“Smart” drugs might NOT always help with focus

Stimulant medications like methylphenidate, dextroamphetamine, and related drugs are often prescribed for adhd (attention defecit hyperactivity disorder).

For individuals with adhd, these medications can be useful, particularly when combined with addressing other mental and physical health conditions that could be impacting focus, and reasonable nutrition, sleep, activity level, study/organizational skills, and healthy ways of using technology.

A recent set of studies looked at whether these  medications help if you do NOT have adhd.

What were the studies? (1)

  • Elizabeth Bowman and colleagues  four double-blinded, randomized  trials, each a week apart, the same 40 healthy participants took one of three popular ‘smart’ drugs (methylphenidate, modafinil, or dextroamphetamine) or a placebo (1).
  • They were assessed on how they performed in a test designed to model the complex decision-making and problem-solving present in everyday lives (1).
  • The exercise known as the Knapsack Optimisation Problem.  In this test, they were given a virtual knapsack with a set capacity, and a selection of items of different weights and values (1).
  • The participants had to figure out how to best allocate items to the bag, to maximize the overall value (1).

What were the results? (1)

  • Overall, participants without adhd and taking methylphenidate, dextroamphetamine, modafinil, and related medications:
  • Small DECREASE in accuracy and efficiency (1).
  • Large INCREASE in time and effort, relative to their results when not taking the medications (1).
  • When given methylphenidate non adhd participants took around 50% longer on average to complete the knapsack problem as when they were given a placebo (1).
  • Participants without adhd became less productive when given methylphenidate (1).
  • The study authors found that, while motivation increased, it led to more erratic thinking (1).

Additional thoughts:

  • Further research is needed on the cognitive effects and performance impact of adhd medications on people without adhd.
  • Whether or not one has adhd, adequate sleep, nutrition, activity level, and organizational skills can help improve  cognitive/academic performance.
  • In my experience, addressing co-existing physical and mental health conditions can also help improve focus and if you also have adhd, potentially reduce how much medication you need while maximizing benefit.

The following post discusses strategies to improve attention:

https://u.osu.edu/emotionalfitness/2021/03/30/strategies-to-improve-attention/

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

 

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

Reference:

  1. Elizabeth Bowman et al. ,Not so smart? “Smart” drugs increase the level but decrease the quality of cognitive effort.Sci. Adv.9,eadd4165(2023).DOI:10.1126/sciadv.add4165

 

Using Systems + Goals to increase success

“You do not rise to the level of your goals. You fall to the level of your systems.  Your goal is your desired outcome. Your system is the collection of daily habits that will get you there.” James Clear (6)

Many people start the new year by setting goals but less than 10 % of people keep their New Year’s resolutions each year (1, 2).

Is there a better way?

First, to set effective goals, consider the following:

  • For goal setting, consider S.M.A.R.T. goals (Specific, Measurable, Achievable, Realistic, Time bound) (4).
  • A goal card (5) may also be helpful.

After effective goal setting, focus on the system:

In his book Atomic Habits, author James Clear suggests the following strategies to think of systems (6):

  • Goals are good for setting a direction, but systems are best for making sustained progress (6).
  • For example, you might ahave a goal to clean up a messy room (6). But if you maintain the same sloppy, pack-rat habits (system) that led to a messy room in the first place, soon you’ll be looking at a new pile of clutter and hoping for another burst of motivation (6).
  • If you’re a student, instead of getting an A, a better goal could be to become a better student (a system).  This would shift your focus to the daily process:
    • How often and how much you study
    • Improve your study skills
    • With whom and where you study
    • How you address difficult topics
    • Your eating, sleeping, and exercise habits.
    • Your method for tracking progress before grades/exam. This could be in terms of quizzing or testing yourself, etc.

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

 

References:

  1. https://www.iflscience.com/brain/psychology-new-year-s-resolutions/
  2. Norcross, John & Mrykalo, Marci & Blagys, Matthew. (2002). Auld Lang Syne: Success Predictors, Change Processes, and Self-Reported Outcomes of New Year’s Resolvers and Nonresolvers. Journal of clinical psychology. 58. 397-405. 10.1002/jclp.1151.
  3. https://www.healthdirect.gov.au/goal-setting#:~:text=Setting%20goals%20is%20an%20effective,the%20recovery%20from%20mental%20illness.
  4. https://www.cdc.gov/dhdsp/evaluation_resources/guides/writing-smart-objectives.htm
  5. Goal card: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5954583/figure/fig1-2055102918774674/
  6. Atomic Habits: Tiny Changes, Remarkable Results by James Clear