Students who take Adderall to improve their test scores may get a slight benefit, but it’s mainly a placebo effect.
The drug Adderall is a combination of the stimulants amphetamine and dextroamphetamine, and is used to treat attention deficit hyperactivity disorder (ADHD). But it’s growing in popularity as a study drug in the US, where around a third of college students are thought to try using prescription stimulants for non-medical reasons.
But does it work? Rachel Fargason, a psychiatrist at the University of Alabama, Birmingham, says the idea of stimulants as cognitive enhancers didn’t tally with her experience of patients who were diagnosed incorrectly. “If they didn’t have ADHD, the stimulants generally didn’t help them cognitively,” she says.
To investigate further, Fargason’s team set up a trial in 32 people between the ages of 19 and 30, none of whom had ADHD.
Believe in yourself
Each participant took a batch of cognitive tests four times. On two of these occasions they were given 10 milligrams of Adderall, while they were given a placebo the other times. With each treatment, they were once told they were getting medication, and once told they were getting a placebo.
Compared with placebo, Adderall produced a slight improvement on two tests, relating to memory and attention, out of 31 tests in total. But simply believing that they were taking a medication – regardless of whether they were or not – had a stronger effect, improving performance on six tests.
The students performed least well when they were told they had taken a placebo – even when they had actually taken Adderall. “Expectation seemed to have more of an effect on objective performance than the actual medication state,” says Fargason.
But neither the drug nor the belief that they were taking it boosted the volunteers’ performances in more complex tests of cognitive ability. “In terms of the value for learning, it’s not clear it really would make that much of a difference,” says Fargason.
Ted Kaptchuk, of Harvard Medical School, says it’s not surprising that the effects of expectation can be so powerful, considering findings from other drugs. “Just thinking you’re getting alcohol will get you a lot of the behavioural symptoms of drinking alcohol.”
Using stimulants inappropriately is risky, says Fargason. They can damage the heart or cause mental health problems in some people. She recommends that students stick to safer alternatives. “A good cup of coffee might do the same thing, as would a 30 minute nap,” she says.
Even superstitious behaviours, like taking a lucky mascot to an exam, might work just as well if one believes that they will, she suggests.
Alcohol and Drug Dependence DOI: 10.1016/j.drugalcdep.2017.05.024
Read more: How you can harness the placebo effect