Non therapeutic Neuro-Enhancement

Drugs such as Aricept ®, Exelon ®, Exelon ® or Reminil ® (cholinesterase inhibitors) are used to treat Alzheimer's disease. They also seem to improve the cognitive abilities of healthy old people and could be used in the future to prevent these degenerative disorders. However, at high doses they can decrease the cognitive performance.

Drugs that increase vascularity, oxygen transport and the consumption of glucose, are candidates to improve cognitive abilities such as memory. Many pharmaceutical companies are working on the development of these products for their economic and business potential. The efficacy of these drugs depends on dose, genetics and personality traits.

Any disease related to a particular alteration of the brain activity (like depression, Alzheimer’s disease or obsessive-compulsive disorders) are potential candidates to Deep Brain Stimulation. In addition, research is been made to see whether DBS may improve certain memory functions.
However, it requires open brain surgery which carry serious health risks and may cause changes in personality.

With Transcranial Direct Current Stimulation (tDCS), the activity of different brain areas can be modulated using a number of electrodes placed on the scalp. In pilot studies, it has been proved that this method can improve several capacities, such as sensorimotor skills, memory, attention and problem solving. No side effect resulting from its use is known yet.

Transcranial magnetic stimulation is a non-invasive method based on the use of weak electromagnetic fields to stimulate neurons. This influences the activity of specific brain region with a minimal discomfort and can improve memory and reasoning, erase severe fatigue symptoms and help learn new skills. Side effects that could result from its application are still unknown.

Neuroplasticity is the ability to modify the structure and function of neuronal circuits. This remodeling is the result of process such as learning. It occurs in response to several physiological situations (like pregnancy or thirst) and after a suffering from an injury. Plasticity is maintained throughout life but is especially important during the early years. It can be induced by brain stimulation, although its effects are unknown.

Aún no se conocen los efectos secundarios psicológicos que tendría aumentar la memoria de manera crónica.
The psychological side effects that the chronic increase of memory would have remain unknown.
Will we overload the brain with too much information that won’t be possible to forget?

Some available drugs for attention deficit hyperactivity disorder (ADHD) have structural similarities to amphetamines. However, they are considered safe enough to be daily taken by children older than 6. Besides this, although it is thought that its consumption can improve cognitive abilities in healthy people, there is still no scientific evidence to support this.

In neuro-enchancemente, “Cosmetic Pharmacology” is referred to the use of drugs to improve the mood of individuals who do not suffer from any pathology. The most commonly used are antidepressants and their byproducts.

Dementia is a syndrome that supposes the deterioration of memory, intellect, behavior and the ability to perform daily life activities.
Data provided by the U.S Presidential Commission of Bioethics indicate that dementia increases with age, affecting 5% of people aged between 71-79, 24% of those aged around 80-89 and 37% of individuals over 90. More than 35 million people worldwide suffer from dementia.

Neural stem cells could be used to regenerate affected cells in order to treat brain or nervous system damage. The method itself has a great potential for treating degenerative diseases and acute attacks such as a stroke.

Sensory prostheses are being developed, such as retinas (sight) or cochlea (hearing).
Currently there is only one type of retinal prosthesis approved in the U.S. and Europe, which partially restores vision of people with degenerative eye diseases (Retinitis Pigmentosa). Although these prostheses have a clear therapeutic purpose, their use in the field of nontherapeutic neuro-enchancemente is being considered.

Dementia has an important impact regarding its medical and social costs, as well as the attention provided outside of the institutional environment. The World Health Organization (WHO) has pointed out that in 2010 the total social cost of dementia worldwide was estimated at 446.448 million euro, an amount that equals 1% of global gross domestic product (GDP).

Drugs intended to treat sleep disorders can prolong wakefulness for days. The U.S. army is investigating its use in healthy people, so it can be used to prevent fatigue in soldiers, who could then stay awake and alert for several days without side effects. The U.S. has already spent $20 million in researching how to make soldiers smarter and stronger than "normal" people ("superhuman").

For the first time in 2002, the Federal Food and Drug Administration of the U.S (FDA) approved the use of Deep Brain Stimulation (DBS) as a treatment for Parkinson's disease. DBS’s success to control several motor symptoms of the disease suggests that it may have a promising future in other fields.

Age is the main risk factor for Alzheimer's disease, in addition to genetic risk.
The majority of patients with Alzheimer’s disease are over 65 and the probability to develop the illness increases after this age. Moreover, the World Health Organization (WHO) indicates that between 25% and 30% of those over 85 suffer from some kind of cognitive

Brain stimulation devices can be bought online. They promise to increase the capacity, efficiency and creativity of the brain. These devices are based on electric currents or electromagnetic fields that penetrate the scalp and skull to stimulate neurons, but there are no clinical studies proving its effectiveness nor its safety. Some of them are not labeled as medical technologies, so proper regulation and control are not guaranteed.

One of the main applications of the Brain Computer Interface (BCI) or Neurofeedback is as supporting technology. With it, patients with disabilities could use their brain activity to control multiple devices, including computers and wheelchairs. Most likely, they will be able to easily manage their prosthesis through BCI one day.

In case drugs for nontherapeutic neuro-enhancement should be included into the current law, they should be classified in one of the following categories:
- Prescription Drugs
- Advertising drugs or ordinarily called OTC (Over The Counter). They are non-prescription medicines.
- Homeopathic Medicines, cosmetics.
- ADUMES or dietary foods for special medical purposes, to be used under close medical supervision.

Brain Computer Interfaces (BCI) measures brainwave patterns in real time, and use them as a "language" to interact with computer systems. It can be used as a tool for Neurofeedback, so we can learn to produce certain desired brain states with visual and auditory feedback.
This has been used in healthy people such as elite musicians that wanted to increase their creativity - although its effectiveness is still discussed.

The Spanish Medicine Agency decides whether a drug is safe enough to be dispensed without medical prescription (advertising drugs or OTC’s).
In all member states of the European Union, these drugs are sold in pharmacies - except from in the United Kingdom and the Netherlands, where they are freely distributed. In Spain, a royal decree has been approved allowing the sale of these drugs through pharmacies’ websites.

These devices affect the functioning of a healthy brain by improving its performance at least in one cognitive domain, for example, the memory. They are called Cognitive Enhancement Devices (CED). These include the Transcranial Direct Current Stimulation, Transcranial Magnetic Stimulation, etc.

The position of the electrodes in the Transcranial Direct Current Stimulation is crucial to obtain reliable effects. As an example, one have to bear in mind that the proper placement of the electrons varies between right- and left-handed subjects, for left-handed people’s brains may be organized differently.

Amphetamines are considered dual substances: they can be medicines and "drugs", legal and illegal, past and present. They have a very complex mechanism of action due to their structural similarity with neurotransmitters and their ability to act on different areas of the brain. The pharmacology of amphetamines is therefore complex and it is being constantly updated.

Cognitive Enhancement Devices (CED) could be covered by the Directive 93/42/EEC of Medical Devices of the EU by defining Medical Device as "any instrument, apparatus, appliance, software, material or other product, used alone or in combination, intended by the manufacturer to be used in human beings to investigate, replace or modify the anatomy or a physiological process”.