Cognitive enhancers

Question 1

Modafinil

Answer 1

Wake-promoting agent that is FDA approved for treatment of daytime sleepiness associated with narcolepsy, sleep apnea and shift work sleep disorder.

Directly inhibits DAT and NET
Indirectly elevates serotonin, glutamate, histamine and orexin, and reduces GABA

Question 2

Modafinil : Repantis et al. 2010

Answer 2

31 randomised controlled trials
-Positive for enhancing effects on attention
-No effects detected in memory, mood, or motivation
-Strong positive effects on executive functioning, memory and wakefulness during sleep deprivation

Question 3

Modafinil

Answer 3

▪ Simple psychometric assessments:
▪enhancement of executive function
▪variably benefits attention, learning and memory
▪ More complex tasks:
▪enhances attention
▪enhances higher executive functions
▪enhances learning and memory

Question 4

Psychostimulants

Answer 4

Amphetamine and methylphenidate:
▪ Prescription stimulants used to treat ADHD
▪ Repantis et al. (2010a) reviewed 19 randomised controlled trials on
effects of methylphenidate:
▪Large positive effect on memory (most prominently spatial
working memory)
▪No effects on attention, executive functioning and mood

Question 5

Psychostimulants -Smith & Farah 2011

Answer 5

reviewed 28 studies on effects of
methylphenidate and amphetamine:
▪Enhanced recall and recognition of verbal material, only after
longer delays (1 hour – 1 week)
▪Working memory: mixed results (greater improvement for less
able subjects)
▪Cognitive control: mixed results, slightly more null results than
positive findings

Question 6

Illieva et al. 2013

Answer 6

▪ Illieva et al. (2013) studied effects of MAS (Adderall) on 13 cognitive
measures:
▪No enhancement of cognition for participants in general, BUT:
▪Below-median baseline performers:
▪Improved word recall
▪Trend toward improved nonverbal IQ

Question 7

Methylphenidate

Answer 7

Reduces glucose metabolism when solving math problems

Reduces activity in default network

Question 8

Coffee

Answer 8

Enhances processing speed
Positive effect on short and long-term memory

Question 9

Coffee Smith 2005

Answer 9

▪ Exposed to physical hazzard and irregular/long working hours
▪ Accident: injury at work that requires medical attention
▪ Low caffeine consumption: 20.4 % reported accident in past 12
months.
▪ High caffeine consumption: 9.6 % reported accident

Question 10

Reality

Answer 10

Pharmaceutical companies cannot develop drugs for non-medical use

▪ Pipeline:
▪34 potential targets for improving cognition
▪8 currently in clinical development by top 10 pharmaceutical
companies
▪Minority will prove effective and safe
▪Fewer more effective and safer than current treatments
▪Very small subset might be useful for CE

Question 11

COMT enzyme

Answer 11

In the pre frontal cortex COMT inactivates dopamine. This is so importnt as it helps regulate memory and decision-making.

Val/val = high dopamine degradation = difficulties with functioning working memory
Met/met = low dopamine degradation = enhances cognitive abilities leads to overstimulation
Val/met = perfect

Question 12

Amplification model

Answer 12

High baseline performance and cognitive enhancement interventions show synergistic effects

Question 13

Cognitive stability

Answer 13

Shielding goals from distraction
Sustained attention

Question 14

Cognitive flexibility

Answer 14

Switching between alternative goals
Adapt behaviour in response to change in environment