Nootropics are drugs used to either treat or benefit cognition deficits. Among this class, methylphenidate is a popular agent, which acts through indirect dopaminergic and noradrenergic agonism and, therefore, is proposed to enhance performance in catecholamine-dependent cognitive domains such as attention, memory and prefrontal cortex-dependent executive functions. However, investigation into the efficacy of methylphenidate as a cognitive enhancer has yielded variable results across all domains, leading to debate within the scientific community surrounding its off-label use in healthy individuals seeking scholaristic benefit or increased productivity. Through analysis of experimental data and methodological evaluation, it is apparent that there are dose-, task- and domain-dependent considerations surrounding the use of methylphenidate in healthy individuals, whereby tailored dose administration is likely to provide benefit on an individual basis dependent on the domain of cognition in which benefit is required. Additionally, it is apparent that there are subjective effects of methylphenidate, which may increase user productivity irrespective of cognitive benefit. Whilst there is not extensive study in healthy older adults, it is plausible that there are dose-dependent benefits to methylphenidate in older adults in selective cognitive domains that might improve quality of life and reduce fall risk. Methylphenidate appears to produce dose-dependent benefits to individuals with attention-deficit/hyperactivity disorder, but the evidence for benefit in Parkinson’s disease and schizophrenia is inconclusive. As with any off-label use of pharmacological agents, and especially regarding drugs with neuromodulatory effects, there are inherent safety concerns; epidemiological and experimental evidence suggests there are sympathomimetic, cardiovascular and addictive considerations, which might further restrict their use within certain demographics.

益智药是用于治疗或有益于认知缺陷的药物。在这一类中，哌甲酯是一种流行的药物，它通过间接的多巴胺能和去甲肾上腺素能激动作用起作用，因此被提议用于提高儿茶酚胺依赖性认知领域的表现，例如注意力、记忆力和前额叶皮层依赖性执行功能。然而，对哌醋甲酯作为认知增强剂功效的研究在所有领域产生了不同的结果，导致科学界围绕其在寻求学术利益或提高生产力的健康个体中的标签外使用展开辩论。通过实验数据分析和方法学评价，明显存在剂量-、围绕在健康个体中使用哌醋甲酯的任务和领域相关的考虑因素，根据需要受益的认知领域，量身定制的剂量给药可能会在个体基础上提供益处。此外，很明显哌醋甲酯存在主观效应，无论认知益处如何，这都可能提高用户的工作效率。虽然没有针对健康老年人的广泛研究，但在老年人中，哌醋甲酯在选择性认知领域具有剂量依赖性益处，这可能会改善生活质量并降低跌倒风险，这似乎是合理的。哌甲酯似乎对患有注意力缺陷/多动障碍的个体产生剂量依赖性的益处，但对帕金森病和精神分裂症有益的证据尚无定论。与任何药物制剂的标签外使用一样，特别是对于具有神经调节作用的药物，存在固有的安全问题；流行病学和实验证据表明，存在拟交感神经、心血管和成瘾方面的考虑，这可能会进一步限制它们在某些人群中的使用。