NEURO NUGGETS |
BY DR MOHD WAEL
Dr Wael MY Mohamed is with the Department of Basic Medical Science, Kulliyyah of Medicine, International Islamic University Malaysia( IIUM).
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FOR decades, science fiction has imagined futures in which humans acquire knowledge and skills instantly, bypassing the traditional, time-consuming paths of learning and training. Films such as The Matrix portrayed cognitive enhancement as the ultimate source of power, while later works like Limitless popularised the idea of a pill that unlocks the brain’ s full potential.
Two decades on, these once-fantastical ideas are no longer confined to cinema; instead, they are increasingly reflected in real-world practices surrounding so-called cognitive enhancers or“ smart drugs.”
Cognitive enhancers, also referred to as nootropics, are substances used with the intention of improving memory, attention, motivation, wakefulness, and mood.
While some are legally prescribed for clinical conditions such as attention-deficit hyperactivity disorder( ADHD) or sleep disorders, others include illicit substances and unregulated supplements.
Global surveys indicate a rapid rise in non-medical use of such drugs among healthy individuals, particularly students and professionals seeking to cope with academic pressure and workplace competition.
This growing demand is facilitated by easy access through prescriptions, online markets, informal sharing, and in some countries, over-the-counter availability.
Most pharmacological cognitive enhancers act on the central nervous system, particularly the dopaminergic pathways that regulate motivation, reward, attention, and executive function.
Dopamine plays a critical role in cognitive performance, but its effects follow an inverted-U relationship: both insufficient and excessive dopaminergic activity can impair cognition.
While moderate increases may improve focus and persistence, excessive stimulation- especially in mesolimbic and mesocortical circuits- can lead to impulsivity, paranoia, and reduced cognitive control. Thus, attempts to chemically“ optimise” the brain may easily overshoot the biological sweet spot.
Commonly used smart drugs include methylphenidate, modafinil, amphetamine-type stimulants, psychedelics( often through microdosing), and emerging new
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psychoactive substances.
These compounds may temporarily enhance alertness and perceived productivity, but evidence for sustained improvements in higher-order executive functions in healthy users remains inconsistent.
Moreover, medical risks are far from trivial. Acute adverse effects include hyperthermia, seizures, cardiovascular complications, and, in severe cases, coma and death.
Chronic use is associated with dependence, anxiety, depression, psychosis, hypertension, myocardial infarction, and stroke. In this context, the line between enhancement and harm becomes uncomfortably thin.
Beyond biological risks, the widespread use of smart drugs raises critical ethical concerns. Some argue that pharmacological enhancement resembles an unfair shortcut, potentially creating new forms of cognitive inequality and social pressure to compete chemically.
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Others warn against normalising drug use as a coping m e c h a n i s m f o r systemic problems such as excessive academic demands and a hyper-productivity culture.
Particularly in vulnerable populations- including p a t i e n t s w i t h neurodegenerative disorders- exaggerated claims about cognitive enhancers risk fostering false hope unless supported by robust clinical evidence.
At the same time, research into cognitive enhancement has legitimate therapeutic potential. Ongoing preclinical and early-phase clinical trials are exploring novel compounds and repurposed medications for conditions such as Alzheimer’ s disease, schizophrenia, depression, age-related cognitive decline, and substance use disorders.
These efforts aim not to create“ super brains” but to restore impaired cognitive function and improve quality of life. However, such applications require rigorous trial design, transparent reporting, and careful ethical oversight.
In conclusion, while the appeal of smart drugs reflects a long-standing human desire to transcend biological limits, current evidence suggests that pharmacological shortcuts to cognitive excellence remain scientifically uncertain and medically risky.
Until safety, efficacy, and long-term outcomes are clearly established, cognitive enhancement should be approached with caution, humility, and a healthy respect for neurobiology’ s complexity.
After all, upgrading your phone without reading the instructions is risky- doing the same to your brain is probably not the best beta test either.- The HEALTH
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