An additional complexity, related to individual differences, concerns dosage. This factor, which varies across studies and may be fixed or determined by participant body weight within a study, undoubtedly influences the cognitive effects of stimulant drugs. Furthermore, single-unit recordings with animals and, more recently, imaging of humans indicate that the effects of stimulant dose are nonmonotonic; increases enhance prefrontal function only up to a point, with further increases impairing function (e.g., Arnsten, 1998; Mattay et al., 2003; Robbins & Arnsten, 2009). Yet additional complexity comes from the fact that the optimal dosage depends on the same kinds of individual characteristics just discussed and on the task (Mattay et al., 2003).
As shown in Table 6, two of these are fluency tasks, which require the generation of as large a set of unique responses as possible that meet the criteria given in the instructions. Fluency tasks are often considered tests of executive function because they require flexibility and the avoidance of perseveration and because they are often impaired along with other executive functions after prefrontal damage. In verbal fluency, subjects are asked to generate as many words that begin with a specific letter as possible. Neither Fleming et al. (1995), who administered d-AMP, nor Elliott et al. (1997), who administered MPH, found enhancement of verbal fluency. However, Elliott et al. found enhancement on a more complex nonverbal fluency task, the sequence generation task. Subjects were able to touch four squares in more unique orders with MPH than with placebo.
One symptom of Alzheimer's disease is a reduced brain level of the neurotransmitter called acetylcholine. It is thought that an effective treatment for Alzheimer's disease might be to increase brain levels of acetylcholine. Another possible treatment would be to slow the death of neurons that contain acetylcholine. Two drugs, Tacrine and Donepezil, are both inhibitors of the enzyme (acetylcholinesterase) that breaks down acetylcholine. These drugs are approved in the US for treatment of Alzheimer's disease.
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.
With the right lifestyle and the right stack of supplements and nootropics, you can enjoy enhanced mental clarity, easier flow, and better vision. The best nootropics for your needs will depend on how much you want to spend, how often you want to take them, and what you want to take them for. Nutritional supplements should be taken daily, for the cumulative effect, but Smart drugs such as noopept and modafinil are usually taken on an as-needed basis, for those times when you are aiming for hyperfocus, better clarity, and better recall, or the ability to process a huge amount of incoming visual information quickly and accurately and to pick up on details that you might otherwise miss.
The magnesium was neither randomized nor blinded and included mostly as a covariate to avoid confounding (the Noopept coefficient & t-value increase somewhat without the Magtein variable), so an OR of 1.9 is likely too high; in any case, this experiment was too small to reliably detect any effect (~26% power, see bootstrap power simulation in the magnesium section) so we can’t say too much.
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The main concern with pharmaceutical drugs is adverse effects, which also apply to nootropics with undefined effects. Long-term safety evidence is typically unavailable for nootropics. Racetams — piracetam and other compounds that are structurally related to piracetam — have few serious adverse effects and low toxicity, but there is little evidence that they enhance cognition in people having no cognitive impairments.