Since dietary supplements do not require double-blind, placebo-controlled, pharmaceutical-style human studies before going to market, there is little incentive for companies to really prove that something does what they say it does. This means that, in practice, nootropics may not live up to all the grandiose, exuberant promises advertised on the bottle in which they come. The flip side, though? There’s no need to procure a prescription in order to try them out. Good news for aspiring biohackers—and for people who have no aspirations to become biohackers, but still want to be Bradley Cooper in Limitless (me).
The information learned in the tasks reviewed so far was explicit, declarative, and consistent within each experiment. In contrast, probabilistic and procedural learning tasks require the subject to gradually extract a regularity in the associations among stimuli from multiple presentations in which the correct associations are only presented some of the time, with incorrect associations also presented. Findings are mixed in these tasks. Breitenstein and colleagues (2004, 2006) showed subjects drawings of common objects accompanied by nonsense word sounds in training sessions that extended over multiple days. They found faster learning of the to-be-learned, higher probability pairings between sessions (consistent with enhanced retention over longer delays). Breitenstein et al. (2004) found that this enhancement remained a year later. Schlösser et al. (2009) tested subjects’ probabilistic learning ability in the context of a functional magnetic resonance imaging (fMRI) study, comparing performance and brain activation with MPH and placebo. MPH did not affect learning performance as measured by accuracy. Although subjects were overall faster in responding on MPH, this difference was independent of the difficulty of the learning task, and the authors accordingly attributed it to response processes rather than learning.
There is no clear answer to this question. Many of the smart drugs have decades of medical research and widespread use behind them, as well as only minor, manageable, or nonexistent side effects, but are still used primarily as a crutch for people already experiencing cognitive decline, rather than as a booster-rocket for people with healthy brains. Unfortunately, there is a bias in Western medicine in favor of prescribing drugs once something bad has already begun, rather than for up-front prevention. There’s also the principle of “leave well enough alone” – in this case, extended to mean, don’t add unnecessary or unnatural drugs to the human body in place of a normal diet. [Smart Drug Smarts would argue that the average human diet has strayed so far from what is physiologically “normal” that leaving well enough alone is already a failed proposition.]
This research is in contrast to the other substances I like, such as piracetam or fish oil. I knew about withdrawal of course, but it was not so bad when I was drinking only tea. And the side-effects like jitteriness are worse on caffeine without tea; I chalk this up to the lack of theanine. (My later experiences with theanine seems to confirm this.) These negative effects mean that caffeine doesn’t satisfy the strictest definition of nootropic (having no negative effects), but is merely a cognitive enhancer (with both benefits & costs). One might wonder why I use caffeine anyway if I am so concerned with mental ability.
Medication can be ineffective if the drug payload is not delivered at its intended place and time. Since an oral medication travels through a broad pH spectrum, the pill encapsulation could dissolve at the wrong time. However, a smart pill with environmental sensors, a feedback algorithm and a drug release mechanism can give rise to smart drug delivery systems. This can ensure optimal drug delivery and prevent accidental overdose.
Feeling behind, I resolved to take some armodafinil the next morning, which I did - but in my hurry I failed to recall that 200mg armodafinil was probably too much to take during the day, with its long half life. As a result, I felt irritated and not that great during the day (possibly aggravated by some caffeine - I wish some studies would be done on the possible interaction of modafinil and caffeine so I knew if I was imagining it or not). Certainly not what I had been hoping for. I went to bed after midnight (half an hour later than usual), and suffered severe insomnia. The time wasn’t entirely wasted as I wrote a short story and figured out how to make nicotine gum placebos during the hours in the dark, but I could have done without the experience. All metrics omitted because it was a day usage.
Let's start with the basics of what smart drugs are and what they aren't.  The field of cosmetic psychopharmacology is still in its infancy, but the use of smart drugs is primed to explode during our lifetimes, as researchers gain increasing understanding of which substances affect the brain and how they do so.  For many people, the movie Limitless was a first glimpse into the possibility of "a pill that can make you smarter," and while that fiction is a long way from reality, the possibilities - in fact, present-day certainties visible in the daily news - are nevertheless extremely exciting.
One fairly powerful nootropic substance that, appropriately, has fallen out of favor is nicotine. It’s the chemical that gives tobacco products their stimulating kick. It isn’t what makes them so deadly, but it does make smoking very addictive. When Europeans learned about tobacco’s use from indigenous tribes they encountered in the Americas in the 15th and 16th centuries, they got hooked on its mood-altering effects right away and even believed it could cure joint pain, epilepsy, and the plague. Recently, researchers have been testing the effects of nicotine that’s been removed from tobacco, and they believe that it might help treat neurological disorders including Parkinson’s disease and schizophrenia; it may also improve attention and focus. But, please, don’t start smoking or vaping. Check out these 14 weird brain exercises that make you smarter.

For illustration, consider amphetamines, Ritalin, and modafinil, all of which have been proposed as cognitive enhancers of attention. These drugs exhibit some positive effects on cognition, especially among individuals with lower baseline abilities. However, individuals of normal or above-average cognitive ability often show negligible improvements or even decrements in performance following drug treatment (for details, see de Jongh, Bolt, Schermer, & Olivier, 2008). For instance, Randall, Shneerson, and File (2005) found that modafinil improved performance only among individuals with lower IQ, not among those with higher IQ. [See also Finke et al 2010 on visual attention.] Farah, Haimm, Sankoorikal, & Chatterjee 2009 found a similar nonlinear relationship of dose to response for amphetamines in a remote-associates task, with low-performing individuals showing enhanced performance but high-performing individuals showing reduced performance. Such ∩-shaped dose-response curves are quite common (see Cools & Robbins, 2004)
Piracetam is a reliable supplement for improving creativity. It is an entry level racetam due to its lack of severe side effects and relative subtlety. Piracetam’s effects take hold over time through continual use. There is less instant gratification compared to other brain enhancers. Additionally, this nootropic can enhance holistic thinking, verbal memory, and mental energy levels.
“I cannot overstate how grateful I am to Cavin for having published this book (and launched his podcast) before I needed it. I am 3.5 months out from a concussion and struggling to recover that final 25% or so of my brain and function. I fully believe that diet and lifestyle can help heal many of our ills, and this book gives me a path forward right now. Gavin’s story is inspiring, and his book is well-researched and clearly written. I am a food geek and so innately understand a lot of his advice — I’m not intimidated by the thought of drastically changing my diet because I know well how to shop and cook for myself — but I so appreciate how his gentle approach and stories about his own struggles with a new diet might help people who would find it all daunting. I am in week 2 of following his advice (and also Dr. Titus Chiu’s BrainSave plan). It’s not an instantaneous miracle cure, but I do feel better in several ways that just might be related to this diet.”
Federal law classifies most nootropics as dietary supplements, which means that the Food and Drug Administration does not regulate manufacturers’ statements about their benefits (as the giant “This product is not intended to diagnose, treat, cure, or prevent any disease” disclaimer on the label indicates). And the types of claims that the feds do allow supplement companies to make are often vague and/or supported by less-than-compelling scientific evidence. “If you find a study that says that an ingredient caused neurons to fire on rat brain cells in a petri dish,” says Pieter Cohen, an assistant professor at Harvard Medical School, “you can probably get away with saying that it ‘enhances memory’ or ‘promotes brain health.’”
Not all drug users are searching for a chemical escape hatch. A newer and increasingly normalized drug culture is all about heightening one’s current relationship to reality—whether at work or school—by boosting the brain’s ability to think under stress, stay alert and productive for long hours, and keep track of large amounts of information. In the name of becoming sharper traders, medical interns, or coders, people are taking pills typically prescribed for conditions including ADHD, narcolepsy, and Alzheimer’s. Others down “stacks” of special “nootropic” supplements.
It can easily pass through the blood-brain barrier and is known to protect the nerve tissues present in the brain. There is evidence that the acid plays an instrumental role in preventing strokes in adults by decreasing the number of free radicals in the body.  It increases the production of acetylcholine, a neurotransmitter that most Alzheimer’s patients are a deficit in.
There is evidence to suggest that modafinil, methylphenidate, and amphetamine enhance cognitive processes such as learning and working memory...at least on certain laboratory tasks. One study found that modafinil improved cognitive task performance in sleep-deprived doctors. Even in non-sleep deprived healthy volunteers, modafinil improved planning and accuracy on certain cognitive tasks. Similarly, methylphenidate and amphetamine also enhanced performance of healthy subjects in certain cognitive tasks.

These days, nootropics are beginning to take their rightful place as a particularly powerful tool in the Neurohacker’s toolbox. After all, biochemistry is deeply foundational to neural function. Whether you are trying to fix the damage that is done to your nervous system by a stressful and toxic environment or support and enhance your neural functioning, getting the chemistry right is table-stakes. And we are starting to get good at getting it right. What’s changed?
70 pairs is 140 blocks; we can drop to 36 pairs or 72 blocks if we accept a power of 0.5/50% chance of reaching significance. (Or we could economize by hoping that the effect size is not 3.5 but maybe twice the pessimistic guess; a d=0.5 at 50% power requires only 12 pairs of 24 blocks.) 70 pairs of blocks of 2 weeks, with 2 pills a day requires (70 \times 2) \times (2 \times 7) \times 2 = 3920 pills. I don’t even have that many empty pills! I have <500; 500 would supply 250 days, which would yield 18 2-week blocks which could give 9 pairs. 9 pairs would give me a power of:
Talk to your doctor, too, before diving in "to ensure that they do not conflict with current meds or cause a detrimental effect," Hohler says. You also want to consider what you already know about your health and body – if you have anxiety or are already sensitive to caffeine, for example, you may find that some of the supplements work a little too well and just enhance anxiety or make it difficult to sleep, Barbour says. Finances matter, too, of course: The retail price for Qualia Mind is $139 for 22 seven-capsule "servings"; the suggestion is to take one serving a day, five days a week. The retail price for Alpha Brain is $79.95 for 90 capsules; adults are advised to take two a day.
Remember: The strictest definition of nootropics today says that for a substance to be a true brain-boosting nootropic it must have low toxicity and few side effects. Therefore, by definition, a nootropic is safe to use. However, when people start stacking nootropics indiscriminately, taking megadoses, or importing them from unknown suppliers that may have poor quality control, it’s easy for safety concerns to start creeping in.
When I worked on the Bulletproof Diet book, I wanted to verify that the effects I was getting from Bulletproof Coffee were not coming from modafinil, so I stopped using it and measured my cognitive performance while I was off of it. What I found was that on Bulletproof Coffee and the Bulletproof Diet, my mental performance was almost identical to my performance on modafinil. I still travel with modafinil, and I’ll take it on occasion, but while living a Bulletproof lifestyle I rarely feel the need.
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