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How effective are pharmaceuticals for cognitive enhancement in healthy adults? A series of meta-analyses of cognitive performance during acute administration of modafinil, methylphenidate and D-amphetamine

Roberts, Carl A, Jones, Andrew, Sumnall, Harry, Gage, Suzanne H, Montgomery, Catharine·2020·European Neuropsychopharmacology
DOI 10.1016/j.euroneuro.2020.07.002
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Abstract

Modafinil, methyphenidate (MPH) and d-amphetamine (d-amph) are putative cognitive enhancers. However, efficacy of cognitive enhancement has yet to be fully established. We examined cognitive performance in healthy non-sleep-deprived adults following modafinil, MPH, or d-amph vs placebo in 3 meta-analyses, using subgroup analysis by cognitive domain; executive functions (updating, switching, inhibitory control, access to semantic/long term memory), spatial working memory, recall, selective attention, and sustained attention. We adhered to PRISMA. We identified k = 47 studies for analysis; k = 14 studies (64 effect sizes) for modafinil, k = 24 studies (47 effect sizes) for Methylphenidate, and k = 10 (27 effect sizes) for d-amph. There was an overall effect of modafinil (SMD=0.12, p=.01). Modafinil improved memory updating (SMD=0.28, p=.03). There was an overall effect of MPH (SMD=0.21, p=.0004) driven by improvements in recall (SMD=0.43, p=.0002), sustained attention (SMD=0.42, p=.0004), and inhibitory control (SMD=0.27, p=.03). There were no effects for d-amph. MPH and modafinil show enhancing effects in specific sub-domains of cognition. However, data with these stimulants is far from positive if we consider that effects are small, in experiments that do not accurately reflect their actual use in the wider population. There is a user perception that these drugs are effective cognitive enhancers, but this is not supported by the evidence so far.

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Authors
Roberts, C. A., Jones, A., Sumnall, H., Gage, S. H., & Montgomery, C.
Affiliations
  • University of Liverpool (GB)
  • Liverpool John Moores University (GB)
Corresponding author
Roberts, Carl A
ORCID
Venue
European Neuropsychopharmacology
Publisher
Elsevier BV
Published
2020-09
Volume
38
Pages
40-62
ISSN
0924-977X (ISSN-L)
DOI
10.1016/j.euroneuro.2020.07.002
OpenAlex
W3045346043
Cited by
78
References
12
Citations by year
2026: 19 · 2025: 15 · 2024: 12 · 2023: 9 · 2022: 14 · 2021: 6 · 2020: 3
FWCI
1.08
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • European Neuropsychopharmacology (publishedVersion)
  • PubMed (publishedVersion)
  • Liverpool John Moores University (acceptedVersion)
Topics
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neuroethics, Human Enhancement, Biomedical Innovations
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
Keywords
cognitive enhancement, modafinil, methylphenidate, d-amphetamine, stimulants, executive function, memory updating, sustained attention, inhibitory control, spatial working memory, memory retrieval, healthy adults, placebo comparison
MeSH terms
Modafinil, Adult, Cognition, Dextroamphetamine, Drug Administration Schedule, Pharmaceutical Preparations, Female, Humans, Male, Methylphenidate, Mental Recall, Nootropic Agents, Healthy Volunteers

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