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Neuro-Enhancement

Gehirndoping

Neuro-enhancement

Brain doping

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Zusammenfassung

„Cognitive enhancement“, die Steigerung der geistigen Leistungsfähigkeit durch psychoaktive Substanzen und andere Interventionen, hat durch die Entwicklung innovativer Prinzipien erneuten Auftrieb erhalten. Derzeit werden mehr als 100 Pharmaka als „cognitive enhancers“ untersucht oder bereits angeboten. Die folgenden Substanzgruppen haben in bestimmten Indikationsbereichen eine gesicherte Wirkung und können demnächst möglicherweise eine Rolle als „cognitive enhancers“ bei gesunden Personen spielen: Antidementiva mit neuroprotektiver (Dimebon, Methylenblau, Selegelin) und primär symptomatischer Wirkung (Cholinesterasehemmer, Memantin), Ampakine (Ampalax, Farampator), Antidepressiva (Fluoxetin) und Stimulanzien (Methylphenidate, Modafinil). Neben den prinzipiellen ethischen Vorbehalten gegen eine „unnatürliche“ Steigerung der geistigen Leistungsfähigkeit, stellen sich für die Nervenheilkunde konkret die folgenden Fragen: (1) Ist der längerfristige Gebrauch von „cognitive enhancers“ vorteilhaft oder kommt es zu Rebound-Effekten bzw. Defiziten in anderen Leistungsbereichen? (2) Welche neuropsychiatrischen Konsequenzen können aus einem etwaigen sanften Druck zur Einnahme von „cognitive enhancers“ in Beruf und Freizeit erwachsen? (3) Können nach langfristigem Gebrauch in großen Bevölkerungsschichten neben Erschöpfung und Abhängigkeit spezifische, bisher unbekannte neuropsychiatrische Erkrankungen auftreten?

Summary

Cognitive enhancement, the increase in the mental ability by psychoactive substances and other interventions has received a renewed boost through the development of innovative principle. More than 100 drugs are currently being developed, tested or used for cognitive enhancement.. Cholinesterase inhibitors, memantine, dimebon, ampakines, fluoxetine and other antidepressants, methylphenidate and modafinil are candidates awaiting a larger distribution as cognitive enhancers in healthy individuals, if their advantages can be demonstrated. Beyond more general neuro-ethical reservations regarding neuro-enhancement, future research will need to address the following neuropsychiatric issues: (1) will the benefits of longer term neuro-enhancement outweigh potential disadvantages such as rebound effects and other neurobiological and psychosocial trade-offs? (2) What will be the neuropsychiatric sequelae of a soft coercion towards drug usage at work and for recreational purposes? (3) Will there be new and specific neuropsychiatric diseases due to long-term usage of neuro-enhancers in a larger population? Novel strategies of neuro-enhancement will have to demonstrate their superiority compared with more traditional and well-established interventions such as coffee and cake.

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Der korrespondierende Autor weist auf folgende Beziehungen hin: Der Autor hat von allen wichtigen Pharmafirmen Honorare für Vorträge und Beratungstätigkeit erhalten.

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  1. Klinik und Poliklinik für Psychiatrie und Psychotherapie, Ismaningerstr. 22, 81675, München, Deutschland

    H. Förstl

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Förstl, H. Neuro-Enhancement. Nervenarzt 80, 840–846 (2009). https://doi.org/10.1007/s00115-009-2801-6

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