Non–Prescription Nootropics & Smart Pills
What are Nootropics?
A nootropic, also referred to as a smart pill, smart drug, or a brain pill, is any substance taken to enhance cognitive abilities. This is the simplest nootropic definition, and as a result, there are many drugs, supplements, herbs, and other substances that can be classified as nootropics.
History of Nootropics
The term “nootropic” was coined in 1972, by Corneliu Giurgea, a chemist and psychologist who observed the memory-enhancing effects of the drug piracetam in a clinical trial.1 Originally, the term was mostly applied to prescription drugs, but since then, nootropic has come to refer to both prescription medications used to treat certain neurological conditions, as well as non-prescription substances that have cognitive benefits. Non-prescription nootropics can have numerous effects on cognitive function; some only have a mild to moderate influence on cognition, while others are more intense. Common cognitive effects of nootropics include improved memory, longer attention span, improved creativity, better focus, improved information processing, reduced fatigue, and increased motivation.2
Mechanism of Action
Since many substances fall under the definition of nootropic, different nootropics work in different ways. Thus, there is no universal mechanism of action that applies to every nootropic. However, in general, nootropics affect cognitive functions by entering the body and interacting with chemicals such as receptors, metabolites, neurotransmitters, enzymes, hormones, and more.3 These chemical interactions usually take place in the central nervous system. Through these various molecules present in the body, nootropics can send signals that produce a cellular response, facilitate chemical reactions used to create a cellular response, and prevent certain chemical reactions or signals from producing a cellular/physiological response.4 Nootropics can also increase the amount of neurotransmitters (chemicals used to send signals from nerve cells to other cells) within the brain and trigger the release of certain hormones.5
As an example of how a nootropic produces its effects, caffeine, a popular nootropic known for its ability to reduce sleepiness, affects the body by antagonizing certain receptors. Receptors are molecules that produce a cellular response when another chemical binds to it. Caffeine is an antagonist of the adenosine receptors, meaning that caffeine prevents adenosine from binding to the adenosine receptors and causing a cellular response.6 Since adenosine is involved in the reactions that produce drowsiness, caffeine improves alertness, increases focus, and reduces drowsiness by preventing the reaction that causes drowsiness from taking place.
Since the term nootropic refers to many different substances, not all nootropics will have similar effects. Some have only mild to moderate effects, while others can drastically affect cognitive abilities. Benefits of non-prescription cognitive enhancers include:7
- A longer attention span and an improved ability to focus.
- Improved short-term, long-term, working, and episodic memory. Benefits appear to be greatest in those with a lower working/episodic memory.
- Stimulant-like effects, including increased alertness, higher energy levels, and reduced fatigue.
- Improved mood.
- Increased motivation to perform a task – particularly on tedious tasks and tasks that require a large amount of effort.
- Increased ability to perform a task for a long period of time (i.e. studying, working out).
- Improved inhibitory control. Inhibitory control refers to the ability to override ingrained, habitual behaviours to better accomplish a goal.
Nootropic Side Effects
With any product intended for consumption, there is always a risk of experiencing adverse side effects. It is important to be aware of the potential side effects of any product you consume.
Some of the common side effects of non-prescription nootropics are:7
- Upset stomach
- Difficulty sleeping
- Increased heart rate
Since there is a wide variety of non-prescription nootropics, not all will have the same side effects. Many supplemental nootropics may have potential side effects in addition to the ones listed above. The risk of side effects from brain-enhancing supplements is generally low, and any side effects usually tend to be mild.8 However, it is still important to be aware of any potential side effects. Check the label before consuming. Do not consume more than the recommended dosage. Additionally, if you are taking any medications, consult with a doctor before taking nootropic supplements, since some nootropic supplements can interfere with certain medications.
Non-prescription Nootropics in Sports
Compared to performance-enhancing drugs and supplements, brain enhancement supplements and drugs are much less used among professional and amateur athletes. However, recent evidence shows that usage of substances designed to enhance cognitive abilities may be on the rise in both professional and amateur/recreational athletes, suggesting that more research investigating the usage of non-prescription nootropics (and prescription nootropics) in sport should be done.9 Though supplements for memory, attention span, and other cognitive functions may appear to have less applications in the world of sport than in academia, some nootropics can be useful for athletes seeking to improve athletic performance.
Nootropics – specifically stimulants and focus supplements – can raise energy levels, improve alertness, ward off fatigue, improve focus, and help athletes perform at an intense level for longer. Currently, natural, non-prescription substances with nootropic effects are not banned since they have not been scientifically proven to dramatically influence athletic results, though they may be monitored.10 As an example, caffeine is not currently considered a form of doping, though it is listed as a monitored substance, since evidence shows that caffeine only has a moderate effect on sport performance.11
Prescription Smart Drugs
Prescription nootropics are drugs with cognitive-enhancing effects that are intended to be prescribed by a health professional in order to treat certain cognitive conditions. These drugs differ from non-prescription nootropics in that they are not supposed to be used without a prescription. Indeed, for many of these prescription drugs, it is illegal to use them without a prescription. These drugs are most often used to treat mild to severe cognitive impairments in conditions such as dementia, ADHD, Alzheimer’s disease, Huntington’s disease, and more. When used for this purpose, cognitive enhancers can help return cognitive functioning to normal levels.12
Brand name is listed first, with generic name in brackets:
- Adderall (dextroamphetamine/amphetamine)
- Dexedrine (dextroamphetamine)
- Vyvanse (lisdexamphetamine)
- Focalin (dexmethylphenidate)
- Ritalin/Concerta (methylphenidate)
- Provigil/Alertec (modafinil)
- Aricept (donepezil)
- Namenda (memantine)
- Razadyne (galantamine)
Prevalence, Usage Groups, and Benefits of Prescription Nootropics
Prescription cognitive enhancers are mostly prescribed to treat conditions that affect cognitive functioning; for example, ADHD, dementia, and Alzheimer’s disease. These medications are intended to return cognitive abilities to normal levels; for example, ADHD stimulant medications are used to treat the symptoms of ADHD by improving focus and counteracting hyperactivity.13 However, most evidence shows that cognitive enhancers only have moderate effects at improving day-to-day cognitive functioning in these conditions, and there is little evidence showing that long-term use of cognitive enhancers has significant benefits for long-term cognitive functioning.14, 15 More research is needed to establish the full range of benefits that cognitive enhancing medications can have on neurological conditions.
In a survey investigating usage of prescription nootropic drugs for non-medical reasons among university students, the students’ self-reported taking prescription drugs mainly to study and stay alert, so that they could improve academic performance.18
In many countries, such as the United States and Canada, it is illegal to use certain prescription nootropic drugs without a prescription.16, 17 However, prescription nootropics are often taken for non-medical reasons by individuals without a prescription. Currently, non-medical use of prescription cognitive enhancers is quite high among students, and usage rates may be growing. Estimates of North American young adults who have taken prescription drugs for non-medical reasons range between 5% and 35%, and approximately 3–11% of college and university students have taken nootropic drugs to improve academic performance.18, 19 Surveys of university students show that most students taking prescription “brain boosters” for non-medical reasons mainly do so to improve academic performance; for example, taking “memory pills” that can increase recall of facts before a test.20, 21 Of prescription nootropics used for non-medical reasons, ADHD medications are usually the drug of choice.18
Prescription nootropics have beneficial effects for healthy individuals who do not have issues with cognitive function. One study showed that these prescription drugs can improve problem-solving abilities, logical reasoning, consolidation of information, recall of information, and reaction time.22 Thus, these prescription smart pills can have many benefits for students aiming to improve academic performance and increase their grades. Additionally, pharmaceuticals for brain enhancement may have many more professional applications among healthy individuals; for example, focus pills could help nurses working late shifts to concentrate on the task at hand. However, usage of prescription cognitive enhancers for non-medical reasons is very controversial today, and many ethical concerns have been raised.23 Non-prescription use of cognitive enhancers has been compared to doping in sports competitions, since it may give individuals an unfair advantage in academics and in the workplace.
Side effects, Risks, and Abuse of Prescription Nootropics
Prescription drugs can have many adverse side effects, ranging from mild to serious. Some common side effects associated with pharmaceutical cognitive enhancers are:
- Increased heart rate
- Increased blood pressure
Always discuss taking any kind of medication with your doctor, and make sure to take it under the supervision of a health professional. A doctor can determine an adequate, safe dosage of medication based on your health needs and medical history. Do not attempt to self-medicate, and do not take prescription medications if you do not have a prescription.
There are considerable risks associated with taking prescription nootropics for cognitive enhancement. Certain medications may have interactions with other drugs you may be taking, and some could have serious adverse side effects. For example, modafinil (brand name Provigil), a drug used to promote wakefulness, has been associated with a number of serious skin reactions requiring medical treatment.24 In addition, the potential for abuse for some nootropic drugs is very high. As an example, heavy use of amphetamine (brand name Adderall) and methylphenidate (brand name Ritalin) often leads to dependency since long-term usage is likely to build up tolerance.25 An overdose of these drugs can cause serious health problems, such as coma and death.25
Doping in Sports
Some pharmaceutical nootropics are already considered a form of doping. Stimulant drugs, a type of nootropic, are widely considered to be doping by many major sports organizations (including the World Anti-Doping Agency and the IOC), since these drugs have been shown to increase an athlete’s ability to perform at an intense level for longer. As well, non-prescription usage of many prescription drugs is already banned by multiple major sporting organizations; for example, modafinil, a drug usually used to treat sleep disorders, is a banned substance that has been at the centre of a number of high-profile doping cases.10, 26
Note: Supplement Analyst does not review any prescription drugs, medications, or other controlled substances.
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- Lanni, C., Lenzken, S. C., Pascale, A., Del Vecchio, I., Racchi, M., Pistoia, F., Govoni, S. (2008). Cognition enhancers between treating and doping the mind. Pharmacological Research, 57 (3), 196–213.
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- Ferré, S. (2007). An update on the mechanisms of the psychostimulant effects of caffeine. Journal of Neurochemistry, 105 (4), 1067–1079.
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- Wood, S., Sage, J. R., Shuman, T., and Anagnostaras, S. G. (2014). Psychostimulants and Cognition: A Continuum of Behavioral and Cognitive Activation. Pharmacological Reviews, 66 (1), 193–221.
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- World Anti-Doping Agency (2016). 2016 List of Prohibited Substances and Methods. Retrieved 4 August 2016.
- Stadheim, H. K., Kvamme, B., Olsen, R., Drevon, CA., Ivy, J. L., Jensen, J. (2013). Caffeine increases performance in cross-country double-poling time trial exercise. Medicine and Science in Sports and Exercise, 45 (11), 2175-83.
- Colucci, L., Bosco, M., Ziello, A. R., Rea, R., Amenta, F., Fasanaro, A. M. (2012). Effectiveness of nootropic drugs with cholinergic activity in treatment of cognitive deficit: a review. Journal of Experimental Pharmacology, 4, 163–172.
- National Institute on Drug Abuse (Jan 2014). Stimulant ADHD Medications: Methylphenidate and Amphetamines. National Institutes of Health. Retrieved 4 August 2016.
- Cappell, J., Herrmann, N., Cornish, S., Lanctôt, K. L. (2011). The pharmacoeconomics of cognitive enhancers in moderate to severe Alzheimer’s disease. CNS Drugs, 24 (11), 909-27.
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- Maier, L. J., Liakoni, E., Schildmann, J., Schaub, M. P., Liechti, M. E. (2015). Swiss University Students’ Attitudes toward Pharmacological Cognitive Enhancement. PLoS ONE 10 (12), e0144402.
- Vargoa, E. J., Jamesa, R. A., Agyemana, K., MacPheea, T., McIntyrea, R., Roncaa, F., Petróczi, A. (2014). Perceptions of assisted cognitive and sport performance enhancement among university students in England. Performance Enhancement & Health, 3 (2), 66-77.
- Bagot, K. S. and Kaminer, Y. (2014). Efficacy of stimulants for cognitive enhancement in non-attention deficit hyperactivity disorder youth: a systematic review. Addiction, 109, 547–557.
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