Yearning to be better than good –Lithuanian students of medicine use of cognitive enhancers among

Background. Use of cognitive enhancers has been getting increasing attention worldwide. The medical field is very demanding and selective from the very beginning. Competitiveness, stress, knowledge of pharmacology and accessibility may compel students to use substances that were not prescribed by the doctor. The primary purpose of this study was to analyze the trends of cognitive enhancers use among Lithuanian medical students. Secondary aims were to evaluate the stress level and sleep quality of these students in the context of non-users.

Methods. An anonymous paper and pencil-based survey was conducted in two universities offering masters in medicine diploma in Lithuania - Vilnius University and Lithuanian University of Health Sciences. Five hundred seventy-nine medical students filled anonymous questionnaires about substance use to enhance cognitive performance and other selected variables, including sociodemographic characteristics, subjective sleep quality, and perceived stress. Statistical analysis was carried out using the SPSS Statistics for Mac program, with the chosen level of significance p<0.05.

Results. 8,1% of students said that they had used substances for cognitive enhancement purpose at least one. Nootropics were the most frequent with a rate of 59,6% among all users. Less frequently mentioned substances included psychostimulants (38,3%, which included modafinil, methylphenidate and amphetamine-derived drugs), and 23,4% other substances (23,4%). Most students were seeking to improve concentration and increase studying time (55,3% and 48,9% accordingly). Male students claimed that they had used cognitive enhancers three times more often than females (14,6% vs. 5,1%, p<0,05). Students who had acquittances that had used these substances also used them more often than those who had not (17,3% vs. 5,1%, p< 0,05), which was the most associated factor with cognitive-enhancing drug-taking behavior. We found no correlation between the history of cognitive enhancement and sleep quality, stress levels, and extracurricular activities.

Conclusions. A substantial part of medical students use substances seeking to cognitively enhance themselves in Lithuania, with the rate of at least 8%. It suggests that cognitive enhancement trend in present in Baltic countries and needs more attention from policymakers and researchers.