Cognitive Enhancers
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| Whats the 476 definition of cognitive enhances? | drugs used in an attempt to optimize mental function by enhancing one or more of the following: *learning and memory *attention *executive function
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| What are the 3 primary reasons for use of cognitive enhancers? | (1) To counter mild cognitive impairment (MCI) or dementia (2) To counter ADD/ADHD-linked deficits in attention (3) To try and improve your own performance/productivity
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| CEs and dementia: dementia is a p____________ and p______________ deficit in ____________ with other deficits. | persistent, progressive, memory
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| CEs and dementia: What CE drugs are used for dementia cases? | Acetylcholinesterase inhibitors and NMDA receptor antagonist.
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| What CE drugs are used in cases of ADD/ADHD? | Ritalin, Adderall, Dexedrine, Wellbutrin (SDRI) and Strattera (SNRI)
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| There are 5 types of CE drugs that can be used for personal cognitive performance. What are they? | 1) Cortisol (your bodies natural compound) 2) caffeine (most commonly used psychoactive drug) 3) Ritalin, adderall, provigil (prescription drugs) 4) Piracetam (supplements) 5) next generation drugs still to be discovered
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| Cortisol can be a natural CE. What induces release of cortisol and where does cortisol release from? | Stress induces the release of cortisol from the adrenal glands
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| How much of an increase in cortisol increases cognitive performance? | Only acute increases (chronically high levels lead to cognitive impairments)
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| Stress also causes activation of the ____________ nervous system/release of ________________ (EPI). | sympathetic, epinephrine
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| Stress also causes activation of the sympathetic nervous system/release of epinephrine (EPI). This get you ready for fight/flight which can initiate clinical anxiety in certain people. What do people use to reduce this anxiety? | Beta blockers
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| Described beta-blockers mxn of action, mode of action and whether they are considered a CE or PE? | mxn of action = beta-adrenergic receptor antagonists. mode = reduce subjective feelings of stress/anxiety. And don't match PE or CE definition but could argue that it does match CE definition as they divert attention to cognitive activities.
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| Purinergic stimulants (caffeine) are CE and found in what plants? | coffee, cocoa, guarana, mate kola
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| What's the mechanism of action of caffeine? | Adenosine receptor antagonist
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| How much caffeine do you need for CE? | 50-300mg generally enhance academic performance (varies a lot between people)
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| What are the predominate effects of caffeine (main reasons for why it helps you study)? | due to its enhancement of attention, vigilance and wakefulness
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| Why do we use caffeine so much normally? | Easy access, cheap, acceptable and safe
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| Methylphenidate such as _______ is a Rx drug used as a CE. What is the mxn of action? | blocks presynaptic DA transporter (DAT) and may slightly increase release of DA + NE.
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| What is the ROA of ritalin? those who manipulate ROA (crush it up and snort it) manipulate the mode of action and getter more alert for _______ performance | Oral for Rx purposes , sports performance
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| What are the serious side effects of Ritalin? | Death, stroke, heart attack, psychiatric problems, slowing of growth in children - both height and weight (youth under 18 are the biggest consumers!!), seizures, visual impairment
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| What is a common but less serious side effect of ritalin? Comment on this | Trouble sleeping. We need sleep! If no sleep this hampers cognition and memory so not sleeping with Ritalin may not work so great for CE
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| What type of warning does Ritalin carry? | A black box warning for abuse and dependence
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| Amphetamine such as Adderall is another PX that can be used as a CE. What is its mechanism of action? | Promotes vescular release of newly synthesized NE and DA
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| What it the ROA of Adderall? | oral for Rx purposes
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| What are the serious side effects of Adderall? | Sudden death, heart attack, stroke, psyciatric problems, slowing of growth (height and weight) in children, seizures, visual impairments (so same as ritalin!)
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| What are the non serious but common side effects of Adderall? | Restlessness, insomnia (again sleep trouble), dyskinesia, dysphoria, and depression.
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| What type of warning does Adderall carry? | A LONGER black box warning for abuse and dependence AND fatality risk! So more serious risk to health
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| What are the serious side effects of Modafinil (Provigil)? | Serious rash (life threatening rash), psyciatric symptoms, and symptoms of heart problems.
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| What are the less serious but common side effects of Provigil? | anxiety, insomnia
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| What type of warning does Provigil carry? | Black box warning for abuse and dependence as well as a warning that it is not suitable for us in children (due to a number of side effects in children)
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| What may the confusion over the mxn of action for the supplement CE called Piracetam, stem from? | 1) from trying to group racetams together... 2) and/or highly variable doses 3) and /or examining the drug in the highly variables brains....e.g. post-stroke vs normal, old vs young, high functioning brain vs low functioning brain
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| Data best support that Piracetam is an effective CE in what cases? | Instances of clinical encephalopathy e.g. older people, people with decline in cognitive post disease, disorders, surgery
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| What are the 5 mechanisms of action that are being targeted in current CE pharmaceutical development? | 1) Adenosine receptor antagonists. 2) H3 receptor inverse agonists. 3) AMPAKINES 4) CREB inducers 5) Phosphodiesterase inhibitors (PDE inhibitors)
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| Who is using off label CEs? | University students and academics, Military shooters, pilots, special operations, Shift Workers in hospitals, factorie,s police, School academics and extramurals and for recreational highs.
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| Do Rx nootropics work?? | Can find convincing studies in BOTH directions.
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| Although you get speedy though from CEs, this may not be ______ thought (you can make _________) and you still need to do the ______! | wise thought, mistakes, study.
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| Overall what are the 3 issues with Nootropic use in relation to health risks? | 1) Black box warnings and side effects. 2) Long term effects (we don't know what happens if take for a long time. 3) Effects on 'normal brain' and young brain is uncertain.
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| Overall what are the 3 issues with Nootropic use in relation to abuse/addiction potential? | 1) they hold potential for physical addiction for stimulants. 2)n hold potential for psychological addiction (not being able to study without them) 3) hold recreational potential
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| Overall is the issue with Nootropic use in relation to ethics of human enhancement? | age of cosmetic neurology?
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| What is the 4th overall issue of Nootropic use not mentioned yet? | Fairness
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| What is a key natural cognitive enhancement other than cortisol? | Behavioural modification/CBT
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| Describe the inverted curve for efficacy | As dose increases, efficacy of the nootropic increases to a certain level and then declines.
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| Describe the J curve for safety | As dose increases safety risk increases
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| Describe the relationship between the inverted U curve and the j curve? | With higher dose levels efficacy is less and safety risks is more
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