Endoscopy surgeries, being minimally invasive, have become more popular in recent times. Latest studies show that there is an increasing demand for single incision or small incision type of surgery as an alternative to traditional surgeries. As aging patients are susceptible to complications, the usage of minimally invasive procedures is of utmost importance and the need of the hour. There are unexplained situations of bleeding, iron deficiency, abdominal pain, search for polyps, ulcers, and tumors of the small intestine, and inflammatory bowel disease, such as Crohn's disease, where capsule endoscopy diagnoses fare better than traditional endoscopy. Also, as capsule endoscopy is less invasive or non-invasive, as compared to traditional endoscopy, patients are increasingly preferring the usage of capsule endoscopy as it does not require any recovery time, which is driving the smart pill market.
This calculation - reaping only \frac{7}{9} of the naive expectation - gives one pause. How serious is the sleep rebound? In another article, I point to a mice study that sleep deficits can take 28 days to repay. What if the gain from modafinil is entirely wiped out by repayment and all it did was defer sleep? Would that render modafinil a waste of money? Perhaps. Thinking on it, I believe deferring sleep is of some value, but I cannot decide whether it is a net profit.

While the commentary makes effective arguments — that this isn't cheating, because cheating is based on what the rules are; that this is fair, because hiring a tutor isn't outlawed for being unfair to those who can't afford it; that this isn't unnatural, because humans with computers and antibiotics have been shaping what is natural for millennia; that this isn't drug abuse anymore than taking multivitamins is — the authors seem divorced from reality in the examples they provide of effective stimulant use today.
The term “smart pills” refers to miniature electronic devices that are shaped and designed in the mold of pharmaceutical capsules but perform highly advanced functions such as sensing, imaging and drug delivery. They may include biosensors or image, pH or chemical sensors. Once they are swallowed, they travel along the gastrointestinal tract to capture information that is otherwise difficult to obtain, and then are easily eliminated from the system. Their classification as ingestible sensors makes them distinct from implantable or wearable sensors.

It’s not clear that there is much of an effect at all. This makes it hard to design a self-experiment - how big an effect on, say, dual n-back should I be expecting? Do I need an arduous long trial or an easy short one? This would principally determine the value of information too; chocolate seems like a net benefit even if it does not affect the mind, but it’s also fairly costly, especially if one likes (as I do) dark chocolate. Given the mixed research, I don’t think cocoa powder is worth investigating further as a nootropic.
Like caffeine, nicotine tolerates rapidly and addiction can develop, after which the apparent performance boosts may only represent a return to baseline after withdrawal; so nicotine as a stimulant should be used judiciously, perhaps roughly as frequent as modafinil. Another problem is that nicotine has a half-life of merely 1-2 hours, making regular dosing a requirement. There is also some elevated heart-rate/blood-pressure often associated with nicotine, which may be a concern. (Possible alternatives to nicotine include cytisine, 2’-methylnicotine, GTS-21, galantamine, Varenicline, WAY-317,538, EVP-6124, and Wellbutrin, but none have emerged as clearly superior.)
Although piracetam has a history of “relatively few side effects,” it has fallen far short of its initial promise for treating any of the illnesses associated with cognitive decline, according to Lon Schneider, a professor of psychiatry and behavioral sciences at the Keck School of Medicine at the University of Southern California. “We don’t use it at all and never have.”
The evidence? Found helpful in reducing bodily twitching in myoclonus epilepsy, a rare disorder, but otherwise little studied. Mixed evidence from a study published in 1991 suggests it may improve memory in subjects with cognitive impairment. A meta-analysis published in 2010 that reviewed studies of piracetam and other racetam drugs found that piracetam was somewhat helpful in improving cognition in people who had suffered a stroke or brain injury; the drugs’ effectiveness in treating depression and reducing anxiety was more significant.
Table 1 shows all of the studies of middle school, secondary school, and college students that we identified. As indicated in the table, the studies are heterogeneous, with varying populations sampled, sample sizes, and year of data collection, and they focused on different subsets of the epidemiological questions addressed here, including prevalence and frequency of use, motivations for use, and method of obtaining the medication.
Many people find that they experience increased “brain fog” as they age, some of which could be attributed to early degeneration of synapses and neural pathways. Some drugs have been found to be useful for providing cognitive improvements in these individuals. It’s possible that these supplements could provide value by improving brain plasticity and supporting the regeneration of cells.10
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If smart drugs are the synthetic cognitive enhancers, sleep, nutrition and exercise are the "natural" ones. But the appeal of drugs like Ritalin and modafinil lies in their purported ability to enhance brain function beyond the norm. Indeed, at school or in the workplace, a pill that enhanced the ability to acquire and retain information would be particularly useful when it came to revising and learning lecture material. But despite their increasing popularity, do prescription stimulants actually enhance cognition in healthy users?


On the other metric, suppose we removed the creatine? Dropping 4 grams of material means we only need to consume 5.75 grams a day, covered by 8 pills (compared to 13 pills). We save 5,000 pills, which would have cost $45 and also don’t spend the $68 for the creatine; assuming a modafinil formulation, that drops our $1761 down to $1648 or $1.65 a day. Or we could remove both the creatine and modafinil, for a grand total of $848 or $0.85 a day, which is pretty reasonable.
Proteus Digital Health (Redwood City, Calif.) offers an FDA-approved microchip—an ingestible pill that tracks medication-taking behavior and how the body is responding to medicine. Through the company’s Digital Health Feedback System, the sensor monitors blood flow, body temperature and other vital signs for people with heart problems, schizophrenia or Alzheimer’s disease.
I do recommend a few things, like modafinil or melatonin, to many adults, albeit with misgivings about any attempt to generalize like that. (It’s also often a good idea to get powders, see the appendix.) Some of those people are helped; some have told me that they tried and the suggestion did little or nothing. I view nootropics as akin to a biological lottery; one good discovery pays for all. I forge on in the hopes of further striking gold in my particular biology. Your mileage will vary. All you have to do, all you can do is to just try it. Most of my experiences were in my 20s as a right-handed 5’11 white male weighing 190-220lbs, fitness varying over time from not-so-fit to fairly fit. In rough order of personal effectiveness weighted by costs+side-effects, I rank them as follows:
The abuse liability of caffeine has been evaluated.147,148 Tolerance development to the subjective effects of caffeine was shown in a study in which caffeine was administered at 300 mg twice each day for 18 days.148 Tolerance to the daytime alerting effects of caffeine, as measured by the MSLT, was shown over 2 days on which 250 g of caffeine was given twice each day48 and to the sleep-disruptive effects (but not REM percentage) over 7 days of 400 mg of caffeine given 3 times each day.7 In humans, placebo-controlled caffeine-discontinuation studies have shown physical dependence on caffeine, as evidenced by a withdrawal syndrome.147 The most frequently observed withdrawal symptom is headache, but daytime sleepiness and fatigue are also often reported. The withdrawal-syndrome severity is a function of the dose and duration of prior caffeine use…At higher doses, negative effects such as dysphoria, anxiety, and nervousness are experienced. The subjective-effect profile of caffeine is similar to that of amphetamine,147 with the exception that dysphoria/anxiety is more likely to occur with higher caffeine doses than with higher amphetamine doses. Caffeine can be discriminated from placebo by the majority of participants, and correct caffeine identification increases with dose.147 Caffeine is self-administered by about 50% of normal subjects who report moderate to heavy caffeine use. In post-hoc analyses of the subjective effects reported by caffeine choosers versus nonchoosers, the choosers report positive effects and the nonchoosers report negative effects. Interestingly, choosers also report negative effects such as headache and fatigue with placebo, and this suggests that caffeine-withdrawal syndrome, secondary to placebo choice, contributes to the likelihood of caffeine self-administration. This implies that physical dependence potentiates behavioral dependence to caffeine.
Powders are good for experimenting with (easy to vary doses and mix), but not so good for regular taking. I use OO gel capsules with a Capsule Machine: it’s hard to beat $20, it works, it’s not that messy after practice, and it’s not too bad to do 100 pills. However, I once did 3kg of piracetam + my other powders, and doing that nearly burned me out on ever using capsules again. If you’re going to do that much, something more automated is a serious question! (What actually wound up infuriating me the most was when capsules would stick in either the bottom or top try - requiring you to very gingerly pull and twist them out, lest the two halves slip and spill powder - or when the two halves wouldn’t lock and you had to join them by hand. In contrast: loading the gel caps could be done automatically without looking, after some experience.)
^ Sattler, Sebastian; Forlini, Cynthia; Racine, Éric; Sauer, Carsten (August 5, 2013). "Impact of Contextual Factors and Substance Characteristics on Perspectives toward Cognitive Enhancement". PLOS ONE. 8 (8): e71452. Bibcode:2013PLoSO...871452S. doi:10.1371/journal.pone.0071452. ISSN 1932-6203. LCCN 2006214532. OCLC 228234657. PMC 3733969. PMID 23940757.
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