they publish another article by the same author and several coauthors from around the world and from multiple backgrounds. The latter piece was extensively discussed at the dedicated forum and so was the former over a year ago. Here’s my two cents on the issue:

First, the topic seems to be growing in popularity. There were under 40 comments on the original nature network forum from 2007/2008 and almost a 100 in the new one, which by the way is still growing. There are some excellent posts on both, so be sure to check them out. The two articles, however, differ dramatically in their general feel. The first one was very cautious, formulated as a series of questions/concerns. The second one is, like, yeah, let’s go, let’s do it and see where we end up. Sure, we need regulation, more data, and such, but cognitive enhancement is where the future is. The forum participants don’t always share the authors’ optimism or enthusiasm, some even dare to point out their conflict of interest (some coauthors are apparently consultants for big pharma).

I don’t pretend to have read the whole of the two fora, but of the posts I have perused, I found none that put the whole thing in historical perspective. We have not been terribly successful in the past in the “pharmacological messing with the brain” department. Despite advances in psychiatric research, most serious conditions, such as schizophrenia, depression, and bipolar disorder remain to a large degree intractable, with most common drugs producing very serious side effects in the long run. Let’s not forget the perhaps most spectacular blunder in the history of pharma which was Bayer’s drug of the heroes.

The basic lesson from all the history of psychotropic drugs is that brain is a delicate clockwork and it tends to go back to equilibrium if pushed just a bit, and goes BANG when pushed too hard. Even caffeine, which many give as an example of a safe cognitive enhancer, when used regularly only produces mild addiction with little cognitive or attention benefit. Of course acute use is clearly beneficial to people who need to have heightened attention here and now, but it is very easy to slip into the habit, which only causes problems.On the other hand, one might argue that our brain was not evolved to sustain such high load of cognitive tasks as it is forced to perform nowadays, so maybe a little pharmacological help would be welcome. Healthy people already chronically use drugs, such as birth control pills, which arguably enhance the quality of life with very  few dangerous side effects.

My basic point is, do we really know that these drugs enhance cognition in the long run in healthy individuals? No. Do we know that they are devoid of serious long term effects? No. How do we find out? By studying these effects, but for goodness’ sake, don’t leave it to the Big Pharma, which is not exactly known for its high ethical standards. Let’s not forget that this is potentially a multibillion dollar industry.

We will probably soon learn much more about the benefits as well as the drawbacks of using the so-called cognitive enhancers. The costs, I bet, will be non-trivial both for the individual and for the society at large. At the end of the day we will have to make the calculation: is it better to have one super-surgeon on dope who will work him- or herself into disability at the age of 60 or maybe should we hire two instead and have them work half the hours and live successful and happy lives without cognitive enhancement. How do we factor human suffering into such an equation?

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Entry filed under: Biomedical research, Health policy. Tags: , , , , , , .

I am a Mac, and… wait, where did the PC go??? Mirror, mirror in the void, who in this cosmos is the most super of all?

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