Friday, November 6, 2009

Heard of cognitive enhancement drugs, which give gulpers an edge on various aspects of cognition such as attention, wakefulness and memory! People with short attention spans (I’m proud to belong to this group) can benefit from such drugs, but those who cannot afford it are at a disadvantage. Take the drug, modafanil which started its career as a narcoleptic helping those addicted to sleeping through the day stay awake. Maybe, the drug doesn’t let the alertness cells in the hypothalamus, the brain’s supposed waking centre, quieten. These cells are said to fire spontaneously and continuously on their own. So the drug may promote this cell state and make them remain in that state.

Modafanil, first used as an anti-narcoleptic, was later found to increase concentration. No wonder, the beneficiaries are students taking critical exams tomorrow. They would want to swallow this pill and do a night out for a thorough revision. A Cambridge University student is said to have imported modafanil from India for just $2.4 per 100mg.

But nobody knows the long-term effects of the drug and what it would turn out to be, after prolonged use in a generation. Drugs often have had a changing fate: chlorpromazine, originally meant as an allergy drug became the first effective tranquilizer for schizophrenics. At the same time, other drugs have done more harm than good with time.

Two examples suffice. Voixx, a blockbuster painkiller, was later said to have carried a risk of cardiac arrests. Another drug is methadone, also an analgesic and used to treat heroin addiction. US Centers for Disease Control and Prevention (CDC) in its latest weekly report reveals that “nearly 60 percent of the 1,668 people who died from prescription opiate overdoses [in Washington between 2004 and 2007] were men…Methadone was the cause of death in 64 percent of these cases…”

If this is the case with adults, then look at what’s in store for kids. A popular drug for the young’s fleeting attention is Ritalin, “which interacts with dopamine [a key neurotransmitter that strangely is said to cause happiness as well as depression]…is said to produce a calming effect, enabling the child to focus more in the classroom.” Though Ritalin was prescribed for kids, adults took it to boost academic performance. And Ritalin is said to alter the brain’s neuro-setup and such changes are known to be associated with the process of drug addiction.

Memory enhancement is the mainstay of most of such drugs. Supercharging the human memory has been a favorite pastime from ages: in fact, the Vedas can be thought of a memory aid, as they are not in a written form but have to be recollected from repeated chanting. This obsession with memory has its downsides. Remembering too much is not what our brains were evolved to do, rather forgetting is preferable.

Take the case of a patient called Shereshevsky, a journalist who had such vast memory that he couldn’t forget anything. His account is vividly described by the brilliant Russian neurologist, Alexander Luria: Shereshevsky’s mind was pinned to the particulars and he couldn’t grasp metaphors. Human thought has at least this distinction of thinking in metaphors. This comes by not due to an impeccable memory, but through slight imperfections as they allow one to see connections between different but related events. As one researcher points out: “The brain seems to have made a compromise in the having more accurate memory interferes with the ability to generalize…You need a little noise in order to be able to think abstractly, to get beyond the concrete and literal.”

One shouldn’t forget that these enhancement drugs were meant for patients with cognitive defects, not for those cognitively functional. Another case study will illustrate this point. My all-time favorite neurologist, the redoubtable Oliver Sacks wrote about a former submarine radio-operator, Jimmie. After more than thirty years of the Second World War, Jimmie is caught in time; he still feels that it is wartime. He has typically lost memory and cannot remember anything after the war till today: a vast span of more than 30 years. Clinically, this condition is caleld retrograde amnesia (popularized by the string of Indian movies titled Ghajini). Knowing that there was little hope for Jimmie’s memory to recover, Sacks consults the erudite Luria. And Luria wisely suggests: “…a man does not consist of memory alone. He has feeling, will, sensibilities, moral being – matters of which neuropsychology cannot speak. And it is here, beyond the realm of an impersonal psychology, that you may find ways to touch him, and change him."

I think these enhancement drugs have come up as the prevalent mood of the times is to look for quick fixes to any problem. But there’s an antidote to this: arts education (as put forth by the polymath judge Richard Posner et al). Attention spans are said to improve due to arts training and in turn, enrich cognition generally. So, one has to decide: swallow the pill (and get addicted) or wallow to arts, etc (and get liberated). Which art form to pick up is entirely up to one’s own calling. Music excites me and with a mellowed sort in the background, I retire into my own zone every day for a few minutes and some private moments. And let my thoughts wander freely during this period. It does liberate me marvelously, enriching me in my own way.

To end, here is what the Noble Laureate Eric Kandel said: "There's no such thing as an enhancement without side effects."

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