Tuesday, May 4, 2010

Got a couple comments on my April 21 blog about memory. Both referred to a segment on the TV show 60 Minutes in which the use of Adderall in college campuses to facilitate studying was discussed. I didn’t see the show, but apparently students are using the drug to help cram for exams.

Adderall is the brand-name for a psychostimulant (a stimulant or “upper”) medication that is used commonly to treat people with ADHD because such patients often have a paradoxical reaction to it. Instead of becoming stimulated, they are calmed down. Adderall is also used to treat Narcolepsy (see the April 30 blog). It requires a prescription drug and may or may not be addictive depending upon the addictive potential of the individual using it. The drug is thought to work by increasing the amount of two neurotransmitters (see earlier blog), dopamine (which is deficient in Parkinson’s disease) and norepinephrine. Its main effect is to increase alertness, libido, concentration, and overall cognitive performance while decreasing user fatigue. So it’s easy to see why students might use it. It is available in two formulations – an instant release and extended release. It is a cousin to methamphetamine and dextroamphetamine and there is some dextroamphetamine in both formulations.

Use of uppers by students is not new and started when amphetamines were first introduced in the 60s as “diet pills.” In fact, when Shire, the pharmaceutical firm that introduced Adderall in 1996, did so as an obesity treatment. Since then pediatricians have tumbled to the fact that it is effective for treating some children with ADHD.

As is the case with all drugs, there is the potential for “off label” use – using the drug for indications not approved to be on the dispensing label. Off label use is not illegal. Physicians commonly prescribe drugs for indications not officially approved by the FDA. As an example, Tegretol, a widely used anticonvulsant was initially introduced for treatment of trigeminal neuralgia. Neurologist quickly adopted the medication to treat seizure disorders. It wasn’t until a decade later, after clinical trials demonstrated it’s anticonvulsant effect, that the FDA approved it for that use.

This issues raised by the two blog readers is a good one. Is the use of a psychoactive drug for the purposes of studying bad? Probably not. In actuality, it’s not much different than brewing a pot of strong coffee for a night of cramming. The difference, of course, is that caffeine does not require a prescription. Both caffeine and Adderall can be addictive, so the difference here is how to obtain the drug. Most doctors will not prescribe it as a study aid, so it is commonly obtained illegally.

I thank the two readers who raised this question. As I've written before, please ask questions about the brain and brain function.

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