Charakteristika von Studierenden, die pharmakologisches Neuroenhancement mit Stimulanzien betreiben: Eine Pilotstudie

Zusammenfassung

Anliegen: Charakterisierung deutscher Studenten, die Methylphenidat (MPH) und/oder Amphetamine (AMPH) zum pharmakologischen Neuroenhancement (PN) konsumieren.

Methode: Semistrukturierte Interviews mit 20 Konsumenten und 20 Kontrollprobanden.

Ergebnisse: Die Konsumenten waren besser über die Möglichkeit der Einnahme illegaler Substanzen zum PN informiert als die Kontrollgruppe. AMPH-Konsumenten nahmen häufiger weitere illegale Substanzen zum PN ein als MPH-Konsumenten, während hinsichtlich legaler Substanzen zum PN kein Unterschied zwischen den beiden Konsumentengruppen bestand. AMPH-Konsumenten hatten AMPH vornehmlich nasal eingenommen. Insgesamt wiesen die Stimulanzienkonsumenten häufiger einen Substanzmissbrauch von Alkohol und THC auf, wobei sich im Vergleich von AMPH- und MPH-Konsumenten keine Unterschiede zeigten.

Schlussfolgerungen: Größere epidemiologische Studien sollten die Gefahr einer Missbrauchs- und Abhängigkeitsentwicklung durch PN analysieren.

Abstract

Objective: Little is known regarding characteristics of subjects using substances exclusively for the purpose of pharmacological neuroenhancement (PN). Aim of this pilot study was to characterize students in Germany who use methylphenidate (MPH) and/or amphetamines (AMPH) for PN.

Methods: Semi-structured interviews among 20 students who reported the use of MPH/AMPH for PN and 20 matched controls.

Results: Subjects using stimulants for PN had significant better knowledge about further illicit substances for PN than controls. Users of AMPH more frequently used further illicit substances for PN than MPH users. Regarding prescription substances for PN no difference was found between MPH and AMPH users. AMPH users predominantly used AMPH intranasally for PN purposes. Stimulant users for PN used illicit substances (not for PN) more frequently with significantly higher rates of diagnoses of substance misuse of alcohol and THC (no difference between AMPH and MPH users).

Conclusions: Larger epidemiological studies are needed to elucidate the risk of misuse and addiction in subjects using stimulants for PN.

Schlüsselwörter

pharmakologisches Neuroenhancement - (Psycho-)Stimulanzien - Missbrauch - Abhängigkeit

Keywords

cognitive enhancement - pharmacological neuroenhancement - stimulants - misuse - addiction

• Literatur

• 1 Franke AG, Lieb K. Missbrauch von Psychopharmaka zum Hirndoping. CME-Artikel. InFo Neurologie & Psychiatrie 2009; 11: 42-51
• 2 Lieb K. Hirndoping – Warum wir nicht alles schlucken sollen. Düsseldorf: Artemis & Winkler; 2010
• 3 Franke AG, Christmann M, Bonertz C et al. Use of Coffee, Caffeinated Drinks and Caffeine Tablets for Cognitive Enhancement in Pupils and Students in Germany. Pharmacopsychiatry 2011; 44: 331-338
• 4 Franke AG, Bonertz C, Christmann M et al. Non-medical use of prescription stimulants and illicit use of stimulants for cognitive enhancement in pupils and students in Germany. Pharmacopsychiatry 2011; 44: 60-66
• 5 Franke AG, Lieb K. Pharmacological neuroenhancement and brain doping: Chances and risks. Bundesgesundheitsbl Gesundheitsf Gesundheitsschutz 2010; 53: 853-859
• 6 Wilens TE, Adler LA, Adams J et al. Misuse and diversion of stimulants prescribed for ADHD: a systematic review of the literature. J Am Acad Child Adolesc Psychiatry 2008; 47: 21-31
• 7 Babcock Q, Byrne T. Student perceptions of methylphenidate abuse at a public liberal arts college. J Am Coll Health 2000; 49: 143-145
• 8 McCabe SE, Knight JR, Teter CJ et al. Non-medical use of prescription stimulants among US college students: prevalence and correlates from a national survey. Addiction 2005; 100: 96-106
• 9 McCabe SE, Teter CJ, Boyd CJ. The use, misuse and diversion of prescription stimulants among middle and high school students. Subst Use Misuse 2004; 39: 1095-1116
• 10 McCabe SE, Teter CJ, Boyd CJ. Medical use, illicit use and diversion of prescription stimulant medication. J Psychoactive Drugs 2006; 38: 43-56
• 11 Teter CJ, McCabe SE, Boyd CJ et al. Illicit methylphenidate use in an undergraduate student sample: prevalence and risk factors. Pharmacotherapy 2003; 23: 609-617
• 12 Kaloyanides KB, McCabe SE, Cranford JA et al. Prevalence of illicit use and abuse of prescription stimulants, alcohol, and other drugs among college students: relationship with age at initiation of prescription stimulants. Pharmacotherapy 2007; 27: 666-674
• 13 Upadhyaya HP, Rose K, Wang W et al. Attention-deficit/hyperactivity disorder, medication treatment, and substance use patterns among adolescents and young adults. J Child Adolesc Psychopharmacol 2005; 15: 799-809
• 14 Teter CJ, McCabe SE, Cranford JA et al. Prevalence and motives for illicit use of prescription stimulants in an undergraduate student sample. J Am Coll Health 2005; 53: 253-262
• 15 Teter CJ, McCabe SE, LaGrange K et al. Illicit use of specific prescription stimulants among college students: prevalence, motives, and routes of administration. Pharmacotherapy 2006; 26: 1501-1510
• 16 Wilens TE, Gignac M, Swezey A et al. Characteristics of adolescents and young adults with ADHD who divert or misuse their prescribed medications. J Am Acad Child Adolesc Psychiatry 2006; 45: 408-414
• 17 Barrett SP, Darredeau C, Bordy LE et al. Characteristics of methylphenidate misuse in a university student sample. Can J Psychiatry 2005; 50: 457-461
• 18 Wittchen HU, Zandig M, Fydrich T. Strukturiertes Klinisches Interview für DSM-IV. Göttingen: Hogrefe; 1997
• 19 First MB, Gibbon M, Spitzer RL, Williams JBW. Users Guide for the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). Washington DC: American Psychiatric Press; 1997
• 20 First MB, Gibbon M, Spitzer RL, Williams JBW. Users Guide for the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Washington DC: American Psychiatric Press; 1997
• 21 Krampen G. Fragebogen zu Kompetenz- und Kontrollüberzeugungen (FKK) – Handanweisung. Göttingen: Hogrefe; 1991
• 22 Rheinberg F. Motivationsdiagnostik. Kompendium psychologische Diagnostik. Band 5. Göttingen: Hogrefe; 2004
• 23 White BP, Becker-Blease KA, Grace-Bishop K. Stimulant medication use, misuse, and abuse in an undergraduate and graduate student sample. J Am Coll Health 2006; 54: 261-268
• 24 McCabe SE, Boyd CJ. Sources of prescription drugs for illicit use. Addict Behav 2005; 30: 1342-1350
• 25 Poulin C. From attention-deficit/hyperactivity disorder to medical stimulant use to the diversion of prescribed stimulants to non-medical stimulant use: connecting the dots. Addiction 2007; 102: 740-751
• 26 Kroutil LA, Van Brunt DL, Herman-Stahl MA et al. Nonmedical use of prescription stimulants in the United States. Drug Alcohol Depend 2006; 84: 135-143
• 27 Sulzer D, Sonders MS, Poulsen NW et al. Mechanisms of neurotransmitter release by amphetamines: a review. Prog Neurobiol 2005; 75: 406-433
• 28 Seeman P, Madras BK. Anti-hyperactivity medication: methylphenidate and amphetamine. Mol Psychiatry 1998; 3: 386-396
• 29 Carboni E, Silvagni A. Experimental investigations on dopamine transmission can provide clues on the mechanism of the therapeutic effect of amphetamine and methylphenidate in ADHD. Neural Plast 2004; 11: 77-95