Messing with our minds

The time when you can take a tablet to boost your mental powers and workplace performance might not be too far off. Researchers are developing pills that could pharmacologically enhance you, helping you to keep up with the office's smarty pants.

Scientists in the United States are involved in the development of so-called "smart" drugs - chemical enhancements for the mind. Pills are being tested that may change the way we perform and what we think of as "normal" performance.

Medicines such as anabolic steroids can already make people stronger, swifter and more enduring. But the new "cognitive enhancers" may offer more powerful, better targeted and longer-lasting improvements in mental acuity. And some are already being tested on volunteers.

One such drug is donepezil, a cholinesterase inhibitor developed for the treatment of dementia. A study published in the journal Neurology found commercial pilots who took 5mg of donepezil for one month performed better during "emergencies" on a flight simulator than pilots taking a placebo.

Modafinil, a drug used to treat the sleep disorder narcolepsy, has also been tested on pilots. A trial reported in the Psychopharmacology journal found it boosted the performance of helicopter pilots flying on simulators who had been deprived of sleep.

Barbara Sahakian, Professor of Neuropsychology at the University of Cambridge, who tested modafinil in a series of experiments on volunteers found they showed greater concentration, faster learning and increased mental agility.

"It may be the first real smart drug," she says. "A lot of people will probably take modafinil. I suspect they do already."

"If people can gain a millimetre, they'll want to take it," says Jerome Yesavage author of the donepezil study. That view is backed by Judy Illes, a psychologist at Stanford's Centre for Biomedical Ethics. Mind-enhancing medicine could become as "ordinary as a cup of coffee", she says.

If drugs such as donepezil and modafinil were proved to raise performance, and hence safety, the implications could be far-reaching for employers.

The question is raised in a review of the new science, dubbed "cosmetic neurology", by Dr Anjan Chatterjee, a neurologist at the University of Pennsylvania. As the rich turn to cosmetic surgery to refine what nature gave them, cosmetic neurology offers a different kind of personal improvement.

It is the "nip and tuck" for the mind. The conventional aids of caffeine, alcohol and tobacco are already used to boost mood and performance, and neurologists argue that the use of other drugs is a logical extension of this self-medication.

The new science is creating problems for neurologists, who are used to treating the sick, not enhancing the healthy. Dr Chatterjee writes: "One plausible scenario is that neurologists will become quality-of-life consultants. Following the model of financial consultants, we could offer a menu of options with the likely outcomes and risks."

The advent of cosmetic neurology is inevitable, he says, and warns: "Prospecting for better brains may be the new gold rush."

Signs that it has already arrived can be seen on college campuses in the US. Faced with the pressure of exams and essay deadlines, students have been abandoning the traditional crutches of coffee and cigarettes for Ritalin, a stimulant best known as a treatment for hyperactive children. It has found a ready black market among students who are desperate to succeed. Users say it helps them to concentrate.

The drug's use has already spread to Britain, Canada and Australia, and university authorities have been warned to be vigilant.

If "natural" performance or responses can be boosted in these areas, it may challenge our concept of what it is to be human. In one view, medicine should be about healing the sick, not turning people into gods. But the boundary between therapy and enhancement can be hard to define.

Drug use is rife in athletics but it is referred to disparagingly as "doping". The underlying assumption is that boosting performance without doing the work is cheating.

Yet no one feels the same way about putting up with a headache or indigestion. We reach for tablets without hesitation.

The ethical dilemma may prove to be academic, however, if the drugs now being tested fail to deliver on performance, or their side-effects prove to be troublesome.

- INDEPENDENT