Smarten up: Drugs to boost brain power

Can we all be brilliant? Bit by bit thousands of researchers are trying to untangle the workings of the brain. But how near are we to understanding what turns some people's brains on and gives them a competitive advantage? Attempts to improve our performance and potential to succeed are not new pastimes, and stories of mystical concoctions and "Viagras for the brain" continue to fill our newspapers...

It isn't really surprising we are entranced by the complexity within us. Take your brain. Try to picture its 100 billion neurones, or brain cells, flawlessly working together to control your every thought, passion, feeling, sensation and movement. Incredible? What if you knew that each typical neurone has between 1,000 and 10,000 connections to other neurones? Mix in over a hundred different chemical agents, or neurotransmitters, to regulate the neurones, add a few million supporting cells and blood vessels and then you have it: your brain, all packed beautifully into about 1,400 g.

People have always been fascinated with artificially improving the brain. Today, shops are filled with products suggesting solutions to all of life's woes: drinks to help you remember, tablets to help you study, capsules to make you more alert. But do these 'wonder drugs' really emerge from an understanding of how our brains actually work? Are we really able to target people's problems selectively and safely, or are we merely providing a clumsy way to escape life's inadequacies without really addressing the cause of its problems? Understandably, many are concerned that the widespread availability of drugs to super-humanise healthy people can only have the knock-on effect of sufferers never solving their problems for themselves.

In the Department of Psychiatry at Cambridge University, we recently identified a new effect of a drug called modafinil. This drug was introduced to help narcolepsy sufferers stay awake, but we found it also improved certain mental abilities in our volunteers, without the side effects commonly experienced with mental stimulants. Healthy male volunteers performed significantly more accurately in neuropsychological tests involving short-term memory, and responded less impulsively - they tended to reflect more upon the tasks they were given, almost to 'stop and think'.

So we can enhance healthy volunteers' performance in memory games and now understand a little more how to unravel the components of memory and attention. Is this potentially a ray of hope for the thousands of people suffering from neurological and psychiatric disorders? Have we discovered a safe way to improve mental performance and increase our understanding of the more complex workings of the brain?

While our studies centred on healthy volunteers who remain essential to this research, the real people who will benefit are those with serious problems hampering their everyday functioning. For example, we identified an improvement in mental performance brought about by a decrease in impulsivity. This suggests that it may be possible to help patients with neuropsychiatric disorders like Attention Deficit Hyperactivity Disorder (ADHD), who, apart from being impulsive, suffer from selective impairments in memory, problem-solving and planning. Drugs such as amphetamine and methylphenidate (Ritalin) are still used to improve some aspects of these people's performance, but have the disadvantage of causing impairments in other brain functions. Worse, these drugs can produce serious side effects such as addiction. Modafinil, in contrast, has been shown to have few side effects and there is no evidence of addiction. The next step is therefore to examine its performance-enhancing qualities in ADHD sufferers.

Have we really found a widely useful 'cognitive enhancer'? The main aim of our research is to help those with serious abnormalities in their brain functioning, for whom the race to understand the complex workings of the mind is most urgent. But can this research be misused? In a workaholic culture that demands increasingly long hours and "all-nighters", the temptation to mitigate the unrealistic demands we have of ourselves - by popping a pill - is dangerous. Over-prescribing valuable medicines, effectively turning them into 'lifestyle' or 'designer' drugs, blackens their names and injures the good reputation on which the medical profession depends. Solving social problems by changing brain chemistry is not the answer: Imagine drug-screening school pupils before they write exams! No-one wants a situation where this is the norm.