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| '''Nootropics''' ({{IPAc-en|n|oʊ|.|ə|ˈ|t|r|ɒ|p|ɨ|k|s}} {{respell|noh-ə|TROP|iks}}), also referred to as ''smart drugs'', ''memory enhancers'', ''neuro enhancers'', ''cognitive enhancers'', and ''intelligence enhancers'', are ]s, ]s, ]s, and ]s that purportedly improve mental functions such as ], ], ], ], ], and concentration.<ref>{{Cite web|url=http://www.mercksource.com/pp/us/cns/cns_hl_dorlands.jspzQzpgzEzzSzppdocszSzuszSzcommonzSzdorlandszSzdorlandzSzdmd_n_10zPzhtm |title=Dorlands Medical Dictionary |work= |accessdate= |archiveurl = http://web.archive.org/web/20080130031824/http://www.mercksource.com/pp/us/cns/cns_hl_dorlands.jspzQzpgzEzzSzppdocszSzuszSzcommonzSzdorlandszSzdorlandzSzdmd_n_10zPzhtm |archivedate = January 30, 2008}}</ref><ref>{{Cite journal|author=Lanni C, Lenzken SC, Pascale A, ''et al.'' |title=Cognition enhancers between treating and doping the mind |journal=Pharmacol. Res. |volume=57 |issue=3 |pages=196–213 |date=March 2008 |pmid=18353672 |doi=10.1016/j.phrs.2008.02.004 |url=}}</ref> The word ''nootropic'' was coined in 1972 by the ] Dr. ],<ref name="isbn0-06-088473-8">{{Cite book|author=Gazzaniga, Michael S. |title=The Ethical Brain: The Science of Our Moral Dilemmas (P.S.) |publisher=Harper Perennial |location=New York, N.Y |year=2006 |pages=184 |isbn=0-06-088473-8 |oclc= |doi= |accessdate=}}</ref><ref name="pmid4541214">{{Cite journal|author=Giurgea C |title= ("Vers une pharmacologie de l'active integrative du cerveau: Tentative du concept nootrope en psychopharmacologie") |language=French |journal=Actual Pharmacol (Paris) |volume=25 |issue= |pages=115–56 |year=1972 |pmid=4541214 |doi= |url=}}</ref> derived from the ] words νους ''nous'', or "mind," and τρέπειν ''trepein'' meaning "to bend/turn". Nootropics are thought to work by altering the availability of the ] supply of neurochemicals (], ], and ]), by improving the brain's ] supply, or by stimulating nerve growth. | |||
| ==Availability and prevalence== | |||
| At present, there are several drugs on the market that improve memory, concentration, and planning, and reduce impulsive behavior. Many more are in different stages of development.<ref name=NatureProfessor>{{Cite journal|author1=Sahakian B|author1-link=Barbara Sahakian|author2=Morein-Zamir S |title=Professor's little helper |journal=Nature |volume=450 |issue=7173 |pages=1157–9 |date=December 2007 |pmid=18097378 |doi=10.1038/4501157a |url=|bibcode = 2007Natur.450.1157S }}</ref> The most commonly used class of drug is ].<ref name="Nature2008">{{cite journal |url=http://www.nature.com/nature/journal/v456/n7223/full/456702a.html |title=Towards responsible use of cognitive-enhancing drugs by the healthy |work=] |date=December 10, 2008 |publisher=] |issn=1476-4687 |oclc=01586310 |bibcode = 2008Natur.456..702G |accessdate=March 25, 2014 |doi=10.1038/456702a |pages=702–705 |volume=456 |issue=7223 |subscription=yes |first1=Henry |last1=Greely |first2=Barbara |last2=Sahakian |first3=John |last3=Harris |first4=Ronald C. |last4=Kessler |first5=Michael |last5=Gazzaniga |first6=Philip |last6=Campbell |first7=Martha J. |last7=Farah}}</ref> | |||
| These drugs are used primarily to treat people with cognitive or motor function difficulties attributable to such disorders as ], ], ] and ]. However, more widespread use is being recommended by some researchers.<ref>{{Cite web|url=http://blogs.dnalc.org/2009/09/21/smart-drugs-and-should-we-take-them/|title=Smart Drugs and Should We Take Them?|publisher=]|accessdate=November 4, 2012}}</ref> These drugs have a variety of ] applications as well, and are marketed heavily on the ]. Nevertheless, intense marketing may not correlate with ]; while scientific studies support the beneficial effects of some compounds, the marketing claims by manufacturers of ] products are not formally tested. | |||
| ===Academic doping=== | |||
| {{main|Academic doping}} | |||
| In academia, ] has been used to increase productivity, although its long-term effects have not been assessed in healthy individuals.<ref name=NatureProfessor/> Stimulants such as ] and ] are used on college campuses and by younger groups.<ref name=NatureProfessor/> One survey found that 7% of students had used stimulants for a cognitive edge, and on some campuses use in the past year is as high as 25%.<ref name=Nature2008/><ref name=StudentSurvey>{{cite journal|last=McCabe|first=Sean Esteban|coauthors=Knight, John R.; Teter, Christian J.; Wechsler, Henry|title=Non-medical use of prescription stimulants among US college students: prevalence and correlates from a national survey|journal=Addiction|date=January 1, 2005|volume=100|issue=1|pages=96–106|doi=10.1111/j.1360-0443.2005.00944.x|pmid=15598197|url=http://www.ncbi.nlm.nih.gov/pubmed/15598197|accessdate=August 15, 2013}}</ref> The use of prescription stimulants is especially prevalent among students attending academically competitive colleges and students who are members of a fraternity or sorority.<ref name=StudentSurvey/> | |||
| Surveys suggest that 3–11% of American students and 0.7–4.5% of German students have used cognitive enhancers in their lifetime.<ref name="doi10.1371/journal.pone.0068821">{{cite doi|10.1371/journal.pone.0068821}}</ref><ref name="C4WDefault-10.3109/10826084.2012.751426">{{cite journal |url=http://informahealthcare.com/doi/abs/10.3109/10826084.2012.751426 |title=Cognitive Test Anxiety and Cognitive Enhancement: The Influence of Students’ Worries on Their Use of Performance-Enhancing Drugs |work=Substance Use & Misuse |volume = 48 |number = 3 |pages=220–232 |date=February 25, 2013 |publisher=Informa Healthcare New York |accessdate=April 5, 2014 |doi=10.3109/10826084.2012.751426 |first1=Sebastian |last1=Sattler |first2=Constantin |last2=Wiegel}}</ref> | |||
| Several factors positively and negatively influence the use of drugs to increase cognitive performance. Among them are personal characteristics, drug characteristics, and characteristics of the social context.<ref name="doi10.1371/journal.pone.0068821"/><ref name="C4WDefault-10.3109/10826084.2012.751426"/><ref name="C4WDefault-10.1186/1747-597X-9-8">{{cite web |url=http://www.substanceabusepolicy.com/content/9/1/8 |title=Evaluating the drivers of and obstacles to the willingness to use cognitive enhancement drugs: the influence of drug characteristics, social environment, and personal characteristics |date=February 1, 2014 |publisher=BioMed Central Ltd |issn=1747-597X |accessdate=April 5, 2014 |doi=10.1186/1747-597X-9-8 |issue=1 |volume=9 |page=8 |journal=Substance Abuse Treatment, Prevention, and Policy |first1=Sebastian |last1=Sattler |first2=Guido |last2=Mehlkop |first3=Peter |last3=Graeff |first4=Carsten |last4=Sauer}}</ref><ref name="PLOS ONE-10.1371/journal.pone.0071452">{{cite journal |url=http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0071452 |title=Impact of Contextual Factors and Substance Characteristics on Perspectives toward Cognitive Enhancement |date=August 5, 2013 |publisher=] |issn=1932-6203 |oclc=228234657 |accessdate=April 5, 2014 |journal=] |lccn=2006214532 |doi=10.1371/journal.pone.0071452 |issue=8 |volume=8 |page=e71452 |first1=Sebastian |last1=Sattler |first2=Cynthia |last2=Forlini |first3=Éric |last3=Racine |first4=Carsten |last4=Sauer}}</ref> | |||
| ==Hazards== | |||
| The main concern with ]s is ]s, and these concerns apply to cognitive-enhancing drugs as well. Cognitive enhancers are often taken for the long-term when little data is available.<ref name=NatureProfessor/> While certain ] compounds are suspected to have nootropic qualities, few side-effects, and a wide ] (low overdose risk),<ref name=BetterBrain>{{Cite journal|author=Malik R, Sangwan A, Saihgal R, Jindal DP, Piplani P |title=Towards better brain management: nootropics |journal=Curr. Med. Chem. |volume=14 |issue=2 |pages=123–31 |year=2007 |pmid=17266573 |doi= 10.2174/092986707779313408|url=http://www.bentham-direct.org/pages/content.php?CMC/2007/00000014/00000002/0001C.SGM}}</ref> other cognitive enhancers may be associated with a high incidence of adverse effects or a narrower therapeutic window (higher overdose risk). While addiction to stimulants is sometimes asserted to be a cause for concern,<ref name="pmid23164208">{{cite journal | author = Noble KA | title = Brain gain: adolescent use of stimulants for achievement | journal = J. Perianesth. Nurs. | volume = 27 | issue = 6 | pages = 415–9 |date=December 2012 | pmid = 23164208 | doi = 10.1016/j.jopan.2012.09.001 | url = }}</ref> a very large body of research on the therapeutic use of the "more addictive" psychostimulants indicate that addiction is fairly rare in therapeutic doses.<ref name="EncycOfPsychopharm">{{Cite book | author = Stolerman IP | editor = Stolerman IP | title = Encyclopedia of Psychopharmacology | year = 2010 | publisher = Springer | location = Berlin; London | isbn = 9783540686989 | page = 78}}</ref><ref name="Westfall">{{cite book | editor = Brunton LL, Chabner BA, Knollmann BC | title = Goodman & Gilman's Pharmacological Basis of Therapeutics | year = 2010 | publisher = McGraw-Hill | location = New York | isbn = 9780071624428 | author = Westfall DP, Westfall TC | section = Miscellaneous Sympathomimetic Agonists | sectionurl = http://www.accessmedicine.com/content.aspx?aID=16661601 | edition = 12th }}</ref><ref name="FDA Abuse & OD">{{cite web | title = Adderall XR Prescribing Information | url = http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021303s026lbl.pdf | page = 11 | work = United States Food and Drug Administration |date=December 2013 | accessdate = December 30, 2013 }}</ref> | |||
| In the United States, ] or dietary supplements do not require safety or efficacy approval before being sold.<ref>{{Cite journal|author=Goldman P |title=Herbal medicines today and the roots of modern pharmacology |journal=Annals of Internal Medicine |volume=135 |issue=8 Pt 1 |pages=594–600 |year=2001 |pmid=11601931 |doi=10.7326/0003-4819-135-8_Part_1-200110160-00010}}</ref> | |||
| ==Drugs== | |||
| ===Vitamins and supplements=== | |||
| * ] – may influence cognitive function through an effect on ] and ] levels, as excess homocysteine has been associated with cognitive impairment and the B vitamins work to reduce homocysteine.<ref name=Selhub2000>{{cite journal |author= Selhub J, Bagley L, Miller J, Rosenberg I |title=B vitamins, homocysteine, and neurocognitive function in the elderly |journal=American Journal of Clinical Nutrition |volume=71 |issue=2 |pages=614S–620s |year=2000 |pmid=10681269}}</ref> A 2008 systematic review of trials found "little evidence of a beneficial impact" from supplements on cognitive function later in life.<ref>{{cite journal |author=Jia X, McNeill G, Avenell A |title=Does taking vitamin, mineral and fatty acid supplements prevent cognitive decline? A systematic review of randomized controlled trials |journal=J Hum Nutr Diet |volume=21 |issue=4 |pages=317–36 |date=August 2008 |pmid=18721399 |doi=10.1111/j.1365-277X.2008.00887.x |url=}}</ref> | |||
| * ] (a ]) with ] and ] (]s) – concurrent supplemental use can protect and potentially improve brain function.<ref name="Review1">{{cite journal | author = Kidd PM | title = Omega-3 DHA and EPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids | journal = Altern Med Rev | volume = 12 | issue = 3 | pages = 207–27 |date=September 2007 | pmid = 18072818 | doi = | url = }}</ref><ref name="RCT1">{{cite journal | author = Manor I, Magen A, Keidar D, Rosen S, Tasker H, Cohen T, Richter Y, Zaaroor-Regev D, Manor Y, Weizman A | title = The effect of phosphatidylserine containing Omega3 fatty-acids on attention-deficit hyperactivity disorder symptoms in children: a double-blind placebo-controlled trial, followed by an open-label extension | journal = Eur. Psychiatry | volume = 27 | issue = 5 | pages = 335–42 |date=July 2012 | pmid = 21807480 | doi = 10.1016/j.eurpsy.2011.05.004 | url = }}</ref> DHA and EPA are compounds that support brain function and ], especially during brain development.<ref>{{cite journal | author= Sheila M. Innis | title= Dietary (n-3) fatty acids and brain development | journal= The journal of nutrition | volume=137 | issue=4 |date=April 2007}}</ref> A ] and a more recent ] on supplemental phosphatidylserine with DHA and EPA indicate that there are clinical benefits for those with ADHD,<ref name="Review1" /><ref name="RCT1" /> in addition to a range of other clinical applications.<ref name="Review1" /> However, ] reviews on the use of supplemental omega-3 fatty acids alone (''without'' phosphatidylserine) indicate that there is limited evidence of treatment benefits for individuals with ADHD<ref name="Cochrane ADHD">{{cite journal | author = Gillies D, Sinn JKh, Lad SS, Leach MJ, Ross MJ | title = Polyunsaturated fatty acids (PUFA) for attention deficit hyperactivity disorder (ADHD) in children and adolescents | journal = Cochrane Database Syst Rev | volume = 7 | issue = | pages = CD007986 | year = 2012 | pmid = 22786509 | doi = 10.1002/14651858.CD007986.pub2 | url = }}</ref> or other learning disorders.<ref name="Cochrane LD">{{cite journal | author = Tan ML, Ho JJ, Teh KH | title = Polyunsaturated fatty acids (PUFAs) for children with specific learning disorders | journal = Cochrane Database Syst Rev | volume = 12 | issue = | pages = CD009398 | year = 2012 | pmid = 23235675 | doi = 10.1002/14651858.CD009398.pub2 | url = }}</ref> A Norwegian study demonstrated a ''potential'' link between Omega-3 consumption during pregnancy and child intelligence test scores.<ref>''Pediatrics''. 2003 Jan;111(1) e39–44</ref><ref name="Chillot">Prevention Chillot yr.2004 vol.56 iss.1 pg. 122–129</ref> | |||
| * ] – has positive effects on cardiovascular health and may have positive effects on cognitive function separately; the active form of Vitamin D seems to be involved in brain development and in adult brain function. In particular, metabolic pathways for Vitamin D in the hippocampus and cerebellum have been found. Epidemiological data show that higher Vitamin D levels (>20 ng/mL or 50 nmol/L) are associated with better cognitive function, but do not seem to be associated with better memory performance.<ref>{{cite journal |author=Buell JS, Scott TM, Dawson-Hughes B, Dallal GE, Rosenberg IH, Folstein MF, Tucker KL |title=Vitamin D is associated with cognitive function in elders receiving home health services |journal=J Gerontol a Biol Sci Med Sci. |volume=64 |issue=8 |pages=888–95 |date=Aug 2009 |pmid=19377013 |url= |doi=10.1093/gerona/glp032 |pmc=2981461}}</ref> Vitamin D has also been shown to be necessary in the production of ].<ref>{{cite web | author=Thomas H. J. Burne, PhD | title= vitamin d and the brain |date=May 2013 | website= http://chemistry.beloit.edu/Ordman/nutrition/aln13/1305lpi.htm}}</ref> | |||
| ===Stimulants=== | |||
| ] are often seen as ''smart drugs,'' but may be more accurately termed ''productivity enhancers.'' These typically improve concentration and a few areas of cognitive performance, but only while the drug is still in the blood at therapeutic concentrations. | |||
| * Anti-ADHD agents | |||
| ** ] pharmaceuticals (], ], and ] ]]) – ] agonists that mimic the effect of endogenous ].<ref name="Miller">{{cite journal | author = Miller GM | title = The emerging role of trace amine-associated receptor 1 in the functional regulation of monoamine transporters and dopaminergic activity | journal = J. Neurochem. | volume = 116 | issue = 2 | pages = 164–176 |date=January 2011 | pmid = 21073468 | pmc = 3005101 | doi = 10.1111/j.1471-4159.2010.07109.x }}</ref> Benefits in ] and ] are evident in the general population, and especially in individuals with ADHD.<ref name="Malenka_2009">{{cite book| author = Malenka RC, Nestler EJ, Hyman SE | editor = Sydor A, Brown RY | title = Molecular Neuropharmacology: A Foundation for Clinical Neuroscience | year = 2009 | publisher = McGraw-Hill Medical | location = New York | isbn = 9780071481274 | page = 318 | edition = 2nd | chapter = Chapter 13: Higher Cognitive Function and Behavioral Control | quote=Therapeutic (relatively low) doses of psychostimulants, such as methylphenidate and amphetamine, improve performance on working memory tasks both in in normal subjects and those with ADHD. Positron emission tomography (PET) demonstrates that methylphenidate decreases regional cerebral blood flow in the doroslateral prefrontal cortex and posterior parietal cortex while improving performance of a spacial working memory task. This suggests that cortical networks that normally process spatial working memory become more efficient in response to the drug. ... is now believed that dopamine and norepinephrine, but not serotonin, produce the beneficial effects of stimulants on working memory. At abused (relatively high) doses, stimulants can interfere with working memory and cognitive control ... stimulants act not only on working memory function, but also on general levels of arousal and, within the nucleus accumbens, improve the saliency of tasks. Thus, stimulants improve performance on effortful but tedious tasks ... through indirect stimulation of dopamine and norepinephrine receptors.}}</ref><ref name="cognition enhancers">{{cite journal | author = Bidwell LC, McClernon FJ, Kollins SH | title = Cognitive enhancers for the treatment of ADHD | journal = Pharmacol. Biochem. Behav. | volume = 99 | issue = 2 | pages = 262–274 |date=August 2011 | pmid = 21596055 | pmc = 3353150 | doi = 10.1016/j.pbb.2011.05.002 }}</ref> | |||
| ** ] – a ] that improves working memory and cognitive control.<ref name="Malenka_2009" /><ref name="cognition enhancers" /> | |||
| * ] – wakefulness promoting agents; increase alertness, particularly in ] individuals<ref name="Mod" /> | |||
| ** ]<ref name="Mod">{{cite journal | author = Mereu M, Bonci A, Newman AH, Tanda G | title = The neurobiology of modafinil as an enhancer of cognitive performance and a potential treatment for substance use disorders | journal = Psychopharmacology (Berl.) | volume = 229 | issue = 3 | pages = 415–34 |date=October 2013 | pmid = 23934211 | doi = 10.1007/s00213-013-3232-4 | url = }}</ref> | |||
| ** ]<ref name="Mod" /> | |||
| * ] A meta-analysis of 41 ], ]-controlled studies concluded that ] or smoking had significant positive effects on fine motor, alerting attention-accuracy and response time (RT), orienting attention-RT, short-term episodic memory-accuracy, and working memory-RT.<ref>{{cite journal |title=Meta-analysis of the acute effects of nicotine and smoking on human performance |author=Heishman SJ, Kleykamp BA, Singleton EG |journal=] |volume=210 |issue=4 |pages=453–69 |date=June 2010 |accessdate=March 23, 2012 |pmid=20414766 |pmc=3151730 |doi=10.1007/s00213-010-1848-1}}</ref> | |||
| *] – most notably, ] – shown to increase alertness, performance, and in some studies, memory.<ref>{{Cite journal| author = Rogers, P. |title = Caffeine, mood and mental performance in everyday life|journal = Psychology Today| volume = 32|issue = 1| pages = 84–89|year = 2007| accessdate = November 1, 2009| doi = 10.1111/j.1467-3010.2007.00607.x}}</ref> Children and adults who consume low doses of caffeine showed increase alertness, yet a higher dose was needed to improve performance.<ref name=Kiefer2007>{{Cite journal| author = Kiefer, I.|title = Brain Food|journal = Scientific American Mind| volume = 18|issue = 5| pages = 58–63|year = 2007| url = http://www.nature.com/scientificamericanmind/journal/v18/n5/full/scientificamericanmind1007-58.html| accessdate = November 1, 2009 | doi = 10.1038/scientificamericanmind1007-58 | |||
| }}</ref> | |||
| ===Miscellaneous=== | |||
| * ] and ] – ]s with neuroprotective properties, especially for those with ].<ref name="Neuroprotection review">{{cite journal | author = Naoi M, Maruyama W, Inaba-Hasegawa K | title = Revelation in the neuroprotective functions of rasagiline and selegiline: the induction of distinct genes by different mechanisms | journal = Expert Rev Neurother | volume = 13 | issue = 6 | pages = 671–84 |date=June 2013 | pmid = 23739004 | doi = 10.1586/ern.13.60 | url = }}</ref> | |||
| * ] – Tianeptine prevents stress-induced dendritic remodeling in various brain structures, enhances several metrics of cognition in animal models, and antagonizes alcohol's neurodegenerative effects.<ref name="pmid19704408">{{cite journal | author = McEwen BS, Chattarji S, Diamond DM, Jay TM, Reagan LP, Svenningsson P, Fuchs E | title = The neurobiological properties of tianeptine (Stablon): from monoamine hypothesis to glutamatergic modulation | journal = Mol. Psychiatry | volume = 15 | issue = 3 | pages = 237–49 |date=March 2010 | pmid = 19704408 | pmc = 2902200 | doi = 10.1038/mp.2009.80 | quote = Cognitive deficits, such as an impairment of attention, memory and problem solving, have often been reported in patients with depressive disorders (69). Cognitive deficits and memory impairments in patients with depression may arise via disruption of the hypothalamic-pituitary adrenal (HPA) axis through hippocampal volume loss and changes in the amygdala. The magnitude of the hippocampal shrinkage reported in certain experimental conditions may partly underlie some of cognitive deficits that accompany major depression. Conversely, any prevention or restoration of these morphological changes in the hippocampus should be parallel to procognitive/promnesiant effects. Accordingly, tianeptine has particularly favorable effects on cognitive functions and the positive effect of tianeptine may be mediated through its upregulation of neurogenesis, but of course, the impact of neurogenesis on cognitive functions remains a matter of controversial debate.<br /><br />Tianeptine prevents and reverses stress-induced glucocorticoid-mediated dendritic remodeling in CA3 pyramidal neurons in the hippocampus (40,41) and stress-induced increases in dendritic length and branching in the amygdala (50). Tianeptine blocks the dendritic remodeling caused by stress or glucocorticoids (41), blocks stress-induced impairments of spatial memory performance in radial and Y-maze (70,71) and antagonizes the deleterious effects of alcohol (72).<br /><br />In a validated model of hippocampal-dependent memory impairment and synaptic plasticity changes by predator stress, acute tianeptine can prevent the deleterious effects of stress on spatial memory, an effect that does not depend on corticosterone levels (73). Tianeptine also facilitates focused attention behavior in the cat in response to its environment or towards a significant stimulus (74). It was shown to exert improving effects on learning as well as on working memory and on reference memory in rodents (72) and to exhibit vigilance-enhancing effects in rats (75) and monkeys (76)...}}</ref> | |||
| * ] – ] | |||
| ===Nutraceuticals=== | |||
| * ] – A neutraceutical herb with "neural tonic" and memory enhancing properties shown in humans in a double-blinded ]s.<ref name="Bacopa Review">{{cite journal |url=http://www.ncbi.nlm.nih.gov/pubmed/23772955 |title=Neuropharmacological review of the nootropic herb Bacopa monnieri. |date=Aug 2013 |accessdate=March 27, 2014 |doi=10.1089/rej.2013.1431 |issue=4 |volume=16 |pmid=23772955 |pmc=3746283 |pages=313–26 |journal=Rejuvenation Research |first1=Sebastian |last1=Aguiar |first2=Thomas |last2=Borowski}}</ref><ref name="PubMed-22747190">{{cite journal |url=http://www.ncbi.nlm.nih.gov/pubmed/22747190 |title=The cognitive-enhancing effects of Bacopa monnieri: a systematic review of randomized, controlled human clinical trials |date=July 2012 |accessdate=March 27, 2014 |doi=10.1089/acm.2011.0367 |issue=7 |volume=18 |pmid=22747190 |pmc= |pages=647–52 |journal=The Journal of Alternative and Complementary Medicine |first1=Matthew P. |last1=Pase |first2=James |last2=Kean |first3=Jerome |last3=Sarris |first4=Chris |last4=Neale |first5=Andrew B. |last5=Scholey |first6=Con |last6=Stough}}</ref><ref>{{Cite journal | last1 = Morgan | first1 = A. | last2 = Stevens | first2 = J. | doi = 10.1089/acm.2009.0342 | title = DoesBacopa monnieriImprove Memory Performance in Older Persons? Results of a Randomized, Placebo-Controlled, Double-Blind Trial | journal = The Journal of Alternative and Complementary Medicine | volume = 16 | issue = 7 | pages = 753–759 |date=July 2010 | pmid = 20590480 }}</ref> | |||
| * ] – Multiple RCTs in healthy volunteers have indicated increases in accuracy of memory, speed in performing attention tasks and improvement in performing difficult mental arithmetic tasks, as well as reduction in fatigue and improvement in mood.<ref name="Neutraceuticals Review">{{Cite journal|author=Kennedy DO, Wightman EL |title=Herbal extracts and phytochemicals: plant secondary metabolites and the enhancement of human brain function |journal=Adv Nutr. |volume=2 |issue=1 |pages=32–50 |date=Jan 2011 |pmid=22211188 |doi=10.3945/an.110.000117}}</ref> | |||
| * ] – A ] of 29 RCTs stated "there is consistent evidence that chronic administration improves selective attention, some executive processes and long-term memory for verbal and non-verbal material."<ref>{{Cite journal|author=Kaschel R |title=Ginkgo biloba: specificity of neuropsychological improvement—a selective review in search of differential effects |journal=Hum Psychopharmacol |volume=24 |issue=5 |pages=345–70 |year=2009 |pmid=19551805 |doi=10.1002/hup.1037}}</ref> | |||
| * ]<ref name="Neutraceuticals Review" /> | |||
| * ]<ref name="Neutraceuticals Review" /> | |||
| * ]<ref name="Neutraceuticals Review" /> | |||
| * ]<ref name="Neutraceuticals Review" /> | |||
| * ]<ref name="Neutraceuticals Review" /> | |||
| * ] – Anti-inflammatory, antibiotic, and neuroprotective antidepressant compound which has extremely low toxicity.<ref name="Neutraceuticals Review" /> | |||
| * ]s – A double-blind, placebo-controlled study showed improvement in spatial working memory after administration of isoflavones.<ref name="PubMed-9071926">{{cite journal |url=http://www.ncbi.nlm.nih.gov/pubmed/19480732 |title=Soya isoflavone supplementation enhances spatial working memory in men. |date=Nov 2009 |publisher=] |accessdate=March 24, 2014 |doi=10.1017/S0007114509990201 |pmid=19480732 |issue=9 |volume=102 |pages=1348–54 |journal=Br J Nutr |first1=Aa |last1=Thorp |first2=N |last2=Sinn |first3=Jd |last3=Buckley |first4=Am |last4=Coates |first5=Pr |last5=Howe}}</ref> One RCT showed soy isoflavone supplementation improved performance on 6 of 11 cognitive tests, including visual-spatial memory and construction, verbal fluency and speeded dexterity, but worse on two tests of executive function.<ref>{{cite journal |author=Gleason CE, Carlsson CM, Barnet JH, Meade SA, Setchell KD, Atwood CS, Johnson SC, Ries ML, Asthana S |title=A preliminary study of the safety, feasibility and cognitive efficacy of soy isoflavone supplements in older men and women |journal=Age Ageing |volume=38 |issue=1 |pages=86–93 |date=January 2009 |pmid=19054783 |pmc=2720778 |doi=10.1093/ageing/afn227}}</ref> | |||
| * ] – Stimulated ] in an ''in vitro'' experiment<ref name="pmid12675022">{{Cite journal|author=Kolotushkina EV, Moldavan MG, Voronin KY, Skibo GG |title=The influence of Hericium erinaceus extract on myelination process in vitro |journal=Fiziol Zh |volume=49 |issue=1 |pages=38–45 |year=2003 |pmid=12675022 |doi= |url=}}</ref> and stimulated ] in an ''in vitro'' experiment with human ] cells.<ref name="pmid18758067">{{Cite journal|author=Mori K, Obara Y, Hirota M, ''et al.'' |title=Nerve growth factor-inducing activity of Hericium erinaceus in 1321N1 human astrocytoma cells |journal=Biol. Pharm. Bull. |volume=31 |issue=9 |pages=1727–32 |date=September 2008 |pmid=18758067 |doi= 10.1248/bpb.31.1727|url=}}</ref>{{npsn|date=May 2014}} Also improved cognitive ability, in a double-blind, parallel-group, placebo-controlled trial.<ref name="pmid18844328">{{Cite journal|author=Mori K, Inatomi S, Ouchi K, Azumi Y, Tuchida T |title=Improving effects of the mushroom Yamabushitake (Hericium erinaceus) on mild cognitive impairment: a double-blind placebo-controlled clinical trial |journal=Phytotherapy Research |volume=23 |issue=3 |pages=367–72 |date=March 2009 |pmid=18844328 |doi=10.1002/ptr.2634}}</ref>{{npsn|date=May 2014}} | |||
| ===Racetams=== | |||
| The ] are structurally similar compounds, such as ], ], ], and ], which are often marketed as cognitive enhancers and sold ]. Racetams are often referred to as nootropics, but this property of the drug class is not well established.<ref name="NHM">{{cite book | author = Malenka RC, Nestler EJ, Hyman SE | editor = Sydor A, Brown RY | title = Molecular Neuropharmacology: A Foundation for Clinical Neuroscience | year = 2009 | publisher = McGraw-Hill Medical | location = New York | isbn = 9780071481274 | page = 454 | edition = 2nd }}</ref> The racetams have a poorly understood ]; however, piracetam and aniracetam are known to act as ]s of ]s and appear to modulate ] systems.<ref>{{Cite journal|author=Gualtieri F, Manetti D, Romanelli MN, Ghelardini C |title=Design and study of piracetam-like nootropics, controversial members of the problematic class of cognition-enhancing drugs |journal=Curr. Pharm. Des. |volume=8 |issue=2 |pages=125–38 |year=2002 |pmid=11812254 |doi=10.2174/1381612023396582 |url=}}</ref> | |||
| ==See also== | |||
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| ==References== | |||
| {{Reflist|2}} | |||
| {{reflist|colwidth=30em}} | |||
| ==External links== | |||
| * {{cite journal |url=http://www.nature.com/nature/journal/v456/n7223/full/456702a.html |title=Towards responsible use of cognitive-enhancing drugs by the healthy |work=] |date=December 10, 2008 |publisher=] |issn=1476-4687 |oclc=01586310 |bibcode = 2008Natur.456..702G |accessdate=March 25, 2014 |doi=10.1038/456702a |pages=702–5 |volume=456 |issue=7223 |subscription=yes |first1=Henry |last1=Greely |first2=Barbara |last2=Sahakian |first3=John |last3=Harris |first4=Ronald C. |last4=Kessler |first5=Michael |last5=Gazzaniga |first6=Philip |last6=Campbell |first7=Martha J. |last7=Farah}} | |||
| {{Psychostimulants, agents used for ADHD and nootropics}} | |||
| ] | |||
| ] | |||
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