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Brain stimulants are still illegal

December 25, 2007

Re "They're bulking up mentally," Dec. 20

The article suggests that "brain doping" with alleged cognitive enhancers is legal, effective, benign and ethical. As a board certified behavioral neurologist, I disagree.

Prescription medicines are legal when they are prescribed by a licensed provider who has made a diagnosis of a condition that is a known indication for the use of that medicine. Giving psychostimulants to normal individuals who do not have such a diagnosis is no more legal than prescribing narcotics to individuals who are not suffering with pain.

While psychostimulants can increase concentration or focus in normal individuals, the tests that confirm that have involved repetitive tasks demanding sustained attention and have shown this on a short-term basis. It is true that psycho- stimulants can improve academic and occupational performance in individuals diagnosed with attention deficit-hyperactivity disorder. There is little evidence these medications provide a long-term benefit to normal individuals.

The article played down the most important harmful effect of psychostimulants. Amphetamines and methylphenidate are highly addictive, not much different from crystal meth. When used improperly, this can be devastating.

Michael E. Mahler MD

Los Angeles

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