What's the Straight Dope on Nootropics?

Great Debates
1

(Some people here might remember me as the guy who is firmly against bad science, particularly bad medicine (a certain fan of cannabinoid oils got a week of broadsides from me not too long ago). So keep in mind I’m trying to take all this with a grain of salt.)

Nootropics are a set of ((mostly) legal) psychoactive drugs focused on enhancing cognition. Some of these are low-hanging fruit - everyone already knows how great caffeine is, and the positive effects it has on cognition - but others are also quite interesting. Modafinil, for example: many members of the “rationalist” community use it off-label, and it allegedly shaves a few hours of sleep off your schedule at no significant cost, giving you a few more hours in the day. That’s pretty valuable if you’re the kind of person who never feels like they have enough time in the day or can never get enough sleep.

/r/Nootropics goes into detail about a lot of them, and while the available studies may not always quite be up to the FDA’s standards, the subject is interesting to me, and I could use a little extra brain power most days.

Normally, I’d be quick to dismiss most of this and demand higher-quality and better studies. The reason I haven’t done that in this case mostly has to do with who has been advocating for nootropics: the rationalist community. These guys kinda tend to have their shit together when it comes to science, logic, and reasoning (I cannot recommend the Less Wrong Sequences or SlateStarCodex highly enough; I feel like I’ve become a much better thinker since I started reading them). So for now, I’m tentatively going off the available research (/r/nootropics is pretty good about citations) and testing out a thing or two.

Does anyone else have experience with these kinds of supplements?

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I don’t have experience with anything except caffeine.

Most of the drugs mentioned are unproven. All drugs that have effects, have side-effects. Doctors are reluctant to prescribe drugs to healthy people to improve their performance, because all drugs that have effects, have side-effects.

Regards,
Shodan

3

If you don’t already have the website science based medicine .org on your radar take a look at it.

here’s what they say about it, particularly BrainPlus IQ and

and the russian drug phenibut:

TL/DR: lots of hype, no evidence.

mc

4

Don’t make the mistake of assuming a transhumanist group like LessWrong are immune to cognitive bias. They really want to push cognition. The owner also has issues with a superiority complex, presuming his pursuit for greater rationalism makes his logic unassailable, rather than the more rational “we’re all permanently biased” position. And there is a bit of cult of personality there.

Point is, if it’s something they want to be true, they’re just as biased as anyone.

5

Does even caffeine actually help cognition? Or does caffeine withdrawal just hinder cognition?

6

As a non-bioscientist, I don’t feel particularly qualified to comment on this topic, but it is one that interests me.

I’d agree with the former poster, while I am unaware of the “rationalist” community online, I have read a few articles on the RationalWiki and would not trust their ego to not get in the way of considering the topic logically. They’re liable to be proponents of anything sciencey and which might make themselves even smarter.

But I will note specifically that two of the things mentioned, Phenibut and St John’s Wort, are the real deal.

I have taken Phenibut to help sleep and, frankly, would not recommend driving with it in your system. I wouldn’t use it for anxiety or as a social lubricant, but I suppose that it would work in much the same way as alcohol. It makes your brain lazy.

While I haven’t taken St John’s Wort, there is no real hint of shadiness nor slim-research around it. The general consensus seems to be that it’s a natural equivalent of something like Fluoxetine in terms of what it does. I wouldn’t recommend messing around with it unless you had ruled out a number of other anti-depressants with your doctor and she was willing to oversee trialling it as an alternative.

All of the other things, their status depends on single studies that may be of limited quality and value. They’re mostly, probably, the produce of Chinese researchers either backing the supplement industry or trying to prove the value of “Traditional Chinese Medicine”. Or, simply, the result of someone doing decent but preliminary work that is not conclusive.

I’d suggest that it’s likely that something in there would, at some dose, do something. But it’s likely that the majority are placebos.

It’s a low-dose stimulant, which includes other drugs like methamphetamines and cocaine. Having taken neither, I can’t say how well those help one to think and concentrate, but I think it’s safe to say that there is some sort of measurable physical effect. (If we ignore dependency and withdrawal issues.) They aren’t placebos.

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Well, just for reference, here are the ones I’m looking into:

  • L-Theanine (mixed with Caffeine)
  • Creatine
  • Bacopa Monnieri Extract

These are broadly seen as extremely safe.

And while the studies are not exactly “high quality”, the preliminary studies show significant effects. Here’s an example for L-Theanine. None of these studies are very strong - a few dozen people at most, and a systematic review of 11 existing papers - but they seem to point in largely the same direction. Plus, you know, an entire community or two of largely science-minded people doing independent surveys - not exactly up to SBM’s entirely reasonable standards*, but still a (very weak) indicator.

*Not being facetious, SBM is a wonderful resource that I have used quite often.

Does the hesitance to prescribe medicine with potential side-effects hinder studies into things like steroids, supplements, nootropics, and the like? It seems like if that’s actually a precept in medicine, it would lead to a lot fewer major studies on things like this. That said, I honestly don’t know, so if that’s not the case I’ll gladly drop it.

FWIW, I looked to see if the folks I’m getting my info from had anything on “BrainPlusIQ”. What I found was pretty much universally negative - “Don’t buy it, there’s not even an ingredients list, looks like a total scam”. The sites they direct to test their stuff, sell pure ingredients or pills with short, clear lists of ingredients. In fact, the one I ordered from specifically sells at doses corresponding to the evidence from the best available studies (however strong they may be).

8

Err, just to clarify, that’s prescribe to healthy people. Obviously side-effects won’t stop doctors from prescribing sick people the meds they need, but I’m wondering if there’s hesitation to even look into drugs which would improve “normal” function but could have negative side-effects, regardless of how positive that tradeoff might be.

And yeah, I can understand the bias. Speaking as someone whose memory doesn’t really work as well as he wants it to, I really want this shit to work. :frowning:

9

It depends.

It is a lot easier to test something to see if it improves performance in healthy individuals if the substance is not a prescribed drug. You mention some studies on a substance commonly found in black tea, in combination with caffeine, which is also available OTC. Creatine has also been studied rather a lot, mostly (IME) as a muscle-building supplement. Creatine is found in foods already. Etc.

Things like anabolic steroids, which are available in the US only by prescription, are another matter. All the studies I have found on anabolics mention that clinical trials on their effectiveness do not employ the same dosages as the bro-science says are necessary to trigger the anabolic effect, at least to the degree that bodybuilders and football players want. Plus, anabolics are against the rules in the Olympics and many/most other sports. So there is that much less inclination to test if they help athletic performance.

This is in the US. The Russians and Bulgarians and East Germans made a whole body of science on performance-enhancing drugs, although a lot of that was how to mask that they were administering such drugs to their athletes.

But in general, it is harder to get funding for a study if you say “I want to give a bunch of people a big whack of some medicine that is only available on prescription, and see if it helps with memory/their ability to recognize shapes/their clean-and-jerk.”

Regards,
Shodan