Written by Dr. Inez Van Roy on:

Medically Reviewed by our Medical Affairs Team

Think of nootropics, smart drugs, or enhancers. What comes to mind? Do these smart drugs improve brain function? Can they help you get rid of your ADHD? 

What are nootropics?

Nootropic, a term introduced by C. Giurgea in 1973, translates to towards (tropic) the mind (noos). In those times it mostly referred to a group of compounds used to enhance learning and cognition.

Nootropic, cognitive enhancer and ‘smart drugs’ are used interchangeably. Their goal is usually to improve memory and cognitive function, or support optimal brain health.

These are mostly gaining popularity for alternative use with academic students and professionals. They use it to keep going longer and staying more alert. Some people are also looking for a high.

There’s a wide range of nootropic substances, from caffeine and vitamins to amphetamine and racetams. Though they might be different in form or effect on the mind. All nootropics want to boost mental performance and fight cognitive decline. The effects however are variabel.  

You can find these in pharmaceutical medications as well as dietary supplements or herbs. Psychostimulants like Ritalin are nootropics designed to help with ADHD symptoms. The effects of over-the-counter nootropics are less predictable and researched. People do however like to use these products as an alternative to heavy pharmaceuticals.

What is ADHD (attention deficit hyperactivity disorder)?

The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) defines attention deficit hyperactivity disorder as “a persistent pattern of inattention and/or hyperactivity-impulsivity. This occurs in social settings, at school or work, or during leisure activities”. ADHD causes problems with functioning, affects academic performance and disrupts relationships with others. The symptoms are not better explained by another disorder like anxiety or depression.

The DSM-V states that ADHD is a developmental disorder. That means it begins in childhood and can continue through adulthood if no action is taken to manage the symptoms. 

Many people with ADHD are looking to manage their cognitive symptoms by using nootropics, or smart drugs. Psychiatrists are prescribing stimulants to balance out the neurotransmitters in the brains. The question is if there are any other options for those who want to add supplements in their diet or want to change their lifestyle.

Prescription nootropics

The word nootropics is used to describe any substance that positively influences our brain function. Prescriptions that improve mental function are nootropics. These prescription nootropics manage symptoms and improve cognitive function for 

  • Alzheimer’s disease, 
  • ADHD, 
  • narcolepsy and other sleep disorders. 

It is not recommended to use these medications without advice from a doctor. They do have side-effects and don’t tend to provide more than a placebo effect for those without these disorders.

Stimulant drug

The stimulant drugs usually referred to as cognition-enhancing drugs or nootropics are:

  • Ritanil, Methylphenidate used for ADHD and narcolepsy,
  • Adderall, Amphetamines used for ADHD and narcolepsy
  • Provigil, Modafinil used to treat narcolepsy/ other sleep disorders and sometimes ADHD 
  • and Axura, memantine used to treat Alzheimer’s disease

These prescription medications are no candy. It is advised to work with a specialist if you need these pills. Follow the advice of your medic to take the appropriate dose, healthy individuals don’t need these. Keep reading to know more about how these work and what are their side-effects.

Over-the-counter nootropics

Certain cognition enhancers can be found over-the-counter. These nootropics can be found in the alternative medicine scene, your local pharmacy or online. Some of these are natural nootropics, like caffeine or ginkgo biloba. Others are synthetic, like piracetam.

Natural nootropics

1. Caffeine

Caffeine is an example of a natural nootropic. Most people drink a cup of coffee to fight mental fatigue and to boost their mental focus.  Caffeine is the active ingredient in coffee. This is the most widely used psychoactive drug in the world, and is also a nootropic.

2. L-theanine

L-theanine is a naturally occurring amino acid derived from tea. It could be taken in tea form, or in tablets. Historically L-theanine is also used to promote relaxation. This does not cause drowsiness or other side effects of sleep medications. More research is needed to prove the effect on mood.

This natural stimulant is mostly consumed (in tea or supplement form) together with caffeine. Some people report better cognitive functions, without the headaches by combining the two. More research is still needed to confirm this.

3. Omega-3 fatty acids

Omega-three fatty acids can help with cognitive performance. It could also boost mood and cardiovascular function. Eating a balanced diet with enough fat fish should provide you with all the fatty acids that you need. If needed you can supplement these by taking fish oil supplements. The evidence of these supplements is usually inconclusive, as effects are small.

Fatty acid supplements are usually very safe. Side effects are minimal (f.e. Bad taste/ breath, bad-smelling sweat. Some people do report headaches or gastrointestinal symptoms. It is not recommended to take these supplements if you are allergic to seafood or if you take drugs that affect blood clothing.

4. Ginkgo biloba

Ginkgo biloba or maidenhair tree is a plant extract that possibly improves blood circulation to the brain. This herbal supplement is important as it increases oxygen and glucose levels for your cells. These are needed for cognitive function.

Ginkgo might be an antioxidant. It might help against aging and oxidative stress. It is used sometimes to help with memory in those who suffer from dementia or Alzheimer’s disease. It can also have positive effects in healthy people, however they seem to wear off easily.

Ginkgo does not seem to have many short-term side-effects however, we are not sure of the long-term effects. 

5. Panax ginseng

Panax ginseng is a plant, they use the root to make the herbal extract. It is used to  improve memory and cognitive function.

It could possibly help with mental fatigue. Panax ginseng is available as a herbal nootropic supplement.

6. Rhodiola

Rhodiola or king’s crown grows in cold, Arctic or European regions. The root is considered an adaptogen. Theoretically it could help your body adapt to stress.  Traditionally it was used as a medicine to boost endurance, performance and altitude sickness. They believed it helped against fatigue and weakness. 

Today it is more used to help mental performance and boost memory. People also use it to manage their mental health (stress, anxiety and depression). The effects are rather mild.

Synthetic nootropics

1. Racetams

Racetams are a class of synthetic compounds. They are known to modulate central neurotransmitters like glutamate or acetylcholine. Piracetam is one of the most researched nootropics and racetams. 

It has improved memory in healthy subjects more than a placebo drug, according to some researchers. Some sources do not find this effect. It is also prescribed for myoclonus, or severe twitching. Piracetam is in many countries regulated as a prescription, in the USA however it is usually sold as a supplement. The FDA (the Food and Drug Administration) does not approve this as a legal supplement. 

2. Creatine

Creatine can be made by our liver, kidneys and pancreas. The majority of our creatine however comes from animal protein. Synthetic supplements can however boost your creatine intake. Healthy adults can still use creatine supplementation and have effects. 

Creatine has many beneficial effects like strengthening muscle size and performance. Supplementing also has a positive effect on certain working memory tasks, for both younger and older adults.

The effects of creatine supplementation might be higher for older adults and those with a vegetarian or vegan diet. 

How do nootropics work? 

Nootropics work mostly by supporting or enhancing attention, creativity, mood and memory. As discussed, there are many nootropics and they all work a little differently. 

In general nootropics tend to increase blood circulation, oxygen and nutrient flow in the brain. Indirectly or more directly, depending on the smart drug, these might 

How do Ritalin and Adderall treat Adhd?

Ritalin and Adderall stimulate the central nervous system. Both stimulants increase the availability of dopamine and norepinephrine. This aids the stimulation of the brain and leads to improved attention. By stimulating the brain, people with ADHD feel a reduction of their symptoms. People with ADHD might have a functional impairment of the pathways involved with these neurotransmitters.

What are the side effects of Adderall and Ritalin?

Adderall and Ritalin can lead to addiction if ingested too often or at high doses. It is important to take the right dosages and follow the guidelines of your specialist. 

Abuse or addiction happens when people are looking for the rush. Misusing these substances might cause paranoia, anger or psychosis. On a physical level taking too much stimulants might lead to a high temperature, heart complaints and seizures.

The following are also possible side effects of Adderall or Ritalin: 

  • appetite suppression, 
  • insomnia, 
  • nausea, 
  • vomiting, 
  • headache, 
  • painful muscle spasms in the neck or back; 
  • excessive sweating (diaphoresis), 
  • dizziness on standing up quickly after sitting or lying down. 

Do stimulants make people without ADHD smarter?

Stimulants don’t make anyone “smarter”. They could help someone who needs it to focus better. People without ADHD perceive limited effects from such a nootropic drug. Only people who tend to perform less on certain cognitive control tasks might see a difference. Even those effects can be questioned as research shows the placebo effect might play a role. Certain individuals expect to be high and will feel that way as an effect. 

Taking a prescriptive smart drug or other heavy pharmaceuticals when not needed, is not advised for it’s adverse effects.

How does piracetam work?

Piracetam interacts with receptors in the brain and modulates chemical reactions and signals in the brain. This has an impact on our cognition. Other researchers believe piracetam might also play a role in providing the brain with more energy. It does this by increasing oxygen levels in the brain, making cells and mitochondrial membranes more permeable and might have an influence on the synthesis of cytochrome. 

Other research believes it works mostly as a neuroprotector (or antioxidant), or by increasing the density of acetylcholine. This way it could also have a number of cognitive benefits.

Piracetam is not without side effects: headaches or dizziness are possible in some people. More serious adverse reactions include anxiety, depression and hallucinations.

Are nootropics safe to use? 

Nootropics don’t show many short-term side-effects. Safety over the long-term still needs more research. 

It is recommended to start with small doses to see how these supplements affect your body. Talk to your doctor to see which cognitive enhancers are safe for you. 

The safest way to boost brain function is still eating a healthy diet, exercising and getting enough sleep. Some nootropics could cause dependency, like caffeine and when misusing stimulants.

How do I avoid caffeine addiction?

How much caffeine is too much? The amount of caffeine recommended for an average adult is no more than 400 mg a day. That comes down to probably four cups per day. If you drink more, you might want to gradually cut back.

Another way to avoid caffeine addiction is cutting back when you experience the following symptoms:

  • Headache
  • Insomnia
  • Nervousness
  • Irritability
  • Frequent urination or inability to control urination
  • Fast heartbeat
  • Muscle tremors
  • Jittery feeling

Avoid coffee if you are a minor or if you are pregnant.

Is it safe to use multiple nootropics at the same time?

Combining two or more nootropics at the same time is called a “stack”. You might already be stacking without conscious effort. Some teas contain the famous caffeine/L-theanine combination. Also many commercially available supplements are sold as a nootropic stack. The effect of this stack or any dietary supplement is highly personal, however it is usually marketed to enhance cognition. 

The advantage of starting with individual cognitive enhancers, rather than a stack is that you will have more control. You will notice easily which supplement is not working for you.

These stacks can interact with your current medication or medical condition. 

Summary

Nootropics can take the form of pharmaceutical medications, nutritional supplements or herbs. They all have one thing in common – improving memory. They improve cognition and blood flow to your brain, making nootropics act as neuro-protectives for your cells.

Many nootropic supplements are available over-the-counter. There’s no need to take them with a doctor’s prescription. Asking their advice is still a good idea as these might interfere with your current medical condition (f.e. Pregnancy) and your medication.

Your medic can provide you guidance for the correct dose. Following these guidelines is very important to avoid side-effects and addiction (f.e. Coffee, Ritalin, Adderall).

When looking for a brain boost, the first steps should be a diet, getting enough sleep and exercising regularly.

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