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.
Intrigued by old scientific results & many positive anecdotes since, I experimented with microdosing LSD - taking doses ~10μg, far below the level at which it causes its famous effects. At this level, the anecdotes claim the usual broad spectrum of positive effects on mood, depression, ability to do work, etc. After researching the matter a bit, I discovered that as far as I could tell, since the original experiment in the 1960s, no one had ever done a blind or even a randomized self-experiment on it.

There are a variety of substances to get magnesium from. Considerable enthusiasm for the new compound magnesium l-threonate was stirred by 2 small animal rat studies finding that magnesium l-threonate was able to increase magnesium levels in the brain and improve learning/memory tasks. (There are no published human trials as of October 2015, and evidence of publication bias, which I take as evidence against there being large effects in humans.) Animal studies mean very little, of course (see the appendix), but I thought it’d be interesting to try using l-threonate, so I bought the $30 Life Extension Neuro-Mag Magnesium L-Threonate with Calcium and Vitamin D3 (205g), which according to the LEF product page works out to ~60g of Magtein™ magnesium L-threonate and ~4.31g elemental magnesium inasmuch as LEF claims 2000mg of threonate powder provides 144mg elemental magnesium or a 14:1 ratio. (I don’t need the calcium or vitamin D3, but this was the only magnesium l-threonate on Amazon.) Experiment-wise, I’ll probably look at sleep metrics and Mnemosyne performance; I put off designing a blind self-experiment until after trying some.
This continued up to 1 AM, at which point I decided not to take a second armodafinil (why spend a second pill to gain what would likely be an unproductive set of 8 hours?) and finish up the experiment with some n-backing. My 5 rounds: 60/38/62/44/5024. This was surprising. Compare those scores with scores from several previous days: 39/42/44/40/20/28/36. I had estimated before the n-backing that my scores would be in the low-end of my usual performance (20-30%) since I had not slept for the past 41 hours, and instead, the lowest score was 38%. If one did not know the context, one might think I had discovered a good nootropic! Interesting evidence that armodafinil preserves at least one kind of mental performance.

Using neuroenhancers, Seltzer said, "is like customising yourself - customising your brain". For some people, he added, it was important to enhance their mood, so they took antidepressants; but for people like him it was more important "to increase mental horsepower". He said: "It's fundamentally a choice you're making about how you want to experience consciousness." Whereas the 1990s had been about "the personalisation of technology", this decade was about the personalisation of the brain - what some enthusiasts have begun to call "mind hacking".
My predictions were substantially better than random chance7, so my default belief - that Adderall does affect me and (mostly) for the better - is borne out. I usually sleep very well and 3 separate incidents of horrible sleep in a few weeks seems rather unlikely (though I didn’t keep track of dates carefully enough to link the Zeo data with the Adderall data). Between the price and the sleep disturbances, I don’t think Adderall is personally worthwhile.
Whole pill at 3 AM. I spend the entire morning and afternoon typing up a transcript of Earth in My Window. I tried taking a nap around 10 AM, but during the hour I was down, I had <5m of light sleep, the Zeo said. After I finished the transcript (~16,600 words with formatting), I was completely pooped and watched a bunch of Mobile Suit Gundam episodes, then I did Mnemosyne. The rest of the night was nothing to write home about either - some reading, movie watching, etc. Next time I will go back to split-doses and avoid typing up 110kB of text. On the positive side, this is the first trial I had available the average daily grade Mnemosyne 2.0 plugin. The daily averages all are 3-point-something (peaking at 3.89 and flooring at 3.59), so just graphing the past 2 weeks, the modafinil day, and recovery days: ▅█▅▆▄▆▄▃▅▄▁▄▄ ▁ ▂▄▄█. Not an impressive performance but there was a previous non-modafinil day just as bad, and I’m not too sure how important a metric this is; I must see whether future trials show similar underperformance. Nights: 11:29; 9:22; 8:25; 8:41.
The body has its own inherent detoxification pathways that are responsible for packaging and removing heavy metals safely from the system. For example, glutathione is known as the body’s ‘master antioxidant’ and aside from playing an important role in preventing free radicals from causing damage to the body’s cells, it also helps to bind to heavy metals and remove them from the body. Research shows that glutathione levels are lower than normal in those on the autism spectrum, so enhancing levels through the diet may be an effective way to prevent the accumulation of heavy metals. Consuming sulfur-rich foods such as broccoli, cabbage, onions, garlic, kale and cauliflower can boost glutathione levels, as well as milk thistle, which has unique flavonoids that also support glutathione production.

This research is in contrast to the other substances I like, such as piracetam or fish oil. I knew about withdrawal of course, but it was not so bad when I was drinking only tea. And the side-effects like jitteriness are worse on caffeine without tea; I chalk this up to the lack of theanine. (My later experiences with theanine seems to confirm this.) These negative effects mean that caffeine doesn’t satisfy the strictest definition of nootropic (having no negative effects), but is merely a cognitive enhancer (with both benefits & costs). One might wonder why I use caffeine anyway if I am so concerned with mental ability.
Ampakines bind to AMPARs to block uptake of glutamate, thereby increasing synaptic responses, and this has indeed been shown to minimize the effects of conditions such as Alzheimer’s. Ampakines are also being studied as possible treatments for schizophrenia, depression, ADHD and more. But there is a huge risk associated with ampakine consumption. They are now tightly regulated because if you exceed a safe dosage, you will begin to suffer neuronal damage from glutamate toxicity, which leads to some of the very conditions that ampakines are thought to attenuate. Ampakine consumption can also lead to a decrease in long-term synaptic depression (LTD), a process by which specific synapses (the space between neurons across which information is sent) are intentionally weakened in order to avoid a plateau in the efficiency of your synapses. In other words, it allows your neurons and their connections to continue growing in efficiency. LTD is believed to be necessary for healthy synaptic plasticity (the adaptability of synapses), memory function and motor skills. To be honest, there is debate over whether cognitive functions like motor learning are truly dependent upon LTD, but it is possible that if you were to take a higher-than-recommended dose of an ampakine, the overstimulation that would result may lead to suppressed LTD and consequently to poor memory and motor function.
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.
Back home, I contacted Aubrey Marcus, whose company Onnit Labs produces Alpha Brain. He attributed my lucid dreaming to increased levels of the neurotransmitter acetylcholine, which enhances REM dreaming. Alpha Brain has two ingredients that boost acetylcholine levels: GPC choline, which the body converts to acetylcholine, and Huperzine A, an alkaloid derived from Chinese club moss, also known as Huperzia serrata. "Huperzine A disarms the enzyme that naturally breaks down acetylcholine," Marcus said. "So while the GPC choline is being converted to acetylcholine, the Huperzine A is keeping it from disappearing. It's like plugging the drain and turning on the faucet."
Herbs and plants have been used for cognitive enhancement for at least 5,000 years in Indian and Chinese medicine, long before the first synthetic nootropic was created. The practice of Indian Ayurvedic medicine includes the use of a group of nootropic plants known as Medhya Rasayana, the four primary plants of which are Mandukaparni, Yastimadhu, Duduchi and Shankhapushpi, though other lesser known plants are also used. One of the most common supplements in Ayurvedic medicine is Brahmi, known scientifically as “Bacopa monnieri” or “B. monnieri “ and more commonly as water hyssop, Thyme-leaved Gratiola, herb of grace or Indian pennywort. It is named after Lord Brahma, the creator God and originator of Ayurveda, and has been used for centuries to treat disorders ranging from pain and epilepsy to inflammation and memory dysfunction. The exact mechanism behind its action is not fully understood, but it is believed to promote antioxidant activity as well as protect neurons in the prefrontal cortex, hippocampus and corpus striatum against cytotoxicity and DNA damage associated with Alzheimer’s. The prefrontal cortex is critical in rational, social and personality behavior, the hippocampus is believed to be the seat of memory and the autonomic nervous system and the striatum play a role in the reward system of action, so the protection Brahmi provides is extremely helpful in preventing the degeneration of many important cognitive faculties. An effective dose ranges from 300 to 450 mg per day. Winter cherry (ashwagandha) is another well-known Ayurvedic supplement that can promote improved cognitive development, memory and intelligence and reduce the effects of neurodegenerative diseases such as Parkinson’s, Huntington’s and Alzheimer’s. The optimal dose is 6,000 mg per day divided into three 2,000 mg doses. Aloeweed (shankhpushpi) is also used in Ayurvedic medicine to improve memory and intellect as well as treat hypertension, epilepsy and diabetes. Effective doses for most neuroenhancing benefits range as high as 40 g per day.
New psychiatric drugs have a way of creating markets for themselves. Disorders often become widely diagnosed after drugs come along that can alter a set of suboptimal behaviours. In this way Ritalin and Adderall helped make ADHD a household name, and advertisements for antidepressants have helped define shyness as a malady. If there's a pill that can clear up the wavering focus of sleep-deprived youth or mitigate the tip-of-the-tongue experience of middle age, then those rather ordinary states may come to be seen as syndromes.
In addition to this, privilege also plays an important role in this epidemic. "Not everyone has access to eat healthily", she mentions. In fact, she recalls an anecdote in which a supermarket owner noticed how people living off food stamps rarely use them to buy fruits and vegetables. Curious about this trend, the owner approached someone with food stamps, to which she admitted she didn't buy them because she didn't know the price prior to weighing them and felt ashamed of asking. His solution? Pre-cutting and packaging fruits in order to make them more accessible to those with lower incomes. 
(On a side note, I think I understand now why modafinil doesn’t lead to a Beggars in Spain scenario; BiS includes massive IQ and motivation boosts as part of the Sleepless modification. Just adding 8 hours a day doesn’t do the world-changing trick, no more than some researchers living to 90 and others to 60 has lead to the former taking over. If everyone were suddenly granted the ability to never need sleep, many of them would have no idea what to do with the extra 8 or 9 hours and might well be destroyed by the gift; it takes a lot of motivation to make good use of the time, and if one cannot, then it is a curse akin to the stories of immortals who yearn for death - they yearn because life is not a blessing to them, though that is a fact more about them than life.)
Some suggested that the lithium would turn me into a zombie, recalling the complaints of psychiatric patients. But at 5mg elemental lithium x 200 pills, I’d have to eat 20 to get up to a single clinical dose (a psychiatric dose might be 500mg of lithium carbonate, which translates to ~100mg elemental), so I’m not worried about overdosing. To test this, I took on day 1 & 2 no less than 4 pills/20mg as an attack dose; I didn’t notice any large change in emotional affect or energy levels. And it may’ve helped my motivation (though I am also trying out the tyrosine).
On the other hand, sometimes you’ll feel a great cognitive boost as soon as you take a pill. That can be a good thing or a bad thing. I find, for example, that modafinil makes you more of what you already are. That means if you are already kind of a dick and you take modafinil, you might act like a really big dick and regret it. It certainly happened to me! I like to think that I’ve done enough hacking of my brain that I’ve gotten over that programming… and that when I use nootropics they help me help people.
Like caffeine, nicotine tolerates rapidly and addiction can develop, after which the apparent performance boosts may only represent a return to baseline after withdrawal; so nicotine as a stimulant should be used judiciously, perhaps roughly as frequent as modafinil. Another problem is that nicotine has a half-life of merely 1-2 hours, making regular dosing a requirement. There is also some elevated heart-rate/blood-pressure often associated with nicotine, which may be a concern. (Possible alternatives to nicotine include cytisine, 2’-methylnicotine, GTS-21, galantamine, Varenicline, WAY-317,538, EVP-6124, and Wellbutrin, but none have emerged as clearly superior.)
Including comprehensive lists of what to eat and what to avoid, a detailed quiz that will tell you where you are on the brain health spectrum, and 24 mouth-watering brain-boosting recipes that grow out of Dr. Mosconi’s own childhood in Italy, Brain Food gives us the ultimate plan for a healthy brain. Brain Food will appeal to anyone looking to improve memory, prevent cognitive decline, eliminate brain fog, lift depression, or just sharpen their edge.

A study mentioned in Neuropsychopharmacology as of August 2002, showed that Bacopa Monnieri decreases the rate of forgetting newly acquired information, memory consolidations, and verbal learning rate. It also helps in enhancing the nerve impulse transmission, which leads to increased alertness. Also, it is known to relieve the effects of anxiety and depression. All these benefits happen as Bacopa Monnieri dosage helps in activating choline acetyltransferase and inhibiting acetylcholinesterase which enhances the levels of acetylcholine in the brain, a chemical that is also associated in enhancing memory and attention.
At small effects like d=0.07, a nontrivial chance of negative effects, and an unknown level of placebo effects (this was non-blinded, which could account for any residual effects), this strongly implies that LLLT is not doing anything for me worth bothering with. I was pretty skeptical of LLLT in the first place, and if 167 days can’t turn up anything noticeable, I don’t think I’ll be continuing with LLLT usage and will be giving away my LED set. (Should any experimental studies of LLLT for cognitive enhancement in healthy people surface with large quantitative effects - as opposed to a handful of qualitative case studies about brain-damaged people - and I decide to give LLLT another try, I can always just buy another set of LEDs: it’s only ~$15, after all.)
The methodology would be essentially the same as the vitamin D in the morning experiment: put a multiple of 7 placebos in one container, the same number of actives in another identical container, hide & randomly pick one of them, use container for 7 days then the other for 7 days, look inside them for the label to determine which period was active and which was placebo, refill them, and start again.

At SelfHacked, it’s our goal to offer our readers all the tools possible to get optimally healthy. When I was struggling with chronic health issues I felt stuck because I didn’t have any tools to help me get better. I had to spend literally thousands of hours trying to read through studies on pubmed to figure out how the body worked and how to fix it.
I eventually met Seltzer in an underground food court not far from the Pentagon. He's slim, with a shaved head, and he spoke precisely, rarely stumbling over his words. I asked him if he had any ethical worries about smart drugs. After a pause, he said that he might have a concern if somebody popped a neuroenhancer before taking a licensing exam that certified him as, say, a brain surgeon, and then stopped using the drug. Other than that he couldn't see a problem. He said that he was a firm believer in the idea that "we should have a fair degree of liberty to do with our bodies and our minds as we see fit, so long as it doesn't impinge on the basic rights, liberty and safety of others". He argued: "Why would you want an upward limit on the intellectual capabilities of a human being? And, if you have a very nationalist viewpoint, why wouldn't you want our country to have the advantage over other countries, particularly in what some people call a knowledge-based economy?" He went on: "Think about the complexity of the intellectual tasks that people need to accomplish today. Just trying to understand what Congress is doing is not a simple thing! The complexity of understanding the gamut of scientific and technical and social issues is difficult. If we had a tool that enabled more people to understand the world at a greater level of sophistication, how can we prejudice ourselves against the notion simply because we don't like athletes to do it? To me it doesn't seem like the same question. And it deserves its own debate."
Recent findings also suggest that taking extra vitamins could help preserve memory, especially as we age. Researchers at Australia's University of Sydney tested 117 people in a retirement home by putting them through a battery of mental tests that included remembering a string of words, listing as many words as possible that begin with a certain letter of the alphabet, and doing mental addition and subtraction. Those who regularly took vitamin C, they found, scored higher on the tests.

It's been widely reported that Silicon Valley entrepreneurs and college students turn to Adderall (without a prescription) to work late through the night. In fact, a 2012 study published in the Journal of American College Health, showed that roughly two-thirds of undergraduate students were offered prescription stimulants for non-medical purposes by senior year.
My first dose on 1 March 2017, at the recommended 0.5ml/1.5mg was miserable, as I felt like I had the flu and had to nap for several hours before I felt well again, requiring 6h to return to normal; after waiting a month, I tried again, but after a week of daily dosing in May, I noticed no benefits; I tried increasing to 3x1.5mg but this immediately caused another afternoon crash/nap on 18 May. So I scrapped my cytisine. Oh well.

There is no official data on their usage, but nootropics as well as other smart drugs appear popular in the Silicon Valley. “I would say that most tech companies will have at least one person on something,” says Noehr. It is a hotbed of interest because it is a mentally competitive environment, says Jesse Lawler, a LA based software developer and nootropics enthusiast who produces the podcast Smart Drug Smarts. “They really see this as translating into dollars.” But Silicon Valley types also do care about safely enhancing their most prized asset – their brains – which can give nootropics an added appeal, he says.


The best of the old world combined with the science of the new. Huntington Labs offers a Focus, Memory and Clarity supplement that delivers a targeted and specifically stacked combination of nootropics, or “brain enhancers.” Specially chosen extracts, herbs and substances work together to boost attention, creativity, flexibility, focus, speed, memory and clarity. Green Tea Extract: Traditional supplement for mental performance. Promotes better brain function naturally. Huperzine A: Boosts alertness and enhances memory; extracted from Fir moss. Bacopa Monniera: Contains Bacosides which improve cognitive function and memory. L-Glutamine: An essential amino acid that builds protein and aids memory. Huntington Labs pays special attention to the “stacking” benefits of all of these natural nootropic brain boosters, and hopes that you will experience the max benefits from your daily recommended dose. We guarantee it or your money back!
Mosconi holds a dual PhD in neuroscience and nuclear medicine. She is the associate director of the Alzheimer’s Prevention Clinic at Weill Cornell Medical College/New York-Presbyterian Hospital, and the founder of the Nutrition and Brain Fitness Lab at New York University School of Medicine. With her training and experience, she ought to understand and practice rigorous science. She makes all the right noises about scientific literacy and recognizing pseudoscience, but she seems unable to look in the mirror and see her own errors.
These actually work! I purchased these because of some focus and clarity issues. I like that there are two formulas, one for morning and one for night, and that they both help with the appropriate things at the appropriate times. The pills are easy to take, and not too large, which I have found to be an issue with some other supplements. They are capsules with what appears to be powder in them and appear to be well-made. There is no funky after taste or after effects. When several other natural approaches have not worked, these did, and the wait to see a difference was not long at all! The increase in focus and clarity and even some energy was evident within 2 days. They also come in 60 count bottles, so if you only take 1 per day, they will last 2 months!! I am incredibly impressed with these supplements and will likely be ordering them again.

Pre and Post-Natal Depression are both complex conditions that can have multifactorial underlying drivers, including genetic and environmental influences. These are currently poorly investigated and the gold standard of treatment is often medication to help stabilise mood. Whilst SSRIs and other types of antidepressants have proven to be helpful for many, they do not address potential causes or drivers of poor mental health and can often mask symptoms. Antidepressants are also not regularly recommended during pregnancy, which is why being more mindful of nutrition and lifestyle habits can be a safer option for you and your baby. There are some natural, evidence-based steps you can take to help support optimal mental wellbeing:

Nootropics may seem attractive to anyone who wants to try to improve their cognitive function and is willing to purchase powders, pills and other forms of these natural and synthetic supplements. Nootropic users have their own terminology, referring to measured combinations of nootropics and vitamins and minerals as “stacks.” For instance, Danger and Play, a site for active people, features a stack for beginners.[5] The recipe includes 1600 mg of the piracetam along with recommended dosages of supplements such as ALCAR, rhodiola and magnesium. There are recipes for morning, afternoon and night, thus providing daylong guidance on how to most effectively stack for more energy, greater concentration, and improved information retention. The stack tip specifically states that the ingredients are not addictive, especially if taken in strict accordance with the recipe.


And many people swear by them. Neal Thakkar, for example, is an entrepreneur from Marlboro, New Jersey, who claims nootropics improved his life so profoundly that he can’t imagine living without them. His first breakthrough came about five years ago, when he tried a piracetam/choline combination, or “stack,” and was amazed by his increased verbal fluency. (Piracetam is a cognitive-enhancement drug permitted for sale in the U. S. as a dietary supplement; choline is a natural substance.)
Fish oil (Examine.com, buyer’s guide) provides benefits relating to general mood (eg. inflammation & anxiety; see later on anxiety) and anti-schizophrenia; it is one of the better supplements one can take. (The known risks are a higher rate of prostate cancer and internal bleeding, but are outweighed by the cardiac benefits - assuming those benefits exist, anyway, which may not be true.) The benefits of omega acids are well-researched.
A common dose for this combination is 500 milligrams per day of Lion’s Mane, 240 milligrams per day of Ginkgo Biloba, and 100 milligrams twice per day of Bacopa Monnieri. Consider buying each ingredient in bulk to have stock and experiment with. If you are not experiencing positive results after 12 weeks, try adjusting the dosages in small increments. For example, you can start by adjusting Bacopa Monnieri to 150 milligrams twice per day for a couple weeks. Be patient: the end result is worth the trial and error.
Nootropic (new-tro-pik) is the term for supplements, also known as smart drugs, that improve brain function. They can be food substances like phenethylamine and L-Theanine, found in chocolate and green tea, respectively. Nootropics also include extracted and purified components of medicinal plants, as well as substances synthesized from chemical precursors, such as piracetam, the world's first official nootropic (piracetam was created in 1964 in Belgium by a team of scientists whose leader, Dr. Corneliu E. Giurgea, coined the term). Since then piracetam has been widely used as a cognitive enhancer and to treat neurological diseases like Alzheimer's.
Cocoa flavanols (CF) positively influence physiological processes in ways which suggest that their consumption may improve aspects of cognitive function. This study investigated the acute cognitive and subjective effects of CF consumption during sustained mental demand. In this randomized, controlled, double-blinded, balanced, three period crossover trial 30 healthy adults consumed drinks containing 520 mg, 994 mg CF and a matched control, with a 3-day washout between drinks. Assessments included the state anxiety inventory and repeated 10-min cycles of a Cognitive Demand Battery comprising of two serial subtraction tasks (Serial Threes and Serial Sevens), a Rapid Visual Information Processing (RVIP) task and a mental fatigue scale, over the course of 1 h. Consumption of both 520 mg and 994 mg CF significantly improved Serial Threes performance. The 994 mg CF beverage significantly speeded RVIP responses but also resulted in more errors during Serial Sevens. Increases in self-reported mental fatigue were significantly attenuated by the consumption of the 520 mg CF beverage only. This is the first report of acute cognitive improvements following CF consumption in healthy adults. While the mechanisms underlying the effects are unknown they may be related to known effects of CF on endothelial function and blood flow.
The different ADHD medications like Adderall and Ritalin are classified as stimulants, and deal with these symptoms by increasing the neurotransmitters known as dopamine and norepinephrine, which are associated with pleasure, movement, and attention. They have a calming and focusing effect on people affected with ADHD, and are helpful for the inattentiveness, poor memory, impulsiveness, and mood swings experienced by those people.
Mosconi does not make a persuasive argument that the brain requires anything unique, anything more than the same good nutrition that benefits the entire body. Her Brain Food plan provides much good advice about healthy lifestyle and diet, but the good advice is mixed with unsupported claims, speculations, extrapolations that go far beyond the evidence, and some very questionable ideas. (Himalayan pink sea salt? Water that doesn’t hydrate?) Her plan might reduce the risk of Alzheimer’s; it might not. Is it any better than any of the many other plans recommended in the “Awakening from Alzheimer’s” videos? The only way to tell would be to do controlled studies, which have not been done or even contemplated, as far as I could see. It might not be any better than the general health advice provided by science-based conventional medical practitioners. There may be no difference between eating for your brain and eating for your entire organism.
It’s a frosty Monday evening in March, but in the back of Idea Coffee, a dingy café near the Empire State Building, things are heating up. A group huddles around a small black box—the $160 ApeX Type A brain stimulator, with its retro-looking meter and dial and two electrodes. It’s supposed to bolster learning by delivering a mild electric current to the brain. The guy who’s been experimenting with it for a week notes that the only thing he’s noticed so far is a metallic taste in his mouth.

Taking these drugs without a doctor’s supervision can be dangerous. There are interactions and contraindications that can cause serious problems. These drugs should not be used if you drink alcohol or take an antidepressant. (50) The possibility of adverse drug reactions should not be taken lightly. By some calculations, adverse drug reactions are now the fourth leading cause of death in the US. (51)
These days, nootropics are beginning to take their rightful place as a particularly powerful tool in the Neurohacker’s toolbox. After all, biochemistry is deeply foundational to neural function. Whether you are trying to fix the damage that is done to your nervous system by a stressful and toxic environment or support and enhance your neural functioning, getting the chemistry right is table-stakes. And we are starting to get good at getting it right. What’s changed?
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