The Sunday Times

January 3rd, 2010

It’s a no-brainer – bring on the pills that will make us smarter

In among all the gloomy predictions for the next decade is one that is astonishingly cheering. In the near future neurologists will be able to halt the process of Alzheimer’s disease. At present they can treat only the symptoms but soon, having detected the disease in its early stages with biomarkers, they will be able to stop it getting any worse with drugs that are neuro-protector agents.

This was a prediction made by Professor Barbara Sahakian, a distinguished neuroscientist at Cambridge University’s department of psychiatry, last week. I can only imagine that everyone was too busy hurrying to the sales to give this extraordinary statement the attention it deserves. It sounds like a real liberation, both for Alzheimer’s sufferers and their families and for anyone who fears old age.

Quite apart from the personal miseries of Alzheimer’s, the economic costs of dementia are vast and are threatening to become overwhelming as we face the grey tsunami of an ageing population. This is a disaster that may now not happen because research in this field is developing so fast.

That isn’t the only extremely cheering thing Sahakian said. She was discussing cognitive enhancement drugs — smart pills — and while she gave a lot of attention to their use for people with cognitive disabilities and neuro-psychiatric disorders, she also talked about their use for healthy people. Some of the drugs that already help patients with Alzheimer’s or ADHD (attention-deficit hyperactivity disorder) can also bring great benefits to healthy adults.

People are already using them to make their brains work better — to improve their memory or concentration, to enhance their entrepreneurial skills, or their performance at chess, on the piano, for a speech, in exams or in writing to a deadline.

Sahakian made no secret of the fact that some of her scientific colleagues regularly use cognitive enhancers — such as modafinil — to deal with jet lag, to improve their mental powers or just to get in a good day’s work. She even wrote an article in Nature magazine in 2007 called Professor’s Little Helper, which gives you the general idea. Smart pills really do make you smarter and they’re here, for those who can get hold of them.

I have been waiting for them for years, ever since a brilliant young Californian scientist told me in 1982 that they were on their way. A few years after that another Californian told me that he had managed to speed-write several lucrative soft porn novels while on Ritalin — the drug frequently prescribed for children suffering from ADHD (and, sadly, prescribed for lots of children who don’t suffer from it as well).

In crude terms it’s a kind of “speed”, to use the 1960s slang for amphetamines or uppers; it certainly does concentrate the mind and up one’s productivity, although it wouldn’t be the well informed person’s first choice of smart pill.

However, there’s a growing demand for it among the healthy, even in this country: recent research at Liverpool John Moores University found that children with prescriptions for ADHD treatments were routinely selling their drugs and so, sometimes, were their parents.

Students around the world are increasingly getting hold of other smart pills, such as modafinil or Adderall, and the trend is growing. There’s some evidence that ambitious parents are getting smart pills from the internet for their children. But this use of unprescribed smart pills is not really very smart: the user doesn’t know what he’s getting from uncontrolled suppliers.

All the same, it is tantalising. Here are respectable scientists unashamedly popping pills to bolster their already bulging brains. Sahakian herself asks why not, if the drugs are safe, effective and non-addictive? Which of us over 40 hasn’t noticed a gradual loss of certain memories and an inability to store new ones? Which of us hasn’t envied someone else’s higher powers of concentration, or speed of thought, or greater talent in playing Bach? How frustrating it is to sense that one is using only a tiny part of one’s mind and its memories. How exhilarating it would be to leave all such limitations behind, if only for a few hours.

The most obvious objection to this brave new brain world is that not enough is yet known about the long-term effects of some of these drugs. That will change in time; before long the risk-reward relationship will be much better understood. But I suspect that even if the smartest smart pills really were safe and non-addictive, there would still be people who would be against them.

There will always be those who for religious reasons say we shouldn’t interfere with nature or attempt to play God, as if we didn’t do that all the time; trying to eliminate polio or treating cancer are obvious examples. Besides, what is wrong with humans playing God? I am all for it, especially as God doesn’t seem to be doing it.

Then there will always be puritans who object to anything with a hint of pleasure about it; puritanism is “the haunting fear that someone, somewhere, may be happy”, which I certainly would be if I could play the piano just a little bit more like Mitsuko Uchida. Then there is the usual argument that taking smart pills would be unfair — unfair to those who didn’t want to take them, or to those who couldn’t get them.

While there is some truth in that, there is not enough. The world is full of unfairness; we already have a very unequal distribution of life enhancement across the world. Take people with bad eyesight. The tiny minority of the very rich get laser correction. The fairly rich get contact lenses. Others have to make do with prescription spectacles, while the world’s poor can have only off-the-shelf glasses and the very poor get nothing. Does that mean there should be no sight enhancement for anyone? And as for the argument that smart pills are a kind of cheat, one can only ask whether it is cheating to wear contact lenses, or fit prosthetic limbs, or eat brain-enhancing superfoods.

What Sahakian is trying to do in talking to non-scientific audiences is to get a public debate going. Normally the call for a public debate fills me with gloom, but in this case we really need one. Cognitive enhancement is already a fact of life and now the smart pills are here. They will bring risks as well as wonderful rewards and we ought as a society to be ready for them, to use them wisely and well and legally. I can’t wait.

Meanwhile, a happy and cognitively enhanced new decade to everyone.