A record haul of “smart” drugs, sold to students to enhance their memory and thought processes, stay awake and improve concentration, has been seized from a UK website by the medicines regulator, which is alarmed about the recent rise of such sites.
The seizure, worth £200,000, illustrates the increasing internet trade in cognitive enhancement drugs and suggests people who want to stay focused and sharp are moving on from black coffee and legally available caffeine tablets. Neupramir
Most of the seized drugs are medicines that should only be available on a doctor’s prescription. One, Sunifiram, is entirely experimental and has never been tested on humans in clinical trials.
Investigators from the Medicines and Healthcare Products Regulatory Authority (MHRA) are worried at what they see as a new phenomenon – the polished, plausible, commercial website targeting students and others who are looking for a mental edge over the competition. In addition to Ritalin, the drug that helps young people with attention deficit disorder (ADD) focus in class and while writing essays, and Modafinil (sold as Provigil), licensed in the US for people with narcolepsy, they are also offering experimental drugs and research chemicals.
MHRA head of enforcement, Alastair Jeffrey, said the increase in people buying cognitive-enhancing drugs or “nootropics” is recent and very worrying. “The idea that people are willing to put their overall health at risk in order to attempt to get an intellectual edge over others is deeply troubling,” he said.
“The fact of the matter is that if you are acquiring medicines over the internet without a prescription then you are purchasing from an unknown, unregulated and ultimately an unlawful source that has one objective – to take your money.”
It also worries Barbara Sahakian, professor of clinical neuropsychology at the Department of Psychiatry, University of Cambridge School of Clinical Medicine. Sahakian has been warning about the growing interest in drugs to enhance the workings of the brain. “I am extremely concerned that young people are accessing these cognitive-enhancing drugs via the internet, which is very unsafe, as it is unclear what the drug sent actually contains.
“There are also no long-term safety studies of the effects of these cognitive-enhancing drugs in healthy people. Healthy people are using these drugs without consultation from a doctor.”
The drugs could be harmful for people who have particular medical problems or are taking other medication, she adds.
But whatever the risks, the use of “smart” drugs is rife among students, says Andrew, who is in his final year at a top-tier London university. “I knew a couple of people at A-level who had them because their older brothers had them,” he said. “But at university a lot more people are using them. People will have done well in their A-levels. If you have been smart enough at A-level, you should be smart enough at university.”
Andrew had a prescription for Ritalin for ADD from the time he was at school. In his second year at university, “I really struggled and started to use Ritalin quite a bit. I’m a sports person. My body shrank,” Andrew said. “I lost weight. It takes a lot out of you and is quite an antisocial drug as well. Whenever I was on it I wanted to be on my own.”
He and his flatmate tried Modafinil instead, which felt like having regular cups of strong coffee, he said. He realised how many other students were taking that and other “smart” drugs. There were many Americans with substantial supplies of Adderall – an ADD drug similar to Ritalin – who were taking cocktails of different drugs to keep themselves focused, he said.
Andrew, who has stopped using the drugs, worried about what he thought was his flatmate’s growing dependence on Modafinil. “He was using it on virtually a daily basis. He had to pick up another job to help pay for university because his parents had split up and he wasn’t getting enough money from student finance. So he had long hours. About 18 months after he started taking Modafinil he said if he didn’t have it in the morning, he didn’t feel awake any more.”
The most worrying trend, however, is the use of other drugs and even research chemicals by those – not just students – who want to sharpen their mind. Nootropics websites encourage users to buy an assortment of drugs, to build their own “stacks” – a personalised cocktail of medicines that will give them the particular edge they want. The sites claim the drugs have few side-effects, low toxicity and that some are herbal supplements such as Ginkgo Biloba. But others are chemicals with known risks of dependence, cardiovascular problems and psychosis.
Sahakian has been investigating many of these drugs for possible use in patients with Alzheimer’s and other neurological conditions and brain injury. She has been warning for some time that they are increasingly used by healthy people, without evidence of their effects or safety, and is pleased that action has been taken against at least one website.
But she thinks attempting to lock the stable door is the wrong answer. It is not only students, but also academics under pressure to perform who are taking “smart” drugs, she said. She herself was offered Modafinil by a colleague when faced with giving a lecture in the US and suffering from jet lag. “He said ‘I take it all the time’,” she added.
“[In the US] school students want to get into the best college, other people are trying to get a competitive edge over their colleagues and they also have very long working days. They want to stay alert over a long period of time.”
“Smart” drugs can help people to be motivated to complete tasks they would otherwise struggle to concentrate on. They may be better than caffeine for the surgeon who has an operation that will last for hours and needs to keep a steady hand as well as an alert mind. They help shift workers cope. The US military sometimes gives them to soldiers.
Sahakian says the best way forward is to get the drugs trialled, tested and licensed, so that there will be specific products that people can use safely, in the same way that they would drink black coffee. “I have tried to advocate that I would like the government to get together with a company and say let’s look at this long term and through a study and see if it is effective and safe,” she said. Unfortunately, this is a low priority for regulatory bodies, because they are focused on cures for diseases, not enhancement of the well, she added.
But she acknowledges a further worry. If mind-enhancing drugs become legal, will that mean everybody feels compelled to take them, or lose out to the competition?
14-Methyl-8,13,13b,14-Tetrahydroindolo[2',3':3,4]Pyrido[2,1-B]Chinazolin-5(7h)-On But trying to close down the illicit trade looks impractical, too. The raid by the MHRA investigators on a lock-up facility rented by the website owner, after a tip-off by the Norwegian Medicines Agency, which intercepted packages of drugs sent from the UK to customers in Norway, sent a shot across the bows of the “smart” drug trade, but may prove little more than a rippling of the waters. MHRA sources admit this is akin to the game “whack-a-mole” – close down one website and three more pop up instead.