C.T.E., Technology

Investigating the Validity of Smart Drugs

 January 22, 2018

By  Deborah L Weiner Katz, OTR/L, CCM, CLCP

We write a great deal about conditions that diminish the capacity of the brain, such as traumatic brain injury or Alzheimer’s disease, but we have yet to write about boosting that capacity. Have you heard of nootropics? We read about these so-called “smart drugs” that come in the form of pills or supplements, and decided to investigate further.

According to this report, the nootropics industry was already a billion dollar industry in 2015. It is expected to grow to six times that amount by 2024. Different nootropics are designed to enhance specific aspects of cognition. These include reaction time, working memory and mental stamina. Some nootropics positively affect components that control neuron growth. Others increase the availability of substances necessary for brain function.

Business may be good but the scientific community is not convinced. Physicians are concerned about potential misuse and adverse consequences. In a press release dated June 14, 2016, the American Medical Association adopted a new policy discouraging the non-medical use of prescription drugs for cognitive enhancement in healthy individuals. They are concerned about the temptation to use these drugs to gain a competitive edge over others at work or in school.

Prescription stimulants carry real risks. The cognitive effects vary from person to person. They are dose-dependent and fairly limited in healthy individuals. However, nootropics also include food substances found in chocolate and green tea. They can be extracted from medicinal plants and purified. Nootropics can also be synthesized from piracetam, which is regarded as the world’s first nootropic. It is a cognitive enhancer used to treat neurological diseases, created by a team of Belgian scientists in 1964.

There are actually seven types of nootropics that have been classified. The ones that are most commonly referred to as smart drugs are the most commonly abused. Think of caffeine and Adderall. One is a stimulant that students and professionals use to boost productivity. The other is caffeine. Forget coffee jokes, there is actually a nationwide shortage of Adderall at the moment. Its legal use is intended for children with ADHAD but according to the FDA, adult abusers are responsible for the shortage.  The agency claims to have produced enough of its active ingredient, an amphetamine, to satisfy all legal demand. That is why it halted delivery of the ingredient to drug manufacturers, hence the shortage.

Are nootropics a legitimate pursuit? On one hand, the word ‘shortcut’ comes to mind but how is that different from so many other heights and enhancements pursued by your average American? As medical professionals, we recommend taking the time to weigh the risks and rewards. A $6 billion dollar industry is bound to produce a good product but it is just as likely to flood the market with disappointments.


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