What are Nootropics

Nootropics are smart drugs, supplements or foods that are taken to enhance memory, cognition or intelligence, increase concentration, attention or motivation and to relieve anxiety or stress, with the aim of improving academic performance and results.

Although at the simplest level they include herbs, spices, phytochemicals like caffeine and energy drinks, the drugs that being taken by students are increasingly synthetic. Many are prescription drugs originally designed for medical and psychiatric disorders, such as attention deficit hyperactivity disorder (ADHD), extreme fatigue, circadian disorders, narcolepsy or Alzheimer’s. Others were originally identified to increase sports performance or are experimental drugs not yet licensed. The size of the nootropic market is growing at an alarming rate.,

How common are they?

A 2013 survey by the University of Cambridge newspaper ‘Varsity’, found that 10% of British students admitted taking a nootropic drug originally developed for use in narcolepsy, to improve concentration. A recent study at the Universities of Zurich and Basel found 15% of Swiss university students currently take smart drugs to help them get better grades and in the USA up to 25% of college students have admitted using “one of the five most common” nootropics drugs in the last year.

And its not just the students, lots of university academics, medical staff and business executives are known to regularly use neuroenhancers, particularly if they are working shifts, have pressing deadlines or are involved in foreign travel. There is also increasing reports of their use in schools.

Do they work?

I would love to say no, but evidence shows that when used in healthy people many (but not all) of them do enhance high-level cognitive processes including motivation, working memory, planning, attention, problem solving, and multitasking, In many cases those who benefit most, are the ones who have the poorest initial cognitive scores but everyone is different.

Are they safe?

The foods are….  And high levels of caffeine have been consumed by students for decades and although likely to cause the jitters, no long-term negative effects have ever been found. However when people talk about nootropic drugs, its not really foods they are talking about.

The Problem is that there has been very little research on the use of neuroenhancing prescription drugs in healthy people and in some instances the drugs being sold are experimental and not yet licensed. Circumstantial evidence from interviews with people who habitually use nootropics suggest that there are some side-effects (headaches, vomiting, muscle wasting and weight loss), there may also be social consequences (they make you feel you want to be alone) and they are thought to be addictive (making you believe that you can’t do without them). There is also some suggestion that although they enhance brain performance, they stifle brain plasticity or growth. No studies have looked at the effects of long term use.

Also in most cases there is very little guarantee that what you are taking is, what you think you are taking. Most students are buying pills off the internet, prices are low and the companies selling the pills are usually in Russia, Eastern Europe, China or Hong Kong. No research has been done on the content of the pills bought off the internet but studies into the similarly unregulated supplement market has shown huge contamination risks and very poor dose accuracy. The truth is for the most part, you won’t know what you are taking. There is also a worrying trend for companies to market suppliments as natural. The underlying substance may be found in real foods but rarely in anywhere near the same dose.

And we are all different… not all of the performance enhancing nootropics have the same effect on everyone, some people have recorded feeling totally “spaced out”, having acutely sensitive hearing or poor pen control. As many student will decide to first try nootropics when they are under pressure or about to sit exams, this could actually result in a decrease in performance – not what they were expecting.

Stacking

Is the term used for layering a number of nootropic drugs over the top of each other to get a combined effect. Companies may sell combined pills or recommend cocktails of different drugs. Pills may also be recommended to be ‘stacked’ with caffeine.

Advice

I would not advice taking any supplement or pill bought unregulated from the internet.

I have purposefully not mentioned any of the drugs by name but I am happy to discuss them in detail and have a fact sheet for anyone who is interested. Or a quick google search on nootropics will give you hundreds of companies who describe all their products in detail and offer to sell them to you.

For me the important thing is that school children and students know about the growing prevalence of nootropics and also the risks of taking something which they have not been prescribed, for which there is very little research and almost no guarantees. Paracelsus, a fifteenth century medic and the founder of the school of toxicology said “the dose makes the poison” and this is definitely the case here only it’s also likely that the dose is person specific.

It is also worth noting that eating well, taking exercise and sleeping have all been found to boost cognition and academic performance. Sensible lifestyle choices may be just as effective as taking drugs.

Further reading

Lucke et al (2011) Academic doping or Viagra for the brain? – The history of recreational drug use and pharmacological enhancement can provide insight into these uses of neuropharmaceuticals. EMBO Rep. 2011 Mar 3; 12(3): 197–201. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3059919/

Partridge et al (2011) Smart Drugs “As Common As Coffee”: Media Hype about Neuroenhancement.. PLoS One. 2011; 6(11): e28416. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227668/

Emanuel et al (2013) Cognitive Enhancement Drug Use Among Future Physicians: Findings from a Multi-Institutional Census of Medical Students. J Gen Intern Med. 2013 Aug; 28(8): 1028–1034.

Mayer et al (2013) To Dope or Not to Dope: Neuroenhancement with Prescription Drugs and Drugs of Abuse among Swiss University Students. PLoS One. 2013; 8(11): e77967.

Saniotis et al (2014) “Messing with the mind”: evolutionary challenges to human brain augmentation. Front Syst Neurosci. 2014; 8: 152. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4179735/

Brain-Enhancing ‘Smart Drugs’ Are Going Commercial –  http://motherboard.vice.com/read/brain-enhancing-smart-drugs-are-going-commercial

Stix G. (2009) Turbocharging the brain. Scient Am Mag 2009;301:46-55

Maher B. (2008) Poll results: look who’s doping. Nature 2008;452:674-5.

Turner et al (2003). Cognitive enhancing effects of modafinil in healthy volunteers. Psychopharmacology 2003;165:260-9.

Yesavage et al (2002) Donepezil and flight simulator performance: effects on retention of complex skills. Neurology 2002;59:123.

Sugden et al (2012). Effect of pharmacological enhancement on the cognitive and clinical psychomotor performance of sleep-deprived doctors: a randomized controlled trial. Ann Surg 2012;255:222-7.

Farah et al (2004). Neurocognitive enhancement: what can we do and what should we do? Neuroethics Publications 2004;9.

Greely et al (2008). Towards responsible use of cognitive-enhancing drugs by the healthy. Nature 2008;456:702-5.