December 11th, 2008
02:13 PM ET

Prescribing a clearer mind?

By Dr. Sanjay Gupta
CNN Chief Medical Correspondent

As things stand now, it is illegal for a healthy person to take prescription stimulants such as Ritalin and Adderall without a prescription. It is happening, though. In surveys of college students, some places reported use as high as 25 percent! They say they use it to boost memory, concentration and focus. And, who wouldn’t want that?

Seven scientists are asking the question aloud in a commentary that caught my eye. I have been doing stories about brain cognition for some time, and they are always some of our most popular stories. That’s because you would be hard pressed to find someone who says their memory, focus and concentration is as good as it can be. I know mine certainly isn’t. And, therein lies the problem. Should I be taking a drug to solve the problem or is our society way too over medicated already?

In case you are curious, the authors were no slouches. The group of scientists includes ethics experts and the editor in chief of the journal Nature. They all call for more research into the risk of the drugs including addiction and long term effects of amphetamines, which are an important ingredient in these brain enhancing drugs. They also want policies to ensure people are not coerced or forced into taking them. For example, you wouldn’t want your employer requiring  you to alter your brain chemistry because they thought it made you more productive or focused.

I guess the real question is would you take these medications? Let’s say they went over the counter tomorrow, would you start taking them or recommending them for your family members even if you or they had never been diagnosed an with attention disorder?

Editor’s Note: Medical news is a popular but sensitive subject rooted in science. We receive many comments on this blog each day; not all are posted. Our hope is that much will be learned from the sharing of useful information and personal experiences based on the medical and health topics of the blog. We encourage you to focus your comments on those medical and health topics and we appreciate your input. Thank you for your participation.

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soundoff (39 Responses)
  1. Brandi - bottom of the boot

    i must say that i would rather have it prescribed by a doctor. merely because i already take daily medications.

    however, as a nursing student, i would do anything to improve my concentration and focus at this point. it would be nice if there was something out there that was not stimulant based though, i dont think i would like my nurse taking a stimulant while providing care to me. i would probably tell the nurse to get the heck away from me. that is what is scary to me, to end up with a health care professional who is not being very professional, if you know what i mean. i take nursing very seriously, its people's lives you are dealing with. mistakes are rampant and can be deadly. its a lot of responsibility, being clear-headed is imperative.

    so there, you have another angle on this topic as im sure you know as well as i do that substance abuse is not foreign to the medical community. then again, there is a lot more to that angle, like HIPPA and the conflict of protecting patients. how do you protect them when their own healthcare providers health information is protected? people are people after all, its not as easy as an ethics law reads to turn in your close friend or co-worker, and then you must recognize it first. we are not always honest with ourselves.

    if i have jumped around, possibly it is my lack of ability to focus. 🙂

    love your work Dr. Gupta.

    December 11, 2008 at 17:05 | Report abuse | Reply
  2. Georgia

    Due to the fact that I am now officially a 'young' senior, I have admitted to myself that unless I am concentrating on only one thing at a time - as opposed to most of my working life doing twenty things at a time, I mess up. I forget; I lose things; I can't remember names, etc. Otherwise, I can maintain, and have this year, a 4.0 in college still. However, daily life as I know it with family and friends is over during that time. I have to only concentrate on those studies. Along with that, watching my dad and four of his family members die of dementia, you bet I would take the medications. You'd have to know how much I am against most medications usually to appreciate this decision. But tohave my total memory and be alert at all times able to do various things again - in a heartbeat!

    December 11, 2008 at 19:25 | Report abuse | Reply
  3. Dr. Shaila Nanjundiah (audiology)

    Dr. Gupta:

    From my clinical experience, children with mild form of ADD and those with auditory /sensory processing problems in elementary or middle school often go unnoticed. Since their academic scores are not necessarily affected, these problems are not recognized by schools, parents or even the doctors.

    Once out of the structured/ protected childhood environment, these young adults may develop poor coping behavior especially with increasing academic, peer and professional pressures. As a result, they may present difficulty with concentration and focus. In fact, it is possible that their ability to process information or to attend to a given task is impacted especially due to background noise.

    In my opinion, schools, pediatricians' office and even work places should incorporate periodic intervention by trained professionals to avoid dependence on ritalin and other stimulants later in their life.

    Why challenge the neurotransmitters biochemically when there are simple non- invasive habilitative techniques that may address the needs of people with undiagnosed attention problems- early in life?

    Shaila Nanjundiah
    Audiopedics, LLC

    December 12, 2008 at 00:43 | Report abuse | Reply
  4. Lisa Radin

    If I had, or thought I had ADHD, I might take OTC med. Majority of people don't admit to mental health issues, so availability of such meds could be a good idea. But 2 concerns: these meds cause weight gain (contributing to reason kids obese) and psychotropic meds can cause negative thoughts (suicide) and change blood dynamics (insulin, cholesterol). Unless, pharmaceutical company can develop low dose that has less side affects – as educated person in this area – I'd have fear of buying OTC. But many don't understand the above issues. It's a Catch 22. Bigger issue is having people go public (to doctors) with their mental health issues – but society doesn't support – too much of stigma and insurance has poor coverage. I certainly wouldn't recommend same dosage as scripts – maybe 10% – for trial. My thoughts.

    December 12, 2008 at 09:29 | Report abuse | Reply
  5. Jill

    I am 30 years old and I have been taking Adderall XR for one year. I had been given Ritalin when I was in high school, but I didn't take it for long due to gastrointestinal side effects. This time around, I asked my doctor if I could try ADD medication because I was having trouble at work after the death of a close family member. It was extremely helpful at first, but as it goes with stimulant medication, the effects have lessened over time. It still helps with concentration and I don't fidget all day long, but I'm not hyperproductive as I was for the first few months of taking it. Therein lies the problem with making these drugs available without a prescription. Over time, one needs a higher dose to get the same effects, and I think that if it were not monitored, many people would go ahead with increasingly higher doses. I wouldn't reccommend these drugs to anyone who didn't really have a problem getting things done. That said, it would be nice if the ADD/ADHD drugs weren't SO tightly controlled. It would be nice to be able to get refills. I asked one doctor for ADD medication in my mid-twenties, and she acted as if I were an established drug abuser and refused me outright. Because of her reaction, I didn't ask my current doctor for help until I felt like I couldn't do my job at all, though the medication would have been helpful all along. Medications like Adderall should be available in controlled amounts to those who might be helped by it.

    December 12, 2008 at 10:15 | Report abuse | Reply
  6. Marsha

    You bet I would! Some years ago I was prescribed Ritalin for a few months, and both my outlook and concentration improved immensely. I do not believe I became dependent or addicted, though, because I didn't even take the medicine as frequently as prescibed.

    I think it's ironic that doctors are very quick to prescribe these drugs to children but not to adults, who could stand to benefit as much or more. Apparently these drugs often help curb one's appetite, which you would think would be great with the high incidence of obesity in our population.

    December 12, 2008 at 12:12 | Report abuse | Reply
  7. Shelly

    I'd be concerned about long term effects... With that said, if medications, such as Adderall, were available over the counter I would take them. I think people can reach a higher aptitude and do greater things.

    December 13, 2008 at 09:41 | Report abuse | Reply
  8. Patty

    I am taking phentermine which is an appetite suppressant but, basically a stimulant similar to Adderall and Ritalin. I have been taking it off and on for years because of the energy, focus and concentration benefits.
    I realize that is not what it is indicated for and that I am self-medicating by using it for reasons other than weight loss (my weight is fine). I have not had to increase the dosage despite the length of time I've been taking it.
    I do worry about long term effects but when I weigh the risks and benefits
    the benefits, for me, outweigh the risks. My blood pressure is good and my health in general is good. So, until I find something else that works, I plan to continue. I don't take it every day. I have tried many different antidepressants which seem to do very little as far as the benefits stated above.

    December 14, 2008 at 22:32 | Report abuse | Reply
  9. Catherine

    I would be tempted. Several members of my family, myself included, seem to have undiagnosed ADD. I have always felt that I would do better in life if I were treated for the disorder; my life tends to the chaotic, the unfinished, the inability to move from identifying things that need to get done, to getting them done, in any linear way. I haven't asked a doctor about it because I've been afraid of being labeled, and also of becoming addicted to drugs the long-term effects of which few seem to know much about. But if it were available to me in an impulsive mood, I would almost certainly try it.

    December 16, 2008 at 10:16 | Report abuse | Reply
  10. NT

    The line between enhancement and treatment is already blurry - e.g. cosmetic surgery, fertility treatments, orthodontics, and of course Viagra. Two important ethical issues, which science alone will not be able to resolve, are access to enhancements (those who can afford them vs those who might most benefit) and autonomy (does the "patient:" or someone else make the risk-benefit determination?) . I suspect much of the feigned moral indignation about brain-altering drugs comes from folks who regulalry down caffeinated beverages, smoke cigarettes, consume large qualitities of sugar, and/or drink alcoholic beverages, all of which have powerful neurologic effects. Again, the line is blurry. One person's enhancement is another person's "normal."

    December 16, 2008 at 15:28 | Report abuse | Reply
  11. Lauren Conley

    I'm not sure I see the ethical dilemna in taking something that helps people succeed where otherwise they may not. I'm one of those people who Dr. Nanjundiah was talking about, one of the ones who failed academically once I left the structured environment of my high school. I have hearing and vision problems (almost deaf left ear, almost blind right eye, and lazy left eye...my right ear hears OK though lol). And school was a nightmare (I was never diagnosed with any problems thoguh deep inside I knew I had a learning disability), but I found that if I could just "fake it" through class, I could teach myself most of what was in the book. College...was another matter, entirely. Didn't help that my first two months my mouth was wired shut from surgery. No hearing, little vision, and now I couldn't speak. As an 18 year old with a high IQ, I'd have swallowed ritalin by the fistful if I thought it could keep me focused. Instead, I flunked out, scared and ashamed. So although I don;t believe drugs should be the immediate choice, I think they should be available. After all, you only ususally get the one chance to succeed your first time. Why take the chance?

    December 16, 2008 at 21:56 | Report abuse | Reply
  12. Tammy

    I would not! I have had problems with depression and anxiety and even panic attacks. I would not want to stimulate my brain when already there are some chemical imbalances due to major life stressors. I even think that some doctors over-prescribe these meds to children as all children up until 3rd or 4th grade have attention issues (obviously some worse than others and some simply DO need the medication). Why not try all alternatives first as in diet and psychotherapy before reverting to AMPHETAMINES! Many children are doped up on speed and many may be able to live normal, happy, healthy lives with some natural alternatives.

    December 18, 2008 at 18:24 | Report abuse | Reply
  13. Encartica

    Only if the medications were prescribed by a qualified doctor and the quality of life of the individual in question was severely compromised. Other than that, never! Congrats to you and your wife on your third child. 🙂

    December 19, 2008 at 10:38 | Report abuse | Reply
  14. Liza

    I sympathize with Patti. Off and on for many years, I've been using an ECA stack (and other products with ephedra once those became unavailable). I started taking it as a supplement to my workouts to help drop some excess body fat, but quickly realized that it acted as a stimulant and boosted my energy and memory. I've wanted to stop using them for quite some time now, but every time I try to quit I just can't cope without them. I acknowledge that this is a personal problem that I have; however, I feel that a prescription drug with similar effects used properly would be much less dangerous for me. I would definitely try it if it were available OTC.

    December 31, 2008 at 15:04 | Report abuse | Reply
  15. Ivan J

    Drugs have become the easy solution for most health cases inolving the functioning of the brain but that is because we live in times of easy access and mis diagnosing. People become conscious of their weakness and automatically consider it a flaw in themselves that they seek medical attention and an easy short term cure. What should be done especially in mis-diagnosing children with (ADD) is go back to basics like opreant conditioning, and Nature vs. nurture letting kids be kids and parents be parents

    January 11, 2009 at 05:29 | Report abuse | Reply
  16. Miraida Morales

    If I have no illness but merely want to increase focus, memory and concentration, I would not take medication such as Ritalin even if I could legally do so. I would much rather try to improve these areas through natural means such as behavior modification, cutting out some stress, sleeping better, and eating better. I would perhaps try to take a natural remedy first if I wanted to do more.

    January 23, 2009 at 12:48 | Report abuse | Reply
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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.