Scott Morrison hails 'miracle' as Coalition snatches unexpected victory

The Coalition has been re-elected in a shock result in which Labor lost seats in Queensland, Tasmania and NSW and failed to make more than minimal gains nationally.But former prime minister Tony Abbot...

Michelle Grattan, Professorial Fellow, University of Canberra - avatar Michelle Grattan, Professorial Fellow, University of Canberra

Coalition likely to win election in Trump-like upset, but Abbott loses Warringah

Against expectations, Scott Morrison has led the Coalition government back to power.Wes Mountain/The Conversation, CC BY-NDWith 57% of votes counted in the election, the ABC is projecting that the Coa...

Adrian Beaumont, Honorary Associate, School of Mathematics and Statistics, University of Melbourne - avatar Adrian Beaumont, Honorary Associate, School of Mathematics and Statistics, University of Melbourne

Infographic: what we know about the results of Election 2019 so far

As of 10.01pm Saturday, May 18 2019:...

Emil Jeyaratnam, Data + Interactives Editor, The Conversation - avatar Emil Jeyaratnam, Data + Interactives Editor, The Conversation

Bob Hawke, the environmental PM, bequeathed a huge 'what if' on climate change

Since the news broke of his passing, Bob Hawke has been feted as the “environmental prime minister”. From saving the Franklin River, to protecting Antarctica from mining, conservationists ...

Marc Hudson, Researcher, University of Manchester, University of Manchester - avatar Marc Hudson, Researcher, University of Manchester, University of Manchester

You are what you vote: the social and demographic factors that influence your vote

Your income, type of work, where you were born, and other social and demographic factors influences your vote more than you may think.The Conversation / ShutterstockAustralia has changed in many ways ...

Rob J Hyndman, Professor of Statistics, Monash University - avatar Rob J Hyndman, Professor of Statistics, Monash University

View from The Hill: Bob Hawke was master of managing government

It’s always easy to romanticise the past – in celebrating the prime ministership of Bob Hawke it is important to remember it had its peaks and troughs.Trouble marked many years – the...

Michelle Grattan, Professorial Fellow, University of Canberra - avatar Michelle Grattan, Professorial Fellow, University of Canberra

Vic Stockwell’s Puzzle is an unlikely survivor from a different epoch

Sign up to the Beating Around the Bush newsletter here, and suggest a plant we should cover at batb@theconversation.edu.au.On the western side of Mount Bartle Frere, the tallest mountain in Queensland...

Andrew Thornhill, Research botanist at the Botanic Gardens and State Herbarium of South Australia/Environment Institute, University of Adelaide - avatar Andrew Thornhill, Research botanist at the Botanic Gardens and State Herbarium of South Australia/Environment Institute, University of Adelaide

Vital Signs: for the best election predictions, look to the betting markets, not the opinion polls

It turns out that betting markets are quite good predictors, on average.www.shutterstock.comOpinion polls haven’t done too well in some important recent elections.Polls failed to foresee the Bre...

Richard Holden, Professor of Economics, UNSW - avatar Richard Holden, Professor of Economics, UNSW

What I learned from Bob Hawke: economics isn't an end itself. There has to be a social benefit

When I was growing up in Adelaide in the 1970s I wanted to be like Bob Hawke. Other kids generally wanted to be cricket, football or rock stars. I wanted to be a research officer with the Australian C...

Tim Harcourt, J.W. Nevile Fellow in Economics and host of The Airport Economist, UNSW - avatar Tim Harcourt, J.W. Nevile Fellow in Economics and host of The Airport Economist, UNSW

GetUp!'s brand of in-your-face activism is winning elections – and making enemies

GetUp! protesters outside the second leaders' debate in Adelaide earlier this month.David Mariuz/AAPIt can be hard for a political cause to get noticed in a jaded world awash with information, but con...

Mark Rolfe, Honorary associate, School of Social Sciences, UNSW - avatar Mark Rolfe, Honorary associate, School of Social Sciences, UNSW

VIDEO: Michelle Grattan on the passing of Bob Hawke - and the final campaign push

University of Canberra Deputy Vice-Chancellor Leigh Sullivan speaks to Michelle Grattan about the week in politics. They discuss the passing of former Labor prime minister Bob Hawke and his legacy, as...

Michelle Grattan, Professorial Fellow, University of Canberra - avatar Michelle Grattan, Professorial Fellow, University of Canberra

As we face pressing global issues, the pavilions of Venice Biennale are a 21st century anomaly

One of the most powerful images at this year's Venice Biennale is Christoph Büchel's Barca Nostra, 2018-2019, Shipwreck 18th of April 2015. La Biennale di VeneziaThe 58th Venice Biennale of Art o...

Felicity Fenner, Associate Professor at UNSW Art & Design, UNSW - avatar Felicity Fenner, Associate Professor at UNSW Art & Design, UNSW

This is what happens to a baby's body during birth

Delivering a human baby – which has a large, highly developed brain – is risky for mother and baby. jaredandmelanie/flickr , CC BYPregnancy, labour and delivery are incredibly physically ...

Ian Wright, Professor of Paediatrics and Child Health Research, University of Wollongong - avatar Ian Wright, Professor of Paediatrics and Child Health Research, University of Wollongong

Final poll wrap: Race tightens in Ipsos and Dutton just ahead in Dickson, plus many more seat polls

The election campaign is finally coming to an end, with Australians to head to the polls tomorrow.AAP/Bianca de Marchi/Tracey NearmyThe federal election will be held tomorrow. Polls close at 6pm Austr...

Adrian Beaumont, Honorary Associate, School of Mathematics and Statistics, University of Melbourne - avatar Adrian Beaumont, Honorary Associate, School of Mathematics and Statistics, University of Melbourne

imageOn the up.Angry Parsley, CC BY-SA

People desire to enhance themselves in all sorts of ways: physically through cosmetic surgery; sexually through Viagra; and through using cognitive enhancing, or smart, drugs to perform better at school or work. In such a globally competitive environment it is likely that the market for the last of these will continue to grow.

The use of these drugs by healthy people for lifestyle reasons is increasing. This has been documented, both by formal and informal surveys and by the Care Quality Commission’s data on prescriptions for methylphenidate (Ritalin); 56% in the past five years in England alone. The increase in prescriptions has been attributed to several factors, including the potential for diversion and misuse, and the CQC has recommended that methylphenidate use be monitored carefully.

In a survey published in Nature, 62% of (1,400) users of smart drugs reported taking methylphenidate, making it the most popular choice. Another 44% reported taking modafinil and 15% said they had taken beta blockers such as propranolol. The survey also reported that a third of the drugs that were used for non-medical purposes were purchased over the internet.

A new class

In my publications on this topic and my lectures, I have warned about the harms of purchasing these prescription-only drugs over the internet. There seems now to be another class of drugs which is being purchased over the internet: the racetams, which are used for the treatment of dementia or cognitive impairment.

Many clinical trials and reviews, including a Cochrane review, have looked at the use of piracetam, one of the original racetams, but there now seem to be more potent ones.

In general, these drugs are said to enhance brain metabolism and neuro-protection. Nefiracetam binds to a receptor in the brain called GABA-A and allows activity at even more receptors, including ones called NMDA, which play a part in controlling synaptic plasticity and memory function. Nefiracetam has been shown to effectively treat apathy and motivation issues in patients after stroke. Another, aniracetam has been shown to modulate the AMPA receptor and has actions on others called D2, nACh and 5-HT2A in the brain. Noopept is derived from the racetam family of drugs and shares similar mechanisms of actions, but is far more potent than piracetam, which is used to treat epilepsy.

For treatments currently approved by the regulatory bodies there is advice and information for all these drugs that tell you how fast different ones work, what they do and the benefits of choosing one over another.

The market

The Medicines and Healthcare products Regulatory Agency (MHRA) recently announced the UK’s biggest-ever single seizure of smart drugs. With more than 20,000 units, of 13 different types of cognitive enhancement medicines, the seizure had a value of about £200,000. The drugs seized from a UK website included noopept, phenylpiracetam, centrophenoxine, oxiracetam, sunifiram, citicoline and aniracetam, which illustrates the burgeoning demand and variety of the new active substances entering the marketplace.

The seizure came following intelligence from the Norwegian Medicines Agency, after a number of packages were detained by Norwegian customs, and a full investigation was initiated by the MHRA.

So the demand is there. But what are the concerns about the use of these drugs? For one, there are no long-term safety and efficacy studies of these drugs in healthy people. One of the drugs seized, Sunifiram, has never been subject to clinical trials involving humans.

Furthermore, we know that the brain is in development into late adolescence. Therefore we do not know the long-term consequences of the effects of these drugs on a healthy developing brain. It may give a boost now, but what will be the effect of repeated use down the line? We just don’t know. Without consultation from a doctor, counter-indications that suggest you shouldn’t use them, such as other medications which may interact with these drugs or a pre-existing medical condition, may not be clear.

Many young people also purchase these drugs via the internet, which is a very dangerous way of obtaining prescription-only drugs, because you do not know what you actually purchasing. As Alistair Jeffrey, the MHRA’s head of enforcement, put it: “If you are acquiring medicines over the internet without a prescription then you are purchasing from an unknown, unregulated and ultimately an unlawful source that has one objective – to take your money."

Legitimate uses

There are important benefits to society of cognitive enhancing drugs, particularly when considering people with neuro-psychiatric disorders, such as Alzheimer’s disease, and brain injury.

However, use by healthy people is an issue. Both the International Neuroethics Society and the Society for Neuroscience have discussed the ethical issues of this increasing use of these drugs by healthy people. And the impact of this on neuroscience and on society requires urgent further discussion among professionals and the public.

While reports have acknowledged that there may be a role for these smart drugs in sections of society, including in the military and for doctors working through the night, there is an urgent need for long-term studies of their safety and efficacy in healthy people. There is a role for government and pharmaceuticals companies to prevent harms in healthy users by conducting these trials.

If we can stop the ravages of Alzheimer’s disease on the minds of elderly people and improve the educational experience and outcome for disadvantaged young people with attention deficit hyperactivity disorder (ADHD), then it is clearly worth further developing these drugs – they may prove essential to improving functionality, quality of life and well-being. But for healthy people, exercise, education or lifelong learning are excellent ways to boost your brain power.

image

Barbara Sahakian consults for Cambridge Cognition, Servier and Lundbeck. She holds a grant from Janssen/J&J. She holds shares in CeNeS and share options in Cambridge Cognition. She is also associated with the Human Brain Project

Read more http://theconversation.com/record-seizure-of-smart-drugs-including-one-untested-in-humans-shows-growing-market-33563