Intended for healthcare professionals


Pharmacological enhancement of performance in doctors

BMJ 2010; 340 doi: (Published 18 May 2010) Cite this as: BMJ 2010;340:c2542
  1. Colin Sugden, clinical research fellow1,
  2. Rajesh Aggarwal, clinical lecturer in surgery1,
  3. Charlotte Housden, graduate student2,
  4. Barbara J Sahakian, professor of clinical neuropsychology2,
  5. Ara Darzi, professor of surgery1
  1. 1Division of Surgery, Department of Surgery and Cancer, Imperial College London, London W2 1NY
  2. 2University of Cambridge, Department of Psychiatry and MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, Cambridge CB2 2QQ
  1. a.darzi{at}

    The benefits have not been proved, and more evidence is needed

    In recent years society’s attitude to various types of personal enhancement has shifted. Examples include the popularity of multivitamins and diet pills, the widespread use of caffeine (despite side effects such as anxiety, tremor, and tachycardia), and the unregulated off-label use of methylphenidate (Ritalin), fluoxetine (Prozac), and sildenafil (Viagra).

    Since the serendipitous discovery that drugs used to treat narcolepsy (modafinil) and attention deficit hyperactivity disorder (such as methylphenidate and atomoxetine) can improve the brainpower of healthy people, public and scientific interest has grown. Although the current level of use among doctors is unknown, data indicate that a large proportion of other groups in society (such as students and more senior academics) are currently choosing to use these substances.1

    The scientific, moral, and ethical questions about cognitive enhancement are complex and have been acknowledged as such by the Royal Society and the Academy of Medical Sciences; both have held workshops and public events on the topic. In addition, the BMA has produced …

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