Schleim Stephan, Quednow Boris B
Theory and History of Psychology, Faculty of Behavioral and Social Sciences, Heymans Institute for Psychological Research, University of Groningen, Groningen, Netherlands.
Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
Front Pharmacol. 2018 Jan 22;9:3. doi: 10.3389/fphar.2018.00003. eCollection 2018.
Since two decades, neuroenhancement is a major topic in neuroethics and still receives much attention in the scholarly literature as well as in public media. In contrast to high hopes at the beginning of the "Decade of the Brain" in the United States and Europe that we subsume under the "pharmacological optimism hypothesis," recent evidence from clinical neuroscience suggests that developing drugs that make healthy people smarter is even more difficult than finding new treatments for patients with mental disorders. However, cognitive enhancing drugs even for patients with impaired intellectual performance have not been successfully developed yet and new drugs that might have a disruptive impact on this field are unlikely to be developed in the near future. Additionally, we discuss theoretical, empirical, and historical evidence to assess whether cognitive enhancement of the healthy is common or even epidemic and if its application will further increase in the near future, as suggested by the "neuroenhancement prevalence hypothesis." Reports, surveys, and reviews from the 1930s until today indicate that psychopharmacological neuroenhancement is a fact but less common than often stated, particularly in the public media. Non-medical use of psychostimulants for the purpose of cognitive enhancement exists since at least 80 years and it might actually have been more common in the past than today. Therefore, we conclude that the pharmacological optimism hypothesis and neuroenhancement prevalence hypotheses have to be rejected and argue that the neuroenhancement debate should take the available evidence more into account.
二十年来，神经增强一直是神经伦理学中的一个主要话题，在学术文献和公共媒体中仍备受关注。与美国和欧洲在“大脑十年”之初所抱的厚望（我们将其归纳为“药理学乐观假设”）相反，临床神经科学的最新证据表明，开发能让健康人变得更聪明的药物比为精神障碍患者寻找新疗法还要困难。然而，即使是针对智力表现受损患者的认知增强药物也尚未成功研发出来，而且近期内不太可能开发出可能对该领域产生颠覆性影响的新药。此外，我们讨论理论、实证和历史证据，以评估健康人的认知增强是否普遍甚至泛滥，以及按照“神经增强流行假设”的说法，其应用在不久的将来是否会进一步增加。从20世纪30年代至今的报告、调查和综述表明，精神药理学神经增强确有其事，但并不像通常所说的那么普遍，尤其是在公共媒体中。出于认知增强目的的精神兴奋剂非医疗用途至少已存在80年，实际上过去可能比现在更为常见。因此，我们得出结论，必须摒弃药理学乐观假设和神经增强流行假设，并认为神经增强辩论应更多地考虑现有证据。
