From: Hal Finney (hal@finney.org)
Date: Fri Jan 24 2003 - 17:11:25 MST
I was reading Flying magazine yesterday, and because of the long lead
time in print publishing it was only now reporting on a study released
last summer. I don't think it was mentioned here. Some links:
http://www.ahealthyme.com/article/hscoutn/102470909
http://www.aan.com/press/press/releases/070902_alzheimer.htm
http://www.pharmj.com/Editorial/20020720/news/raisesethical.html
The study, reported in the journal Neurology, involved giving a group
of pilots some training/testing in a flight simulator. They were then
given either a placebo or the Alzheimers drug donepezil, which enhances
acetylcholine, for 30 days. Then they were tested again on the flight sim
to see how much they had retained. (They didn't fly for those 30 days.)
These were not Alzheimer's patients, they were typical pilots with
an average age of 52, but the drug provided significant performance
enhancement. The placebo group showed a decline in performance on the
tests, as might be expected after 30 days away. The donepezil group,
however, performed at the same level as they had 30 days earlier.
They had retained all of the training benefits over that 30 day period
away from the cockpit.
The authors of the paper point out that this result raises new ethical
questions. Here is a case where normal, healthy people had their mental
performance enhanced by a drug. If this result can be extended and proven
for the general population, would it imply that most people might want
to start taking this drug, at least as they get older? More generally,
if there is a drug that makes people smarter, should everyone take it?
Now, in practice things are not so clear cut. The drug does have some
side effects. And my wife, who works as a therapist with some Alzheimer's
patients, cautions that this drug (sold under the name Aricept) often
shows decreased effectiveness after a while. This may be due to the
progressive nature of Alzheimer's, or it might be that the enhancement
of the cholinergic system becomes less effective as the brain adjusts
to its new chemistry.
We still have something of a taboo about healthy people meddling
with their brain chemistry (beyond a few socially approved examples
like alcohol). Peter Kramer's book Listening to Prozac, published ten
years ago, described a number of examples of people who were basically
healthy mentally who nevertheless got great benefits from Prozac; it made
them more confident, more successful. But there is a stigma attached,
and few of us would ask a doctor to put them on Prozac for a few months
just to see if it made our lives better.
Chances are this is going to change over the next few decades, as more
effective drugs are found, with fewer side effects. In a way, it's good
that older people suffer mental deficits, as it provides a socially
acceptable justification for research into medications that enhance
mental performance. As good drugs are found they may well leak down
into the healthier segments of the population. Eventually the stigma
will hopefully break down and people will adopt a more Extropian attitude
towards enhancing their minds.
Hal
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