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Smart drugs reduce quality of effort, and slow decision-making

246 points| wjb3 | 2 years ago |bps.org.uk | reply

225 comments

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[+] mdorazio|2 years ago|reply
The authors of the paper seem to have misinterpreted why many cognitively healthy students take ritalin/adderall. It's not to make you smarter or more able to solve complex problems, it's to let you focus and cram on large workloads for far longer than you otherwise would be able to. Basically, quantity over quality.

A much better test would have been to give all the study participants some new material requiring multiple hours of study to memorize & learn, then give them a test. The knapsack problem is fine to test some measure of "intelligence", but a bad choice to simulate academics.

[+] jfrbfbreudh|2 years ago|reply
I take ADHD meds and find that it definitely dulls my thinking and creative problem solving, but it at least gives me the motivation to actually write code vs. do nothing.

Ideally, I’d have unmedicated days where I just sit and think through problems, and then medicated days where I’d work on the actual implementation. Unfortunately, I just spend all of my time on HN and youtube on my unmedicated days.

[+] unshavedyak|2 years ago|reply
> Unfortunately, I just spend all of my time on HN and youtube on my unmedicated days.

I often wonder about this with me. I've got various hallmarks of ADHD (especially after my SO was diagnosed), but generally i'm productive.

In this specific case, i can't figure out if it's something like ADHD that drives this behavior _or_ just normal human avoidance of work i dislike.

Ie i of course don't have this problem when it's an interesting problem. I also tend not to have this problem after i get started, since most larger domains have interesting subdomains. Difficulty (read: vagueness, scope issues, etc) definitely lead to more of this for me though.

Human brains are weird.

[+] morei|2 years ago|reply
My work around for this is to take a walk without headphones. For me, it means that the only thing I can do is think (can't read, can't watch video, etc). And by the time I've finished a 30 mins walk, I've usually got a bunch of things that I'm enthused about working on.
[+] raducu|2 years ago|reply
> I just spend all of my time on HN and youtube on my unmedicated days.

The first times I tried stimulants, after 2-3 hours of euphoric productivity, the effects would wear off but the residual stimulation would be enough to make me continue working and I would always think "hey, I can do this no problem without the stimulants, I just need to push over the hump", but never seemed to work.

A few years in, and yes, I can do without stimulants on easy tasks, but not really on complex stuff.

I also can drive wile not on stimulants and not be a complete nervous mess afterwards, which is a big permanent gain for me.

Also the "OMG, OMG, I'm so screwed by this messup at work, they're going to find me, things are going to crash because of it" changed to "it's going to be ok, things always work out in the end"

[+] r3d0c|2 years ago|reply
the opposite for me, makes it easier for me to solve problem because i can cohesively hold multiple thoughts in my head for long enough for me to see the patterns to be able to understand them, along with the emotional regulation an increase in executive functioning ability that meds help with (which is what adhd really is, not just problems with motivation or bad at concentrating)

but i also work out 5-6 days a week and that + meds have been a huge boon than just meds because it keeps the depression down too, which is what you might be afflicted with because on my rare off days i still can do some work & be motivated

[+] ActorNightly|2 years ago|reply
Im the same way. Days are not enough. You basically need to have like an umedicated week to gain your creativity back. I also (2xmicro)dose shrooms (i.e enough where I feel a very very slight trip but can still function).
[+] changexd|2 years ago|reply
Your comment almost makes me thought this was my reply
[+] cmcaleer|2 years ago|reply
Anecdote regarding 'smart drugs': The most interesting thing I observed in starting treatment of my ADHD as an adult is that it I think that it stimulated my brain such that I was better able to recognise my tiredness. I remember taking dexamphetamine while I was titrating in the afternoon and pulling over an hour later while driving because I felt I was too tired to safely drive. This was after what I had considered a 'normal' amount of sleep in the past.

When I spoke to people who took these drugs in university (almost all w/o ADHD) sleepiness or calmness never reported by them as a side effect. I avoided coffee and 'energy' drinks in the past because I had this effect, and didn't really understand how people took caffeine to keep themselves awake - I thought it was kind of a meme and I wouldn't understand why my coworkers would drink it during night shifts.

I don't think dehydration adequately explains these to me, as I do take care to try to stay hydrated.

[+] gtirloni|2 years ago|reply
I can relate. Various friends took them and I never bothered. They looked like crackheads and it scared me.

I was recently diagnosed with severe ADHD by several doctors (something I've been treating as anxiety/depression for my whole life), and was prescribed lisdexamfetamine.

It makes me super calm and my thoughts organized. When I'm tired, I feel tired. If I'm sleepy, I'm sleepy. My productivity isn't insane, it's just more stable and predictable now.

I wish I had been diagnosed many decades ago.

[+] jm4|2 years ago|reply
I had the same experience with amphetamine. I think it's an ADHD thing. My doctor started me off on a low dose and I was falling asleep when I took it. We bumped it up and I'm working harder to stick to a good sleep schedule. It's mostly subsided, but I do still need the occasional afternoon nap.

I didn't have that same experience with methylphenidate. That one was a much more pronounced effect. I felt pretty locked in and it was easy to focus. The downside was I was getting headaches, stomach cramps, I would sweat more and my heart was always racing like I had too much coffee.

The amphetamine feels much different. It's more of a chilled out effect where all the noise seems to go away. It doesn't make me feel any smarter, but I do feel less distracted and I'm able to complete boring routine tasks. I wonder if that's why I sometimes get sleepy with it. It's like a relaxation spa for my brain.

[+] jhfdbkofdchk|2 years ago|reply
yeah that's how you know you legit have ADHD, when a cup or two of coffee makes you calm instead of wired. I do have a threshold where if I drink too much coffee I can't sleep, get jittery etc.
[+] specto|2 years ago|reply
Same here, it makes me super relaxed and tired feeling
[+] karmakaze|2 years ago|reply
> All of the drugs also increased the number of times the participants moved items in and out of the knapsack. “Thus, if one measures motivation in terms of time spent or number of items moved, drugs clearly enhanced motivation,” the team writes. However, on average, the drugs did not increase ‘effort quality’ or productivity, measured as the average gain in knapsack value per move. Productivity was lower in all three drug conditions, compared with placebo.

This "measured as the average gain in knapsack value per move" is an unusually chosen metric. Why would it not simply be the best/total score in the allotted time. This preemptively punishes sustained effort which is one of the increased behaviors. I'd like to see this done again with a different problem, a different metric, or simply their raw data.

Now that I think about it, all of these types of reports should include the raw data or GTFO. This one seems to provide some on the referenced https://www.science.org/doi/10.1126/sciadv.add4165

> MATLAB code that generates the statistics and figures, along with underlying data, can be found in the notebook “figures.mlx” and “SOM.mlx” of the GitHub repository bmmlab/PECO (https://zenodo.org/badge/latestdoi/592775835).

[+] anonymouskimmer|2 years ago|reply
Why are you leaving out the rest of the performance criteria that the article mentions are done more poorly while on any of the drugs?
[+] matznerd|2 years ago|reply
This study is about the amphetamine stimulants methylphenidate, dextroamphetamine, and the eugeroic (wakefulness agent) modafinil, and not about nootropics. Though the term smart drug can be inclusive of all of them...

Real smart drugs = nootropics = piracetam and piracetam-like molecules. Stimulants generally decrease performance, increase false positives, and lead to worse performance as this study showed (especially in a first time user).

Most nootropics take about 14 days to hit their stride and the effect isn't discernible immediately (though can be detected in an EEG)...

See study: "Increase in the power of human memory in normal man through the use of drugs"

"Nootropyl (Piracetam) a drug reported to facilitate learning in animals was tested for its effect on man by administering it to normal volunteers. The subjects were given 3x4 capsules at 400 mg per day, in a double blind study. Each subject learned series of words presented as stimuli upon a memory drum. No effects were observed after 7 days but after 14 days verbal learning had significantly increased."

https://pubmed.ncbi.nlm.nih.gov/826948/

Study: "Single-dose piracetam effects on global complexity measures of human spontaneous multichannel EEG"

"The results indicate that a single dose of piracetam dose-dependently affects the spontaneous EEG in normal volunteers, showing effects at the lowest treatment level. The decreased EEG complexity is interpreted as increased cooperativity of brain functional processes."

https://pubmed.ncbi.nlm.nih.gov/10555876/

Study: "Single doses of piracetam affect 42-channel event-related potential microstate maps in a cognitive paradigm"

"U-shaped dose-dependent effects were found; they were strongest after 4.8 g piracetam. Since these particular ERP segments are recognized to be strongly correlated to cognitive functions, the present findings suggest that single medium doses of piracetam selectively activate differently located or oriented neurons during cognitive steps of information processing."

https://pubmed.ncbi.nlm.nih.gov/8272204/

[+] scythe|2 years ago|reply
The authors are rather unfair to modafinil, also, lumping it in with the other two even though the negative "effects" of modafinil were not statistically significant (except in the rather dubious case of the rank testing of "productivity deviations") and the mean deviation was very small. Also, the "value attained" is not available for modafinil specifically; for this criterion — which is the most believable, as it measures what participants actually tried to achieve — the drugs are all counted together, while on other measures they are listed separately. This is particularly disconcerting since the total value attained makes its way into the abstract and the press release yet gets shorted on the analysis.
[+] cvdub|2 years ago|reply
Is piracetam still the goto for the nootropics community? I thought people were moving away from that for some reason, but I can’t remember why or where I heard that.
[+] Solortho|2 years ago|reply
About nootropics, I really enjoy noopept, it allows me to perform long and focused session of work without any side effect.
[+] willtemperley|2 years ago|reply
It's not unusual for students to crush and snort ritalin before exams in the UK.

We have an interesting system - final year exams are essentially a one-shot thing in the UK. If you are lucky enough to able to retake a final exam, your mark is capped at 40% - a third class mark. An upper second class degree is required for PhD entry.

Little wonder people will do _anything_ to pass those exams.

[+] anonymouskimmer|2 years ago|reply
What's the justification for capping scores on retakes? I can't believe that any empirical data supports it.
[+] onemoresoop|2 years ago|reply
IS there an advantage to snorting it? Does it not damage the nasal passages?
[+] Inviz|2 years ago|reply
Modafinil is a great tool to have in one's toolbelt.

There're days and situations when having uninterrupted focus for 10-14 hours does make a big impact. Condensing certain workloads into one day can save a lot of time in a longer run. For example going through huge refactoring with a lot of moving parts can be very draining to work through if you need to load in the context every day. Striking the iron while it's hot can help a great deal.

[+] ryukoposting|2 years ago|reply
Shocker, your brain function is impaired while on a drug you've never taken before and you weren't prescribed.

In my experience, it doesn't matter if you have multiple psychological evaluations and 10+ years of success with a consistent dosage of an ADHD medication. Most doctors just won't write the prescription because of this sort of bunk.

[+] anonymouskimmer|2 years ago|reply
I think this research is pointing out that using ADHD-like medication as "smart drugs" for school work in people without ADD/ADHD is problematic. I don't know exactly how they are used by those without a medical need, but I thought it was as temporary fixes, not taken habitually.

The article specifically says:

> More work will be needed to establish exactly why these drugs have these effects in those without a medical need for them, as well as to explore the potential impacts of other so-called smart drugs.

[+] baryphonic|2 years ago|reply
> While on a drug, participants made a poorer, more random first attempt at filling a knapsack than they did after taking the placebo, and this had an especially negative impact on the subsequent performance of those who’d been above average in the placebo condition, explaining why they dropped below the mean. Overall, the results suggest that the participants’ approach to solving the knapsack task became less systematic while they were on each of the three drugs, the researchers write.

I can't help but think that since the knapsack problem is NP-complete, any attempt to fill the sack could subjectively appear "more random." Certainly the participants could use certain heuristics, but since in general there is no known way to systematically solve the problem, this study seems to enable some confirmation bias on the part of the experimenters.

[+] jugg1es|2 years ago|reply
I'd like to see if they still get these results if they use people who are acclimated to these drugs before-hand. The first time taking any drug always hits the hardest and it's possible these people were just too high.
[+] gehwartzen|2 years ago|reply
Having been on Adderall I agree with most here that it increases my executive function but doesn’t really make me smarter.

I have a long history of experimenting with both legal and illicit drugs and the only one I found to actually significantly increase my cognitive ability to solve complex problems is low dose Ketamine. Low dose lsd/shrooms as well but to a much lesser degree.

[+] Extropy_|2 years ago|reply
I've found that small amounts of psilocybin mushrooms appear to calm me and allow me to "get in the zone" a lot better, as well as radically increase my creativity. I also found that low-dose MDMA, taken after eating, dramatically increased my focus and productivity while somewhat dulling my creativity. I've never tried LSD or Ketamine though.
[+] ActorNightly|2 years ago|reply
Generally, there is no drug that can make you smarter. Psychedelics can help you explore different perspective, but thats just being equivalent to a Monte Carlo approach to problem solving.

That being said, if you are ADHD, stimulants can essentially make you more efficient, which will make you appear smarter.

[+] tflinton|2 years ago|reply
I've been taking Adderall for a very long time. Prior to it I had a very difficult time motivating myself and simply being able to block out a thousand other thoughts and stimulus. I developed techniques to cope prior to taking it but once I started it was like night and day. It doesn't at all make me smarter but allows me to decide what I want to do rather than some sub-cognitive part of me. Should people take it to make them smarter? In my experience it helps focus, not intelligence.
[+] TrackerFF|2 years ago|reply
I have ADHD (inattentive), and wasn't diagnosed until I was in my mid 20s - I somehow managed to graduate from university. I attribute the countless all-nighters for that. I never tried ADHD meds before I was officially diagnosed, but I good chunk of my classmates would regularly use meds in the days / weeks leading to exams, so that they could cram for 12 hours.

From experience, the different drugs available can feel wildly different on me - so I'm going to assume that would also be valid for the non-ADHD users?

But, anyway, looking back - the playing field def seemed uneven. How on earth are unmedicated neurodivergent going to compete against "enhanced" healthy people - it's like playing football with crutches, while your opponent is not only healthy, but also using steroids.

EDIT: And, yes, I'm sure some % of the students that perform better when using meds may have some underlying/undiagnosed condition.

[+] culi|2 years ago|reply
I think you have a very simplified view of how ADHD and stimulants work. There's no actual research to back up the oft-repeated claim that stimulants affect people with an ADHD diagnosis differently from those without one. Actually the one bit of research I found suggests the exact opposite—that stimulants negatively impact the productivity and concentration of people without ADHD

https://www.healthline.com/health-news/if-you-dont-have-adhd...

[+] Hnrobert42|2 years ago|reply
This study makes me think my dose may be too high. When my Adderall hits in the morning, EVERYTHING seems like a good idea. Then, I end up spending two hours writing the perfect email.
[+] cvdub|2 years ago|reply
Adderall reduces your task activation threshold, the amount of effort required to start something.

It’s definitely possible to reduce this threshold too far! If you do you’ll end up jumping into the first project you come across and tackling it with gusto, whether or not it’s high value. Having too much caffeine with Adderall makes this effect much worse for me.

A little bit of laziness is good! You need to be able to power through the tedious stuff you have to do in life, but you never want to stop thinking, “this is tedious and boring, do I really have to do this? Is there a better way?”

It’s easy to lose the forest for the trees.

[+] mp05|2 years ago|reply
This is me to a tee when I was frankly abusing Adderall as a young adult. My judgment of how best to use my time goes straight down the toilet when I'm jacked on amphetamines. The physical side effects are not very desirable either.
[+] photochemsyn|2 years ago|reply
They missed an opportunity to compare microdosing psychedelics like LSD with the amphetamine class stimulants. Many users report that psychedelics do have interesting cognitive effects related to enhanced creativity and making long-range connections between disparate subjects, though I'm not sure it would help with knapsack optimization.

As others note, the ADHD-type drugs just let you work longer without needing sleep, although the bill must eventually be paid with interest, which is why people who take a lot of stimulants tend to go through boom-bust cycles over time. Such drugs also have a kind of jangly nervous side effect which inhibits the creation of complex mental architectures of the kind that mathematicians rely on, so I'm not surprised by the study's results. They're more suited to rote learning (unfortunately common in today's academia) and repetitive tasks (factory work etc.).

[+] cmcaleer|2 years ago|reply
> why people who take a lot of stimulants tend to go through boom-bust cycles over time

SBF (and all those in Alameda+FTX who got scripts from their in-house psych) in particular having the biggest boom-bust cycle in stimulant history. Though that doesn't count world leaders alleged to have stimulant use history.

[+] tomohawk|2 years ago|reply
I decided long ago to not take substances such as these, or even caffeine. I also abstain from tobacco, alcohol, and the like.

This forced me to develop skills and discipline over the years to achieve self control, and this has more than paid off. I find I can work a 12 hour day, and then go in the next day and do the same. It doesn't seem like a huge deal to me - especially when I consider family members who are/were farmers where this is quite a normal work day and used to be quite normal for everyone until about WWII.

Am I an outlier? I don't know, but I know others who have taken the same path with similar results.

I've worked with many people who cannot function without caffeine, let alone other substances. They will often claim how it enhances their abilities, but it doesn't come across that way in my observations. They seem to be dependent on a substance for normal, or even sub-normal performance.

[+] tanjtanjtanj|2 years ago|reply
The average farmer works less hours than the average office worker. This isn't even due to modern automation, it seems they have generally always worked <40 hours even during harvests. People began to work longer hours during industrialization and even then I can't find any time when working 12 hours a day was the norm.
[+] dboreham|2 years ago|reply
12 hours farming is not really the same as 12 hours figuring out k8s.
[+] instagraham|2 years ago|reply
Wow. Worth noting that there doesn't seem to have been much research or coverage of modafinil since the 2016 boom in "it's safe and makes you smart!" media hype.

By far the easiest to obtain and abuse, though it's as yet unclear what abusing it looks like

[+] The_Colonel|2 years ago|reply
Abuse typically means taking higher than prescribed doses which then "unlocks" some kind of euphoria - e.g. Adderall, benzodiazepines etc.

Modafinil can't really be abused in this way, it doesn't get you high and increasing the dose is usually counter-productive.

Another element of abuse is addiction and Modafinil has no physical addiction and IMHO minimal to non-existent psychological addiction.

[+] Inviz|2 years ago|reply
Would you mind sharing where's your antagonism towards modafinil coming from? Is it your personal experience or is it everybody's enthusiasm rubs you the wrong way?
[+] beefman|2 years ago|reply
I've long wished for more studies like this. So it's good to see.

This one does miss some important variables:

1. Dose-dependent effects

2. Naive vs experienced users of a drug

3. Novel vs familiar task

Though the authors spend a lot of time showing these stimulants reduce work efficiency, their central finding seems to be: "There was no significant effect of drug on performance"

https://www.science.org/doi/10.1126/sciadv.add4165

[+] zeroCalories|2 years ago|reply
My personal experience as someone diagnosed with ADHD is that they definitely make me more effective. My attention gets grabbed and redirected in inefficient ways, and being on the meds allows me to keep my focus fully on a task. But when I'm working on something I find exciting or fun, like a production failure, or a video game, I don't think my meds help me. Sometimes I wonder if my ADHD is even real.
[+] michael1999|2 years ago|reply
How does a placebo for amphetamines work? I'd know the difference in 30 minutes.
[+] insanitybit|2 years ago|reply
Good question. Adding a third control group that took caffeine would have been interesting, since it's so well studied and mimics some of the side effects of amphetamines.
[+] GuB-42|2 years ago|reply
You can definitely get high with a placebo. I have seen people in festivals getting high just by touching people, the "explanation" being that the people were sweating the drugs and by touching enough of them, you get enough for yourself to get high. This is as convincing to me as homeopathy, so definitely placebo, and it happened to people who took these drugs before and are familiar with their effects.

And here, they are not giving you a big dose of MDMA so you can dance until sunrise, they are giving you a moderate dose of amphetamines to (tentatively) boost your ability to solve a maths problem.

Unless you have already trained yourself, don't overestimate your ability to discriminate, the placebo effect is really strong here.