Nootropic stimulants

Neuropsychologist tells about the first memory clinics neurostimulator to improve the focus and impact of the use of neuroprotective drugs by healthy people

Maintaining brain health and mental well-being - the biggest challenges of the XXI century. How do we maintain a good intelligence work throughout life, especially now that we live longer? In addition, we maintain a sense of mental well-being? These two topics were the key to the Foresight Project "mental capital and well-being", organized by the UK government, as the government wanted to solve two important problems. The first is that we are now living longer and age increases the risk of developing Alzheimer's disease. Thus, when we grow up, we need to maintain the brain in shape and maintain good cognitive abilities and mental well-being throughout life, the duration of which can now reach 90 or 100 years. Another issue requiring resolution is the fact that government and business have lost large sums of money due to lost work time as a result of depression. So, how can we maintain a sense of well-being throughout life? In this project, we investigated the factors that promote health and well-being of the brain, such as a good education, and we also looked at the factors that lead to a decrease in brain health, such as stress, drug addiction, and the like.

In my work I focused on how we can improve cognitive function and mental well-being of man, his motivation. My work is mainly affected neuropsychiatric disorders, such as Alzheimer's disease, attention deficit hyperactivity disorder (ADHD), for the treatment of which have good nootropic drugs, but in the process I also requested to cooperate with the neuroscience community - we call it Neuroethics. I'll explain a little bit what kind of scope and what were my research, to emphasize the importance of this sector and the drugs that we currently use to enhance cognitive abilities in people who are in need - in individuals with impaired cognitive functions iz for neuropsychiatric disorders or brain damage. Some of these drugs are also used to improve the quality of life of healthy people, which leads us to neurotic issues and the question of how society sees itself and how we see our way to maintain good cognitive abilities and mental well-being. As we want to develop this area and how we want to achieve the goal?

There are now so called CANTAB tests. I am a co-inventor of these tests, which are carried out on the touch screen. They were developed because we did not have enough good tools for early detection of memory problems and Alzheimer's disease. We know that good products can help with the treatment of disorders of cognitive functions, such as approaching a problem with memory, but we had to find people who have these problems is still at a very early stage, because as you may know, during illness Alzheimer's appear amyloid plaques and neurofibrillary tangles in various brain regions, mainly in the hippocampal formation (an area of the brain behind the ears). These plaques and tangles - a neuropathological changes that violate the memory function.

Thus, we need to find good tools to resist neuropathological changes and implement them. Currently, neuro-pharmaceutical companies are developing drugs that we call the neuroprotective agent, and these drugs can inhibit the underlying disease processes. But before we had these drugs, we have the so-called cholinesterase inhibitors. These drugs work by increasing the level of acetylcholine in the brain, and eventually improve concentration and attention of people with Alzheimer's disease.

Now we can use Semax, Phenotropil, Cogitum, Modafinil for awake brain.

Episodic memory - a type of memory that we use every day. For example, when you park the car in the multi-storey car park, and then you need to remember: "Where have I left the car," you use this type of memory. Or if you are in a hurry to resort home, open the door, throw the keys somewhere, and then after a few hours you have to go, and you think: "Where have I left the keys?" - And try to remember where they are. This episodic memory. As you can see, we use it every day, and if it is damaged, it becomes very difficult to operate. And we have shown that CANTAB PAL tests are very strongly associated with functional outcome of the disease, they can be used in clinics on iPads for the early detection of memory disorders.

So, we have the cholinesterase inhibitors, drugs also known under the names "Aricept" and "donepezil" and other types of drugs in the same way - they raise the level of acetylcholine in the brain. For patients with ADHD we used psychostimulants, amphetamines, also known as (e.g. "Adderall") and methylphenidate (for example, "Ritalin"). These drugs, particularly "Ritalin", is extremely effective for the treatment of ADHD. They work about 70% of patients, helping them in their daily lives, and, apparently, help them for a long time to hold the attention - and this is the main problem for these patients. We again used in the clinic, some of the tests CANTAB, to assess how well patients can hold the attention. We used a test for rapid visual information processing (RVP) and on this test found that methylphenidate has a very good effect: it improves the results of this activity. But the most interesting thing is that when we examine the effect of methylphenidate to healthy people, we also see improvements. Thus, these medications work not only for people who have cognitive impairment due to neuropsychiatric disorders, and they also improve the cognitive function of healthy people.

In recent years we have worked with a drug called Modafinil. Modafinil has been approved by the FDA for the Food and Drug Administration in the United States, as well as here in the UK for the treatment of narcolepsy - irresistible attacks of daytime sleepiness. In the US, the drug has yet another indication for - sleep disorders caused by shift work, as it was found that modafinil reduces the number of accidents in people who work in shifts. We also considered modafinil as an adjunct to antipsychotic drugs for people with a first episode of psychosis or schizophrenia. Patients suffering from schizophrenia, there are three different issues. There psychotic symptoms - hallucinations and delusions. During hallucinations patient hearing voices and delusions - it is abnormal, unusual thoughts that arise in patients. These psychotic symptoms do well the known antipsychotic drugs (agents that block receptors D2). But cognitive impairment in patients with schizophrenia, as well as the motivation problem, known as negative symptoms, are treated not very good.

The Office for sanitary inspection by the Food and Drug Administration have realized that an important part of the treatment of people with schizophrenia - an improvement in their cognitive abilities: they discovered that they have problems with the rehabilitation. For example, if you are a student, it can be difficult and you have been diagnosed with "schizophrenia" to return to the university and concentrate on their studies, or if you are working and you have been diagnosed, you might be hard to go back to work and learn new things in the workplace . All these cognitive problems that exist in some people. Thus, the government realized that the biggest obstacle on the road to recovery - a cognitive problems, and that they should be treated. But at the moment we do not have the approved drugs. In our projects, in Cambridge, in my laboratory, we have used the cognitive training, gaming this method, we were able to improve cognitive function in people with schizophrenia - including improving their episodic memory - through games. But we are also trying to improve their cognitive abilities by prescribing modafinil. And we found that it causes positive changes, improvements in working memory - a very important type of memory associated with executive functions such as, for example, planning or solving problems that you face at the university or at work. And this drug, modafinil, exerts influence on norepinephrine, dopamine and GABA affects balance and glutamic acid and possibly even directly affects the glutamic acid. Thus, according to our hypothesis, the drug provides improved cognitive functions.

During our study of patients with schizophrenia and other groups of patients, such as depression, we discovered that modafinil can be an effective agent for improving cognitive functions in these people. It also affects the motivation associated with the implementation of tasks: it enhances people's motivation to perform tasks that seem unpleasant or not very interesting, which means that modafinil - is to some extent drug, increases efficiency. Some in our society is realized, and healthy people have decided to use this medication. And when I looked, why people make such a decision, I have identified three main reasons. First, healthy people want to gain a competitive advantage in the university, at work or at school or to go to the best university. The second reason - the desire to stay longer fresh and focused. For example, I asked my fellow teachers, and many of them have used these drugs to cope with the jet lag syndrome. And people use the drug in large cities, because they need to work longer and they want to stay alert and focused. In Silicon Valley, also use some of neuroprotective drugs. And the third reason - to perform tasks that lay people constantly and which do not inspire enough motivation to take on them: the drug helps people to take up the task and execute it. In terms of clinical treatment, I think, if we can combine some of these neuroprotective drugs with cognitive training sessions in the format of games, fun and motivating, we are likely to get the maximum possible improvement in the cognitive abilities of people with neuropsychiatric disorders and brain injuries.

Part of my concern about the fact that healthy people use nootropics, primarily related to security issues. We have no long-term studies showing that these drugs are safe for healthy people. So what we really need to carry out such research before healthy people will be able to take these drugs. The second issue that worries me is that these drugs are difficult to obtain, and because of that people are buying them over the Internet - and this is an extremely dangerous way to get medications available only by prescription. You do not know what you're buying - it could be anything. If you are taking other medication, you can get drug interactions, which can be very dangerous. So we need to take this into account. And the third issue that causes me concern, more social, connected with questions of Neuroethics.

What kind of society we are creating? Shall we take a nootropic drugs in the future to create a better balance between work and personal life, to do the work in a shorter period of time and may be disclosed: to spend more time with his family, receive education throughout their lives, to give more time for leisure to enjoy life? Do we have built with the help of these drugs better balance between work and personal life - unless, of course, we know that they are safe? Or do we simply turn into a society, living 24/7, and we will work all the time, simply because we can work all the time? Society and so is subject to enormous stress, some of which is caused by globalization and greater and greater pressure on people at work. This is one of the reasons why people take these drugs - to cope with the demands at work. As a society, we need to think about how we want to improve our cognitive abilities. Exercise - a terrific way to improve brain function, and in addition, they improve mood, and are useful for physical health. So I recommend exercise as a way to improve the cognitive abilities of healthy individuals. But we really need to develop new neuroprotective drugs, more efficient and safer - for people with neuropsychiatric disorders and brain injuries.