What drugs could help you debate better? Doctors weigh in

Tonight America’s oldest president takes on his loose cannon predecessor in the first presidential debate in Atlanta. Presidents Biden and Trump have faced waves of speculation regarding their respective mental conditions — and whether or not each is fit to hold office. Given their ages and stages, Biden and Trump have been accused of suffering from cognitive decline, dementia or Alzheimer’s. And this evening, both candidates’ mental states will be on full display for millions of Americans to closely watch and scrutinize.

Will the two even make it through the ninety-minute debate without shouting at each other and endless rambling? The odds are low. And Trump and his allies have previously alleged Biden was “jacked up” and “high as a kite” during his State of the Union address earlier this year, calling for pre-debate drug tests. But what aids, or “performance-enhancers” could a candidate take to be at the top of his game?

Alzheimer’s, or dementia, is well-known to be incurable. However, there are many medicines and drugs designed to help manage symptoms, slow progression and help patients be mentally coherent. Yet there does not seem to be a clear consensus among doctors with this area of expertise regarding what drugs would bring the desired effects. Some do not even believe that any such drug could help a candidate be fully coherent for two plus hours.

“There’s a good chance either candidate could be on a stimulant medication, whether it’s cognitive disorders or attention deficit disorders, even just to improve their speaking and ability to express themselves,” said Dr. Hillary Glazer, a board-certified Memory Neurologist in Weston, Florida. She cited amphetamines, such as dextroamphetamines, also known as Adderall and Ritalin. Such medications last for at least two hours or more and can help with remembering what point you’re trying to make when talking and what question you’re answering. 

Dr. Jason Karlawish, a board-certified doctor in geriatric medicine and professor at the University of Pennsylvania, cited methylphenidate drugs to improve initial performance, and Cholinesterase inhibitor drugs to address cognitive performance.

Dr. Glazer also mentioned Leqembi, a new Alzheimer’s drug on the market designed to slow down cognitive impairment. She prescribed Leqembi to one of her patients, allowing him to return to his job as a lawyer. “It’s important to know that there are medications out there to slow down cognitive impairment and things we can do for it.”

She would not speculate whether either candidate has Alzheimer’s, but added that specialists like her can diagnose memory disorders by hearing a person speak for two minutes.

However, Dr. Karlawish emphasizes, for the elderly without a confirmed diagnosis, there is an extremely limited confirmed selection of drugs which would “enhance a geriatric politician’s debate performance.” “Whatever pharmaceuticals the two candidates imbibe, they’ll do so in the spirit of brave self-experimentation, the sort of chemical augmentation championed by gonzo journalist Hunter S. Thompson.”

“I don’t recommend it,” Dr. Karlawish added.

But not everyone agrees. “Such drugs do not exist,” says Dr. Thomas Wisniewski, director of the New York State Center of Excellence for Alzheimer’s Disease. There aren’t drugs “that boost mental function transiently to overcome some sort of neurodegenerative or age associated with mental dysfunction.”

“It’s a ridiculous story,” he added. 

Biden and Trump have a few options, but none guarantee a spotless performance. Looks like the two candidates may be on their own for this one… buckle up, America.