Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Eschenallee 3, 14050 Berlin, Germany.
Pharmacol Res. 2010 Jun;61(6):473-81. doi: 10.1016/j.phrs.2010.02.009. Epub 2010 Mar 1.
The term neuroenhancement refers to improvement in the cognitive, emotional and motivational functions of healthy individuals through, inter alia, the use of drugs. Of known interventions, psychopharmacology provides readily available options, such as the anti-dementia drugs, e.g. acetylcholinesterase inhibitors (donepezil, galantamine, rivastigmine) and memantine. Based on a systematic review we found that expectations about the potential of these drugs exceed their actual effects, as has been demonstrated in randomised controlled trials. Both single and repeated dose trials were included in the systematic review, however repeated dose trials have only been conducted for donepezil. In six small trials lasting 14-42 days, the following results emerged: donepezil improved the retention of training on complex aviation tasks and verbal memory for semantically processed words. In one study episodic memory was improved, whereas in others it remained unaffected by donepezil. In a sleep deprivation trial, donepezil reduced the memory and attention deficits resulting from 24h of sleep deprivation. Two studies reported even transient negative effects. Regarding the safety profile of donepezil, these studies found that it was rather well tolerated. In any case, since large longitudinal studies are not available no conclusions can be drawn. Seven small studies about the effects of a single dose of memantine, and one study with a single dose of rivastigmine have been reported. Again, these studies are not adequate to answer our research question. If, as here and elsewhere suggested, the concept of pharmaceutical neuroenhancement is not to be rejected in principle, the decision of healthy individuals to take drugs for the purpose of neuroenhancement should be based on exhaustive information. At the moment, the research that would support or oppose the use of acetylcholinesterase inhibitors and memantine for neuroenhancement by healthy individuals has not yet been performed.
神经增强这个术语是指通过使用药物等手段来改善健康个体的认知、情感和动机功能。在已知的干预措施中，精神药理学提供了现成的选择，例如抗痴呆药物，如乙酰胆碱酯酶抑制剂（多奈哌齐、加兰他敏、利伐斯的明）和美金刚。基于系统评价，我们发现这些药物的潜在效果超出了实际效果，随机对照试验已经证明了这一点。系统评价中包括单次和重复剂量试验，但只有多奈哌齐进行了重复剂量试验。在持续 14-42 天的 6 项小型试验中，得出以下结果：多奈哌齐改善了复杂航空任务的训练保留和语义处理词的言语记忆。在一项研究中，情景记忆得到了改善，而在其他研究中，多奈哌齐对其没有影响。在一项睡眠剥夺试验中，多奈哌齐减少了 24 小时睡眠剥夺导致的记忆和注意力缺陷。两项研究报告了甚至短暂的负面效应。关于多奈哌齐的安全性概况，这些研究发现它耐受性相当好。无论如何，由于没有大型纵向研究，因此无法得出结论。已经报告了 7 项关于单剂量美金刚的影响的小型研究和 1 项关于单剂量利伐斯的明的研究。同样，这些研究也不足以回答我们的研究问题。如果像这里和其他地方所建议的那样，药物神经增强的概念原则上不应被拒绝，那么健康个体决定为了神经增强而服用药物的决定应该基于详尽的信息。目前，还没有进行支持或反对健康个体使用乙酰胆碱酯酶抑制剂和美金刚进行神经增强的研究。
