Smarten up your act

Smarten up your act

The Sydney Morning Herald, Saturday, September 11, 1999

Professor Graham Johnston can foresee the day when athletes are not the only young people who have to be screened for performance-enhancing drugs before a warmongering big event.

School and university students sitting for major exams might have to be tested, too, if society decides that taking drugs to boost intelligence is cheating.

Johnston, a professor of pharmacology at the University of Sydney, has spent decades researching substances that affect the brain, and believes that there should be more debate about the ethical implications, particularly for education, of the inevitable development of memory-enhancing drugs.

Equity of access would be one important issue, he says. "Would rich kids on the North Shore be able to afford them, while the kids out west wouldn't?"

Many pharmaceutical companies are working on such drugs, testing their effects on the memory and learning ability of animals like mice and chickens, says Johnston, who recently completed a commercial contract trying to develop similar agents.

Their use by elderly people with failing memories or brain disease would be considered acceptable by many people. It is the prospect of a smart drug for normal people that is controversial.

The issue has come to the fore with last week's announcement by American researchers that they have created smart mice by adding an extra gene to the rodents' brains. And next week the first clinical trial begins in Australia to see if a pill containing the popular herbal extract ginkgo biloba can boost the intelligence of healthy people aged 18 to 40 years.

Leader of the Australian study, Dr Con Stough, says many students already take substances they hope will improve their performance. Who hasn't relied on coffee to stay up the night before an exam to cram, he asks?

Today's students still rely on caffeine in tea and coffee, but some also get it in preparations such as chewing gum, powder and tablets made from extracts of the South American tree guarana. Some also take ginkgo, despite a lack of scientific evidence it works in young people.

Stough, a lecturer in cognitive neuroscience at the Swinburne University of Technology in Melbourne, is undecided about the ethics of students taking memory-boosting drugs just to pass exams. But he believes there will be great benefits in general to society if such drugs become widely available.

"Most people think this is a brave new world issue, and ethically difficult. But people wouldn't have to take the drugs if they didn't want to." Higher intelligence is associated with higher-paying jobs, he adds. "So not to give the option to someone who is intellectually disabled would be morally wrong." The downside, says Stough, may be that intelligence would become overvalued by society. Alternatively, the option of a smart drug might make some people intellectually lazy.

The only known way to increase IQ, and then only by a small amount, is with a lot of intellectual training, says Dr Lazar Stankov, a reader in psychology at the University of Sydney. He has no ethical qualms about the widespread use of an intelligence-boosting drug, if one were developed that was safe. "Plenty of studies have shown people with high IQs can produce more wealth, more knowledge, and other things our society values. A small increase in IQ, even one small point, if the whole population goes up, would have an enormous monetary effect on the functioning of society," he says.

A high school principal, Ms Larissa Treskin, however, says the concept of intelligence, as measured by IQ tests, is a very dated, narrow one. Children may excel in different areas, such as music, maths or managing people. "Emotional intelligence, or the ability to cope with different situations, is one of the most important keys to success in life, along with the quality of resilience, says Treskin, president of the NSW Secondary Principals' Council.

A drug to improve memory would be a "small thing in the big picture", she says. "In an age of technology, remembering information is the least of our worries." Developing wisdom is more important. "And I don't think we're going to get any wisdom pills soon."

Critical thinking, rather than just a good memory, is needed at university, says Skye McDonald, a senior lecturer in psychology at the University of New South Wales. The trick is to distinguish the essential from the inessential.

"If a drug just increases your capacity to remember what is on a page, you may be able to spit it out in an exam, but there's not a lot of value in spending time writing down things that are irrelevant."

She says qualities such as self-discipline, ability to concentrate, and motivation, are all important in determining academic success.

If an effective drug were developed it would be a huge money-spinner, says Dr Mike Anderson, a psychologist at the University of Western Australia. "Why wouldn't you want to be more intelligent?"

But this prospect is a long way off and researchers are simply "flying kites" with talk of such drugs, because we do not have a good understanding of intelligence yet. "Who knows whether how mice learn has got any connection to human intelligence?" Anderson says.

The smart mice, created at Princeton University, were given an extra gene that made more of the youthful form of a brain receptor that helps associate two events, which is the basic mechanism of memory. The receptor becomes naturally less efficient with age, leading to a fading of memory.

Known as Doogie mice, the smart mice could remember objects four to five times longer than normal mice. They were also better at remembering a place or sound that was associated with receiving a mild electric shock. And they learnt much more quickly to behave as normal, once the shock treatment was stopped.

In a classic test for mice - a water maze with a hidden escape platform - the Doogies learnt how to get out in three attempts, compared with six for normal mice.

A professor of pathology at the University of Melbourne, Colin Masters, also stresses a huge gap exists between the mouse brain and the human brain. "We're just at the dawn of understanding the molecular basis of brain function in humans."

The mice research is unlikely to have any relevance to Alzheimer's disease, he says, because the degenerative brain condition is far more complex than just memory loss. It could lead to the development of drugs to enhance normal memory, but this might not necessarily be a good thing. Too good a memory could clutter the brain, he suggests, or make you forget important things.

Johnston works on a different class of receptors in the brain, those where anti-anxiety benzodiazepine drugs like Valium take effect.

It is a little-known fact that Valium impairs memory slightly, he says. He is looking at the effects of pure compounds in herbs, green tea and red wine on these brain receptors. Anaesthetic drugs work on the same receptors and, in other countries, cautions are given for people taking herbal remedies to alert their doctors before a general anaesthetic, in case the combination deepens unconsciousness.

Ginkgo biloba is an ancient tree considered to be a living fossil. Ginkgo leaf extract is one of the most frequently prescribed herbal medications in France and Germany, mostly for a condition known as "cerebral insufficiency" in elderly people. Symptoms include difficulties in concentration and memory, absentmindedness, confusion, lack of energy, tiredness, depressed moods, anxiety, dizziness, tinnitus and headache.

A review of controlled trials, published in The Lancet in 1992, found extracts were effective in managing these symptoms when given for four to six weeks. But further studies were required to define how long treatment should continue and the best doses.

Ginkgo extracts have no significant side effects, although there has been at least one report of bleeding in the brain associated with long-term use and little is known about its effects in pregnancy or while breastfeeding, says a review in Australian Family Physician.

A recent review of research on ginkgo and Alzheimer's disease, published in the Archives of Neurology, found the herbal extract led to a "small" improvement, about 3 per cent, in cognitive function in people who took it for three to six months. Only four of the 50 studies on the topic met the researchers' strict conditions for inclusion in the analysis, such as the patients had been clearly diagnosed as having Alzheimer's, and the studies used an objective measure of their cognitive function.

Stough says ginkgo is known to improve blood circulation to the body's extremities, like the brain, and it is also thought to stimulate brain receptors that release the neurotransmitter acetylcholine, believed to be associated with general intelligence.

He has already conducted a trial of the effects of ginkgo on people aged 50 to 70, but the results are still being analysed. The latest study will assess the effects, if any, on young people with intact memories.