Developmental & Behavioral Pediatrics, Steven & Alexandra Cohen Children's Medical Center of New York, New Hyde Park, New York.
Feinberg School of Medicine, Northwestern University, Chicago.
Curr Opin Pediatr. 2018 Jun;30(3):430-437. doi: 10.1097/MOP.0000000000000615.
Given the pervasiveness of psychotropic medication in the youth population and an increasingly competitive culture regarding educational performance, children, teenagers, and/or their parents may increasingly seek psychotropic substances in an effort to enhance a student's cognitive abilities and/or academic performance. Physicians must become aware of this very important and clinically relevant issue and work to ensure that medications remain in the hands of patients seeking wellness and not enhancement.
The current article highlights findings on the pervasiveness of stimulant misuse and diversion in youth, the motivations and effects of stimulant use, health and legal consequences associated with use, and physician perceptions and preventive practices. Ethical concerns regarding pharmacological cognitive enhancement in pediatrics are also outlined - including coercion for nonusers, inequities in access, and threats to an individual's sense of self with regard to authenticity and autonomy.
Pharmacological cognitive enhancement in pediatrics will become a larger, clinically relevant issue in the coming years. Physicians who care for children and adolescents must become more aware of this issue. Given the myriad health, legal, and ethical concerns, clinicians should discourage use of pharmaceuticals for enhancement purposes in the pediatric population.
鉴于精神类药物在青少年人群中的广泛使用，以及教育表现方面竞争日益激烈的文化，儿童、青少年和/或其父母可能会越来越多地寻求精神类药物，以提高学生的认知能力和/或学习成绩。医生必须意识到这个非常重要且与临床相关的问题，并努力确保药物仅用于寻求健康的患者，而不是用于增强。
本文重点介绍了青少年中兴奋剂滥用和转移的普遍性、兴奋剂使用的动机和效果、与使用相关的健康和法律后果，以及医生的看法和预防措施。还概述了儿科中药理学认知增强的伦理问题——包括对非使用者的强制、获取途径的不平等，以及对个人真实性和自主性的自我意识的威胁。
儿科药理学认知增强在未来几年将成为一个更大的、与临床相关的问题。照顾儿童和青少年的医生必须更加意识到这个问题。鉴于众多的健康、法律和伦理问题，临床医生应该劝阻在儿科人群中使用药物进行增强。
