Nootropics - Can a Pill Make You Smarter?

​‘Nootropics’ refers to any natural or synthetic substance that may have a positive impact on mental skills.  Nootropics fall into three general categories: dietary supplements, synthetic compounds, and prescription drugs.  Peddlers promote nootropics to stave off dementias and increase cognitive abilities including both memory and intelligence.  But it is far easier to make lifestyle betterments to achieve proven results.

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A Romanian psychologist and chemist, Corneliu Giurgea, derived the word ‘nootropic’ in 1972 from the Greek words ‘nous’ or mind and ‘trepein’ meaning to bend or turn.  Nootropics, also referred to as smart drugs or cognitive enhancers, are drugs, supplements, or other substances that improve cognitive function, particularly executive functions, memory, creativity, or motivation.

The use of cognition-enhancing drugs by healthy individuals in the absence of a medical indication is one of the most contested subjects among medical professionals, including the ethics of their use, and concerns over side effects by ungoverned and misinformed consumers.

​Some of the endemic problems in assessing the efficacy of these compounds are the small number of participants in studies and the scarcity of large randomized, double-blind, placebo-controlled clinical trials.  Many of the studies focus on improving memory in elderly populations so the results are not pertinent to a general population. 

​Professional associations define intelligence as ‘the ability to derive information, learn from experience, adapt to the environment, understand, and correctly utilize thought and reason.’  Those same organizations define memory as ‘the ability to retain information or a representation of experience, based on the mental processes of learning or encoding, retention across some interval of time, and retrieval or reactivation of the memory.’  There are standardized tests to measure both memory and intelligence and these provide a basis for empirical measurement.

​Although current nootropics offer only modest improvements in cognitive performance, it appears likely that more effective compounds are on the way their off-label use will increase.  The supplement industry is well-tooled to generate a new spin on simple compounds advertising amazing results with little supporting evidence.

Trailing is a selected list of commonly used nootropics:

• Humans consume caffeine in various carriers such as tea, coffee, soft drinks, and capsules but oddly few studies corroborate the common cultural idea that it speeds reaction time, short-term memory, and learning.
• Piracetam refers to a group of synthetic nootropics with many animal studies but almost no human studies.  These synthetic compounds are available over the counter in the United States, but in many other countries they require a prescription.
• Physicians prescribe stimulant medications such as Adderall for the treatment of ADHD, but students and competitive gamers also use them to enhance performance.
• Another prescription used as a nootropic is modafinil (Provigil).  The United States Food and Drug Administration approved it to treat narcolepsy and sleep apnea, but some studies suggest that it may help with learning and memory in healthy people.
• L-theanine is an amino acid found primarily in green and black tea, some mushrooms, but one can obtain it in pill form.  There is some evidence it might be effective in managing anxiety disorders.
• CDP-choline may help memory, at least in people who have vascular dementia, and physicians prescribe it in Europe for such conditions.
• Creatine helps build muscle mass, but studies have also found that it may improve reasoning skills and short-term memory in healthy people
• A traditional Indian (ayurvedic) herb, Bacopa monnieri, also known as brahmi, assists with some neuropsychiatric diseases.
• Flavonoids are various compounds found naturally in many fruits, vegetables, wine, tea, and chocolate.  Evidence in support of the neuroprotective effects of flavonoids has increased significantly in recent years.
• Vitamin K plays a role in brain cell survival and cognitive performance.
• Ginkgo biloba and rhodiola rosea may have some positive effect on short-term working memory.

​For the consumer, the effects of these compounds are highly subjective and dependent to some degree on placebo effects.  The huge supplement industry in the United States loves these circumstances because they result in sales of elements or compounds to treat maladies that might not exist with results that are impossible to measure.  

Around half of the adult population in the United States consumes vitamin supplements and the global nootropics market size will reach about $4.9 billion by 2025.  Nootropics manufacturers target high-income professional overachievers seeking to gain an edge at work and feature innovative packaging, product placement, and promotion.

As seen in the chart above, provided by Grandview Research, the bulk of nootropics sales were for the following purposes:

• Memory enhancement.
• Mood and depression.
• Attention and focus.
• Longevity and anti-aging.

With the number of people over the age of 60 expected to double between 2000 and 2050, the projected incidence of dementia and related health care costs is also set to rise significantly.  Interest in staving off the horror of dementia appears to be another driver of sales of nootropics.

Some cognition-enhancing drugs produce their beneficial effects on learning and memory by increasing the availability of glucose for uptake and utilization into the brain.  The hypothesis further suggests that many cognition-enhancing drugs act through a peripheral mechanism rather than directly on the brain.

​A more informed approach would be to examine lifestyle changes that show similar or better empirical support for increasing intelligence and memory skills.  Another large question is whether the qualities inherent in a pill are translatable into true nutrition from a healthy diet.  

While the limited empirical data points to minor positive effects from the use of nootropics on intelligence and memory, simple lifestyle changes are proven to provide an immediate positive impact.  The easiest, fastest, most effective, and the least expensive fix is to implement these before employing special measures such as consuming nootropics, some of which uncertain in terms of long-term health effects.

​Lifestyle changes can provide immediate improvements to intelligence and memory:

• Meditation was associated with better executive functioning and working memory.
• Adequate sleep is correlated with intelligence.
• Exercise is also correlated with memory and intelligence.
• A good diet is associated with mitigating dementias.