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Published online before print September 23, 2009, doi:10.1212/WNL.0b013e3181beecfe)
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 Volume 73, Number 17, October 27, 2009
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NEUROLOGY 2009;73:1406-1412
© 2009 American Academy of Neurology
Special Article

Responding to requests from adult patients for neuroenhancements

Guidance of the Ethics, Law and Humanities Committee

Dan Larriviere, MD, JD, Michael A. Williams, MD, FAAN, Matt Rizzo, MD, FAAN, Richard J. Bonnie, LLB On behalf of the AAN Ethics, Law and Humanities Committee*

From the Department of Neurology and School of Law (D.L.) and Schools of Medicine and Law (R.J.B.), University of Virginia, Charlottesville; Sandra and Malcolm Berman Brain & Spine Institute (M.A.W.), Department of Neurology, Sinai Hospital of Baltimore, MD; and Department of Neurology (M.R.), Roy J. and Lucille A. Carver College of Medicine, Iowa City, IA.

Address correspondence and reprint requests to Dr. Dan Larriviere, Department of Neurology, Box 800394, University of Virginia, Charlottesville, VA 22908 dgl6t{at}virginia.edu

In the last decade, persons who have no diagnosed medical or mental health condition are increasingly seeking and utilizing, for the ostensible purpose of enhancing their memory or cognitive skills, prescription drugs that were originally developed to improve executive function or memory in persons diagnosed with disorders such as attention deficit hyperactivity disorder or Alzheimer disease. Evidence suggests that this practice, now known as neuroenhancement, is gathering momentum. As a result, neurologists may be encountering patients without a diagnosed illness asking for medications with the goal of improving their memory, cognitive focus, or attention span. Strong arguments have been made for and against this practice, often reflecting strongly held convictions concerning the appropriate practice of medicine. The purpose of this report is to provide neurologists with an overview of the ethical, legal, and social issues surrounding the use of pharmaceuticals prescribed to enhance or augment normal cognitive or affective functioning, as well as practical guidance for responding to an adult patient’s request for neuroenhancement.

Abbreviations: ELHC = Ethics, Law and Humanities Committee; FDA = Food and Drug Administration.

Supplemental data at www.neurology.org

e-Pub ahead of print on September 23, 2009, at www.neurology.org.

*Members and staff of the AAN Ethics, Law and Humanities Committee who participated in development of this report and guidance are listed in the appendix.

Approved by Ethics, Law and Humanities Committee on April 28, 2009; approved by the AAN Board of Directors on September 3, 2009.

Disclosure: Author disclosures are provided at the end of the article.

Received May 28, 2009. Accepted in final form August 10, 2009.






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