
Nootropics: their effects, their risks, and where to get them - r11t
http://sites.google.com/site/thinkinginanutshell/nootropics
======
silentbicycle
Eh, piracetam. Anirecatam or oxiracetam are more expensive, but they're also a
better value, because while piracetam is cheap, you're also eating three-plus
grams a day of something that tastes like ground-up mothballs. (When the
author of the linked article says, "it'll probably have the taste and texture
of sugar", you should know they're either blissfully ignorant or pissing
themselves laughing. Piracetam tastes like sunshine and gumdrops, totally!)
Piracetam and friends may work for you, or they may not, but (as these things
go) they're among the most benign nootropics. Either way, they will probably
take at least a week of consistent use to have a real effect. (For piracetam,
at least, that's often too much trouble, though gelcaps help.) I still
wouldn't necessarily recommend them, but odds are you'll just find them boring
and move on, neurons intact, albeit with a distinct hatred for orange juice.

Taking choline can make them work better, though for some people, racetams
(alone or combined with choline) can cause major headaches. Regularly eating
foods with moderate amounts of choline (particularly eggs) is a middle path.
YMMV.

While not mentioned in the article, I've had good results with l-theanine,
which is mainly present in green tea. (The sort of salty / MSG-ish taste from
Japanese matcha and gyokuro is from high concentrations of l-theanine. It's an
amino acid, and tastes very _umami_.) At the very least, it counteracts
caffeine jitters, and if you're still reading this, you may already be taking
enough caffeine. A bit makes me feel calm-but-alert, though IMHO there's not
much point in taking significantly more than occurs in green tea already. I
like green tea, but if coffee's more your thing, then powdered l-theanine is
quite cheap - it's extracted in bulk from low-grade tea. It's worth a try.

I've also had good results from getting enough sleep and exercising, as lame
as that sounds. (I like martial arts, weight training, and bicycling. Find
something fun.) There are going to be diminishing returns from nootropics,
particularly if you're sleeping or eating poorly to begin with.

Also: Vasopressin / desmopressin is a major antidiuretic hormone, so if you're
experimenting with it, keep that in mind.

~~~
RevRal
>When the author of the linked article says, "it'll probably have the taste
and texture of sugar", you should know they're either blissfully ignorant or
pissing themselves laughing.

The author did go on to say that piracetam tastes like nasty sugar.

Also, your comment is reasonable, so I don't know why you're being downvoted.

~~~
silentbicycle
In these sort of threads, people who indiscriminately encourage people to take
amphetamines tend to get upvoted* , and everybody else is a buzzkill. If
people don't want information, though, so be it. (I was a bit heavy-handed on
the whole "no free lunch" aspect.)

* Update - happened again.

That said, I find it interesting that, in the course of posting this, I've
been upvoted and downvoted five times.

Also, "nasty sugar"? More like "ground-up burnt plastic, with a slap".

~~~
shard
I would describe piracetam as having a sharp chemical-ly gag-inducing flavor.
I cannot imagine taking it long term without putting it in a capsule.

~~~
gwern
Citrus juices, like orange juice. They mask it well enough.

------
jonbischke
The Immortality Institute forums have some great discussion on nootropics.
This one for instance:

<http://www.imminst.org/forum/index.php?showtopic=35751>

This comment in particular I thought was very thought-provoking:

 __The MOST important tactic to prevent brain disorders: avoid fructose, and
carb over-consumption. The brain degrades MUCH faster under the assault of a
glucose-driven metabolism. It runs much cleaner -- metabolically speaking --
on fatty acids, which it can do up to approx 50% of its energy needs. __

I'd be curious to hear of other places on the web where people are discussing
nootropics as it a very interesting area to me.

~~~
JimboOmega
While carb overconsumption is all-around bad for you, the brain needs glucose
more than just about any other organ. Neurologic symptoms are often the first
signs of hypoglycemia, and the brain's functional ability falls rapidly with
glucose levels.

------
isthisaquestion
there was a long reddit IAMA thread where some med student said he'd tried
everything and the only one he'd consider using long-term is a daily extended-
release dextroamphetamine, like dexedrine spansules. i've got no clue about
this stuff but he sounded like he knew what he was talking about.

this thread:
[http://www.reddit.com/r/IAmA/comments/b4duo/iama_grad_studen...](http://www.reddit.com/r/IAmA/comments/b4duo/iama_grad_student_who_has_tried_nearly_every/)

------
JCThoughtscream
Piracetam has the distinct disadvantage of having to take large doses of it
before any noticeable effects. I think one of the more popular tips for it is
to mix it in with orange juice to dilute the taste. Coupled with the headaches
it can cause, and it's very much a matter of whether or not you can personally
elicit any benefits from it.

If not, save yourself a few bucks. If so, have fun~

~~~
markbao
If you encounter headaches when using piracetam, or any of the racetam family
stimulants, it's a sign that you have to start taking choline. Choline is used
rapidly by the body when medicating on piracetam, causing headaches, so you
have to replace it with a choline supplement.

I've heard that piracetam is so subtle that it's not worth messing around
with, and that aniracetam is only a little bit better. If you're serious about
using a nootropic, use a more potent analeptic like modafinil or amphetamines,
if they're available to you.

~~~
JCThoughtscream
Amphetamines have the distinct disadvantage of being more rigorously regulated
- not to mention a whole host of various physiological drawbacks including
overdose-induced psychosis.

Modafinil, sure. Its drawbacks are fairly minor. I seem to recall that it's
fairly ubiquitous in medical circles - certainly, you'd probably want your
surgeon working ten-hour shifts on a delicate operation to be on the stuff
than not.

------
ErrantX
The important thing you need to do if your planning to take these drugs is _do
the initial work_.

You cant (at least not from my observations) just start taking these tomorrow
and see improvements; you'll be mentally and organisationally unprepared and
the effects will likely be negative. You should:

\- get _really_ organised; get into a routine and stick to it. This is key
because if you drop out of the routine things can spiral out of control

\- learn how to recover fast. At uni I learned quickly how to get home at 4am
and be up/bright at 7am ready for work - and last the whole day (I never took
drugs but coffee + OJ were consumed in large quantities).

\- focus your mind with mental exercises and so forth. This will help you
concentrate generally and will help the drugs do their job.

I advise you try all of that first and get a routine/pattern sorted - often
that might give you the desired affect anyway (worked for me :)).

------
tokenadult
I wonder what a carefully designed research study would look like

<http://norvig.com/experiment-design.html>

to show that so-called nootropics do anything at all. What would be a good
objective test (as contrasted with patient self-report) of better mental
function? What treatments are best suited for placebo-controlled trials?

After edit: thanks to another participant for a link to a 1981 study that
didn't seem to look at human behavioral outcomes (better memory, etc.) but
rather physiological outcomes in an animal model. As the link in this comment

<http://norvig.com/experiment-design.html>

notes, it's always a good idea to look for replication of a first published
result. Has there been any replication at all of any peer-reviewed result
regarding the more common kinds of nootropics?

~~~
corruption
Posting this link on _nearly every_ study which is not in your subject area is
beyond tedious. I cringe every time I see it.

Ask the question - have their been any well designed studies with nootropics -
by all means, but enough's enough. If you have no subject matter expertise,
don't make claims about lack of good studies. It's like the morons spouting
"correlation is not causation". Sure they are right, but the first step in
good science is to _create_ a model, the second step is to test it for
causality. In the meantime the best we have is correlational studies. The
alternative is just to believe whatever your biases allow.

Diminishing the result of the study (which is often the implication of posting
that link in my opinion) is just showing a lack of understanding of how good
science iterates between induction and retroduction over time.

BTW: There are 24,000 studies with the search term nootropic. 2500 with
piracetam. Even a cursory look may be useful in the future.

~~~
tokenadult
_There are 24,000 studies with the search term nootropic._

To ask the question you suggested asking, which of those are well designed
studies? (And to follow up with what is my concern, which of the better
designed studies show an objectively measured improvement in cognitive
function over a reasonably long span of observation?) Which studies, if any,
make a positive case for meaningful effect with a good safety profile of
nootropics in human patients?

Citations would be greatly appreciated from any reader who has citations
available. I will look them up. I checked the Cochrane Reviews yesterday while
this thread was first active.

~~~
corruption
Your questions seem to err on the side of researchers _not_ doing good
research. Why is that?

My assumption when reading a study is that it _is_ well designed. I trust in
the scientific establishment vs random people on the internet, but are fine to
be proven wrong when I read the methodolgy.

Even a cursory look at the wikipedia page or some of the meta analyses will
tell you the information you are after. I found it within a few minutes of
searching. But instead of looking you make assumptions and jump to conclusions
based on your own biases. How is that helpful to anyone? What are you adding
to the conversation by promoting your own biases?

Remember, the null hypothesis apriori false in nearly all research.

~~~
tokenadult
_Your questions seem to err on the side of researchers not doing good
research. Why is that?_

Experience in reading the peer-reviewed medical research literature since the
1970s. It used to be that one had to go to an actual biomedical library, as I
have done on many occasions, and look up the articles through journal indexes
and then walk to the shelf where the journals are kept. That still works, but
now many of us also do online searches. Peter Norvig's article

<http://norvig.com/experiment-design.html>

is a good reminder that just getting into a peer-reviewed journal doesn't
always establish that the published conclusion is correct (or important).

I see the Wikipedia article on piracetam

<http://en.wikipedia.org/wiki/Piracetam>

still has some "citation needed" notes up by some factual claims, and some
very old journals cited for some of the claims that do have citations. Because
I had recently read

<http://www.sciencebasedmedicine.org/?p=3534>

about reviews of the actual effectiveness of one prescribed medicine that
supposedly helps cognitive deficits, I was particularly interested in this
thread to see what citations there are for recent, replicated research with
proper protocol that back up the drugs most discussed in this thread. (I
figured that anyone taking those drugs to good effect would readily remember
the citations.) Over the decades, I've seen different kinds of smart drugs
come and go out of vogue. Eventually, every use of smart drugs needs to ask,
"What smart things are people who take this drug doing that aren't being done
by people who don't take the drug?" People in the business of selling drugs
have a lot of incentive to obscure the basic question of drug effectiveness in
the interest of appealing to drug-buyers' hopes, which is why I request
especially cogent evidence for claims such as those made about the drugs
discussed in this thread.

~~~
corruption
"is a good reminder that just getting into a peer-reviewed journal doesn't
always establish that the published conclusion is correct (or important)."

Which science school did you go to? Science is about the body of evidence, not
an individual study. It's about understanding mechanisms, gradually iterating
between induction and retroduction to uncover new hypotheses then prove a
mechanism over time. It's about gradually building up an argument over many
years of research across the field, not any one individual study.

I agree that we need to be careful in interpreting studies (I am a
statistician, I should know), but your stance from ignorance adds nothing to
the conversation, and in a worst case scenario belittles the efforts of an
entire field that you no nothing about, but are _biased_ against all the
research you haven't even read from the outset.

------
carterschonwald
I feel like folks are tap dancing around the border of the parts of the topic
that fall under the "behind the counter" category, so I'm going to jump over
for y'all.

Adderall and related schedule II nootropic stimulants are amazingly effective
for their intended roles and when used at medically indicated dosages (rather
than doing the abusive equivalent of swallowing a bottle of no-doze caffeine
pills) are among the safest drugs for which it is possible to get a
prescription, in that any side effects induced by taking a prescribed dosage
will cease soon after cessation of the medication.

That being said, the view that they are study drugs is not quite a complete or
accurate picture of their cognitive effect. A more accurate but still
imprecise view would be that at the correct dosage, adderall and family
"reduce the activation energy needed for attentional engagement" and "increase
the baseline activity level of higher order planning faculties" (that is,
every time you have a "I should do this vs i want to do that" moment and chose
the "should do this" path, you are actively using the higher order planning
faculties).

These effects are why adderall et al are great for treating those who have
ADHD, ie those who have a dysfunctionally high activation energy for
attentional engagement in tasks, and perhaps due to insufficient activity of
those higher order planning faculties that influence moment to moment behavior
also have impulsive behavior and all the externalities that these difficulties
imply. Study drugs they are not, they just happen to help you focus on what
you really really want to focus on if you try hard enough.

If you do not have much in the way of excessively impulsive behavior or
difficulty focusing on what you really really want to be doing when both well
rested and in shape, then you do not stand to gain much / anything from using
them.

If you're not well rested, either drink some strong tea (because caffeine and
theanine are great!) or go to sleep, and if you're not in good physical
health, go fix that with some exercise instead of whatever you'd be
procrastinating with because that affects your quality of life and net
productivity more than getting another hour of work done. Adderall et al will
not make you better at focusing just then and there.

I feel that people often lose sight of the fact that while the human brain can
do amazing things, there are limits. With nootropics such as adderall, even a
slightly higher dosage in the normal dosage range can essentially result in a
sort of unpleasant "overload" of your ability to direct your focus. I suspect
this is a miniature version of whatever those who recreationally abuse these
stimulants experience, in which case they must be idiots because i don't
understand how that could be pleasant.

if you have allergies that can be made tolerablish without something like
zyrtec or claritin and you have work you need to do, don't take the allergy
medication, they have essentially the exact opposite (I believe antagonistic
is the term used) cognitive effect of prescription dosages of adderall et al.

Obvious caveat, everything I say is merely reflects my personal experience
managing adhd, reading up on various bits, and observing how many people work.
Also, it seems that at least anecdotally that the manner in which a person
with unmedicated adhd structures and approaches work is radically different
from how everyone else does so, and that part of the adhd treatment process is
sort of a (think HeMan) "By the power of ADDERALL, I shall use my newfound
powers of ease of attentional engagement to devise more effective and
efficient ways of structuring how I approach work"

theres probably things i'm overlooking, omitting, oversimplifying or
exaggerating, but hopefully this has some useful information for someone.

~~~
darien
Are you on adderall right now?

~~~
carterschonwald
nope, I'm only that rambly when exhausted but not able to fall asleep.

------
RevRal
I've been interested in piracetam for a while.

Anybody with personal experience?

Wiki: <http://en.wikipedia.org/wiki/Piracetam>

~~~
itistoday
Yes, I took it for several days and developed an annoying headache/feeling. It
did not, at all, improve cognitive function. In my case it impaired it.

YMMV of course.

I've had far better luck with fish oil (Omega-3 supplements), taken every
morning with earl grey tea. The fish oil helps me concentrate, while the tea
releases caffeine more slowly than coffee does, preventing jitteriness and
extending its duration.

~~~
lsb
To make fish oil, you need fish that are low enough in the food chain to not
have many PCBs. Fish oil is usually made from the menhaden fish (aka the
alewife fish), which used to be plentiful all around the Atlantic coastline of
the US, feeding on algae. With all those fish turned into fish oil pellets,
there are massive algae blooms, and the food chain's getting disrupted.

See <http://www.ethicurean.com/2009/03/23/menhaden/> and
<http://motherjones.com/environment/2006/03/ill-take-menhaden>

~~~
itistoday
Thanks for that! Any recommendations on alternatives? I find other sources of
Omega3 (flax seed) to be not as good unfortunately...

------
skmurphy
Mind Boosters by Ray Sahelian MD [http://www.amazon.com/Mind-Boosters-Natural-
Supplements-Enha...](http://www.amazon.com/Mind-Boosters-Natural-Supplements-
Enhance/dp/0312195842) provides some good background on various pathways and
mechanisms of action for different supplements. He advocates a conservative
approach to supplements focused on counter-acting effects of aging.

------
rjurney
Piracetam for me is about as effective as Adderall. Which is to say that it is
very effective. I took it a lot in college. Be careful taking it with coffee
though, it potentiates stimulants.

------
gcanyon
I have used several puzzle web sites to benchmark my brain from day to day.
Obviously puzzles are a narrow measure of cognitive capacity, but that's true
of any benchmark. I've used <http://www.ricochetrobots.com> and the Puzzle
Maniak game on the iPhone (usually the loopy puzzle).

------
gnosis
Does anyone here have any experience with sulbutiamine?

------
goodside
(Disclaimer: I'm not a doctor, nurse, or med school dropout. You shouldn't
listen to me.)

Nootropics don't work, but this is mostly by definition. Just like any
algorithm that works isn't AI, and successful minorities aren't minorities,
when a drug is shown beyond all doubt to improve the ability to deliver
sustained mental effort, it's not a nootropic. It's a stimulant.

I'm baffled why people spend so much time hunting the perfect combination of
vitamins and piracetam and fish oil when prescription stimulants are so
readily available, obviously effective, and completely safe at clinical doses.
They're the Apple products of nootropics: They just work.

~~~
jamesbritt
"I'm baffled why people spend so much time hunting the perfect combination of
vitamins and piracetam and fish oil when prescription stimulants are so
readily available,"

Because nootropic != stimulant.

Your brain depletes assorted neurotransmitters during the course of the day
and that depletion reduces cognitive ability. You can improve your state of
mind by helping the body replenish them.

Choline, for example, is not a stimulant per se, but it may help boost levels
of acetylcholine. That, in turn, can improve your cognitive activity if you
are low on acetylcholine.

It's similar to taking general vitamins and minerals. For most people there's
a easy limit after which taking more simply does nothing but cost money. They
are not, in themselves, magic health enhancers you can pile on to make
yourself more fit. However, if you are engaged in some physical activity that
depletes vitamins and minerals, then ingesting higher levels than normal will
help you maintain that activity and overall better health.

