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Conversely, with modafinil-a medicine being used to treat narcolepsy-stimulant actions are associated with an impact on NA, glutamate (NMDA or N-methyl-D-aspartate) and DA. Methylphenidate increases the levels of noradrenaline (NA) and dopamine (DA) in both the prefrontal cortex and the cortical/subcortical regions, and this effect may be associated with levels of improved attention in Attention Deficit Hyperactivity Disorder (ADHD). Whilst their mechanism of action is not fully understood, most popular CEs (e.g., methylphenidate, modafinil and amphetamine salt mixtures) are stimulants. The clinical impact of CEs’ ingestion can be significant, with these molecules being able to affect various neurotransmitter pathways in the brain, including the cholinergic, dopaminergic, noradrenergic and serotonergic pathways. CEs are typically being obtained, and at times by healthy individuals, on prescription, over-the-counter, online, or through other sources such as family or friends. CEs, also known as “smart drugs” or “nootropics”, are a heterogeneous group of chemical substances that are used to improve cognitive function, particularly memory, alertness, attention, learning performance, creativity and motivation. Cognitive enhancement can be achieved in two ways, e.g., “pharmacologically”, by taking cognitive enhancer (CE) drugs/substances or “non-pharmacologically”, by maintaining a healthy lifestyle, which includes being physically, mentally and socially active eating a healthy, balanced diet drinking alcohol only in moderation and maintaining good sleep habits.

Considering the risk factors and motivations that encourage university students to use CE drugs, it is essential to raise awareness about CE-related harms, counteract myths regarding “safe” CE use and address cognitive enhancement in an early stage during education as a preventative public health measure.Ĭognitive enhancement is defined as an “amplification or extension of core capacity of the mind by improving the internal and external information processing systems”. Discussion: The availability of CEs for non-medical indications in different countries is influenced by a range of factors including legal, social and ethical factors. The impact of stimulant CEs may include tolerance, dependence and/or somatic (e.g., cardiovascular neurological) complications. It is therefore suggested that CEs are increasingly being used among healthy individuals, mainly students without any diagnosed cognitive disorders, to increase their alertness, concentration, or memory, in the belief that these CEs will improve their performance during examinations or when studying. Results: The most popular molecules identified here included the stimulant CEs, e.g., methylphenidate, modafinil, amphetamine salt mixtures and caffeine-related compounds stimulant CEs’ intake was more prevalent among males than females drugs were largely obtained from friends and family, as well as via the Internet. Whilst 1400 studies were identified within this study through a variety of electronic databases (e.g., 520 through PubMed, 490 through Science Direct and 390 through Scopus), 48 papers were deemed relevant and were included in this review. Methodology: A systematic review was conducted in adherence with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Aim: To investigate the level of knowledge, perception and impact of the use of a range of CEs within Higher Education Institutions. It has been demonstrated that healthy students (i.e., those without any diagnosed mental disorders) are increasingly using drugs such as methylphenidate, a mixture of dextroamphetamine/amphetamine, and modafinil, for the purpose of increasing their alertness, concentration or memory. The diverted non-prescription use of these molecules and the related potential for dependence and/or addiction is being reported. This manuscript provides an overview of popular CEs, focusing on a range of drugs/substances (e.g., prescription CEs including amphetamine salt mixtures, methylphenidate, modafinil and piracetam and non-prescription CEs including caffeine, cobalamin (vitamin B12), guarana, pyridoxine (vitamin B6) and vinpocetine) that have emerged as being misused. Recent research studies investigated the use of CEs being taken as study aids by university students. Introduction: Cognitive enhancers (CEs), also known as “smart drugs”, “study aids” or “nootropics” are a cause of concern.