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Pharmakologisches Neuroenhancement und „Hirndoping“

Chancen und Risiken

Pharmacological neuroenhancement and brain doping

Chances and risks

  • Originalien und Übersichten
  • Published:
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz Aims and scope

Zusammenfassung

Unter „pharmakologischem Neuroenhancement“ versteht man die Einnahme psychoaktiver Substanzen aller Art durch Gesunde mit dem Ziel der geistigen Leistungssteigerung, beispielsweise bezüglich Wachheit, Gedächtnis oder Stimmung. „Hirndoping“ dagegen meint die missbräuchliche Einnahme einer Subgruppe solcher Substanzen, die verschreibungspflichtig oder illegal sind. Zu diesen Substanzen zählen vor allem Psychostimulanzien (Amphetamine, Methylphenidat) und Modafinil, aber auch Antidementiva (Acetylcholinesterase-Inhibitoren, Memantine) und Antidepressiva (selektive Serotoninwiederaufnahmehemmer), die eigentlich zur Therapie des Aufmerksamkeitsdefizit-/Hyperaktivitäts-Syndroms, der Alzheimer-Demenz und Depressionen eingesetzt werden. Nachweisbare Effekte bei Gesunden auf Konzentration, Aufmerksamkeit und Wachheit finden sich nur für Stimulanzien und Modafinil, die jedoch relevante Nebenwirkungen und Sicherheitsrisiken aufweisen, die einen bedenkenlosen Einsatz bei Gesunden nicht rechtfertigen. Koffein zum pharmakologischen Neuroenhancement kann als wirksame Alternative angesehen werden. „Hirndoping“ wirft eine Reihe ethischer und gesellschaftlicher Fragen auf, die einer fortgesetzten Diskussion bedürfen – Forderungen nach einer Liberalisierung müssen kritisch hinterfragt werden.

Abstract

Pharmacological neuroenhancement refers to the use of psychoactive substances by healthy subjects with the purpose of cognitive enhancement, e.g., vigilance, concentration, memory, or mood. “Brain doping”, however, refers to the illicit use of a subcategory of these substances such as prescription drugs. This subcategory includes psychostimulants (e.g., amphetamines, methylphenidate), modafinil, antidementia drugs (acetylcholine-esterase inhibitors, memantine), and antidepressants (selective serotonin reuptake inhibitors) which are being prescribed for the treatment of ADHD (attention deficit/hyperactivity disorder), Alzheimer’s disease, and depression. Only psychostimulants and modafinil show significant effects on concentration, attentiveness, and vigilance in healthy subjects. However, a general use by healthy persons can not be justified because of relevant side effects and safety risks. Caffeine for pharmacological neuroenhancement can be seen as an equally effective alternative. “Brain doping” raises numerous ethical and social concerns that require a continued discussion. Demands of liberalization should be critically questioned.

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Literatur

  1. Lieb K (2010) Hirndoping – Warum wir nicht alles schlucken sollten. Artemis und Winkler, Düsseldorf (im Druck)

  2. Baron DA, Martin DM, Abol MS (2007) Doping in sports and its spread to at-risk populations: an international review. World Psychiatry 6:118–123

    PubMed  Google Scholar 

  3. Teter CJ, McCabe SE, Cranford JA et al (2005) Prevalence and motives for illicit use of prescription stimulants in an undergraduate student sample. J Am Coll Health 53:253–262

    Article  PubMed  Google Scholar 

  4. Deutsche Angestelltenkrankenkasse (DAK) (2009) Gesundheitsreport 2009. Analyse der Arbeitsunfähigkeitsdaten. Schwerpunktthema Doping am Arbeitsplatz. Eigenverlag, Berlin Hamburg

  5. Franke AG, Bonertz C, Christmann M et al (2009) Use of potential neurocognitive enhancing substances and attitudes towards them among pupils in Germany. Brain Matters, Sept. 24.–26., 2009, Halifax, Nova Scotia, Canada

  6. Maher B (2008) Poll results: look who’s doping. Nature 452:674–675

    Article  CAS  PubMed  Google Scholar 

  7. Wilens TE (2008) Effects of methylphenidate on the catecholaminergic system in attention-deficit/hyperactivity disorder. J Clin Psychopharmacol 28:S46–S53

    Article  CAS  PubMed  Google Scholar 

  8. Prince J (2008) Catecholamine dysfunction in attention-deficit/hyperactivity disorder: an update. J Clin Psychopharmacol 28:S 39–45

    Article  Google Scholar 

  9. Oades RD, Sadile AG, Sagvolden T et al (2005) The control of responsiveness in ADHD by catecholamines: evidence for dopaminergic, noradrenergic and interactive roles. Dev Sci 8:122–131

    Article  PubMed  Google Scholar 

  10. Bukstein O (2008) Substance abuse in patients with attention-deficit/hyperactivity disorder. Medscape J Med 10:24

    PubMed  Google Scholar 

  11. Kollins SH (2008) A qualitative review of issues arising in the use of psycho-stimulant medications in patients with ADHD and co-morbid substance use disorders. Curr Med Res Opin 24:1345–1357

    Article  PubMed  Google Scholar 

  12. Wilens TE (2007) The nature of the relationship between attention-deficit/hyperactivity disorder and substance use. J Clin Psychiatry 68(Suppl 11):4–8

    Article  CAS  PubMed  Google Scholar 

  13. Barkley RA, Fischer M, Smallish L, Fletcher K (2003) Does the treatment of attention-deficit/hyperactivity disorder with stimulants contribute to drug use/abuse? A 13-year prospective study. Pediatrics 111:97–109

    Article  PubMed  Google Scholar 

  14. Biederman J, Monuteaux MC, Spencer T et al (2008) Stimulant therapy and risk for subsequent substance use disorders in male adults with ADHD: a naturalistic controlled 10-year follow-up study. Am J Psychiatry 165:597–603

    Article  PubMed  Google Scholar 

  15. Bright GM (2008) Abuse of medications employed for the treatment of ADHD: results from a large-scale community survey. Medscape J Med 10:111

    PubMed  Google Scholar 

  16. U.S. Food and Drug Administration (FDA) Sicherheitshinweis am 29.5.2005: Public health advisory suicidal thinking in children and adolescents being treated with strattera (Atomoxetine). Rockville, Maryland

  17. Gould MS, Walsh BT, Munfakh JL et al (2009) Sudden death and use of stimulant medications in youths. Am J Psychiatry 166:992–1001

    Article  PubMed  Google Scholar 

  18. Rugino TA, Samsock TC (2003) Modafinil in children with attention-deficit hyperactivity disorder. Pediatr Neurol 29:136–142

    Article  PubMed  Google Scholar 

  19. Minzenberg MJ, Carter CS (2008) Modafinil: a review of neurochemical actions and effects on cognition. Neuropsychopharmacology 33:1477–1502

    Article  CAS  PubMed  Google Scholar 

  20. Wesensten NJ, Killgore WD, Balkin TJ (2005) Performance and alertness effects of caffeine, dextroamphetamine, and modafinil during sleep deprivation. J Sleep Res 14:255–266

    Article  PubMed  Google Scholar 

  21. Killgore WD, Kahn-Greene ET, Grugle NL et al (2009) Sustaining executive functions during sleep deprivation: a comparison of caffeine, dextroamphetamine, and modafinil. Sleep 32:205–216

    PubMed  Google Scholar 

  22. Rugino T (2007) A review of modafinil film-coated tablets for attention-deficit/hyperactivity disorder in children and adolescents. Neuropsychiatr Dis Treat 3:293–301

    CAS  PubMed  Google Scholar 

  23. Franke AG, Lieb K, Fellgiebel A (2009) From symptomatic to disease modifying therapy? Recent developments in the pharmacotherapy of Alzheimer’s disease. Fortschr Neurol Psychiatr 77:326–333

    Article  CAS  PubMed  Google Scholar 

  24. Nehlig A, Daval JL, Debry G (1992) Caffeine and the central nervous system: mechanisms of action, biochemical, metabolic and psychostimulant effects. Brain Res Brain Res Rev 17:139–170

    Article  CAS  PubMed  Google Scholar 

  25. Ferre S, Ciruela F, Borycz J et al (2008) Adenosine A1-A2A receptor heteromers: new targets for caffeine in the brain. Front Biosci 13:2391–2399

    Article  CAS  PubMed  Google Scholar 

  26. Fisone G, Borgkvist A, Usiello A (2004) Caffeine as a psychomotor stimulant: mechanism of action. Cell Mol Life Sci 61:857–872

    Article  CAS  PubMed  Google Scholar 

  27. Marley E, Nistico G (1972) Effects of catecholamines and adenosine derivatives given into the brain of fowls. Br J Pharmacol 46:619–636

    CAS  PubMed  Google Scholar 

  28. Smith JV, Burdick AJ, Golik P et al (2002) Anti-apoptotic properties of Ginkgo biloba extract EGb 761 in differentiated PC12 cells. Cell Mol Biol (Noisy-le-grand) 48:699–707

    Google Scholar 

  29. Smith JV, Luo Y (2004) Studies on molecular mechanisms of Ginkgo biloba extract. Appl Microbiol Biotechnol 64:465–472

    Article  CAS  PubMed  Google Scholar 

  30. Birks J, Grimley Evans J (2009) Ginkgo biloba for cognitive impairment and dementia. Cochrane Database Syst Rev CD003120

  31. Wilens TE, Adler LA, Adams J et al (2008) Misuse and diversion of stimulants prescribed for ADHD: a systematic review of the literature. J Am Acad Child Adolesc Psychiatry 47:21–31

    Article  PubMed  Google Scholar 

  32. Huss M, Hölling H, Kurth BM, Schlack R (2008) How often are German children and adolescents diagnosed with ADHD? Prevalence based on the judgment of health care professionals: results of the German health and examination survey (KiGGS). Eur Child Adolesc Psychiatry 17(Suppl 1):52–58

    Article  PubMed  Google Scholar 

  33. Schlack R, Hölling H, Kurth BM, Huss M (2007) The prevalence of attention-deficit/hyperactivity disorder (ADHD) among children and adolescents in Germany. Initial results from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 50:827–835

    Article  CAS  Google Scholar 

  34. Galert T, Bublitz CH, Heuser I et al (2009) Das optimierte Gehirn. Gehirn Geist 11:1–12

    Google Scholar 

  35. Greely H, Sahakian B, Harris J et al (2008) Towards responsible use of cognitive-enhancing drugs by the healthy. Nature 456:702–705

    Article  CAS  PubMed  Google Scholar 

  36. Synofzik M (2006) Kognition a la carte? Der Wunsch nach kognitionsverbessernden Psychopharmaka in der Medizin. Z Ethik Med 18:37–50

    Article  Google Scholar 

  37. Synofzik M (2009) Ethically justified, clinically applicable criteria for physician decision-making in psychopharmacological enhancement. Neuroethics 2:89–102

    Article  Google Scholar 

  38. Jongh R de, Bolt I, Schermer M, Olivier B (2008) Botox for the brain: enhancement of cognition, mood and pro-social behavior and blunting of unwanted memories. Neurosci Biobehav Rev 32:760–776

    Article  PubMed  Google Scholar 

  39. Kandel E, Schwartz JH, Jessel TM (1995) Neurowissenschaften. Eine Einführung. Spektrum, Heidelberg

  40. Kandel E (2007) Auf der Suche nach dem Gedächtnis: Die Entstehung einer neuen Wissenschaft des Geistes. Siedler, München

  41. Normann C, Boldt J, Maio G, Berger M (2010) Options, limits and ethics of pharmacological neuroenhancement. Nervenarzt 81:66–74

    Article  CAS  PubMed  Google Scholar 

  42. Schöne-Seifert B (2008) Enhancement. Die ethische Debatte. Mentis, Paderborn

  43. Schöne-Seifert B, Ach JS, Opolka U, Talbot D (2010) Neuro-Enhancement. Ethik vor neuen Herausforderungen. Mentis, Paderborn

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  1. Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität, Untere Zahlbacher Str. 8, 55131, Mainz, Deutschland

    A.G. Franke M.A. & K. Lieb

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  2. K. Lieb
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Correspondence to A.G. Franke M.A..

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Franke, A., Lieb, K. Pharmakologisches Neuroenhancement und „Hirndoping“. Bundesgesundheitsbl. 53, 853–860 (2010). https://doi.org/10.1007/s00103-010-1105-0

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