Obligation to take focusing drugs?

I've asked this before elsewhere, but I'd like to ask it again for fresh thoughts.

Drugs like Ritalin, Methylin, Concerta, and Modafinil are all mind-focusing drugs.

With Objectivism's premium on focusing the mind, is there a personal, ethical obligation for Objectivists to avail themselves of these drugs? Or: Should Objectivists take steps when they can to further focus the mind, as with using these drugs?

Jordan

Post 1

Wednesday, May 6, 2009 - 3:27pm

Say rather they are pacifying drugs, dulling the taker to conformity...

Post 2

Wednesday, May 6, 2009 - 4:39pm

Conformity to what? The meds are just supposed to help with focus.

Jordan

Post 3

Wednesday, May 6, 2009 - 9:11pm

Don't these drugs have side effects? Dr. Dean Edell says that Ritalin is not an especially good idea, if your child can avoid it. He thinks it dulls their creativity. Some children may need it, if they have an attention deficit disorder, as it calms them down and enables them to attend to their studies better, but there are side effects. Virtually all drugs have side effects. They're often worth taking, because the ailment or disability that they're designed to treat is worse than the side effects. But why take the drug and endure the side effects if you don't need it?

- Bill

Post 4

Thursday, May 7, 2009 - 3:47am

Jordan does not know much about drugs. (Where's Ed Thompson? Nurse! Nurse! We need meds! Stat!!)

I just got the current catalog from Life Enhancement (Durk and Sandy). The cover promises "Resveratrol Elevates Memory and Cognition." I now take their 5-Hydroxy Trypophan and their Balopa Vitality. They have other mind enchancing, focusing or stimulating formulations. For many years they had a citrus mix of Acetylcholine and Inosital that was big with computerists.

I am big on B-vitamins and take a large pill every day, along with a multiple. The multiples are a men's formula that delivery many times the RDAs (500% C, 4000% Thiamin, etc., etc.) and although they are "once a day" in fact I take one multiple with each meal.

Kids on college campuses (being stupid) will buy pharms meant for the "attention deficit" in order to help focus during exam week or at other times. These drugs do have side effects.

Jordan's point is broadly correct. You owe to yourself optimal mental performance. There are many ways to achieve this without drugs that are approved by the FDA. I mean, think about that -- if you have the mental clarity to focus -- do you really think that government approved drugs are necessarily good for you?

(Edited by Michael E. Marotta on 5/07, 3:50am)

Post 5

Thursday, May 7, 2009 - 12:47pm

I would caution against taking a multi-vitamin more than once in a day. Some minerals taken to excess can be toxic, while others have no adverse health effects if taken to excess. The best way to focus your mind is eating healthy; plenty of lean proteins, complex carbs, and healthy fats like olive oil, avocados, nuts, etc.

Post 6

Thursday, May 7, 2009 - 1:42pm

Michael,

Yeah okay, my knowledge of pharmaceuticals is limited. I just started thinking about this issue again in light of an article in this month's editition of Discover Magazine.

Jordan

Post 7

Friday, May 8, 2009 - 3:00am

JA: "The best way to focus your mind is eating healthy; plenty of lean proteins, complex carbs, and healthy fats like olive oil, avocados, nuts, etc."

John, it is true that diet and exercise -- which you left out -- are important. We all feel better after exercise: gets the oxygen to the brain and all. Yoga is good. Standing on your head for a few minutes helps wash out the brain. Fish is considered "brain food" because it is high in acetylcholine. All of that is fine. But diet and exercise only do so much for you. I apologize for being redundant, but I posted this link in the "Eden" article replies.

http://www.cartoonbank.com/item/122479

Among the myriad of foods are some that boost intelligence, focus, awareness, creativity, alertness. It has been said that the revolutions of the Enlightenment were a result of the coffee houses. You probably heard that Lloyd's of London started in a coffee house. That was a commercial revolution.

It is difficult to explain the causal links from epistemology to aesthetics to people too stupid to learn the words. You want freedom? Boost intelligence, creativity, awareness, alertness and new ideas.

About Bacopa Vitality�
In use for several thousand years in the Indian Ayurvedic tradition as a brain nerve tonic, the herb Bacopa monniera is now being recognized for its memory-enhancing and revitalizing effects.* Most interesting of the many uses of Bacopa is its ability to help increase novelty-seeking behavior, an attribute of intelligence associated with increased mental pleasure and increased lifespan.* Literally a brain food, Bacopa is thought to help nourish your neurons as it restores depleted synaptic activity.*
http://www.life-enhancement.com/product.asp?SID=1&id=121

Jordan, sorry, I was just being flip. The details are not important here and now. I appreciate your raising the question. While it does matter which enhancers you take, your question was about the taking. And to me, yes, according to Objectivism, with your life as your standard, you have a moral obligation to enhance your mental abilities, mental health, mental longevity.

You can google Durk Pearson and Sandy Shaw, of course. Have you see this article
HOW MERV GRIFFIN ENHANCED AND EXTENDED THE LIVES OF MILLIONS
by Dr. Jack Wheeler.
All incoming freshmen at MIT have their IQs measured, but they couldn't measure his. The upper limit they can extrapolate a score to is 220. His IQ was so far beyond 220 they didn't know what it was. It could be 300, they had no idea, for MIT had never seen an intelligence like his. ...
"Merv," I replied, "this is a very unusual guy. We have IQs of chimpanzees compared to him.

(Edited by Michael E. Marotta on 5/08, 3:13am)

Post 8

Friday, May 8, 2009 - 6:33am

Yes Michael, definitely exercise is important. Right now I am the healthiest I've ever been in my life because I eat right and exercise 6 days a week. And I also take daily supplements, I just wanted to stress they're not meant to be a substitute to a good diet and frequent exercise. But some minerals found in daily vitamins if taken to excess can create a mineral toxicity. Iron is one example.

Post 9

Friday, May 8, 2009 - 9:07am

JA: But some minerals found in daily vitamins if taken to excess can create a mineral toxicity. Iron is one example.

Right! That's why it is important for men to take men's vitamins, not generic and even older women stop needing iron in the quantities they once did. Myself, I watch selenium. Good in small doses, surely, but not in large. And so on... All in all it is important that we stay informed, exchange information, and make wise choices based on good facts.

That said, what about the topic question? Do you believe that Objectivism specifically requires you to enhance your mind (brain) as well as your body?

Post 10

Friday, May 8, 2009 - 9:20am

I'm not sure if it's an obligation, if it is I think it would be one because it would be something you value for yourself. So in that sense you would have an obligation to yourself, but of course not to others. I think if you want to extend your life-span as much as you can while still enjoying it, it would make sense to eat healthy and exercise. I've also taken a liking to weight training, I find that workout relieves the most stress for me, more so than cardio. But Yoga is good too for that.

Post 11

Friday, May 8, 2009 - 9:28am

is there a personal, ethical obligation for Objectivists to avail themselves of these drugs?

I don't think you have a moral obligation to do any such thing, any more than you have a moral obligation to study every waking moment to develop a skill.

However, a primary part of a fulfilling life is productive activities and concentration and memory enhancing drugs may help you achieve those productive ends. But do you have an *obligation* to use them? I'd say no, no more than a writer has an obligation to use a computer instead of pen and paper. It seems like it would make sense, but depending on your values interests and goals, it may not.

Post 12

Friday, May 8, 2009 - 9:35am

Virtually all drugs have side effects

This was true in the days of biological fishing expeditions for drugs, when millions of compounds were tested then copied. But in the age of biotechnology this is getting to be less the case, new drugs can be designed to fit only the receptors they need to fit, having no side effects, or in the near future could be fine tuned for particular genetic makeups (still wondering how the FDA will handle that, when the day comes when you will KNOW if you will be the 10% who get an adverse fatal reaction, will they still ban it for everyone else?)

Further, we are even now seeing drugs that don't just bring you from a broken state to a normal state, but actually make you better.

Jumenex for instance, an effective Alzheimer's treatment, has been shown to increase the length of time you retain memories by up to 3x. It's also suspected of helping to prevent you from ever getting Alzheimer's.

Post 13

Friday, May 8, 2009 - 9:57am

MFD:Jumenex for instance, an effective Alzheimer's treatment, has been shown to increase the length of time you retain memories by up to 3x. It's also suspected of helping to prevent you from ever getting Alzheimer's.

Citations, please. Neither Google nor Google scholar was helpfull.

Nice to have you aboard and thanks for the input.

Post 14

Friday, May 8, 2009 - 1:31pm

Dr. Peter Breggin has a more negative view of those drugs - especially as they relate to children -
http://www.breggin.com/index.php?option=com_content&task=view&id=46&Itemid=66

Post 15

Saturday, May 9, 2009 - 9:43am

http://www.ncbi.nlm.nih.gov/pubmed/18042509

Mike,

Where's Ed Thompson?

[break]
MFD:Jumenex for instance, an effective Alzheimer's treatment, has been shown to increase the length of time you retain memories by up to 3x. It's also suspected of helping to prevent you from ever getting Alzheimer's.

Citations, please.

Here I am and here are some recent, somewhat-relevant citations ...

In the fall of 2006, a study was published in the Journal of Child and Adolescent Psychopharmacology communicating the discovery that the active ingredient in Jumenex -- "selegiline" -- was better for kids with ADHD than Ritalin (methylphenidate) is:
********************

Placebo-controlled study examining effects of selegiline in children with attention-deficit/hyperactivity disorder.

Rubinstein S, Malone MA, Roberts W, Logan WJ.

Division of Neurology, Brain and Behaviour Programme, The Hospital for Sick Children, Toronto, Ontario, Canada.

There is evidence suggesting a role for dopamine in attention-deficit/hyperactivity disorder (ADHD). Pharmacological treatments that act on the dopamine system have been successful in reducing ADHD symptoms. However, unlike traditional stimulants (i.e., methylphenidate), selegiline is a monoamine oxidase inhibitor (MAOI) that has been shown to reduce ADHD symptoms without producing undesirable side effects.

In this study using a randomized, double- blind, placebo-controlled, crossover design, cognitive tasks and behavioral rating scales were administered to measure the effectiveness of selegiline in treating different symptoms of ADHD in 11 children aged 6-13.

Results indicate that selegiline may target specific symptoms of ADHD including: sustained attention, the learning of novel information, hyperactivity, and peer interactions.

Because the drug was not associated with negative side effects and did not specifically reduce symptoms of impulsivity, selegiline may be a preferred treatment for individuals who present with the primarily inattentive subtype of ADHD.
********************
Link:
http://www.ncbi.nlm.nih.gov/pubmed/16958566

Note the relative absence of side-effects of selegiline (as compared to drugs like Ritalin).

In the spring of 2007, a study was published in the journal, Current Medical Research and Opinion, communicating the discovery that over 1 year of selegiline use (i.e., long-term use) was beneficial to Parkinson's patients ...
********************

Safety and efficacy of newly formulated selegiline orally disintegrating tablets as an adjunct to levodopa in the management of 'off' episodes in patients with Parkinson's disease.

Lew MF, Pahwa R, Leehey M, Bertoni J, Kricorian G; The Zydis Selegiline Study Group.

Keck/University of Southern California School of Medicine, Los Angeles, CA 90033, USA. marklew@usc.edu

OBJECTIVE: Patients receiving levodopa for Parkinson's disease experience motor fluctuations and immobility ('off' episodes) between doses. This study assessed adjunctive Zelapar (selegiline orally disintegrating tablet (ODT)) for managing off episodes and for long-term safety.

METHODS: This open-label extension evaluated long-term safety, efficacy, and tolerability of adjunctive selegiline ODT 2.5 mg in patients who completed either of two large phase 3 double-blind studies. The study was to end after 12 months but was amended to be open-ended. Investigators could increase levodopa doses and introduce controlled-release formulations of levodopa or dopamine agonists if warranted. Additionally, results of a small randomized trial of open-label selegiline ODT 1.25 mg in comparison to conventional selegiline was added only to the safety analysis. Efficacy variables included changes in daily off time and Patient's Global Impression of Improvement (PGI-I) and Clinical Global Impressions Severity of Disease (CGI-S) ratings. Safety assessments included adverse events and oropharyngeal findings.

RESULTS: This study enrolled 254 patients: 248 from the large phase 3 studies (efficacy analysis) and an additional six from the prior open-label comparison (safety analysis) in order to evaluate a larger population for safety purposes. Mean reduction from baseline in daily off time was 9.4% (1.6 h) for patients previously given selegiline ODT, 6.0% (1.2 h) for those switched from placebo, and 8.1% (1.4 h) overall. PGI-I and CGI-S ratings indicated little or no change from baseline. Treatment-related adverse events occurred in 132 (52%) patients. No severe oral irritations were attributed to selegiline ODT or prompted discontinuation.

CONCLUSIONS: Long-term selegiline ODT 2.5 mg/day was effective, safe, and well tolerated in patients with Parkinson's disease experiencing off episodes during levodopa therapy.
********************

Link:

http://www.ncbi.nlm.nih.gov/pubmed/17407630

Note the dose of 2.5mg per day, which is likely higher than most healthy people would need (for boosting mental performance/longevity). Perhaps Michael Dickey has personal experience with dosing?

In the winter of 2007, a study was published in the journal of HIV Clinical Trials communicating the discovery that transdermal (selegiline patches, absorbed through the skin) selegine, while not helping out on a 6-factor mental performance test, did help HIV patients out on an 8-factor mental performance test:
********************

Selegiline transdermal system (STS) for HIV-associated cognitive impairment: open-label report of ACTG 5090.

Evans SR, Yeh TM, Sacktor N, Clifford DB, Simpson D, Miller EN, Ellis RJ, Valcour V, Marra CM, Millar L, Schifitto G; AIDS Clinical Trials Group and the Neurologic AIDS Research Consortium.

Harvard School of Public Health, Boston, Massachusetts, USA.

OBJECTIVE: To assess the long-term safety (primary aim) and efficacy (secondary aim) of the MAO-B inhibitor Selegiline Transdermal System (STS) for the treatment of HIV-associated cognitive impairment.

BACKGROUND: HIV infection is associated with increased oxidative stress. In vitro and animal studies have shown that selegiline can reduce oxidative stress levels while enhancing the synthesis of neurotrophic factors. We conducted and reported a 24-week, double-blind, placebo-controlled study with STS in HIV-infected individuals with cognitive impairment (ACTG 5090). We now report the results of the 24-week open-label follow-up.

METHOD: Subjects received either 3 mg/24 h or 6 mg/24 h STS daily. The primary efficacy endpoint was changes in the mean of z scores of six neuropsychological tests (NPZ-6). Additional outcomes included NPZ-8 and NPZ scores by cognitive domain.

Results: 86 subjects were enrolled. There were few severe adverse experiences (n = 13). There was no significant change in NPZ-6 score, whereas significant changes were observed in NPZ-8 score and several cognitive domains.

CONCLUSION: Long-term use of selegiline was safe and well tolerated in this HIV cohort of HIV with cognitive impairment. Cognitive improvement may be delayed in neuroprotective trials, suggesting that trials longer than 6 months may be necessary to assess the efficacy of putative neuroprotective agents.

********************

Link:

Note that the study went for 2 years (and the dose was moderate-to-high), and they still didn't find any significant side effects of selegiline.

Ed

(Edited by Ed Thompson on 5/09, 10:46am)

Post 16

Saturday, May 9, 2009 - 9:49am

Oh, and as to Jordan's initial question, I think it's encumbant upon Objectivists to do something (but not everything) to facilitate the length and height of our own mental focus. Staples might be the getting of good:

--sleep
--physical exercise
--thinking (mental exercise)
--protein and essential fatty acids
--vitamin C, B-vitamins, and minerals

Ed
[currently takes Mega-Mind, the poor-man's version of Higher Mind, one of the best (perhaps the best) brain-boosting products available today, presription or non-]

Disclaimer:
Ed Thompson receives no monetary or other benefits from the company, Source Naturals: the makers of MegaMind(R) and Higher Mind(R). What Ed Thompson says about these products is solely his opinion and is not endorsed by anyone in any way related to the company. Use health products at your own risk. :-)

(Edited by Ed Thompson on 5/09, 10:44am)

Post 17

Saturday, May 9, 2009 - 12:27pm

Ed,

I notice that the Higher Mind supplement contains this warning: "Do not use this product: Within 7 days before or after surgery; or after any physical injury or trauma; or if you are taking warfarin, aspirin, NSAIDs, or any other anticoagulant or antiplatelet aggregation drug"

That one is definitely out for me, since I take aspirin fairly regularly (either in normal dosages for an occasional headache, or the lower dosage as a daily regime for cardiovascular health). What is the ingredient(s) in this formulation that warrants all of those extra warnings?

Post 18

Sunday, May 10, 2009 - 6:18am

http://www.ncbi.nlm.nih.gov/pubmed/18214851

Steve,

The culprit is likely the wonderful herb, Ginkgo biloba. Here is evidence for that:
**********************************
Mol Nutr Food Res. 2008 Jul;52(7):764-71

Potential interaction of Ginkgo biloba leaf with antiplatelet or anticoagulant drugs: what is the evidence?

Bone KM.

School of Health, University of New England, Armidale, NSW 2350, Australia. Kerry.Bone@mediherb.com.au

Some writers hold the view that the combination of Ginkgo biloba with anticoagulant or antiplatelet drugs represents a serious health risk. Such concerns are largely based on the assumption that Ginkgo has clinically relevant antiplatelet activity, as well as accounts of bleeding episodes associated with Ginkgo consumption. To investigate whether these bleeding episodes have a pharmacodynamic, idiosyncratic or coincidental basis, a review of controlled clinical studies and case reports was undertaken.

Results from controlled studies consistently indicate that Ginkgo does not significantly impact haemostasis nor adversely affect the safety of coadministered aspirin or warfarin. Most of these studies were undertaken using EGb 761, a well-defined extract of Ginkgo biloba. In contrast, EGb 761 has not generally been implicated in the case reports. In general, the quality of these case reports is low. Nevertheless, the possibility of an idiosyncratic bleeding event due to Ginkgo use cannot be excluded on the basis of the available information.

However, there is scant information from case reports or controlled trials to support the suggestion that Ginkgo potentiates the effects of anticoagulant or antiplatelet drugs. Such high-level safety concerns for this herb are deemed to be unsupported by the currently available evidence.

**********************************

Link:

Note that Kerry Bone at the U of New England, Australia doesn't think that Ginkgo's going to be a problem for folks taking cardio-protective doses of aspirin.

Ed

Post 19

Sunday, May 10, 2009 - 9:41am