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  • Unless you've been living under a rock, you're likely well aware that stimulants

  • such as Adderall or Ritalin have been increasingly used in recent years by students who are eager

  • to get better grades.

  • In this video, we'll go over the science behind stimulants and whether or not they actually

  • help students in school.

  • What's going on guys! Dr. Jubbal, MedSchoolInsiders.com.

  • Let's get a couple important items out of

  • the way.

  • First, for those of you who are wondering, I have never taken any drugs or substances

  • to help me study or be productive, other than the occasional coffee once every few months.

  • Second, I am not your doctor and I am not providing medical advice in any capacity.

  • Third, this video and the content here are primarily targeted to individuals who are

  • using these substances as cognitive enhancers, without a diagnosis of ADHD, narcolepsy, or

  • other conditions that warrant their prescription.

  • Please speak to your physician prior to starting, stopping, or changing any medications.

  • Now, Methylphenidate such as Ritalin or Amphetamine such as Adderall are the two prescription

  • stimulants most commonly used by students seeking to improve their attention, concentration,

  • and ultimately their grades.

  • These are schedule II substances in the US, placing them in the same category as cocaine,

  • oxycodone, and PCP.

  • That's some serious stuff.

  • Now, while these stimulants are effective with professional supervision for treating

  • ADHD, their utility as a study or concentration aid has not been thoroughly validated.

  • And while the prescribed use and supervision by your physician is relatively safe, misuse

  • or abuse of any stimulant can have adverse effects.

  • A sizable portion of college students use these substances as cognitive enhancers, under

  • the belief that these drugs will improve their grades.

  • To answer the question of whether or not they actually do, let's first start with how

  • the substances work.

  • The cognitive-enhancing effects of stimulants are due to the preferential effect of catecholamines

  • in the prefrontal cortex and activation of the Norepinephrine αlfa 2 and Dopamine D1

  • receptors.

  • Catecholamines are a group of neurotransmitters including norepinephrine, epinephrine, and

  • dopamine.

  • At low clinically relevant doses that a doctor may prescribe, the PFC-dependent function

  • is enhanced, which contributes to the stimulants use in ADHD.

  • But at larger doses, the PFC-dependent attentional processes are improved at the expense of other

  • processes, like working memory or response inhibition.

  • Methylphenidate or Ritalin and Amphetamine or Adderall both increase extracellular levels

  • of Norepinephrine and Dopamine throughout the brain, largely by blocking Norepinephrine

  • and Dopamine reuptake.

  • Amphetamine additionally stimulates the release of Dopamine through the Dopamine transporter.

  • And while amphetamines at higher doses block serotonin reuptake, methylphenidate only blocks

  • Norepi and Dopamine reuptake.

  • Now, let's move to the cognitive effects.

  • The cognitive enhancement properties of stimulants have been studied in the following four categories.

  • First, inhibitory control, which is linked to focus and avoiding distraction.

  • Number two, working memory.

  • Number three, short-term episodic memory, referring to memory and recall within 30 minutes

  • of learning.

  • And lastly, delayed episodic memory, referring to longer intervals, such as one hour to one

  • week between learning and testing.

  • In a systematic review of the literature, Ilieva et al demonstrated that there is a small but

  • significant degree of enhancement of inhibitory control and short-term episodic memory.

  • The effects on working memory are inconclusive, as one statistical analysis demonstrated a

  • small but statistically significant improvement, and the other demonstrated no statistical

  • significance.

  • Delayed episodic memory was the cognitive factor that demonstrated the largest effect.

  • Now, because stimulants had stronger effects on delayed episodic memory over the short-term

  • episodic memory, this data suggest that stimulants may more potently affect a memory consolidation

  • in comparison with encoding or retrieval.

  • Now, this is interesting, there is evidence that stimulants can actually impair performance

  • in normal individuals who are especially high performing.

  • In short, this means that individual variations account for a significant degree of the benefit

  • or detriment in seeing effects.

  • In 2017, Arria et al. published a prospective cohort study examining close to 900 college

  • students without ADHD.

  • Their conclusion, non-prescribed prescription stimulants did not demonstrate any statistically

  • significant effect on university GPA scores.

  • Now, there are multiple other factors that have been linked with stronger cognitive enhancement

  • and improvements in grades.

  • Mindfulness meditation, for example, has demonstrated stronger effects on inhibitory control, which

  • ultimately helps you focus on the task at hand.

  • The cognitive enhancement from stimulants is smaller and more comparable to the cognitive

  • benefits you see with physical exercise.

  • Ultimately, the most important thing that you care about is your GPA and your test scores,

  • right, and stimulants have not been shown to improve student GPAs.

  • However, when speaking about broader cognitive benefits, it's important to note that there

  • are several limitations with the current literature.

  • Notably, sustained attention and processing speed were not adequately studied.

  • Current studies also do not examine performance under fatigue, sleep deprivation, or distraction.

  • And while these possible cognitive benefits are often emphasized, it's important we do

  • not overlook the adverse effects of using these medications.

  • Short term side-effects may include GI problems, blurred vision, irritability, insomnia, increased

  • body temperature, blood pressure, heart rate, and many others.

  • Long term adverse effects include hallucinations, psychosis, cardiac arrest, and death.

  • Don't forget the risk of addiction, headache, panic attacks, aggressive behavior, and a

  • link to suicidal and homicidal tendencies.

  • I've gone over the science and current literature on stimulants used by students for cognitive

  • enhancement and I was as objective as possible, keeping my opinion out of it until now.

  • There are a few points I'd like to raise.

  • Again, keep in mind that these points are for those who do not have a medically valid

  • prescription for these substances.

  • If you are on these medications for a medical condition, this does not apply to you.

  • First, the moral and ethical implications.

  • If you believe that taking stimulants is in fact benefiting you, which again the literature

  • is inconclusive then what is the fairness to those students you are competing with who

  • are not taking the drugs?

  • This opens up a whole other debate that is similar yet distinct from performance-enhancing

  • drugs in sports, food for thought.

  • Number two, let's talk about the long-term consequences.

  • The potential upside is limited based on the data we have, and yet there are significant

  • health risks, from cardiovascular complications to addiction and other significant detrimental

  • effects on your health and well-being.

  • The legal implications of using these substances without a prescription are also substantial.

  • From a cost-benefit analysis perspective, using stimulants does not appear wise.

  • Lastly, understand that by using stimulants to help you study, you're using a shortcut,

  • a crutch and that crutch overall makes you a weaker student.

  • Relying on stimulants to help you concentrate or focus diminishes your ability to rely on

  • your own habits, your own willpower, and your own systems to provide the results that you

  • want.

  • You may be thinking right now, so what?

  • But let's take a moment to think about how this actually pans out long term.

  • If you're in college right now and you rely on stimulants, you'll find it harder and

  • harder to perform without them.

  • You simply won't be building the habits and strategies to make you an effective student

  • and when you start medical school, your study habits and strategies will be so weak that

  • you'll again be dependent on stimulants, unable to be an effective student without

  • them.

  • If the idea of being dependent on a prescription medication with significant medical adverse

  • effects and legal repercussions doesn't bother you, understand that you will be drug

  • tested in the medical profession.

  • And that can be the end of your medical career.

  • By taking this shortcut, you're cheating yourself out of the necessary growth and development

  • that you need as a student and as an effective and competent future physician.

  • Now, I'm not here to say what is morally right or wrong.

  • However, in my opinion, it simply doesn't make sense for students to use stimulants

  • without a prescription as cognitive enhancers.

  • You don't need them.

  • I never touched them, and yet I still crushed undergrad, aced the MCAT, beast in medical

  • school, and matched into plastic surgery.

  • I did much better than the students who were taking the stimulants and yet I did it the

  • old fashion way.

  • Hone your habits, adjust your study strategies and continue to practice.

  • The hard work pays off, trust me.

  • The content on this channel is a good place to start, but if you do wanna take your productivity,

  • study strategies, and overall effectiveness to the next level, check out MedSchooIInsiders.com.

  • Thanks for watching and good luck.

Unless you've been living under a rock, you're likely well aware that stimulants

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アデロール(&覚せい剤)は学生の成績を向上させるか?- 文献の概要 (Does Adderall (& Stimulants) Improve Student GPA? – Overview of the Literature)

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    Summer に公開 2021 年 01 月 14 日
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