Mental Health and Science
Let’s Talk About Nootropics, Transparently.
A brief review of controversial cognitive-enhancing supplements with insights from scientific and medical literature
This article is not about whether nootropics are good or bad. Instead, it is about how much we know about them and why awareness of benefits and side effects matters for our health.
Knowledge and hype are two different things. While knowledge adds clarity, hype (intensive publicity or promotion) confuses consumers. I provide a preliminary and condensed review of my decades on the reading list. This post sets the context and foundational background for my future articles on the topic.
While there are promising use cases of nootropics for some mental health conditions, so far, we know very little about them, mainly covering potential side effects if they are used unsupervised.
Therefore, my purpose is to highlight what we know based on a comprehensive review of the medical and fitness literature over two decades, citing a few outstanding scientific papers.
I recently published an article reviewing 17 molecules used as nutrients in food and supplements. Some readers of my writing have shown interest in learning about nootropics from my experience and research.
With this inspiration, I decided to write this article as nootropics are a research interest to me as they are related to brain performance.
First, let me set the context by giving a little background on nootropics, also known as smart drugs or cognitive enhancers, in sports, nutrition, biohacking, and the fitness communities.
I came across nootropics in the early 1990s when studying cognitive science. The word “nootropics” originated from the Greek language and is a combination of the words “noos” meaning mind and “trope” meaning turning, as documented in this source.
Nootropics can be supplied in prescribed medication and publicly available supplement forms. However, some foods also include nootropics ingredients in fewer amounts.
As I highlighted before, healthcare professionals suggest getting nutrients mainly from food and only get medication and supplement forms in deficiencies with advice from qualified professionals.
From the literature and anecdotal evidence, the primary use cases of nootropics are improving cognitive functions, including memory, attention, task switching, problem-solving, creativity, motivation, and overall health and fitness performance.
These use cases look compelling to the public as we all want a satisfying life with improved cognitive skills. Thus, we see a significant focus on the use of nootropics by several communities.
However, despite the inundated claims in media, insights into nootropics are not conclusive. Thus, we know little about their efficiency. The lack of knowledge, of course, does not mean they are useless.
On the contrary, they may have potential performance-boosting benefits. Understanding the mechanism of nootropics and their side effects can give us a balanced view.
Lack of knowledge does not negate their potential benefits. However, ingesting substances without knowing their impact on our biology does not appear to be a wise choice.
Qualified healthcare professionals prescribe some nootropics to address specific cognitive conditions such as ADHD and Alzheimer's Disease. The commonly prescribed nootropic medications are Adderall, Memantine, Methylphenidate, and Modafinil.
However, some people use publicly available ones on a trial-and-error basis. While some nootropics such as caffeine, creatine, l-theanine, ginseng, and Ginkgo Biloba look relatively safer and are publicly available in health shops and pharmacies, some are restricted substances in many countries due to potential harm to public health.
Based on discussions with my healthcare consultants, I used a few publicly available nootropics such as citicoline and acetyl-l-carnitine for various reasons. After careful use, I did not experience noticeable side effects.
However, as mentioned in my previous review of supplements, I do not use restricted and not researched supplements as a principle. Instead, I only use safe and well-researched ones such as N-Acetyl-Cysteine, NADH, Alpha-Lipoic Acid, creatine, menaquinones, magnesium, cobalamin, and alfacalcidol.
After this background, I’d like to provide perspectives from scientific papers that I reviewed over the last decade. One of the helpful reviews was published in the Journal of Alzheimer’s Disease in 2012.
The paper covered the review, including the evolution of research in the field for over two decades. Unfortunately, the published article is not publicly available; however, researchers or interested readers can purchase it.
As pointed out in the review, starting in 1972, when memory-enhancing properties of piracetam were observed in clinical trials, hundreds of drugs have been evaluated in clinical trials or preclinical experiments.
The review informs that:
“To classify the compounds, a concept is proposed assigning drugs to 18 categories according to their mechanism of action, in particular drugs interacting with receptors, enzymes, ion channels, nerve growth factors, re-uptake transporters, antioxidants, metal chelators, and disease-modifying drugs, vaccines, and monoclonal antibodies interacting with amyloid-β and tau.”
Another helpful review paper was titled Towards Better Brain Management: Nootropics, published in Current Medicinal Chemistry in 2007.
The paper informs that “nootropics are a heterogeneous group of compounds of diverse chemical composition and biological function that allegedly facilitate learning and memory or overcome natural or induced cognitive impairments.
The literature survey of the paper incorporated hallmarks of the success achieved in the design and development of potential nootropic agents. In addition, the review attempted to discuss various approaches available to enhance memory, including the classification of the known memory enhancers.
A scientific paper titled Probable Nootropicinduced Psychiatric Adverse Effects published in Innovation in Clinical Neuroscience highlights that “the misuse of nootropics may potentially be dangerous and deleterious to the human brain, and certain individuals with a history of mental or substance use disorders might be particularly vulnerable to their adverse effects.”
The focus of the paper authored by two medical doctors is the disclaimer of “any substance that may alter, improve, or augment cognitive performance, mainly through the stimulation or inhibition of certain neurotransmitters.”
The paper includes four cases, namely: Armodafinil, Ampakines, Citicoline, and Piracetam. The paper is publicly available on the NIH (National Institute of Health) website.
By using these four cases, the authors identified numerous side effects of reviewed nootropics such as headache, diarrhea, nasopharyngitis, gastrointestinal discomfort, insomnia, restlessness, fatigue, dizziness, psychomotor agitation, myalgias, dysphoria, memory loss, spatial memory impairment, possible motor function impairment, and even tremors.
In the paper, the overall evidence regarding the benefits of nootropics in healthy individuals seeking mental enhancement is still controversial.
My only experience out of these four cases is citicoline, as it is a well-researched molecule depicting neuroprotective action against stroke and dementia, modulating neurotransmitters including acetylcholine, dopamine, and glutamate.
As pointed out in the paper, citicoline is “involved in phospholipid metabolism and enhances the integrity of neuronal membranes. It has been shown to improve memory in patients with dementia as well as reduce damage to the brain after traumatic brain injury or stroke.”
Citicoline is publicly available and usually sold in health stores and pharmacies in several countries, including the United States. I tried it with caution taking 250 mg per day.
When I tried it for three months, I experienced a slight improvement in my cognitive skills, such as working memory, attention, and task switching, which I measured using propriety cognitive tests. During the period, I did not experience any side effects. I assume it was probably a shallow dose under half a gram.
There is also significant scientific and medical research focusing on plants’ nootropic ingredients. For example, as documented in this review, bacopa monnieri, a medicinal Ayurvedic herb, is traditionally used for various ailments, known as a neural tonic and memory enhancer.
The paper related to bacopa monnieri (BM) informs that:
“Numerous animal and in vitro studies have been conducted, with many evidencing potential medicinal properties. Several randomized, double-blind, placebo-controlled trials have substantiated its nootropic utility in humans. There is also evidence for potential attenuation of dementia, Parkinson’s disease, and epilepsy. Current evidence suggests BM acts via the mechanisms of antioxidant neuroprotection, acetylcholinesterase inhibition, choline acetyltransferase activation, β-amyloid reduction, increased cerebral blood flow, neurotransmitter modulation, 5-hydroxytryptamine, and dopamine.”
Another interesting double-blind placebo-controlled clinical trial was conducted on the mushroom Yamabushitake (Hericium Erinaceus) on mild cognitive impairment published in the Phytotherapy Research in 2008.
The paper suggests that “Yamabushitake is effective in improving mild cognitive impairment.”
Although the term “nootropics” was mentioned in the literature in the early 1970s, research into cognitive enhancing supplements in multiple disciplines has been intense since the mid-1940s. As depicted in Pubmed, over 38,000 scientific records were published between 1945 and 2022.
Due to proliferating trials and reviews, it is impossible to mention published research in the field.
However, with an open mind and growth mindset, my aim is to create awareness of intense research in the area and consideration of their use with the help of qualified healthcare professionals.
I plan to post compelling research reviews related to specific nootropics in my future articles.
Thank you for reading my perspectives. I wish you a healthy and happy life.
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