Misuse of prescription stimulants by students has become a fact of life on college campuses as some students seek every advantage they can to succeed. Prescription stimulants such as Adderall have been shown to improve symptoms of attention deficit hyperactivity disorder (ADHD), but there is limited evidence the drugs enhance the cognitive abilities of college students without ADHD. There is evidence, however, that they can pose serious health risks.
In a systematic review of hundreds of research studies on prescription stimulants and the misuse of drugs prescribed for those with ADHD, University of Rhode Island Psychology Professor Lisa Weyandt found that between 5 and 35 percent of college students without ADHD reported taking the stimulants.
Her paper was published this week in the Journal of Experimental and Clinical Psychopharmacology.
"Students without ADHD are taking these stimulants thinking that it's going to enhance their academic performance, but we don't have the scientific evidence to support this," said Weyandt, who has studied ADHD for more than 25 years. "It may increase their ability to focus, but it doesn't make them more intelligent or a superior reader. They may complete their assignments, but the quality of their work may not be any better, and it may be making it worse. In some cases prescription stimulants can actually impede their ability to do their work by causing them to over-focus and fixate on one part of the assignment."
Weyandt said those at the greatest risk for misusing stimulants are members of sororities and fraternities -- perhaps because it is more accepted in that subculture, perhaps because of peer pressure or social modeling -- and also students with lower grade point averages or greater levels of internal restlessness, stress, anxiety or depression. Most students reported taking the drugs "as needed" to complete academic projects or during exam periods. Her research also indicates that most students obtain the medication from friends or peers and are taking doses based on what others are taking, a practice she said is "clearly problematic."
According to Weyandt, prescription stimulants are effective at reducing the symptoms of ADHD in those who have been diagnosed with the disorder. The drugs stimulate the central nervous system and target neurotransmitter systems in the prefrontal cortex and striatum areas of the brain, resulting in increased abilities to sustain attention, reduced impulsivity, and improvements in organizational and planning skills. In studies of rats and mice, researchers found that brain cells respond more quickly when the medications were present, increased the creation of new cells, and increased protein production in brain cells.
"But in young rats the stimulants also caused harmful effects to brain cells, but not in adult rats," Weyandt said. "Could the medication be causing other harmful effects at the cellular level that isn't readily observable with our current technology? We know the stimulants can improve aspects of cognition in those with ADHD, but research is limited regarding possible detrimental effects on the brain of those without the disorder."
Weyandt and her graduate students are studying the misuse of stimulants among other populations as well and finding that it isn't just a problem among undergraduates. They recently found that about 6 percent of graduate students in a wide variety of academic programs in five regions of the United States also reported misusing the stimulants within the past year, and 17 percent reported misusing them sometime in their lifetime. She hopes to study the rate of prescription stimulant use in the workplace, too.
Her biggest concern, however, is that college students are placing themselves in danger by taking stimulants without a prescription.
"There are known cardiac effects associated with these medications, such as tachycardia and increased blood pressure, and if you have an underlying heart problem the risks are even greater," she said. "They also cause a decrease in appetite and difficulty sleeping, and I'm concerned that students are taking these medications without being monitored by a physician. In addition to the potential health risks, they're doing it all without evidence that it's truly enhancing their cognitive abilities or improving their academic performance. The risks outweigh the benefits."
Weyandt and her research team of undergraduate and graduate students are preparing to launch a study this fall to help address the misuse of prescription stimulants among college students.
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