The Use and Impact of Cognitive Enhancers among University Students: A Systematic Review

• Published in: Brain sciences 2021-03, Vol.11 (3), p.355
• Main Authors: Sharif, Safia, Guirguis, Amira, Fergus, Suzanne, Schifano, Fabrizio
• Format: Article
• Language: English
• Subjects: Addictions; Amphetamines; Caffeine; Cognitive ability; Cognitive enhancement; drug abuse; Drug tolerance; Drugs & sports; Education; Interviews; Literature reviews; Males; Memory; Mental disorders; Methylphenidate; Modafinil; neuroenhancement; Neurological complications; non-medical drug use; Pharmacy; Piracetam; Prescription drugs; Public health; Pyridoxine; Reviews; Risk factors; Sex differences; Sleep; study drugs; Systematic Review; University students; Vinpocetine; Vitamin B12; Vitamin B6
• ISSN: 2076-3425; 2076-3425
• DOI: 10.3390/brainsci11030355

Cognitive enhancers (CEs), also known as "smart drugs", "study aids" or "nootropics" are a cause of concern. Recent research studies investigated the use of CEs being taken as study aids by university students. This manuscript provides an overview of popular CEs, focusing on a range of drugs/substances (e.g., prescription CEs including amphetamine salt mixtures, methylphenidate, modafinil and piracetam; and non-prescription CEs including caffeine, cobalamin (vitamin B12), guarana, pyridoxine (vitamin B6) and vinpocetine) that have emerged as being misused. The diverted non-prescription use of these molecules and the related potential for dependence and/or addiction is being reported. It has been demonstrated that healthy students (i.e., those without any diagnosed mental disorders) are increasingly using drugs such as methylphenidate, a mixture of dextroamphetamine/amphetamine, and modafinil, for the purpose of increasing their alertness, concentration or memory. To investigate the level of knowledge, perception and impact of the use of a range of CEs within Higher Education Institutions. A systematic review was conducted in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Whilst 1400 studies were identified within this study through a variety of electronic databases (e.g., 520 through PubMed, 490 through Science Direct and 390 through Scopus), 48 papers were deemed relevant and were included in this review. The most popular molecules identified here included the stimulant CEs, e.g., methylphenidate, modafinil, amphetamine salt mixtures and caffeine-related compounds; stimulant CEs' intake was more prevalent among males than females; drugs were largely obtained from friends and family, as well as via the Internet. It is therefore suggested that CEs are increasingly being used among healthy individuals, mainly students without any diagnosed cognitive disorders, to increase their alertness, concentration, or memory, in the belief that these CEs will improve their performance during examinations or when studying. The impact of stimulant CEs may include tolerance, dependence and/or somatic (e.g., cardiovascular; neurological) complications. The availability of CEs for non-medical indications in different countries is influenced by a range of factors including legal, social and ethical factors. Considering the risk factors and motivations that encourage university students to use CE drugs, it is essentia