The Brain User's Guide to Pills: an overview of Cognitive Enhancing
elicited much interest, especially about other ways to enhance
mental performance, creatine in particular. Prepare to read the mother of all
brain posts, the alpha and the omega of cognitive enhancing substances (a.k.a
or "smart drugs.") What I've found greatly surprised me: while there are an
enormous number of substances with the potential for preventing the
degradation of memory and intelligence, many of which are regularly used to
slow or reverse mental aging in the elderly and also to treat a variety of
mental and developmental disorders, there is
little or no research on using these drugs on
Lack of demand.
At the same time, there
is surprisingly little interest or awareness
among the general public
in the use of nootropics. Surely, even if
people are not interested in cognitive enhancement for its own sake, it should
be clear that by being smarter we also give ourselves the chance to become
more successful professionally, and become more wealthy or whatever our
definition of success is. After all, the majority of us in modern times live
by our brains -- doctors, journalists, programmers, you name it. So before I
proceed further, I'm going to take a guess about the answers to these twin
questions of absence of research and lack of demand. The impatient can skip to
the table at the bottom.
The first question is easier to answer. We live in a welfare state (or
something pretty close to one); the government is more interested in providing
a safety net to unfortunate individuals than helping fortunate ones excel.
Clearly then, the emphasis of publicly funded research is on using nootropic
drugs to treat pathological conditions than to enhance cognition in healthy
individuals. Further, because of medicare and medicaid, and the nature
of health insurance in general, it is much more lucrative for pharma to target
people with ailments. While I might disagree with all forms of government
welfare, it is the reality of the world we live in, and I will move on instead
of complaining about it.
What about the lack of public awareness or interest? Why the obsession with
caffeine but ignorance of other safer, possibly more potent substances? This
appears to be due to a complex of related reasons. One is that people have
trouble believing that cognition can be enhanced (and probably view coffee as
a cure for sleepiness rather than what it really is.) A related, second reason
is ethical opposition perhaps stemming from the argument that wealthier people
will have more access to smart drugs if they become available. Finally,
there's a psychological aversion to consuming pills when you're apparently
In praise of poppin' pills.
While the idea that the human form is
perfect may have biblical roots, some form of it appears to be held by most
people, sometimes subconsciously. We believe that our "normal" condition is
healthy, and that we don't need to fix ourselves up unless we deviate from it.
I disagree: if we can augment our physical and cognitive abilities without
serious side-effects, I can't see why we shouldn't do so, and further, our
"normal" condition must be viewed as diseased. As for ethics, as far as I'm
concerned, ethics can bite my chemical ass. Consider this
about smart drugs that asks "What would happen
if people got smarter? Is this a good thing or a bad thing?"
goes on to ask a number of similarly inane questions. It is very hard for me
to fathom that people could not want to be the smartest, healthiest or most
successful person that they have the potential to be.
Wading through the crap.
of research on geriatric subjects means that there's an enormous number of
compounds to look at. The lack of research on healthy volunteers has led to a
large number of quacks on the Internet. Even with pagerank, the ratio of
genuine to fake articles is around 1:5. Fortunately, some simple and
well-known rules of thumb increase the signal/noise ratio considerably: for
instance, you can generally trust articles on PubMed, and anything that
contains 'natural' or 'herbal' in the title is a scam :) The process still
took way longer than expected, but I felt it was worth the trouble. Many
compounds fell by the wayside, either because of side effects, not enough
studies, or because the efficacy is proven only in the aging population. In
particular, DMAE, Vasopressin, ALCAR, hydergine, pyrinitol, ginkgo biloba, B.
monnieri and vinpocetine are all potentially interesting but I can't recommend
any of them based on the current evidence. This list includes a number of
compounds frequently used and sold as smart drugs.
Disclaimer: obviously, I have no medical qualifications whatsoever and none of
this is medical advice. With that out of the way, let's get to the meat.
Possibly the dumbest thing you
can do to yourself is not to take a daily multivitamin supplement. One are
more vitamins are essential for every single known mechanism of cognitive
enhancement. The role of vitamins is more to keep things chugging along
smoothly than to bestow super-normal cognitive abilities, but the fact that
there are so many different vitamins, and that our diets differ so much from
the "natural" diet of our ancestors means that without vitamin supplements,
you are very likely to fall short on one or more essential nutrients, with an
inevitable effect mental performance. Of course, vitamins are also essential
for all kinds of disease prevention, but I'm not going to talk about that
Omega-3 Fatty acids.
supplement group. Here are the facts, in short: a balanced omega-3/omega-6
dietary ratio is essential for good health, including mental health; however,
omega-3/omega-6 ratios dramatically skewed in the Western diet. Omega-3's are
essential for correcting cognitive deficiencies; when given to pregnant women,
it improves mental health of fetus; it prevents learning disorders in
children; deficiency of omega-3 is implicated in a variety of mood disorders;
it also improves general health in a variety of ways. So again the role is one
of disease/disorder prevention than cognitive enhancement per se, but the risk
of deficiency is high and swallowing your daily two omega-3 capsules is so
easy there's no reason not to be doing it.
The cognitive benefits appear
to be mainly due to theanine, which increases seratonin and dopamine levels,
but possibly also due to tea's antioxidant properties. Again, studies on young
healthy volunteers are lacking, and most of the evidence is circumstantial.
There appear to be a number of noncognitive benefits however, and therefore
tea goes on the recommended list. Note that tea has caffeine in it; check the
label. Also note that there are a number of overblown health claims around
green tea, as with anything else that is herbal, Eastern or ancient.
Caffeine hits you like a
hammer -- it has a very broad spectrum of action, and comes with a list of
side effects that would put viagra to shame, not the least of which is stained
teeth. Ugh! But it works, and that's been established without question by a
barrage of scientific studies. Since I said a lot about it
, I won't say much more, except to suggest getting caffeine pills
instead of drinking the corrosive liquid.
Only one scientific
exists. But that study is conclusive -- vegetarians benefit substantially on
intelligence and memory tasks from creatine supplementation. What about meat
eaters, who get more creatine in their diet than vegetarians? If you read the
paper, there is a good bit of evidence that it benefits everyone. As well, the
mechanism of action appears to be well understood compared to other substances
(improving brain oxygen supply via ATP stabilization). Note, however, that you
lose the benefits once you stop taking creatine. Creatine is safe in the short
term if taken properly, and while there is no particular evidence that it
could be harmful in the long term, there haven't been any large studies on it,
so use it at your own risk.
Remarkably safe, reasonably
side-effect free. Multiple modes of action have been hypothesized, primarily
through replenishment of the neurotransmitter acetylcholine. According to
wikipedia, "it has become popular as a cognitive enhancement drug among
students, who often buy it in bulk as a powder and then consume it with orange
juice to mask the strong, bitter taste." This
by someone attempting to determine the effect on healthy
individuals is illustrative of the frustrations of trying to find information
on the use of nootropics for normal people, but the balance of evidence
appears to point in piracetam's favor.
Easily the most intriguing
item on this list. Modafinil has been in the
a lot -- it's claim to fame is that it lets you go 40 hours without sleep and
without loss of productivity, and the US army is interested in it for obvious
reasons. Adrafinil was the precursor drug developed in the 70s, and it works
by metabolizing into modafinil; the latter when taken directly has a quicker
action and fewer side effects. Adrafinil and modafinil are ampakines, which
fall into the broad category of stimulants along with amphetamines (which
Erdos famously used), ritalin and caffeine. While the earlier drugs offer
varying tradeoffs between efficacy and side-effects, ampakines promise to
deliver the goods without the nuisance.
While there is no doubt about the wakefulness promoting properties, claims
have also been made about cognitive enhancement, and there is much anecdotal
evidence to support increased vigilance and alertness. It's also been claimed
that effects persist after usage is stopped. Double-blind studies are as usual
harder to come by, and I can't tell for sure how effective they are. It's also
been claimed that the effects persist after you stop taking them.
Unsurprisingly, modafinil is classified as a drug, although off-label use
(prescription for a purpose other than approved by the FDA, which is not
illegal) in healthy individuals is apparently widespread. Further, adrafinil
is classified as a dietary supplement, and so should be even easier to obtain.
This seems really, really worth checking out further.
Safety/side effects/side benefits
Obviously good for you
Same as above
Antioxidant/several other benefits
Several mild but unpleasant side effects
Recommended (short term)
Remarkably safe, few side effects
Aids muscle building; Long term safety unknown
Suggested, especially for vegetarians
Anti-sleep, Stamina/focus, long term effects
Drastic action, effects not sufficiently well understood
More research needed
Classified as drug; hard to obtain
Obviously, there is even less
research on using nootropics in combination. I wouldn't worry about the first
three, and caffeine is used by a large percentage of the world's population,
so the potential for surprise is small. While piracetam is very safe, it tends
to interact, typically synergistically, with other drugs including caffeine,
and therefore the dosage may have to be modulated. As for how creatine and
modafinil interact with each other and with caffeine and piracetam, I have no
Exercise appears to improve cognition in two different ways
-- increasing brain oxygen supply and increasing dopamine and serotonin levels
(which are important mood and reward chemicals.) Only aerobic exercise has
this property, and not, say, weight training. Even mild exercise such as
walking is significantly better than no exercise at all. Therefore I would
as often as you can manage and walking every day.
Of course I'm putting my
money where my mouth is :) My plan, as a result of this post, is to continue
taking vitamins, omega-3s and creatine daily, start taking green tea regularly
instead of sporadically, cut down caffeine to a less-than-daily frequency, buy
piracetam and start using it daily, and try to obtain modafinil and experiment
with it. Let's see how it goes. I haven't been doing any cardio recently, and
it looks like I'll need to start up again. Finally, thanks to everyone who
asked me questions last time and prompted me to research and write this.