People don’t chase pills from psychiatrists because they love pharmacology. Well, some do. But this isn’t about them. This is about the people who genuinely want an extra hour of good thinking in the middle of a technology-induced fragmented day. Most just want to perform to the level they know they are capable of – but aren’t living up to. They’ve heard whispers from friends that Adderall and its ilk make you sharper, smarter, undistractible. The data in healthy, non-ADHD adults actually says: not so fast. You may get a bit more drive and on a few very circumscribed tasks a small bump in accuracy or speed. That’s not absolutely nothing. It’s also not what most people are fantasizing is unlocked with that controlled rx.

Let’s take a peek at the reality on the ground. A careful series of meta-analyses in 2020 pooled placebo-controlled studies of modafinil, methylphenidate, and d-amphetamine in healthy, non–sleep-deprived adults. The average performance lift was small and domain-specific. Methylphenidate showed an overall effect around 0.21 SD, with its best signals in recall (~0.43), sustained attention (~0.42), and inhibitory control (~0.27). Modafinil’s overall effect hovered near 0.12 SD. D-amphetamine’s picture was mixed and small – essentially nil. Translating that into your office where you’re getting Slack’d left and right and you might see: tens of milliseconds off reaction time, a tad fewer errors on tidy lab tasks, and only for an hour or two. Marginally useful in the right niche; not a game-changer in any way. And this is without weighing the tangible, everyday side effects that, despite what your buddies might tell you, are absolutely real and relevant.

It gets worse for stimmies, unfortunately. Give a healthy adult a stimulant and point them at an open-ended optimization problem – a fair proxy for real jobs where strategy matters more than pure, brute grinding. In a smart, within-subject, double-blind test, modafinil, methylphenidate, and dextroamphetamine all increased effort. Awesome. Not unexpected, they’re called stimulants for a reason and have been plied onto soldiers for generations for a reason. People in the study worked longer and clicked more. Click click click. Maybe even randomly. But guess what: solution quality went down. More drive, worse performance. The myth is that effort and output quality move together; the reality is that on hard problems, extra Addy-induced zip only amplified the wrong decisions. Do more, worse. Not a great yield. Again, still not accounting for real-world adverse side effects.

Amphetamine, specifically, looks even gnarlier when you get away from anecdotes and into data. Another study dosed healthy volunteers at 0.45 mg/kg (roughly 30–35 mg for many adults). Working memory at short delays didn’t improve. What did change was thought quality: psychosis-like experience scores rose, and those increases tracked worse spatial working memory at the longest delay (correlation around −0.58). You can feel “switched on” while your cognition gets noisier precisely when you need it quiet. These certainly aren’t miracle pills.

Methylphenidate is so-so: some mild, selective boosts but essentially a ceiling you hit quickly.. In healthy adults, 10 mg produced small improvements in numeric working memory while leaving broader measures unchanged. A companion experiment at the same dose found no meaningful improvement to scanning or stability in a simulated driving context – this isn’t Bradly Cooper in Limitless. It’s safe enough in that setting, but no monumental cognitive lift. When the dose is scaled up, it shifts brain states: 60 mg shifts time spent in a frontoparietal-dominant, task-positive network, and in that zone people react faster on low-demand visual tracking – especially if they start with higher striatal D1 receptor availability. That’s a plausible mechanism for shaving reaction time on narrow tasks. It’s not a plan generator or going to get you to any breakthroughs in creative thought.

Put these pieces together from recently published research and the picture is pretty clear:

• If the job is vigilance-heavy – long, dull reading, repetitive monitoring – you can expect a small, usable bump: fewer lapses, slightly faster selections, a modest lift to short-horizon recall and inhibitory control. At best 0.1–0.4 SD effects. You will feel it most when the rules are clear and the target is close and really you’re just trying to overcome boredom rather than do novel work.
  
  

• If the job is strategy-heavy –  planning, multi-constraint decisions, creative design – the expected value shrinks and the variance grows. You are more likely to spend more time with more activity for worse results. Faster hands fumbling around making macaroni art rather than masterpieces.
  
  

• Costs aren’t imaginary in healthy users. At common lab doses (and the doses people take from their friends), d-amphetamine increases psychosis-like experiences; in the trial above, those changes tracked worse working memory at higher delays. Drive is not the same as clear cognition. And this is from a single dose. I won’t bore you with the litany of contraindications and common side effects from a stimulant’s packaging insert, but Google it.
  
  

What do you do with this information? My recommendation is to stop seeing stimulants as a general solution and start seeing them like a tool with a very specific, circumscribed use. Let’s call them the Allen wrench of pharmacology. They turn one hexagonal screw (i.e. increase your ability to grind through boring, easy tasks). They are not even Swiss Army knives, let alone some magical Fix-it-All tool for the mind. If your day is a long stretches of watching carefully – and you’ve already gotten good sleep and silenced your alerts – then you might see a small, task-specific improvement. If your day is one large knapsack problem, save yourself from doing less quality at the cost of more psychotic symptoms. The pills might help you grind; they will not hand you easy achievement. They will make it harder.

You can (and should) test this yourself to get data, rather than trusting the feeling that you do more with stimulants. Remember, they make you feel like you’re doing great, they don’t make you do great. That is what dopaminergic activation does. And you don’t need a lab. Pick two repeatable slices of your real work: twenty minutes of vigilance (proofing dense text, catching numerical inconsistencies in a spreadsheet) and twenty minutes of strategy (drafting a plan with constraints). Score them the same way – speed and misses for the first; solution quality for the second. Run three to four sessions on normal sleep and normal caffeine: with stimulants and without. If the hit rate isn’t obviously positive on the work that pays your bills (probably the more creative work), you have your answer. This isn’t a moral judgment, it’s a utility calculation. I have reservations about stimulants being slung willy-nilly into our society for many reasons, but one of the principal ones is: they just don’t do what people think they do and very few people actually realize this.

I don’t blame folks for wanting more out of their minds. It’s why I made Goldmind, after all. There are just much cleaner ways to get that. A 20-minute bout of moderate aerobic work sharpens executive function for the next hour. Caffeine paired with L-theanine produces small-to-moderate gains in reaction time and vigilance across the same window with a better side-effect profile. An extra hour of sleep repays more of the day-long deficit than any acute stimulant gives you. None of that is sexy. None of it feels like when the Adderall starts to hit your brain. It is amphetamines after all. Just remember, when you try to hammer in that nail with an Allen wrench, or fix the leaky pipe with an Allen wrench, that feeling like you’re doing a great job doesn’t translate into actually doing a great job.

 

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References

1. Roberts CA, Seidman Z, Landau SM, Turner DC. How effective are pharmaceuticals for cognitive enhancement in healthy adults? A series of meta-analyses of cognitive performance during acute administration of modafinil, methylphenidate and d-amphetamine. European Neuropsychopharmacology. 2020;38:40–62. doi:10.1016/j.euroneuro.2020.07.002.
   

2. Bowman E, Coghill D, Murawski C, Bossaerts P. Not so smart? “Smart” drugs increase the level but decrease the quality of cognitive effort. Science Advances. 2023;9(24):eadd4165. doi:10.1126/sciadv.add4165.
   

3. Kassim FM, Lim JHM, Slawik SV, et al. The effects of caffeine and d-amphetamine on spatial span task in healthy participants. PLoS ONE. 2023;18(7):e0287538. doi:10.1371/journal.pone.0287538.
   

4. Aitken B, Downey LA, Rose S, et al. Acute administration of 10 mg methylphenidate on cognitive performance and visual scanning in healthy adults: Randomised, double-blind, placebo-controlled study. Human Psychopharmacology: Clinical and Experimental. 2025;40(2):e70002. doi:10.1002/hup.70002.
   

5. Aitken B, Rose S, Downey LA, et al. Driving performance and ocular activity following acute methylphenidate administration in healthy adults: A randomised, double-blind, placebo-controlled study. Journal of Psychopharmacology. 2024;38(8):890–902. doi:10.1177/02698811241286715.
   

6. Yan W, Demiral ŞB, Tomasi D, Zhang R, et al. Methylphenidate promotes a frontoparietal-dominant brain state improving cognitive performance: a randomized trial. Journal of Neuroscience. 2025;45(17):e1693-24-2025 (early view). doi:10.1523/JNEUROSCI.1693-24.2025.