Staying Sharp: Can You Find Concentration in a Bottle?

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Ritalin-type drugs, which have a broadly stimulating effect on the nervous system, clearly improve attention and memory. According to a 2002 study of helicopter pilots operating flight simulators, so does donepezil, a drug that raises levels of the neurotransmitter acetylcholine. In another study, men on 200 mg of modafinil did better at mentally challenging games than subjects taking a placebo. But those results must be kept in perspective. Research at the Walter Reed Army Institute of Research in Silver Spring, Md., found that neither modafinil nor the military pilots' go pills were any better than several cups of coffee at restoring the attention and performance of sleep-deprived people.

If the effects are that mild, what are ethicists so worried about? Almost everything. "As our society becomes more competitive and specialized," says Chatterjee, "even the perception that these medicines provide a slight advantage can drive demand." If new and more effective drugs have few immediately discernible side effects, patients will probably pressure doctors to prescribe them. And as their usage spreads, people may feel forced to take them just to keep up. Would the means to pay for them determine who gets them? Would the rich get smarter and the poor fall further behind? What effects would such drugs have on the personality and mental health of users in the long run? The tendency to forget some things, for example, may be a big part of emotional stability and efficient problem solving.

Those issues don't seem to bother the Americans who pop pills and snap up supplements touted as brain enhancers. The latter are often a waste of money. Studies examining the cognitive benefits of supplements have either proved inconclusive or shown only modest effects. There's some evidence that the popular herb ginkgo biloba boosts cerebral blood flow and improves mental functioning, particularly when taken with ginseng. But there's also evidence that it doesn't.

Some of the most popular brain supplements, including deanol, are stimulants, but they have not been shown to improve cognition. "Americans like to have the five-Starbucks-triple-latte effect," says complementary-medicine guru Dharma Singh Khalsa, who sells his own line of "brain longevity" supplements. He recommends a regimen of antioxidants like vitamins E and C and co-enzyme Q10 to keep the brain healthy. Beyond that, one of his favorite nootropic formulations is a combination of ginkgo, phosphatidylserine (a molecule essential to the health of neural-cell membranes) and omega-3 fats (found in fish oils). But Khalsa emphasizes that nine-tenths of the mental boost people seek can be had by eating well, staying mentally and physically active and keeping stress at bay.

And if that doesn't help, you can always try a cup of joe.

SCHOOLYARD DRUGS Adderall and Ritalin, two drugs widely used to treat attention-deficit disorders, can focus healthy minds as well. These potentially addictive stimulants are increasingly abused by students and professionals—so much so that the U.S. government now considers them "drugs of concern"

Provigil, otherwise known as modafinil, was approved to help narcoleptics and shift workers stay awake. Lately it has joined the ranks of Ritalin as a popular performance aid. Some recent studies suggest it may indeed boost attention and mental acuity