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Nootropics are performance enhancing drugs for your mind, maaan. These come in a huge number of varieties, with even more heaps of woo attached. As these are, by definition, drugs, they often have unwanted side-effects. Generally speaking, if a government agency has banned a drug for being unsafe, it's probably unsafe. And if you decide to purchase drugs from an online source, chances are your brain was already messed up before the drugs arrived.
In this case, the woo-susceptible are typically Silicon Valley dot-com workers, desperate to get ahead — or just keep up — at work. In a gold rush the money is in selling shovels, so startups spring up to push this woo on their fellow startup victims.
Proven, albeit likely overhyped
Overall, proven "nootropics" fall into the categories of "boring, mundane stuff already in widespread use", "medication that only works in extremely esoteric circumstances", and "dangerous stimulants that are banned for good reason".
- Caffeine is rather effective at improving mental focus and temporarily relieving drowsiness, but being omnipresent in just about every culture (except Utah), no one really views it as a "miracle drug". That and it's so cheap that there'd be no point directly advertising it to people (not that people don't sell caffeine pills but renamed as something else). It very easily causes a (mild) addiction, but is for the most part safe.
- Nicotine is proven to help manage stress and improve focus. Plus, it looks cool to boot. But, obviously, the side effects aren't pretty. They include more frequent and severe illnesses, massive increase in the risk of numerous cancers and heart disease, reduced fertility, increased risk of birth defects and lower birth weight, bad breath, on top of also being incredibly addictive. Even if only focusing on just the nootropic effects, the reduced lung capacity will eventually interfere with your cognitive abilities at some point.
Amphetamines have a number of psychiatric uses, especially for things like ADHD. One specific amphetamine, Adderall, is often diverted to college kids to study right before an exam. Of course, as college kids tend to mix everything with booze, this can have some possible side effects. They are often used by professional athletes, especially baseball players, which is why MLB finally banned the stuff without a prescription. Coincidentally, the number of players diagnosed with ADHD skyrocketed. While ADHD is overall greatly underdiagnosed, especially in certain populations, the suspicion here is that maybe not all of these athletes really have ADHD, but are just legally being prescribed amphetamines as ergogenics (because amphetamine does work). Amphetamines also have great nerd-cred, due to their extensive use by Paul Erdős.
- Dexedrine is an amphetamine that actually does show some nootropic effects. It's mainly used by the military, where it does show proven results in cognition and memory and basically everything that nootropics are advertised as (though in lesser amounts). It has attracted some controversy, due to it being linked to a disturbingly large number of friendly fire incidents.
AKA "Ritalin". It appears to improve short term memory and focus, making it useful for someone with ADHD. It has also been shown to be useful for those with bipolar disorder or major depression, and Alzheimer's. It does show some limited improvement in otherwise healthy people, but the longterm side effects can be more trouble than it's worth. It does help focus on "boring" tasks, which is why some college kids abuse it to study.
Modafinil and similar
- Modafinil, used to treat certain sleep disorders such as narcolepsy. As it keeps you awake, it does technically 'enhance performance'. Recently became a banned substance for Olympic athletes. It has been used by students, young professionals, and others who want to stay awake for long periods, although psychiatrist Peter Morgan of Yale has suggested it may cause long-term sleep disturbance by disrupting slow-wave sleep and lead to memory problems. Modafinil is also linked to Stevens-Johnson Syndrome, a hypersensitivity reaction that is sometimes fatal and can cause horrifyingly painful skin lesions all over the body, with resulting extensive scarring, eye damage to the point of blindness, fever, and difficulty swallowing.
- Adrafinil, also used to treat certain sleep disorders... by metabolizing into Modafinil. It was mostly discontinued for standard medical use a result, but continues to be sold by woomongers to give the illusion of choice.
- Armodafinil, which is the R-enantiomer of Modafinil (Modafinil is normally sold as a racemic mixture). It has a half-life of 15 hours.  This woo is great for working overtime!
By far the most common class of drugs promoted as nootropics are the racetam class of drugs. These have very limited effects, but often get far overhyped for what studies show they actually do. Their exact mechanism of operation isn't clear.
- Piracetam, the original racetam. In use in Europe, but even the FDA won't allow them to be marketed as a "dietary supplement". Studies show it improves cognitive performance for people suffering from cognitive decline (e.g., Alzheimer's). This has also been shown in aged rats, where it increased the density of neuroreceptors. Healthy people and young rats experience little to no benefit, so if your doctor doesn't prescribe it, don't bother.
- Nefiracetam. Also helps people suffering from cognitive decline. Has been shown to reduce the amnesia affects of other memory impairing drugs (e.g., alcohol). It appears to possibly be safe for humans (but definitely not for many other mammals such as dogs), so you might want to wait for FDA approval.
- Methamphetamine, like the other amphetamines, is incredibly great at improving mental focus. Along with anabolic steroids, it was originally developed by the Nazis for their soldiers and given the nickname "tank chocolate", after which
both were stolen to create Captain Americait eventually made its way on to the street due to a quick high. However, it's one of the most addictive and physically damaging drugs available.
- Speaking of Meth, Captagon suppresses emotions and improves focus (by metabolizing in the body to amphetamine), making it popular among terrorists to prevent anyone from growing a conscience while murdering innocent civilians.. Because apparently we needed performance enhancing drugs for terrorists.
- Cocaine. Is a helluva drug. One of the most potent stimulants on the (black) market, which technically makes it a nootropic for when you need to be, umm, stimulated, it's also one of the more
Vitamins and nutrients
These are things that are often necessary for good health, but beyond "prevent brain damage due to malnutrition" do not make you smarter.
- B Vitamins. Useful if you have a vitamin deficiency, or cyanide poisoning, but generally a waste of money. Insufficient B-12 can cause memory loss, but that doesn't mean that excess improves memory, and most people can get enough from their diet (except vegans). There are claims that taking B-12 can improve memory in those with Alzheimer's disease, but this is as yet unproven.
- Omega-3 fatty acids. Fish oil being the most common one, but others exist. It is an essential nutrient, and the myelin in your nerve cells is made up of a large amount of this, leading to the exaggeration that this is "brain food". A number of vegetable oils have more than enough and in good enough ratios[note 1] (soy, canola, hemp but not olive, coconut or peanut), so as long as your diet is balanced you'll be fine. If you really must get your fix, stick to linseed/flax oil and take a teaspoon of that a day, rather than shelling out the cash for overpriced fish oils of dubious quality.
- Creatine. Used by body-builders and other athletes as it supposedly provides energy for your muscles, but it has seen some "use" as a nootropic. Unless you are vegan, you really don't need any.
- Ginkgo Biloba. Yet another supposed use for this wonder herb. May possibly help with memory and cognitive function in middle aged (but not young) people, but for the most part not significantly better than placebo. Causes cancer in rats and mice.
In a nutshell
If this stuff worked and was safe, it would be mandatory. Governments have already added various chemicals to processed food such as sodium iodide to salt and niacin to bread, which actually has massively increased the average intelligence (and health) of the public.[note 2]
In popular culture
- The movie Limitless (and the book it was based on, The Dark Fields) revolve around a writer acquiring super-smart pills, and a shadowy group of people murdering each other over the limited supply. Why the people using the drugs couldn't use any of their super-smarts to mass manufacture the pills is a bit of a mystery, but that'd solve the plot in 5 minutes and we can't have that.
- Flowers for Algernon is a science fiction novel about what is basically nootropics, but in surgery form. Notably the story is more about the social effects and viewpoint of a mentally disabled person becoming a genius (and back again), rather than a promotion of the surgery.
- BoJack Horseman featured an episode in the first season where the main character (and friends) take nootropics to try and finish a memoir in one night. The result was a manuscript that was made up of new 9/11 conspiracies and embedded youtube videos of cats (which given the BoJack Horseman universe where all animals (including the food!) are anthropomorphic humanoids, proooobably meant pron), as well as a rather horrific trip.
- Omega-3 and Omega-6 fatty acids compete for the same metabolic enzymes, so even if you get enough Omega 3 you can still have malnutrition if you have too much Omega 6. The ideal is to have a ratio of less than 4 to 1 of Omega-6 to Omega-3. Canola, with a ratio of 2 to 1 is the best widely available cooking oil, though flax seed oil has a ratio of 1 to 4 (more '3 than '6) has the most of any food oil. Yes, there is a grain of truth behind the mountains of woo about flax oil. Unfortunately, flax seed oil burns at too low a temperature to cook with and has the tendency to go rancid very quickly.
- Unless, of course, you are one of those people who insist that the government is already drugging us collectively, maan!
- [https://www.theguardian.com/world/2003/jan/04/afghanistan.richardnortontaylor US Pilots blame "go pills" for friendly fire
- The Cognition-Enhancing Effects of Psychostimulants Involve Direct Action in the Prefrontal Cortex, NIH
- FDA on Modafinil
- Why Can't We All Take Modafinil?, Vice, 1 Dec 2016
- [https://www.theguardian.com/education/mortarboard/2013/may/31/is-modafinil-safe-in-long-term Is modafinil safe in the long term?], The Guardian, 31 May 2013
- Holfinger, Steven et al. “Stevens-Johnson Syndrome After Armodafinil Use.” Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine vol. 14,5 885-887. 15 May. 2018, doi:10.5664/jcsm.7132
- Wikipedia page for Armodafinil
- See the Wikipedia article on Racetam.
- Piracetam, Examine.com
- Piracetam improves cognitive performance by restoring neurochemical deficits of the aged rat brain., Scheuer K, Rostock A, Bartsch R, Müller WE, Pharmacopsychiatry. 1999 Mar;32 Suppl 1:10-6. DOI: 10.1055/s-2007-979231
- Bataclan terrorists using illicit drugs
- Brain Vitamins: Can Vitamins Boost Memory?, Healthline
- Can vitamin B-12 improve memory in Alzheimer's disease?, Jonathan Graff-Radford, Mayo Clinic
- Toxicology and Carcinogenesis Studies of Ginkgo biloba Extract in F344/N Rats and B6C3F1/N Mice