Lisa Mosconi has a web and media presence and a book Brain Food: The Surprising Science of Eating for Cognitive Power. She claims, “There is increasing evidence that implementing the lifestyle changes described in this book has the potential to prevent Alzheimer’s from developing and also to help slow down or even halt progression of the disease.” What’s more, “eating for your brain…actually helps you achieve peak performance in every part of your life.”
It’s 3 p.m., and I am crushing my e-mail inbox. At this time of day, I’m typically struggling to stave off the post-lunch slowdown by downing another cup of coffee or two. But today, message after message is flying off my fingertips effortlessly—work e-mail, personal e-mail, digital errands I’d been meaning to run for months. I’m in the zone, as they say, and for this burst of late afternoon productivity, I might have nootropics to thank.
This is absolutely fantastic work - Dr. Mosconi's clear, concise prose readily breaks down the science of how we can protect our beloved brains from the horrors of dementia and keep our minds humming beautifully for years. Her mastery of the various key subjects - neurobiology, nutrition, biochemistry - is incredible and her ability to decode complex scientific findings into digestible, easy-to-use advice for the layperson is second to none. This is easily one of the best popular science books I've ever come across and by far the best read on nutrition I know of.
Your mileage will vary. There are so many parameters and interactions in the brain that any of them could be the bottleneck or responsible pathway, and one could fall prey to the common U-shaped dose-response curve (eg. Yerkes-Dodson law; see also Chemistry of the adaptive mind & de Jongh et al 2007) which may imply that the smartest are those who benefit least23 but ultimately they all cash out in a very few subjective assessments like energetic or motivated, with even apparently precise descriptions like working memory or verbal fluency not telling you much about what the nootropic actually did. It’s tempting to list the nootropics that worked for you and tell everyone to go use them, but that is merely generalizing from one example (and the more nootropics - or meditation styles, or self-help books, or getting things done systems - you try, the stronger the temptation is to evangelize). The best you can do is read all the testimonials and studies and use that to prioritize your list of nootropics to try. You don’t know in advance which ones will pay off and which will be wasted. You can’t know in advance. And wasted some must be; to coin a Umeshism: if all your experiments work, you’re just fooling yourself. (And the corollary - if someone else’s experiments always work, they’re not telling you everything.)
People charged with doing simple tasks did not exhibit much of an increase in brain function after taking Modafinil, but their performance on complex and difficult tasks after taking the drug was significantly better than those who were given a placebo. This suggests that it may affect “higher cognitive functions—mainly executive functions but also attention and learning,” explains study co-author Ruairidh Battleday.

Starting from the studies in my meta-analysis, we can try to estimate an upper bound on how big any effect would be, if it actually existed. One of the most promising null results, Southon et al 1994, turns out to be not very informative: if we punch in the number of kids, we find that they needed a large effect size (d=0.81) before they could see anything:
Difficulty remembering.  As discussed previously, challenges with episodic memory may start as early as middle age, even if your brain is healthy.  As you get older, problems with memory tend to become more and more frequent.  Once you reach your mid 30s, you will most likely begin to notice an increased frequency of forgetfulness.  At this point, it may become common for you to lose your belongings and misplace your possessions, like your car keys or smartphones.  This can truly be frustrating at best.  At worst, it can be downright scary.  You might also start misplacing names and having more “tip of the tongue” moments.
Caffeine dose dependently decreased the 1,25(OH)(2)D(3) induced VDR expression and at concentrations of 1 and 10mM, VDR expression was decreased by about 50-70%, respectively. In addition, the 1,25(OH)(2)D(3) induced alkaline phosphatase activity was also reduced at similar doses thus affecting the osteoblastic function. The basal ALP activity was not affected with increasing doses of caffeine. Overall, our results suggest that caffeine affects 1,25(OH)(2)D(3) stimulated VDR protein expression and 1,25(OH)(2)D(3) mediated actions in human osteoblast cells.
Recently I spoke on the phone with Barbara Sahakian, a clinical neuropsychologist at Cambridge University and the co-author of a 2007 article in Nature entitled "Professor's Little Helper". Sahakian, who also consults for several pharmaceutical companies, and her co-author, Sharon Morein-Zamir, reported that a number of their colleagues were using prescription drugs like Adderall and Provigil. Because the drugs are easy to buy online, they wrote, it would be difficult to stop their spread: "The drive for self-enhancement of cognition is likely to be as strong if not stronger than in the realms of 'enhancement' of beauty and sexual function." (In places like Cambridge, at least.)
Ampakines are structurally derived from a popular nootropic called “aniracetam”. Their basic function is to activate AMPA glutamate receptors (AMPARs). Glutamate (a neurotransmitter) is the primary mediator of excitatory synaptic transmission in mammalian brains, which makes it crucial for synaptic plasticity (the adaptation of synapses, the space between neurons across which information is sent), learning and memory, so when you activate or stimulate glutamate receptors, you can trigger many of these functions. AMPARs are distributed across the central nervous system and are stimulated by incoming glutamate to begin the neuroenhancing benefits they’re often used for. But it is possible to have too much glutamate activity. When excess glutamate is produced, accumulates and binds to AMPARs, the result is excitotoxicity, which is a state of cell death (in the case of the central nervous system and your brain, neuron death) resulting from the toxic levels of excitatory amino acids. Excitotoxicity is believed to play a major role in the development of various degenerative neurological conditions such as schizophrenia, delirium and dementia.

The placebos can be the usual pills filled with olive oil. The Nature’s Answer fish oil is lemon-flavored; it may be worth mixing in some lemon juice. In Kiecolt-Glaser et al 2011, anxiety was measured via the Beck Anxiety scale; the placebo mean was 1.2 on a standard deviation of 0.075, and the experimental mean was 0.93 on a standard deviation of 0.076. (These are all log-transformed covariates or something; I don’t know what that means, but if I naively plug those numbers into Cohen’s d, I get a very large effect: \frac{1.2 - 0.93}{0.076}=3.55.)

Ginkgo Biloba Leaf(23% extract), Phosphatidylserine 4% Complex(consisting of Lecithin and Phosphatidylserine),N-Acetyl L-Carnitine HCI, St. John's Wort(0.3% extract)(fower heads),L-Glutamine,Dimethylaminoethanol Bitartrate, Bacopa monnieri Leaf Extract(20% bacosides), Vinpocetine(seeds), Huperzine-A(aerial Plant) ; other ingredients: Gelatin(bovine), vegetable magnesium stearate, microcrystalline cellulose and silicon dioxide
Tyrosine (Examine.com) is an amino acid; people on the Imminst.org forums (as well as Wikipedia) suggest that it helps with energy and coping with stress. I ordered 4oz (bought from Smart Powders) to try it out, and I began taking 1g with my usual caffeine+piracetam+choline mix. It does not dissolve easily in hot water, and is very chalky and not especially tasty. I have not noticed any particular effects from it.
Price discrimination is aided by barriers such as ignorance and oligopolies. An example of the former would be when I went to a Food Lion grocery store in search of spices, and noticed that there was a second selection of spices in the Hispanic/Latino ethnic food aisle, with unit prices perhaps a fourth of the regular McCormick-brand spices; I rather doubt that regular cinnamon varies that much in quality. An example of the latter would be using veterinary drugs on humans - any doctor to do so would probably be guilty of medical malpractice even if the drugs were manufactured in the same factories (as well they might be, considering economies of scale). Similarly, we can predict that whenever there is a veterinary drug which is chemically identical to a human drug, the veterinary drug will be much cheaper, regardless of actual manufacturing cost, than the human drug because pet owners do not value their pets more than themselves. Human drugs are ostensibly held to a higher standard than veterinary drugs; so if veterinary prices are higher, then there will be an arbitrage incentive to simply buy the cheaper human version and downgrade them to veterinary drugs.
Dr. Lisa Mosconi, whose research spans an extraordinary range of specialties including brain science, the microbiome, and nutritional genomics, notes that the dietary needs of the brain are substantially different from those of the other organs, yet few of us have any idea what they might be. Her innovative approach to cognitive health incorporates concepts that most doctors have yet to learn. Busting through advice based on pseudoscience, Dr. Mosconi provides recommendations for a complete food plan, while calling out noteworthy surprises, including why that paleo diet you are following may not be ideal, why avoiding gluten may be a terrible mistake, and how simply getting enough water can dramatically improve alertness.
The evidence? Although everyone can benefit from dietary sources of essential fatty acids, supplementation is especially recommended for people with heart disease. A small study published in 2013 found that DHA may enhance memory and reaction time in healthy young adults. However, a more recent review suggested that there is not enough evidence of any effect from omega 3 supplementation in the general population.
Consider something as simple as a phone call. You hear the phone ring – your auditory capacity kicks in. Next, you decide whether to answer – decision-making comes into play. You reach for the phone – calling your motor skills to work. You answer – using your voice – all controlled by your brain, all done in mere moments, without conscious thought. Your brain works non-stop, consuming mental energy and physical resources.
According to the US Food and Drug Administration, "Piracetam is not a vitamin, mineral, amino acid, herb or other botanical, or dietary substance for use by man to supplement the diet by increasing the total dietary intake. Further, piracetam is not a concentrate, metabolite, constituent, extract or combination of any such dietary ingredient. [...] Accordingly, these products are drugs, under section 201(g)(1)(C) of the Act, 21 U.S.C. § 321(g)(1)(C), because they are not foods and they are intended to affect the structure or any function of the body. Moreover, these products are new drugs as defined by section 201(p) of the Act, 21 U.S.C. § 321(p), because they are not generally recognized as safe and effective for use under the conditions prescribed, recommended, or suggested in their labeling."[33]
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