Bowman · Science advances 2023 · placebo-controlled trial · n=?

Not so smart? "Smart" drugs increase the level but decrease the quality of cognitive effort.

Cited 43 times in the scientific literature.

Level 2 - randomized trial

Placebo-controlled trial evaluating pharmacological cognitive enhancers

PubMed 37315143 · doi:10.1126/sciadv.add4165 · record verified 2026-08-26

What was done

Participants completed a complex computational decision task (the knapsack optimization problem) under the influence of methylphenidate, dextroamphetamine, modafinil, or placebo to assess the effects of cognitive enhancers on task performance, decision time, and solution strategies.

What was found

Methylphenidate, dextroamphetamine, and modafinil significantly reduced the knapsack value attained compared to placebo, although the chance of finding the optimal solution (~50%) did not change significantly. Effort (measured by decision time and number of steps taken) increased significantly, but productivity (quality of effort) decreased significantly. Baseline differences across participants reversed, with above-average performers dropping below average due to increased randomness in their search strategies. No exact sample size or effect sizes were reported in the abstract.

Why it matters

These results challenge the assumption that smart drugs improve performance on complex everyday tasks, demonstrating that higher motivation and effort can be offset by poorer strategy execution.

Limits

The abstract omits sample size, participant characteristics, exact drug doses, and numerical effect sizes with confidence intervals. The stylized knapsack task may not capture all aspects of real-world decision-making.

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