Ms. P. is a 3rd year law student who is having trouble in classes. Her performance has slipped a bit throughout the year, and she is concerned that she is not “up to par” or keeping pace with her classmates. She is about to sit for final examinations, which would qualify her to take the bar examination soon thereafter. She has read about “cognitive enhancers” on the Internet, and how certain drugs, such as modafinil and/or methylphenidate have been used with some success by students to improve vigilance, augment learning and memory, and increase academic performance. She goes to her physician, Dr. Cefalo, and describes signs and symptoms of fatigue, “trouble concentrating,” and “easy distraction,” suggesting that she “might have ADD.” After some routine questioning, Dr. Cefalo deduces that Ms. P. does not have attention-deficit disorder (ADD), but rather is seeking pharmacological intervention to assist her studies. Dr. Cefalo asks Ms. P. directly if this is the case. Ms. P. somewhat hesitatingly answers that this is so, but then adds that she is “really desperate. I have to ace these exams, or I’ll crater law school, won’t be able to take the bar exam, and I have a job waiting for me. Besides, I know that I can get this kinda stuff—like even that drug piracetam—either off of the Internet or through friends, but I wanted to come to you to do it the right way.” Ms. P. is well-known to Dr. Cefalo (who has been her treating physician for a number of years), and Dr. Cefalo recognizes Ms. P to be a dedicated, highly motivated young woman, who is characteristically very prudent in her decisions and actions.

Question: Should Dr. Cefalo prescribe modafinil or methylphenidate for Ms.P.? Why or why not?