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If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
The professional and academic landscape has never been more competitive than it is today. The stress of achieving higher and higher standards can sometimes be too much to handle, causing people to feel overwhelmed or burned out.
What if there was a pill you could take that could give you an edge over your competition at work or school? Manufacturers of nootropics claim their products can do just that. But are these smart pills too good to be true? Let’s see what the science has to say.
What are nootropics?
Nootropics, or “smart drugs,” are substances that may improve mental performance, including memory, creativity, motivation, and concentration (who couldn’t use a little of that?) (Suliman, 2016).
Nootropic supplements (sometimes called “cognitive enhancers,” “brain boosters,” or “memory enhancers”) are available over-the-counter, without a prescription. Certain prescription drugs are also considered nootropics and treat medical conditions like attention-deficit/hyperactivity disorder (ADHD) and dementia.
Whether you’re looking to get ahead at work or hoping to prevent age-related memory problems, nootropics may offer some benefit. But with so many products available, it can be overwhelming to know where to start. Here we’ll look at some of the most common products and discuss if there’s any evidence to support their use.
Types of nootropics
Non-prescription, over-the-counter products, and prescription medications are available, depending on your medical conditions.
Healthcare providers may use prescription nootropics to treat people with ADHD. These include drugs like Ritalin (methylphenidate) and Adderall (dextroamphetamine/amphetamine). These stimulant medications improve attention and decrease hyperactivity and impulsive behavior. Another stimulant—Provigil (modafinil)—can help treat excessive daytime sleepiness in people with narcolepsy or shift work sleep disorder.
While these medications can benefit people suffering from certain conditions, you should only take them if your doctor has prescribed them for you since they can sometimes cause serious side effects (e.g., heart problems, increased blood pressure, mental health problems).
Non-prescription nootropic products and dietary supplements are available to anyone looking for a little brain boost. Here are just a few of the many products on the market and what science has to say about them:
Is ADHD a disability? A complex question explained
Many of us find it hard to focus on anything before having our morning cup of coffee—and there’s likely a good reason for this.
Caffeine acts as a stimulant by affecting the release of certain chemicals in the brain, including dopamine, acetylcholine, norepinephrine, and serotonin. Studies have consistently shown that caffeine can enhance cognitive abilities by improving alertness, reducing reaction times, promoting concentration and accuracy, and improving short-term memory (Lewis, 2021).
Just be careful not to overdo it—too much caffeine can lead to anxiety, agitation, restlessness, and insomnia (Cappelletti, 2015).
Studies have shown that L-theanine (found naturally in green tea or supplements) can produce a calming effect and improve brain function. Brain-boosting effects and attention are improved when L-theanine is combined with caffeine (such as in green tea) (Lewis, 2021). This may help explain why green tea is the most popular drink consumed worldwide (after water) (Nobre, 2008).
The extract from the leaves of the Ginkgo biloba tree has been used for medicinal purposes for more than 1000 years. Traditional Chinese medicine and Ayurvedic medicine (a natural and holistic Indian medical system) have used Ginkgo biloba to improve cognitive functioning, mental fatigue, and anxiety. Ginkgo biloba acts as an antioxidant, improves blood flow, and alters certain neurotransmitters (chemicals) in the brain (Carlson, 2007).
Many Ginkgo biloba trials that have shown improvements in cognitive functioning studied older adults with dementia or diseases that decrease blood flow to the brain. Studies in healthy individuals without dementia have shown mixed results. Still, Ginkgo biloba remains one of the top-selling herbal products in the United States (Carlson, 2007).
Panax ginseng (Asian or Korean ginseng) comes from the roots of the Panax ginseng CA Meyer plant. Panax ginseng has been used for thousands of years to treat diseases ranging from depression to diabetes and is also promoted for its anti-aging, fatigue-reducing, and neuroprotective properties (Huang, 2019).
A 2010 review analyzed five randomized, placebo-controlled trials that studied the effects of ginseng on cognitive function. The five trials included relatively young and healthy adults. The review found that ginseng offered some beneficial effects on cognition, including improved working memory and learning. The authors of the review recommended that larger, longer, and better-designed studies be conducted to confirm these results (Geng, 2010).
ADHD and depression: what’s the link?
Extracts from the roots of the Rhodiola rosea plant have been used in traditional medicine to treat anxiety, depression, and fatigue. Researchers believe Rhodiola rosea may improve mental performance by acting as an antioxidant, blocking the release of the stress hormone cortisol, and preventing brain cell (neuron) damage that can lead to Alzheimer’s disease (Lewis, 2021).
Some studies have found that Rhodiola rosea may improve mood, mental performance, and cognition in healthy people. A two-week study of doctors working the night shift found that Rhodiola rosea improved overall fatigue scores based on tests that looked at attention, short-term memory, and the ability to process visual and auditory information. Another two-week study administered Rhodiola rosea to healthy, mildly-anxious college students. After 14 days, the college students reported improvements in stress, anxiety, and mood. However, mental function (measured by different cognitive tests) did not improve (Lewis, 2021).
Extracts from the Bacopa monnieri plant have traditionally been used by the ancient Indian system of medicine (Ayurveda) to treat memory loss and cognitive decline caused by neurological conditions like Alzheimer’s disease. The plant’s anti-inflammatory and antioxidant properties are likely responsible for its beneficial effects (Lewis, 2021).
Several studies ranging in length (3–12 months) have tested Bacopa monnieri in healthy adults and adults with Alzheimer’s disease. Both groups of people had improvements in cognitive function, including attention, working memory, and the ability to process information quickly. Side effects were minimal and usually related to stomach upset (Lewis, 2021).
Choline is an essential nutrient that we get from our diet. In the body, choline gets converted to acetylcholine—a chemical that plays an important role in memory. Researchers are studying whether choline (or an alternative form called citicoline) can improve cognitive performance (Lewis, 2021).
Studies have primarily focused on the effects of citicoline in people with various impairments or diseases. One study administered citicoline to a group of older adults with mild vascular cognitive impairment. The study found that cognitive functioning significantly improved after three and nine months of treatment compared to the group that did not receive citicoline. Some studies have also found that citicoline can be helpful during the recovery phase after a stroke (Lewis, 2021). However, a review of 10 studies found that citicoline offered little to no benefit for people recovering from a stroke (Martí-Carvajal, 2020).
ADD vs. ADHD: what’s the difference?
Should you take a nootropic?
While many studies have shown promising results, there are often just as many studies that don’t find any benefits. Until more evidence is available, it’s hard to say if taking a nootropic supplement will improve your brain health.
The U.S. Food and Drug Administration (FDA) does not regulate the safety or effectiveness of over-the-counter supplements and natural products. Therefore, it’s unclear what the best dose is or what unintended side effects may occur.
If you’re interested in starting a nootropic supplement, talk with your healthcare provider first. Be sure to let them know about all the medicines you take so that they can check for any potential drug interactions. In the meantime, focusing on proven strategies, such a getting enough sleep, eating a healthy diet, and reducing stress, can help improve your mental function and overall health.
- Cappelletti, S., Piacentino, D., Sani, G., & Aromatario, M. (2015). Caffeine: cognitive and physical performance enhancer or psychoactive drug?. Current Neuropharmacology, 13(1), 71–88. doi: 10.2174/1570159X13666141210215655. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26074744/
- Carlson, J. J., Farquhar, J. W., DiNucci, E., Ausserer, L., Zehnder, J., Miller, D., et al. (2007). Safety and efficacy of a ginkgo biloba-containing dietary supplement on cognitive function, quality of life, and platelet function in healthy, cognitively intact older adults. Journal of the American Dietetic Association, 107(3), 422–432. doi: 10.1016/j.jada.2006.12.011. Retrieved from https://pubmed.ncbi.nlm.nih.gov/17324660/
- Geng, J., Dong, J., Ni, H., Lee, M. S., Wu, T., Jiang, K., et al. (2010). Ginseng for cognition. The Cochrane Database of Systematic Reviews, (12), CD007769. doi: 10.1002/14651858.CD007769.pub2. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21154383/
- Huang, X., Li, N., Pu, Y., Zhang, T., & Wang, B. (2019). Neuroprotective effects of ginseng phytochemicals: recent perspectives. Molecules (Basel, Switzerland), 24(16), 2939. doi: 10.3390/molecules24162939. Retrieved from https://pubmed.ncbi.nlm.nih.gov/31416121/
- Lewis, J. E., Poles, J., Shaw, D. P., Karhu, E., Khan, S. A., Lyons, A. E., Sacco, S. B., & McDaniel, H. R. (2021). The effects of twenty-one nutrients and phytonutrients on cognitive function: A narrative review. Journal of Clinical and Translational Research, 7(4), 575–620. Retrieved from https://pubmed.ncbi.nlm.nih.gov/34541370/
- Martí-Carvajal, A. J., Valli, C., Martí-Amarista, C. E., Solà, I., Martí-Fàbregas, J., & Bonfill Cosp, X. (2020). Citicoline for treating people with acute ischemic stroke. The Cochrane Database of Systematic Reviews, 8(8), CD013066. doi: 10.1002/14651858.CD013066.pub2. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32860632/
- Nobre, A. C., Rao, A., & Owen, G. N. (2008). L-theanine, a natural constituent in tea, and its effect on mental state. Asia Pacific Journal of Clinical Nutrition, 17 Suppl 1, 167–168. Retrieved from https://pubmed.ncbi.nlm.nih.gov/18296328/
- Suliman, N. A., Mat Taib, C. N., Mohd Moklas, M. A., Adenan, M. I., Hidayat Baharuldin, M. T., & Basir, R. (2016). Establishing natural nootropics: recent molecular enhancement influenced by natural nootropic. Evidence-Based Complementary and Alternative Medicine : eCAM, 2016, 4391375. doi: 10.1155/2016/4391375. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27656235/
Dr. Steve Silvestro is a board-certified pediatrician and Senior Manager, Medical Content & Education at Ro.