Steve Hyman: This is a programme on pharmacological cognitive enhancement in healthy people, potential and concerns. I am your moderator Steven Hyman, Harvard University Distinguished Service Professor and Director of the Stanley Centre at the Broad Institute of MIT at Harvard. The two scientists who will be discussing the questions will be Nora Volkow MD who is Director of the US National Institute on Drug Abuse and is also a very accomplished researcher, most notably in brain imaging. She has previously been the director of various different departments including nuclear medicine at the Brookhaven National Laboratory in Upton, New York. Our other discussant is Dr. David Nutt who is the Edmund J. Safra Professor of Neuropsychopharmacology and Director of the Neuropsychopharmacology unit in the division of brain sciences at the Hammersmith Hospital, Imperial College London. He is currently President of the British Neuroscience Association and Chair of the Independent (UK) Scientific Committee on Drugs (ISCD) and among many other positions and honours he was previously the Chair of the Advisory Council on the misuse of drugs in Great Britain and President of the British Association of Psychopharmacology. Thus we have two highly qualified and important thinkers on the issue of cognitive enhancement.
Let me ask first Nora and then David about existing drugs, of which we have several, most notably caffeine, methylphenidate known by its brand name of Ritalin, amphetamines, and modafinil known by its brand name of Provigil that are used by healthy people to enhance alertness, make tasks more engaging, and generally to improve cognitive performance. Sometimes these are used illegally, for example without a doctor’s prescription as “study drugs” in secondary school and University, among other settings. Do you think this represents a problem? Are there aspect that might not be problematic? Nora?
Nora Volkow: Certainly I can tell you that in the United States that abuse of stimulant drugs is a serious problem and in fact from surveys it is estimated that 8% of 12th graders have used amphetamine for non-medical purposes in the past year. If you look at the records of the reasons for admissions for prescription and over the counter (OTC) treatment, the number one reason among adolescents (12–17) has to do with stimulant drugs. So stimulant drugs are diverted, they are abused and they can produce quite severe addiction and in fact we know that in many countries addiction to amphetamine is very, very prevalent. So there is a serious problem with respect to the abuse and addition liability of these drugs.
Steve Hyman: David, perhaps you want to continue in the same vein but consider whether for those people who are not at serious risk of addiction, are there still serious problems and if not are there any advantages?
David Nutt: I think we need to see this issue in a historic perspective. The last war was fought with both sides taking stimulants, either amphetamine sulphate or methylamphetamine and it was then seen as a good thing and in fact still we know quite a lot of the military use modafinil to stay awake and keep optimal attention under times of prolonged sleep deprivation. Clearly there are alsp values in these drugs that have been established with the use of amphetamines and methylphenidate for 60 years now for the treatment of ADHD, so I don’t think there’s any major health issues around their use. I think the question of whether they lead to addiction or dependence in some people obviously is a concern. It’s not an issue we are finding of particular concern in the UK at present. The ISCD has just done a survey of university students and we found about 8% have taken Provigil and about 3% have taken amphetamines to help with study, but there certainly is not a big problem with those people going on to seek help for dependence in the UK.
Nora Volkow: Can I interject here Steve to actually put a concept on David because yes, these stimulant drugs have been used by the military for more than 50 years but what’s interesting is that the British stopped using them and it had to do with the fact that use of these stimulants can make a person paranoid and that in turn could have very adverse effects in a military situation. In the United States the use of stimulant drugs has indeed been associated with friendly fire, the cause of this resulted from friendly fire that led to distortions of perceptions as well as paranoid thinking, so there is clear apart from the issue of addition the problem that some of these drugs more than others, particularly amphetamines can produce a full blown psychosis.
David Nutt: Certainly if they’re taken for too long there’s no question of possible harms, although our servicemen tend to look with envy at the fact the Americans can use Provigil because we don’t even let them use that, so they feel they’re a bit disadvantaged in periods of extreme sleep deprivation, but anyway, that’s a side issue I think from what we’re discussing tonight.
Steve Hyman: Right. I think the concerns with stimulants that leads to their being highly restricted are the side effects of the kind that Nora mentioned, and in addition, potentially cardiovascular side effects and addiction liability, but what I’d like to get to are the ethics and policy concerns raised by enhancing cognition in healthy people. So let’s see if we can get away from the side effects of stimulants and imagine that scientists are finally successful in developing a drug to treat memory loss—in fact many are working on such drugs to treat symptoms of dementia. If we had a drug that could enhance memory and did so by a neurobiological process that would also work in healthy people, how would you feel about such a drug? How would you feel for example if students were to use this as study drug? Would it raise the kinds of issues that we’re seeing in sports when people use enhancers?
Nora Volkow: My perspective on this one is if you can develop medication that has no adverse effects and you can improve cognitive abilities either by enhancing your attention or your memory, my perspective is why not? I think the human brain has evolved in ways that allow us to do things that expand our capabilities as individuals, so I think it would be very, very exciting that there could be such medications, again I state without side effects because the current medications that are available do have side effects.
Steve Hyman: Yes, which we’ve already discussed for stimulants.
Nora Volkow: So when you’re dealing with a sport you’re actually trying to get people to have the same chances do you have a sportsman to see which wins, (a) or (b). When you have students and you want them to be able to say for example learn a new language or learn new mathematical skills, why not? Why not accelerate that process?
David Nutt: I wouldn’t disagree with that. I would say that is another stepping stone in human evolution where rather than random selection of genes we now have some targeted medication to improve some mental functions. I wouldn’t have a problem. We discussed this in the UK government’s Foresight report of seven years ago now. The issue was then more one of equity, do the rich have it and the poor not, or do you give it to everyone in order to enhance the quality of a population or a country? We were actually seriously interested in whether these might be strategies that could be used by other countries which perhaps value achievement more than some countries in the West and that would put the West at an economic disadvantage. So there are very interesting political and moral issues of equity about this. But in principle I think if we were able to achieve that kind of drug we should fully endorse it and fully encourage its use.
Steve Hyman: I would certainly be interested in hearing Nora’s view on these policy issues because regulators whether in the United States or Europe approve drugs to treat disease, to improve memory, for example, in dementia. For ethical, legal liability, and many other reasons companies don’t perform clinical trials in healthy people, except for early studies of toxicity in healthy volunteers. It is also hard to imagine that health insurance would pay for these drugs for healthy people which goes directly David to the issue you raised. People who are well who wanted to obtain these drugs would probably have to pay for them out of pocket which creates an equity problem, the question of whether we would have chemical “haves” and “have nots” exacerbating current social inequities. Assuming we discover these drugs, what should we actually do?
David Nutt: I think this is why programmes like this are so important because the debate has to start now. These drugs could be discovered next year and we need to be ahead of the game. We’ve seen similar issues emerge for instance within in-vitro fertilisation etc, so as human technology is almost limitless, we definitely need to prepare the ethical and moral and intellectual groundwork, so I think we should be having this discussion. Maybe they should be pharmaceuticals in which case they will need licence authorisation, but people almost certainly will use them off label as they already are doing with the current stimulants which are licenced for ADHD for instance. But there’s also another scenario, which is that they maybe invented simply as enhancers and not used in dementia. Maybe they will get to be more effective in brains that aren’t demented and we’ve already some evidence for this from some of our own work with the alpha 5 inverse agonists of the GABA-A system which is more obviously effective in impaired young people than it is in the elderly; so maybe people will just develop enhancers and they won’t worry about diagnosis. They will simply sell them as foodstuffs or whatever, they will come by a different route.
Steve Hyman: Nora, any views on this?
Nora Volkow: I think David is completely correct, this is why we need to have these sorts of discussions because there are aspects related to equity and generating a greater gap between those that have it all and those that do not could actually be then amplified if you really have people that were much better prepared than others, but at the same time there’s another area that I think would benefit us. Indeed we really have such type of medications which is we’re seeing an increase in the lifespan of individuals and one of the very important aspects that needs to be addressed is have you increased the quality of life of the person as they go into their later years, so to be able to have medications for example on people that don’t have any type of dementia but as part of the ageing process their memory is not as good as it was before or they cannot learn things will be extraordinarily valuable because you then would have this individual being able to learn new things and have a flexibility to shift their expertise on the basis of their needs, so the recognition that we are increasing the survival of the population and the importance of providing them with a very good quality of life really sets as one of the priorities that these individuals are functioning with their cognitive operations optimally.
Steve Hyman: Let me make this a little bit tougher because I agree with both of you, it’s absolutely critical to be having these discussions. I think the first issue to be solved is that all societies are concerned about healthcare costs and probably would not be very excited about expenditures for new patented and presumably expensive drugs for people who have no illness–just as society doesn’t pay for music lessons or sports training generally; then the second thing is unfortunately all drugs powerful enough to have the effect you want are also going to have some side effects. How are we going to understand what the risks and benefits are in healthy people as opposed to people who have an illness?
David Nutt: Shall I try that one?
Steve Hyman: Why not?
David Nutt: That’s why I prefer a non-medical reason because that’s new, that’s different. We could then create our own rules about monitoring assessment, data collection etc about this new technology. It doesn’t lend itself so easily to a medical model so maybe we should have a different sort of regulatory system for enhancers. You could throw things like creatinine and even steroids for muscle growth into that mix if you wanted. Maybe we should think of a different way of regulating these kinds of enhancing drugs?
Nora Volkow: My perspective on this one is that I think that we’re going to have to re-think the way that we regulate things as there’s more engagement and development targets, aspects that can improve the health of a person because you can improve and this for example we’re seeing it very clearly in the case of obesity, so obesity we don’t have hypertension diabetes, you could improve, right? But yet the pharmaceuticals are having a very hard time to get drugs approved for that condition. So I think that this is going to have to be resolved but I also want to put forward that it’s not just medications that are likely to come across as helping in cognitive enhancers but it’s obviously now methodologies such as transcranial magnetic stimulation or electrical stimulation that in the future may enable us to enhance sustainability of attention for example so that may have benefits also in cognitive enhancements, so it will not just be drugs. I predict that also there are going to be tools that will allow us to optimise the function of the brain.
Steve Hyman: One of the reasons of course that drug companies have had great trouble getting approval for obesity drugs is that people will take them every day for many, many years, maybe for the rest of their lives and this has created on the part of our regulatory agencies the demand that they be very, very safe. The assumption is that even though obesity is bad, most people taking the drug long-term will not have consequence yet like diabetes or heart disease. In such situations, the risk-benefit trade-off is taken in our current regulations to favour safety. Let’s imagine we have a cognitive enhancer or a memory drug and as will happen with any drug, somebody has a bad side effect. How do we provide the information to them ahead of time? Who would be liable? What companies might want to be in this business?
Nora Volkow: This is in a way one of the things that we’re facing now even with regular access time for approval of medication. They will take into another extreme of course when you’re targeting this other market but I also think that the extreme risk-averse situation that we are faced with right now in order to regulate an approval of a medication has led to a certain extent to the situation where we have now big pharma is pulling away for the development of many of these medications because they don’t see their likelihood of getting them approved. That’s why I stated also before we are going to have to re-think how we regulate this approval process and there are some models that could be used for example that have been adopted with orphan diseases where the company can get an interim approval that allows them to test, to prescribe the medication to a relatively small group of individuals and in the process they are gathering information of potential side-effects that otherwise they wouldn’t have picked, while before they get the final approval in a more expensive setup. I think that they are already modelled, that somehow exists that may facilitate a transition into different ways of regulating these type of potential advances.
David Nutt: I have to agree. We have to change the model, it’s not working at present but I think what we’re seeing already and particularly with US students is they actually don’t care about the risks. They’re quite happy to buy the stuff on the Internet and use it as and when they feel it’s useful and I think that is the way things will tend to develop. In the UK people buy vast numbers of chemicals over the internet in order to have fun and if there was a more regulated system with proper insurance and proper quality control I think that would be very appealing to the next generation frankly.
Steve Hyman: Ok, so let me turn to a different problem and David, I think you’ve probably considered this one before as well. The problem sometimes goes by the name of implicit coercion but it goes like this: you’re working either as a graduate student or in a company and all of the other students or all of the other workers around you are using cognitive enhancers, something to keep them alert or memory enhancers and you’re simply not quite as productive; on the other hand for moral, religious or safety reasons you would rather not take these drugs, what happens to you?
David Nutt: I think that’s actually one of the key, crux questions and obviously individuals shouldn’t be forced ever to take a drug that they don’t want to take for whatever reason, and that’s why I think we do need to have some kind of code that would allow people to opt out and be protected. You could do it under employment law I’m sure, I think that would be perfectly possible, but you’re right, I could foresee that kind of pressure happening. In a way we see that happening in culture at present, without medication. The Japanese aren’t allowed to go home until their boss goes home. In the City of London and New York, in the big financial houses if you weren’t stoking yourself up on cocaine before you made the big deals you weren’t cutting enough of the profits to keep your company happy for a while; and then of course it all comes tumbling down. We’ve seen those profiles and we do need to guard against them very strongly with proper legislation.
Nora Volkow: You see that and you see there are students already in high school or graduate school saying that they feel disadvantaged because they don’t want to take stimulant drugs but I do want to make a point that I don’t believe on the magic bullet that we will have a medication that will improve all of a sudden our cognitive abilities, I think that’s a fairy tale. The brain is extraordinarily complex so I can see for example that stimulant medications in a normal person will improve their performance when they are sleep deprived, but they may deteriorate in performance if they are fully awake and are already functioning at high levels. So it’s not a black and white situation and I predict that with even more advanced medications it’s very, very unlikely that you would have this magical feel, just what we know on the complexity of brain processes and how our brain functions, that’s really unlikely to happen.
Steve Hyman: Yes, we do already see these arms races, certainly in sport where they’re illegal, athletes keep trying to find an undetectable new steroid, for example, because it gives them a competitive advantage. Just as people use drugs without safety information I think they will want to believe or will assume that these drugs are better than they are, so I think this implicit coercion issue is with us and will be with us.
Nora Volkow: Absolutely, I think that is correct and it’s already there. The issue though is like coming back to David’s point is what is the type of dialogue that we need to address. One of them, you really have a tremendous disadvantage then your policy intervention will be very different as opposed to a medication that may improve on certain conditions and not the others, so it was in that context that I made the point.
David Nutt: That’s a fair point. Sport is quite an interesting model but I suppose the difference is that people don’t have to engage in sport whereas largely people do have to engage in work, so coercion could be greater there. Nora’s point about students getting distressed because they’re lagging behind in their language course for instance, now that’s probably not because their peers are taking drugs but they might perceive it as such and I think it would be perfectly reasonable for universities to do what sports authorities do and test if they were concerned. I wouldn’t have any opposition to that provided it was made explicit beforehand.
Steve Hyman: David, I can imagine in the US students would not be all that excited about having a urine test before an exam. It would be an interesting social phenomenon.
David Nutt: They’re all going for a pee anyway!
Steve Hyman: Let me in the last few minutes give you another hypothetical. I had talked before about a wished-for drug to improve memory but we all know that there are two sides to this coin. You might be taking a drug because you think it’s going to help you memorise organic chemistry or a new language but then you walk out across the street and you witness a grisly crime or accident and that would, in the context of a memory enhancing drug, be the ideal setup for very severe post traumatic stress disorder, so how do we instruct people assuming we find such drugs to use them safely and effectively?
Nora Volkow: That is a very real scenario, and we at NIDA of course are working on medications that can enhance memory such that a person in treatment can learn new associations unrelated to their drug use. But of course there is always the concern of potential side effects that by facilitating conditioning to rewards we could enhance a person’s susceptibility to addiction.
Steve Hyman: Sorry to interrupt—, it’s worth reminding the audience that a significant reason that people relapse to the use of drugs is they come to associate certain cues or reminders with drug use, so it is a very central issue for you.
Nora Volkow: It’s a memory issue and you pointed that out. What is driving most of the relapses relates to those conditioned responses. They apply the same molecular mechanisms that we use for learning, but what pharmaceuticals or researchers are looking into is can you limit that ratio of dose medication such that you would take a medication say for two or three hours while you are studying and then the effects are gone. I think that playing with the pharmacokinetics of your drug maybe a way to try to make it safer because otherwise you could be at the exposure of memorising things that there is a reason why normally you physiologically you should be forgetting them.
David Nutt: To be fair Steve could I just say, the thing about PTSD is it’s not just the factual memory, it’s the emotional memory and emotional association. It’s theoretically possible to make drugs which enhance memory for facts but not enhance memory for emotional memory, so we would hope to be able to say that, but we might not.
Steve Hyman: We might not. I think the question is whether in different kinds of memory circuits, there are different molecular mechanisms and a lot of the research to date would suggest that it maybe hard to tease them apart, so assuming my darker scenario David, how would you try to address these risks so that again people. I think you’re right that people will learn about these things on the internet and will experiment with them, so what kind of educational safety regime would you put in place?
David Nutt: It has to come down to the individual. People have to know what they’re taking, what the risks are and what the benefits might be and they have to make their own decision. I think we have to get away from this paternalistic kind of regulatory system we’ve had up to now which certainly many patients are uncomfortable with and I think perhaps as pharmaceuticals broaden then many others in the population will be uncomfortable with. It has to be the individual decision. They should sign a form of consent when the buy the medication just like they do now when they consent for an operation.
Nora Volkow: One of the things that I do believe is important in addressing the issue of the paternalistic role that society may have is it’s a decision of the individual but for that individual to really make a decision, informed, he has or she has to have the knowledge and society’s obligation is to provide that information. For example out of the synthetic drugs let’s remember the case of the MPTP. The individuals were taking this drug without realising what it would cost them and then when the toxicity came around of course that stopped MPTP, so we need to be able to provide objective information about what the risks are in ways that are not going to be self-deceiving. So I do believe that we do have that obligation, even though it’s not paternalistic you cannot have a decision, if it’s not informed it really is not a decision.
David Nutt: I’m totally with you and that’s why I like the idea that you pursue these kind of pharmacological approaches in an open and transparent way where people sell the drugs, not as medicines for an illness but as drugs which have utility in some elements of life and they are properly tested, they’re properly evaluated. You know what it’s going to do and you also know what the side effects are, but you don’t regulate it as if it’s an illness that’s treating you. You just say there it is, this is the same as taking a health supplement or something.
Steve Hyman: We have just one or two minutes left and maybe David that was a good summary statement but I want to give you both an opportunity to briefly say anything else that we haven’t touched on that you think our listeners should be aware of.
Nora Volkow: I think that one of the aspects that we haven’t touched is the current drugs that are being used as cognitive enhancements, caffeine, methylphenidate, amphetamines and modafinil. There are many things that we don’t know about them. We’re doing more work now—in terms of caffeine you become tolerant, so it’s cognitive enhancing effects start to decrease. But we also for example really do not understand to what extent the effects of these stimulant drugs are really enhancing cognition. There has been data coming out, again when there’s no evidence of sleep deprivation or fatigue, that there is a discrepancy between how the person perceives they are performing and their actual performance. This has been known by the military so it makes you believe that you are performing better than what you actually are doing which is great in the military because they want you to be very courageous but may not necessarily be a good thing when you are a physician. So there are many research questions that need to be addressed in order to have a better understanding about what the consequences are of these stimulants, what do they really do. If you learn something with them, will it be as long lasting as if you had not learned them under influence and you were not sleep deprived? There’s really not sufficient knowledge to be able to even provide this information to those that are taking them.
David Nutt: I agree with you there and all I would say is whatever we do, we should do it with as much common sense as possible. I am strongly against the idea that we use criminal sanctions against young people who use these drugs to supposedly improve their performance or their attention etc. I think we have to go down the educational and the regulatory route rather than down the legal route. I think it would be very counterproductive to start using legal sanctions against the users.
Steve Hyman: I thank you very much. I hope people have found this as interesting and informative as I have and we are now signing off. Thank you.
Biographies
David Nutt is currently the Edmund J. Safra Professor of Neuropsychopharmacology and director of the Neuropsychopharmacology Unit in the Division of Brain Sciences, Hammersmith Hospital, Imperial College London.
He received his undergraduate training in medicine at Cambridge and Guy’s Hospital, and continued training in neurology to MRCP. After completing his psychiatric training in Oxford, he continued there as a lecturer and then later as a Wellcome Senior Fellow in psychiatry. He then spent two years as Chief of the Section of Clinical Science in the National Institute of Alcohol Abuse and Alcoholism in NIH, Bethesda, USA. On returning to England in 1988 he setup the Psychopharmacology Unit in Bristol University, an interdisciplinary research grouping spanning the departments of Psychiatry and Pharmacology before moving to Imperial College London in December 2008 where he leads a similar group with a particular focus on brain imaging especially PET.
He is currently Chair of the Independent Scientific Committee on Drugs (ISCD) and Past-President of the European College of Neuropsychopharmacology (ECNP), Vice-President of the European Brain Council and President of the British Neuroscience Association. In addition he is a Fellow of the Royal Colleges of Physicians and Psychiatrists and a Fellow of the Academy of Medical Sciences. He is also the UK Director of the European Certificate and Masters in Affective Disorders Courses and a member of the International Centre for Science in Drug Policy. He has edited the Journal of Psychopharmacology for over a decade and acts as the psychiatry drugs advisor to the British National Formulary. He has published over 400 original research papers, a similar number of reviews and books chapters, eight government reports on drugs and 26 books.
Previously he has been member and Chair of the Advisory Committee on the Misuse of Drugs (ACMD – 1998–2009), President of the British Association of Psychopharmacology (BAP), member of the HEFCE/NHS Senior Lecturer Selection Panel and member of the MRC Neuroscience Board. Other previous national contributions include serving as the medical expert on the Independent Inquiry into the Misuse of Drugs Act (2000 Runciman report), and membership of the Committee on Safety of Medicines, the Committee on NHS drugs and the Ministry of Defence Science Advisory Board. He was the clinical scientific lead on the 2004/5 UK Government Foresight initiative “Brain science, addiction and drugs” that provided a 25-year vision for this area of science and public policy and in 2006 he was Director of Bristol Neuroscience.
He broadcasts widely to the general public both on radio and television including BBC science and public affairs programmes on therapeutic as well as illicit drugs, their harms and their classification. He also lecturers widely to the public as well as to the scientific and medical communities; for instance has presented three time at the Cheltenham Science Festival and several times for Café Scientifiques. In 2010 The Times Eureka science magazine included him in the 100 most important figures in British Science, and the only psychiatrist.
Nora D. Volkow, M.D., became Director of the National Institute on Drug Abuse (NIDA) at the National Institutes of Health in May 2003. NIDA supports most of the world’s research on the health aspects of drug abuse and addiction.
Dr. Volkow’s work has been instrumental in demonstrating that drug addiction is a disease of the human brain. As a research psychiatrist and scientist, Dr. Volkow pioneered the use of brain imaging to investigate the toxic effects of drugs and their addictive properties. Her studies have documented changes in the dopamine system affecting the actions of frontal brain regions involved with motivation, drive, and pleasure and the decline of brain dopamine function with age. She has also made important contributions to the neurobiology of obesity, ADHD, and the behavioural changes that occur with ageing.
Dr. Volkow was born in Mexico, attended the Modern American School, and earned her medical degree from the National University of Mexico in Mexico City, where she received the Premio Robins award for best medical student of her generation. Her psychiatric residency was at New York University, where she earned the Laughlin Fellowship Award as one of the 10 Outstanding Psychiatric Residents in the USA.
Dr. Volkow spent most of her professional career at the Department of Energy’s Brookhaven National Laboratory (BNL) in Upton, New York, where she held several leadership positions including Director of Nuclear Medicine, Chairman of the Medical Department, and Associate Director for Life Sciences. In addition, Dr. Volkow was a professor in the Department of Psychiatry and Associate Dean of the Medical School at the State University of New York (SUNY)-Stony Brook.
Dr. Volkow has published more than 500 peer-reviewed articles and more than 90 book chapters and non-peer reviewed manuscripts, and has also edited three books on the use of neuroimaging in studying mental and addictive disorders.
During her professional career, Dr. Volkow has been the recipient of multiple awards, including her selection for membership in the Institute of Medicine in the National Academy of Sciences and the International Prize from the French Institute of Health and Medical Research for her pioneering work in brain imaging and addiction science. She was recently named one of Time Magazine’s “Top 100 People Who Shape our World” and was included as one of the 20 people to watch by Newsweek magazine in its “Who’s Next in 2007” feature. She was also included in Washingtonian Magazine’s 2009 and 2011 list of the “100 Most Powerful Women” and named “Innovator of the Year” by US. News & World Report in 2000.
Professor Steven E. Hyman, MD, is Director of the Stanley Centre for Psychiatric Research at the Broad Institute of MIT and Harvard. He is also Harvard University Distinguished Service Professor of Stem Cell and Regenerative Biology.
Dr. Hyman was one of the key architects of the Broad Institute, when it was launched in 2004 as a bold experiment in biomedicine and became a permanent institution in 2009. Dr. Hyman joined the Broad after a decade of service as Provost of Harvard University. As Provost he served as Harvard’s chief academic officer, and also had a special focus on the development of collaborative initiatives that span multiple disciplines and cross institutional boundaries.
From 1996 to 2001, he served as Director of the US National Institute of Mental Health (NIMH). At NIMH he emphasized investment in emerging genetic technologies that might address the complexity of neuropsychiatric disorders, on neuroscience, and also initiated a series of large clinical trials including a focus on children, a population about which little was known with certainty.
Prior to his government service he was the first faculty Director of Harvard University’s interdisciplinary Mind, Brain, and Behaviour Initiative. In the laboratory he studied the control of neural gene expression by neurotransmitters, especially dopamine, with the goal of understanding mechanisms that regulate emotion and motivation in health and illness.
Dr. Hyman is Editor of the Annual Review of Neuroscience and Founding President of the International Neuroethics Society. He is a member of the Institute of Medicine of the US National Academies of Science, where he serves on the Council and on the board of health sciences policy. He is a Fellow of the American Academy of Arts and Sciences, a Fellow of the American College of Neuropsychopharmacology, and a Distinguished Life Fellow of the American Psychiatric Association. He has received awards for public service from the United States Government and from patient advocacy groups including the National Alliance for the Mentally Ill.
Dr. Hyman received his BA from Yale College in 1974 summa cum laude, and an MA from the University of Cambridge, which he attended as a Mellon fellow studying the history and philosophy of science. He earned his MD from Harvard Medical School in 1980 cum laude.