USE OF PSYCHOSTIMULANTS AND THE CULTURE OF SUPER-PERFORMANCE AMONG MEDICAL STUDENTS: AN INTEGRATIVE LITERATURE REVIEW

Abstract

The academic environment of medical school is characterized by an extensive workload, intense competition, and constant pressure for high performance, factors that may encourage the use of pharmacological strategies aimed at enhancing concentration, wakefulness, and cognitive productivity. In this context, the non-prescribed use of psychostimulants such as methylphenidate, lisdexamfetamine, modafinil, and high doses of caffeine has become increasingly common among medical students, often legitimized by a culture of overachievement that normalizes the medicalization of academic life. This study consists of an integrative literature review aimed at analyzing the prevalence, determinants, effects, and ethical and clinical implications of psychoactive substance use for cognitive enhancement in this population. The findings demonstrate highly variable prevalence rates, exceeding 20% in some samples, and strongly associated with sleep deprivation, anxiety, perfectionism, and social pressure. Although these substances may provide transient improvements in attention and alertness, their inappropriate use has been linked to dependence, insomnia, cardiovascular symptoms, and worsening of psychiatric disorders. It is concluded that the trivialization of psychostimulant use among medical students reflects a multifactorial phenomenon that requires institutional strategies focused on mental health promotion and on confronting the culture of extreme performance.