Brain Enhancers

I saw a documentary the other day titled “Smart Drugs.” It is incredible what people will do to improve their physical and especially mental performance. One fella in the doc was swallowing up to a hundred pills a day!

Nootropics (colloquial: smart drugs and cognitive enhancers) are drugs, supplements, and other substances that are claimed to improve cognitive function, particularly executive functions, memory, creativity, or motivation, in healthy individuals.

The use of cognition-enhancing drugs by healthy individuals in the absence of a medical indication spans numerous controversial issues, including the ethics and fairness of their use, concerns over adverse effects, and the diversion of prescription drugs for non-medical uses. Nonetheless, the international sales of cognition-enhancing supplements have continued to grow over time, and reached US$1.96 billion in 2018.

In 2018 in the United States, some nootropic supplements were identified as having misleading ingredients and illegal marketing. In 2019, the US Food and Drug Administration (FDA) and Federal Trade Commission (FTC) warned manufacturers and consumers about possible advertising fraud and marketing scams concerning nootropic supplements.

Nootropics are frequently advertised with unproven claims of effectiveness at improving cognition. The FDA and FTC warned manufacturers and consumers in 2019 about possible advertising fraud and marketing scams concerning nootropic supplement products. The FDA and FTC stated that some nootropic products had not been approved as a drug effective for any medical purpose, were not proven to be safe, and were illegally marketed in the United States under violation of the Federal Food, Drug, and Cosmetic Act.

Over the years 2010 to 2019, the FDA warned numerous supplement manufacturers about the illegal status of their products as unapproved drugs with no proven safety or efficacy at the doses recommended, together with misleading marketing.

Availability and prevalence

In 2008, the most commonly used class of drug was stimulants, such as caffeine. Manufacturers’ marketing claims for dietary supplements are usually not formally tested and verified by independent entities.

In 2016, the American Medical Association adopted a policy to discourage prescriptions of nootropics for healthy people, on the basis that the cognitive effects appear to be highly variable among individuals, are dose-dependent, and limited or modest at best.

Use by students

The use of prescription stimulants is especially prevalent among students. Surveys suggest that 0.7–4.5% of German students have used cognitive enhancers in their lifetimes. Stimulants such as dimethylamylamine and methylphenidate are used on college campuses and by younger groups. Based upon studies of self-reported illicit stimulant use, 5–35% of college students use diverted ADHD stimulants, which are primarily used for enhancement of academic performance rather than as recreational drugs. Several factors positively and negatively influence an individual’s willingness to use a drug for the purpose of enhancing cognitive performance. Among them are personal characteristics, drug characteristics, and characteristics of the social context.

Side effects

The main concern with pharmaceutical drugs is adverse effects, which also apply to nootropics with undefined effect. Long-term safety evidence is typically unavailable for nootropics. Racetams, piracetam and other compounds that are structurally related to piracetam, have few serious adverse effects and low toxicity, but there is little evidence that they enhance cognition in people having no cognitive impairments.

In the United States, dietary supplements may be marketed if the manufacturer can show that the supplement is generally recognized as safe, and if the manufacturer does not make any claims about using the supplement to treat or prevent any disease or condition; supplements that contain drugs or advertise health claims are illegal under US law.

Some of the most widely-used nootropic substances are the cholinergics. These are typically compounds and analogues of choline. Choline is an essential nutrient needed for the synthesis of acetylcholine (a neurotransmitter), and phosphatidylcholine (a structural component of brain cell membranes).

Citicoline – Compound consisting of choline and cytidine. Several meta-analyses found that it is likely effective for improving memory and learning in older people with mild cognitive decline, as well as in people who are recovering from a stroke. There is little evidence it enhances cognition in young, healthy people.
Choline bitartrate – Choline bitartrate is a tartaric acid salt containing choline (41% choline by molecular weight). At least one meta-analysis has found choline bitartrate to be ineffective at improving any measure of cognitive performance.
Alpha-GPC – L-Alpha glycerylphosphorylcholine has thus far only been studied in the context of cognitive performance alongside other substances such as caffeine. A more comprehensive meta-analysis is needed before any strong conclusions are made about Alpha-GPC’s usefulness as a nootropic.

The term “nootropic” was coined by Corneliu Giurgea in 1972 to describe a new classification of molecules that acted selectively towards the brain’s higher-level integrative activity. In order for a product to qualify as a true nootropic, it must fulfill Giurgea’s five criteria for the category. 1.It should aid with improvement in working memory and learning. 2.Supports brain function under hypoxic conditions or after electroconvulsive therapy. 3.Protection of the brain from physical or chemical toxicity. 4.Natural cognitive functions are enhanced. 5. It requires to be non-toxic to humans, without depression or stimulation of the brain.

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