How do they work?
The research is still inconclusive on exactly how the drugs work to stimulate the mind, but early research indicates they may act on a variety of different systems within the body simultaneously. One explanation is that they may increase blood flow to the brain, which allows the brain to use more oxygen.4
Some nootropics may raise the body’s adrenalin levels and produce effects similar to drinking large amounts of caffeine, which means people can stay awake for extended periods of time.
Some drugs increase the amount of certain chemicals (neurotransmitters) such as dopamine, which are released in the part of the brain associated with dependence.
Types of nootropics
The drugs often used to enhance cognition can generally be divided into 3 groups: Eugaroics, ADHD medications and Nootropic Supplements.
Eugeroics
Eugeroics are a class of drugs that promote wakefulness and alertness. The most commonly used Eugeroic drug that is used to improve cognition is Modafinil.
Brand names: Modavigil®, Modafin®, Nuvigil®
The drug was introduced in the late 1990s to treat narcolepsy, obstructive sleep apnea and shift work sleep disorder. Modafinil promotes wakefulness and alertness and may have some value in treating stimulant withdrawal and could be effective in decreasing drug craving and dependence. However, further research is needed.5,6
Side effects
Use of any drug can have risks. It’s important to be careful when taking any type of drug.
Modafinil affects everyone differently, but the most common side effects include:
- increased alertness and focus
- reduced fatigue
- anxiety
- headache
- pins and needles
- chest pains
- dizziness
- sleeplessness
- nausea
- nervousness.4
Long-term effects
Research into nootropics is still limited which means there is a lot of uncertainty about the side effects the drugs may cause if used on an ongoing basis. It is recommended that these drugs are used only with a prescription from a medical practitioner to avoid any potential harms.
ADHD medications
Types of ADHD medications used as nootropics include:
Methylphenidate, Lisdexamphetamine, Dexamfetamine
Brand names: Ritalin®, Ritalin la®, Concerta®, Ritalin 10®, Dexamphetamine tablets®, Vyvanse®
Ritalin was introduced during the 1950s to treat chronic fatigue, depression, and psychosis associated with depression. It was used extensively in the 1990s to treat ADHD and is now the most common psychotropic medication prescribed to children in the United States and Australia to treat restlessness, impulsive behaviour and inattentiveness.7 New research has explored the potential side effects of using Ritalin® by people without ADHD—such as students using it as a study enhancer. This research showed changes in brain chemistry associated with risk-taking behaviour, sleep disruption and other undesirable effects such as weight loss.8
Side effects
Use of any drug can have risks. It’s important to be careful when taking any type of drug.
Methylphenidate affects everyone differently, but the most common side effects may include:
- euphoria and heightened sense of well-being
- high body temperature
- cardiovascular system failure
- hostility or paranoia
- irregular or increased heartbeat and palpitations
- increased blood pressure and respiration
- increased activity, talkativeness and alertness
- reduced fatigue, drowsiness and appetite
- dry mouth, dilated pupils, nausea and headaches
- increased sex drive
- feelings of cleverness, great competence, and power.9
Long-term side effects
Regular use may eventually cause:
- rapid or irregular heartbeat, high blood pressure and potential inflammation of heart valves
- skin disorders, vitamin deficiency, flushed or pale skin
- stomach ulcers and malnutrition
- mental health and behavioural problems
- dizziness and difficulty breathing
- loss of coordination and physical collapse
- unusual tiredness or weakness
- repetitive physical actions
- convulsions, coma, and death.9,10
Nootropic supplements
Certain B vitamins, fish oil and herbal supplements (such as Gingko biloba and extracts of Bacopa monnieri) may offer a safer option to pharmaceutical drugs to enhance cognitive performance. The benefits may not be as immediate but the effects are reportedly much longer lasting.11 The most commonly used nootropic supplements are CILTEP® and Alpha Brain®. However, the American Medical Association has advised that a number of products being advertised as nootropic supplements have not been examined in terms of safety and efficacy.
Modafinil and is a Schedule 4 substance that can only be prescribed by a doctor or dentist in the ordinary course of their professions.
Methylphenidate is a Schedule 8 drug which means doctors must follow state and territory laws when prescribing it and must notify, or receive approval from, the appropriate health authority.
Using modafinil or methylphenidate without a prescription from a doctor, or selling or giving them to someone else, is illegal. There are also laws against forging or altering a prescription or making false representation to obtain pharmaceuticals or a prescription for them.2
See also, drugs and the law.
- Upfal J. Australian Drug Guide Melbourne 2016
- Hall W, & Lucke J. The enhancement use of neuropharmaceuticals: More scepticism and caution needed Addiction 2010 105(12):2041-3.
- De Jongh R, Bolt I, Schermer M, & Olivier B. Botox for the brain: enhancement of cognition, mood and pro-social behavior and blunting of unwanted memories. Neuroscience & Biobehavioral Reviews. 2008;32(4):760-76.
- Urban K, Gao W. Performance enhancement at the cost of potential brain plasticity: neural ramifications of nootropic drugs in the healthy developing brain. . Frontiers in systems neuroscience,. 2014(8).
- Baker A, Lee N, Jenner L. Models of intervention and care for psychostimulant users. Canberra: Australian Government Department of Health and Ageing.; 2004.
- Lashkaripour M, Adibi A, Mahhadi F, Dashipor A. Modafinil for the Treatment of Methamphetamine Dependence. Drug and Alcohol Dependence. 2016;120:135-41.
- Keane H. Pleasure and discipline in the uses of Ritalin. International Journal of Drug Policy 2008;19(5):401-9.
- Robison L, Ananth M, Hadjiargyrou M, Thanos P. Chronic oral methylphenidate treatment reversibly increases striatal dopamine transporter and dopamine type 1 receptor binding in rats. Journal of neural transmission. 2017;124(5):655-67.
- Novartis, Pharmaceuticals. Ritalin 10 Consumer Medicine Information n.d.
- Trenque T, Herlem E, Taam M, Drame M. Methylphenidate off-label use and safety. Springer Plus 2014 3(1):286.
- Neale C, Camfield D, Reay J, Stough C, Scholey A. Cognitive effects of two nutraceuticals Ginseng and Bacopa benchmarked against modafinil: a review and comparison of effect sizes. British Journal of Clincal Pharmacology. 2013;75(3):728-37.