By Dean Irvine for CNN
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LONDON, England (CNN) -- First published January 25, 2007
It may sounds like something from a J.G. Ballard novel, but a new breed of lifestyle drugs could allow us to choose how much we sleep, boost our memories and even allow us to enjoy ourselves more, without any side effects. Will they unleash human capabilities never seen before or create a dystopian 24-hour society where we are dependent on drugs to regulate our lifestyle and behavior?
"These drugs are coming, and they're coming fast. We live in a culture that doesn't lend itself to holding back performance enhancers. If substances can be produced that don't have any real physical risks, you'll see them," Dr Arthur Caplan, Director of Bioethics Center at Pennsylvania University told CNN.
One drug already available is modafinil, marketed as the vaguely Orwellian-sounding Provigil. Originally developed for sufferers of narcolepsy, it enables those who take it to stay awake and alert for 48 hours.
Of course caffeine and amphetamines have long been used to do the same thing, and substances that change our moods are not new, but modafinil is different.
It is a eugeroic that delivers a feeling of wakefulness without the physical or mental jitter, plus has no associated crash that comes with taking amphetamines. The few reported adverse reactions are no worse than headaches and nausea. Users who have taken a pill can even take a nap; it just turns off the urge to sleep.
There is already a market for it for those without any medical need - it is developing a cult following among workaholics and students studying for exams. The military is also very interested in eugeroic. Their reliance on amphetamines for lengthy operations have had catastrophic consequences in the past. The "friendly-fire" incidents in Afghanistan in 2002 when U.S. pilots killed Canadian troops was blamed on the "go pills" they had taken.
The other benefit that users of the drug have found is that they do not accumulate a "sleep debt". Usually staying awake for 48-hours would mean two nights sleep to catch up. Instead, turn in for a more normal eight-hours and users claim to feel normal.
It sounds like a wonder drug that can liberate us from millennia of sleep patterns and brings into question the limits of human capability.
For Dr. Caplan, it also brings up a number of other factors connected to the drug.
"It doesn't look as if there are any long-term physical risks, but it's next to impossible to say that anything is risk free. Alos there is the issue of coercion. We already live in an age when there is pressure to perform better and outperforming your competitors. There may develop an insidious pressure at work to take the drug, just to keep up," he told CNN.
"And it starts before the workplace. College students will stay up late to cram and something that enables them to function at the maximum of their ability for 48 hours without sleep is an attractive proposition. It's clearly a lifestyle drug, and people are already requesting it as an enhancer."
The concept of unshackling sleep from the body's natural rhythms is a cause for concern for some.
"Why go against the whole of human history and nature that has seen us being awake during the day and asleep at night? You have to question how life if better staying up all the time," a well-rested Neil Stanley, former Chairman of the British Sleep Association told CNN.
It's a valid point, but as an alternative for those already taking stimulants it appears to be a much better option. Friendly fire incidents aside, the catastrophic nuclear explosion at Chernobyl, and the meltdown of a reactor at Three Mile Island both occurred during the wee hours of the morning. While there's no guarantee a stimulant like modafinil could have avert these calamities their usefulness for night-shift workers has not been lost on Provigil's marketing team.
"But essentially there is no substitute for sleep, it's essential for memory creation, learning and all kinds of mental and physical health," said Stanle.
A new type of sleeping pill might see to that. Gaboxadol is the yin to modafinil's yang and may make it's appearance on doctor's prescription forms later this year. It promotes the amount of "slow wave" or deep sleep, but doesn't carry the same risk of addiction or grogginess that many of today's "hypnotic" sleeping pills have. Essentially you could sleep for less time and get the same benefit.
"It's not too hard to envisage a not-too-distance future when you can chose a pill to give you a desired amount of 'slow-wave' sleep. In the future drugs like will work faster and act longer, as to how much is down to how much they find themselves as a lifestyle drug," said Stanley.
A newer version of Provigil is being developed and a number of other performance and personality enhancers are on the horizon. The U.S. Defense Advanced Research Projects Agency (DARPA) tested a compound called CX717 in its quest to find a drug that can create a "metabolically dominant war-fighter of the future" able to function for seven days without sleep.
"As for a drug to increase wakefulness, I don't think they found what they were looking for. There wasn't that feeling of being hyped up that they wanted," Roger Stoll, President of Cortex Pharmaceuticals, the developer of CX717, told CNN.
CX717 is an ampakine, a compound that increases the brains computing powers. They work by boosting the activity of glutamate, a nerve message chemical that makes it easier to learn and encode memory. It re-writes the rules of what it takes to create a memory and just how strong those memories can be.
As a "zombie" drug, CX717 didn't have the desired effect. Clinical trial in 2005 showed it increased cognitive responses among test subjects and Stoll thinks it could be a significant drug to treat attention deficit and hyperactivity disorder (ADHD). Even if it can't market the drugs as such a pill that improves your memory is sure to be attractive to more than just ADHD sufferers.
While Cortex focus is on neuro-degenerative diseases they are developing other compounds to sharpen the mind. "It's possible we could tailor these products to be more exciting and thereby more enticing for people looking for a kind of 'systemic elevation.' There is huge potential in enhancing drugs," said Stoll.
Will cans of soda containing eugeroics or ampakines be as common as caffeine drinks on the shelves of 24-hour stores? The potential is certainly there for a brave new world of personality medication.
"There are all sorts of things being developed, from memory enhancers to drugs that will overcome social phobias and some that actually enhance pleasure responsiveness, making feeling happy more intense," said Caplan.
Feeling a bit nervous about a first date or party? Take a tablet. Don't feel you're maximizing your enjoyment? Pop a pill and you'll be fine. But only if you can afford it.
"It's the rich and upper classes that will get the benefits of these drugs and then there is the division between developed and developing nations," Caplan told CNN.
So where does personal medicalization end and social responsibility begin? Wouldn't long distance drivers be better off taking a break, rather than popping a pill? Previous substances hailed as wonder drugs in the past, such as Prozac haven't proved to be a panacea.
"I don't dispute the medical effects of modafinil, but I do worry about the attractiveness of it and others like it, plus there's the bigger threat of becoming psychologically dependant," said Stanley.
"I'm wary of these drugs, but also resigned to them. We'll have to find a way to manage them. Ban enhancements in a competitive, capitalist society? I don't think so. It may be regrettable, but it is inevitable. If it sounds terrifying, well that's what our great-grandparents said about airplanes," said Caplan.
Lifestyle drugs could become as normal as cosmetic surgery as a form of self improvement.
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