It is important that this type of approach is discussed with a qualified health professional, such as a registered nutritional therapist, to ensure it is an appropriate strategy for you, as well as to help you avoid missing out on vital nutrients, whilst eliminating certain foods. They can also provide advice on improving your longer term health, which over time may allow for foods to be reintroduced without negative symptoms occurring.
Forums including have more than 140,000 subscribers discussing products with names like Orange Brainwash and GodMode. Nootropics are blends of ingredients touted as a low-risk way to enhance learning, memory, motivation, and even serenity. These ingredients range from herbs such as water hyssop (Bacopa monnieri) and arctic root to chemicals such as vinpocetine.
Safety Warning	Do not exceed recommended dose. Not intended for pregnant or nursing mothers or children under the age of 18. Individuals taking blood thinners, any other medications, or have any known medical conditions should consult a physician before using any herbal supplements. Discontinue use and consult your doctor if any adverse reactions occur. Not intended to treat obesity; consult a physician before beginning any weight loss program. KEEP OUT OF REACH OF CHILDREN. DO NOT USE IF SAFETY SEAL IS DAMAGED OR MISSING. KEEP BOTTLE CLOSED TIGHTLY AND STORE IN A COOL, DRY PLACE.	Do not exceed recommended dose. Not intended for pregnant or nursing mothers or children under the age of 18. Individuals taking blood thinners, any other medications, or have any known medical conditions should consult a physician before using any herbal supplements. Discontinue use and consult your doctor if any adverse reactions occur. Not intended to medical conditions; consult a physician before beginning any weight loss program. KEEP OUT OF REACH OF CHILDREN. DO NOT USE IF SAFETY SEAL IS DAMAGED OR MISSING. KEEP BOTTLE CLOSED TIGHTLY AND STORE IN A COOL, DRY PLACE.	CAUTION: Do not exceed recommended dose. St. John’s Wort may contribute to photosensitivity resulting in skin irritation and redness in persons exposed to strong sunlight or tanning booths. Avoid use in patients at risk of bleeding, taking anticoagulants, or with clotting disorders, based on case reports of bleeding. Discontinue use 2-3 weeks prior to some surgical and dental procedures due to increased risk of bleeding. Avoid use in couples who are trying to conceive, based on theoretical reduction of fertility. Pregnant or nursing mothers, children under 18, individuals with history of seizure, taking MAO inhibiting drugs, or with a known medical condition should consult a physician before using this or any dietary supplement. This product is manufactured and packaged in a facility which may also process milk, soy, wheat, egg, peanuts, tree nuts, fish and crustacean shellfish.	—	This product is a dietary supplement. If you feel an adverse reaction, please contact our support staff immediately to notify us of the issue so that we can offer assistance. Please consult with a physician prior to beginning this supplement. This product has not been approved by the Food and Drug Administration.	Keep out of reach of children. Do not use if safety seal is damaged or missing. Store at a room temperature. Avoid in patients at risk of bleeding, taking anticoagulants, or with clotting disorders, based on case reports of bleeding. Discontinue use 2-3 weeks prior to some surgical and dental procedures due to increased risk of bleeding. Use cautiously in patients with history of seizure, based on reports of seizure due to Ginkgo seed ingestion. Not intended for children under 18 years of age. Avoid use in couples who are trying to conceive, based on theoretical reduction of fertility. Pregnant or nursing mothers, children under 18, individuals making MAO inhibiting Drugs, or with a known medical condition should consult a physician before using this or any dietary supplement.

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My worry about the MP variable is that, plausible or not, it does seem relatively weak against manipulation; other variables I could look at, like arbtt window-tracking of how I spend my computer time, # or size of edits to my files, or spaced repetition performance, would be harder to manipulate. If it’s all due to MP, then if I remove the MP and LLLT variables, and summarize all the other variables with factor analysis into 2 or 3 variables, then I should see no increases in them when I put LLLT back in and look for a correlation between the factors & LLLT with a multivariate regression.
The realm of natural nootropics is also accompanied by a family of synthetic nootropics called racetams, most notably piracetam and aniracetam. Piracetam is known to directly enhance learning, memory and attention and, with no observed adverse side effects, can restore cognitive performance in patients who have suffered cranial trauma, inflammation, strokes and ischemic complications following coronary bypass surgery. It can also improve symptoms of delirium and reduce depression and anxiety. In adults, the standard dose of piracetam ranges from 1,200 to 4,800 mg, often broken up into three smaller doses throughout the day. Aniracetam has been shown to concentration-dependently counteract cell death induced by excitotoxicity caused by glutamate, resulting in an overall neuroprotective effect. While you may not be shoveling mouthfuls of glutamate down your hatch or eating cartonsful of MSG-containing Chinese food each night, the same mechanism of action can help protect your brain from excitotoxicity or inflammation caused by other central nervous system irritants, such as toxins, chemicals, herbicides, pesticides, rancid oils, etc. Effective doses of aniracetam range from a single 400 mg dose to two doses per day between 500 and 750 mg, taken with meals.

The compound has great nootropic properties that includes memory enhancement and protection against brain aging. There are studies that suggest that the compound is an effective treatment for disorders like vascular dementia, Alzheimer’s, brain stroke, anxiety and depression. However, there are some side effects associated with Alpha GPC, like headache, heartburn, dizziness, skin rashes, insomnia, and confusion.
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.
I have lots of problems with procrastination and productivity, most likely due to a mild case of ADHD, and recently it's been getting worse and worse. I was a bit hesitant to take Addium at first because I, like most people, had heard about it as a tool for students to use for cramming and it's results sound a little bit like the results of taking Adderall recreationally, which isn't my cup of tea. I was also hesitant to try it because it's marketing just makes it seem like it's a scam pill, and I unfortunately take quality of advertising rather seriously. I changed my mind (after another particularly trying week at work) after a friend of mine actually recommended it for me and told me that she was having great results from it. In my mind, I figured that if a real person,someone I know and trust, tells me in real life that I should maybe try it...then I may as well give it a shot. I ordered the Addium and as soon as I got it, I started taking it immediately. The Addium actually works. I can't believe it. It's helped a lot with my productivity at work. I'm taking just one tablet per day and it seems to be doing the trick. I think the best part about it is that it's not something that you have to continuously take every day.
“In an era of confusion about what we should eat, Brain Food is a shining light. This is the straight story about ‘neuro-nutrition’ firmly rooted in research by a neuroscientist who has a deep understanding of how food affects our cognitive health. Dr. Mosconi gives us advice we can easily implement into our lives and a story about the science behind it that is both delightful and accessible. A must read!”
I had tried 8 randomized days like the Adderall experiment to see whether I was one of the people whom modafinil energizes during the day. (The other way to use it is to skip sleep, which is my preferred use.) I rarely use it during the day since my initial uses did not impress me subjectively. The experiment was not my best - while it was double-blind randomized, the measurements were subjective, and not a good measure of mental functioning like dual n-back (DNB) scores which I could statistically compare from day to day or against my many previous days of dual n-back scores. Between my high expectation of finding the null result, the poor experiment quality, and the minimal effect it had (eliminating an already rare use), the value of this information was very small.
Celastrus paniculatus, also known as the Intellect Tree, is perhaps one of the more interesting Ayurvedic medicinal plants that has been used for thousands of years, and one that I personally use quite frequently as part of the supplement “Qualia Mind”. In the Ayurvedic tradition, oil derived from C. paniculatus (Malkanguni oil) is used to enhance memory and intellectual capacity, as well as to improve dream recall and induce lucid dreams. In a study performed on healthy rats, the oil was shown to improve 24-hour memory retention after a single dose, an effect accompanied by a reduction in monoamines like norepinephrine, dopamine and serotonin, indicating a decreased turnover of these neurotransmitters which, in turn, may aid in reducing conditions like depression. In another study with rats, C. paniculatus oil administered for 14 days reversed stress-induced spatial learning and memory impairment and restored working memory. In mice with scopolamine-induced memory deficits, the oil has been shown to improve both spatial and fear memory (a type of fear conditioning through which an organism learns to avoid detrimental situations or events). Traditionally, is taken in seed form, starting with 10 seeds and working up to 15 and finally 20 seeds.
Traditional Chinese medicine also has a long, well-established relationship with nootropic herbs and plants. One of the most popular and well-known is ginkgo biloba, derived from the Chinese maidenhair tree, a relic of the ancient world. The maidenhair tree is the last living species of the division Ginkgophyta>. Some believe that the name ginkgo is a misspelling of the original Japanese gin kyo, meaning “silver apricot”. It’s seen as a symbol of longevity and vitality and is known to be effective at stimulating the growth of new neurons. Researchers have demonstrated that ginkgo flavonoids, the main constituents in ginkgo extract, provide potent anti-Alzheimer’s effects via antioxidant activity in the brains of mice and also stabilize and improve the cognitive performance of Alzheimer patients for 6 months to 1 year. Effective doses range from 120 to 240 mg one to four hours before performance, and for older adults, doses range from 40 to 120 mg three times a day.
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.

According to the official website, Cognizin is based on Citicoline, which is a highly beneficial nutrient that’s useful for assisting certain brain functions that are related to mental focus and cognitive processing. What’s more, it’s shown to improve your brain’s metabolism regarding the use of acetylcholine, which is an important neurotransmitter involved in the storage and processing of memory.
Qualia Mind, meanwhile, combines more than two dozen ingredients that may support brain and nervous system function – and even empathy, the company claims – including vitamins B, C and D, artichoke stem and leaf extract, taurine and a concentrated caffeine powder. A 2014 review of research on vitamin C, for one, suggests it may help protect against cognitive decline, while most of the research on artichoke extract seems to point to its benefits to other organs like the liver and heart. A small company-lead pilot study on the product found users experienced improvements in reasoning, memory, verbal ability and concentration five days after beginning Qualia Mind.
Power times prior times benefit minus cost of experimentation: (0.20 \times 0.30 \times 540) - 41 = -9. So the VoI is negative: because my default is that fish oil works and I am taking it, weak information that it doesn’t work isn’t enough. If the power calculation were giving us 40% reliable information, then the chance of learning I should drop fish oil is improved enough to make the experiment worthwhile (going from 20% to 40% switches the value from -$9 to +$23.8).
I’ve been taking nootropics on and off for a month, and despite my spurts of productivity, I’m still not 100 percent sure that they’re working. I could well be placebo-ing myself into thinking I'm working harder and focusing better than I typically do. But apparently enough people are feeling some effect, placebo or not, because nootropics start-ups are thriving. There’s truBrain, Nootrobrain, Nootroo, and a host of others. Nootrobox, the company that makes my pills, says that it’s selling "five figures" worth of cognitive supplements monthly to customers that include top Silicon Valley executives and Hollywood moguls.
The abuse liability of caffeine has been evaluated.147,148 Tolerance development to the subjective effects of caffeine was shown in a study in which caffeine was administered at 300 mg twice each day for 18 days.148 Tolerance to the daytime alerting effects of caffeine, as measured by the MSLT, was shown over 2 days on which 250 g of caffeine was given twice each day48 and to the sleep-disruptive effects (but not REM percentage) over 7 days of 400 mg of caffeine given 3 times each day.7 In humans, placebo-controlled caffeine-discontinuation studies have shown physical dependence on caffeine, as evidenced by a withdrawal syndrome.147 The most frequently observed withdrawal symptom is headache, but daytime sleepiness and fatigue are also often reported. The withdrawal-syndrome severity is a function of the dose and duration of prior caffeine use…At higher doses, negative effects such as dysphoria, anxiety, and nervousness are experienced. The subjective-effect profile of caffeine is similar to that of amphetamine,147 with the exception that dysphoria/anxiety is more likely to occur with higher caffeine doses than with higher amphetamine doses. Caffeine can be discriminated from placebo by the majority of participants, and correct caffeine identification increases with dose.147 Caffeine is self-administered by about 50% of normal subjects who report moderate to heavy caffeine use. In post-hoc analyses of the subjective effects reported by caffeine choosers versus nonchoosers, the choosers report positive effects and the nonchoosers report negative effects. Interestingly, choosers also report negative effects such as headache and fatigue with placebo, and this suggests that caffeine-withdrawal syndrome, secondary to placebo choice, contributes to the likelihood of caffeine self-administration. This implies that physical dependence potentiates behavioral dependence to caffeine.
Now, what is the expected value (EV) of simply taking iodine, without the additional work of the experiment? 4 cans of 0.15mg x 200 is $20 for 2.1 years’ worth or ~$10 a year or a NPV cost of $205 (\frac{10}{\ln 1.05}) versus a 20% chance of $2000 or $400. So the expected value is greater than the NPV cost of taking it, so I should start taking iodine.
More photos from this reportage are featured in Quartz’s new book The Objects that Power the Global Economy. You may not have seen these objects before, but they’ve already changed the way you live. Each chapter examines an object that is driving radical change in the global economy. This is from the chapter on the drug modafinil, which explores modifying the mind for a more productive life. 
It is at the top of the supplement snake oil list thanks to tons of correlations; for a review, see Luchtman & Song 2013 but some specifics include Teenage Boys Who Eat Fish At Least Once A Week Achieve Higher Intelligence Scores, anti-inflammatory properties (see Fish Oil: What the Prescriber Needs to Know on arthritis), and others - Fish oil can head off first psychotic episodes (study; Seth Roberts commentary), Fish Oil May Fight Breast Cancer, Fatty Fish May Cut Prostate Cancer Risk & Walnuts slow prostate cancer, Benefits of omega-3 fatty acids tally up, Serum Phospholipid Docosahexaenonic Acid Is Associated with Cognitive Functioning during Middle Adulthood endless anecdotes.
Caveats aside, if you do want to try a nootropic, consider starting with something simple and pretty much risk-free, like aromatherapy with lemon essential oil or frankincense, which can help activate your brain, Barbour says. You could also sip on "golden milk," a sweet and anti-inflammatory beverage made with turmeric, or rosemary-infused water, she adds.
Learning how products have worked for other users can help you feel more confident in your purchase. Similarly, your opinion may help others find a good quality supplement. After you have started using a particular supplement and experienced the benefits of nootropics for memory, concentration, and focus, we encourage you to come back and write your own review to share your experience with others.
Also known as Arcalion or Bisbuthiamine and Enerion, Sulbutiamine is a compound of the Sulphur group and is an analogue to vitamin B1, which  is known to pass the blood-brain barrier very easily. Sulbutiamine is found to circulate faster than Thiamine from blood to brain. It is recommended for patients suffering from mental fatigue caused due to emotional and psychological stress. The best part about this compound is that it does not have most of the common side effects linked with a few nootropics.
By the way, before we move on, allow me to clarify what I mean by “slow caffeine metabolizer”. Ever wondered why your co-worker can slam four giant mugs of coffee during a brief morning of work, while one shot of espresso leaves you jittery and irritated? Turns out that not everyone metabolizes caffeine the same. Generally speaking, in healthy adults, caffeine has a half-life that ranges from about 3 to 7 hours. For example, if the half-life of caffeine in your blood is 5 hours, that means that it takes 5 hours for caffeine levels to be reduced by 50%. Then it takes another 5 hours for that amount to be reduced by 50%. While caffeine metabolism time also depends upon age and environmental factors, a big influence on varying caffeine half-life times is your genetic makeup.
Of course learning, working memory and cognitive control represent just a few aspects of thinking. Farah concluded that studies looking at other kinds of cognition - verbal fluency, for instance - were too few and too contradictory to tell us much. Both Chatterjee and Farah have wondered whether drugs that heighten users' focus might dampen their creativity. After all, some of our best ideas come to us not when we sit down at a desk but rather when we're in the shower or walking the dog - letting our minds roam. Jimi Hendrix reported that the inspiration for "Purple Haze" came to him in a dream; the chemist Friedrich August Kekule claimed that he discovered the ring structure of benzene during a reverie in which he saw the image of a snake biting its tail. Farah told me: "There is some evidence that suggests that individuals who are better able to focus on one thing and filter out distractions tend to be less creative.
Using the 21mg patches, I cut them into quarters. What I would do is I would cut out 1 quarter, and then seal the two edges with scotch tape, and put the Pac-Man back into its sleeve. Then the next time I would cut another quarter, seal the new edge, and so on. I thought that 5.25mg might be too much since I initially found 4mg gum to be too much, but it’s delivered over a long time and it wound up feeling much more like 1mg gum used regularly. I don’t know if the tape worked, but I did not notice any loss of potency. I didn’t like them as much as the gum because I would sometimes forget to take off a patch at the end of the day and it would interfere with sleep, and because the onset is much slower and I find I need stimulants more for getting started than for ongoing stimulation so it is better to have gum which can be taken precisely when needed and start acting quickly. (One case where the patches were definitely better than the gum was long car trips where slow onset is fine, since you’re most alert at the start.) When I finally ran out of patches in June 2016 (using them sparingly), I ordered gum instead.

An important dietary step to avoid heavy metal toxicity is choosing seafood and fish that has reduced levels of exposure. The Seafood Watch web page is a fantastic resource that has an extensive list of fish, seafood and sushi products that are safe, as well as those that are best to stay away from. For example, choosing wild pacific caught salmon is safer than Atlantic caught salmon.
Spinach is rich in the antioxidant lutein, which is thought to help protect against cognitive decline, according to researchers from Tufts University. And a longitudinal study at Harvard Medical School found that women who reported eating the most leafy green and cruciferous vegetables had a markedly lower rate of cognitive decline, compared to those who ate the least.
As with any thesis, there are exceptions to this general practice. For example, theanine for dogs is sold under the brand Anxitane is sold at almost a dollar a pill, and apparently a month’s supply costs $50+ vs $13 for human-branded theanine; on the other hand, this thesis predicts downgrading if the market priced pet versions higher than human versions, and that Reddit poster appears to be doing just that with her dog.↩
Choline works best when stacked with nootropics. Stacking choline with a nootropic can also help prevent or reduce side effects. Often, people find that they get headaches when they take nootropics by themselves and that stacking them with choline helps reduce this problem. It is usually suggested to stack nootropics with a choline source, especially if you do not get enough from your diet.
Nootropics include natural and manmade chemicals that produce cognitive benefits. These substances are used to make smart pills that deliver results for enhancing memory and learning ability, improving brain function, enhancing the firing control mechanisms in neurons, and providing protection for the brain. College students, adult professionals, and elderly people are turning to supplements to get the advantages of nootropic substances for memory, focus, and concentration.
It’s that time of the year again. It’s Blue Monday. We’re halfway into January, trudging through the deepest and darkest of the winter months, as we try to keep our heads high after the Christmas festivities with the motivation of our New Year’s resolutions. Some of you may have never heard of Blue Monday and let’s just say you’re not exactly missing out.

In August 2011, after winning the spaced repetition contest and finishing up the Adderall double-blind testing, I decided the time was right to try nicotine again. I had since learned that e-cigarettes use nicotine dissolved in water, and that nicotine-water was a vastly cheaper source of nicotine than either gum or patches. So I ordered 250ml of water at 12mg/ml (total cost: $18.20). A cigarette apparently delivers around 1mg of nicotine, so half a ml would be a solid dose of nicotine, making that ~500 doses. Plenty to experiment with. The question is, besides the stimulant effect, nicotine also causes habit formation; what habits should I reinforce with nicotine? Exercise, and spaced repetition seem like 2 good targets.
“Who doesn’t want to maximize their cognitive ability? Who doesn’t want to maximize their muscle mass?” asks Murali Doraiswamy, who has led several trials of cognitive enhancers at Duke University Health System and has been an adviser to pharmaceutical and supplement manufacturers as well as the Food and Drug Administration. He attributes the demand to an increasingly knowledge-based society that values mental quickness and agility above all else.
I find this very troubling. The magnesium supplementation was harmful enough to do a lot of cumulative damage over the months involved (I could have done a lot of writing September 2013 - June 2014), but not so blatantly harmful enough as to be noticeable without a randomized blind self-experiment or at least systematic data collection - neither of which are common among people who would be supplementing magnesium I would much prefer it if my magnesium overdose had come with visible harm (such as waking up in the middle of the night after a nightmare soaked in sweat), since then I’d know quickly and surely, as would anyone else taking magnesium. But the harm I observed in my data? For all I know, that could be affecting every user of magnesium supplements! How would we know otherwise?
Nuts and seeds. Nuts and seeds are good sources of vitamin E, says Pratt, explaining that higher levels of vitamin E correspond with less cognitive decline as you get older. Add an ounce a day of walnuts, hazelnuts, Brazil nuts, filberts, almonds, cashews, peanuts, sunflower seeds, sesame seeds, flax seed, and unhydrogenated nut butters such as peanut butter, almond butter, and tahini. Raw or roasted doesn't matter, although if you're on a sodium-restricted diet, buy unsalted nuts.
Seriously. Every single thing you experience comes through your brain. It create the fabric of your reality, and by the same token, the energy your brain makes is what allows you to shape that reality. Work, relationships, success, happiness — everything depends on your brain, and building a stronger one will trigger upgrades that extend across every aspect of your life.

Past noon, I began to feel better, but since I would be driving to errands around 4 PM, I decided to not risk it and take an hour-long nap, which went well, as did the driving. The evening was normal enough that I forgot I had stayed up the previous night, and indeed, I didn’t much feel like going to bed until past midnight. I then slept well, the Zeo giving me a 108 ZQ (not an all-time record, but still unusual).
But before you go lock yourself in a dark, quiet room in order to prevent this overburden on your brain, you should know that there are scientifically researched compounds designed to amplify cognitive function and help your brain deal with this excess load, or simply get you through a period of sleep deprivation, increased creativity or work demands, the need to pull an all-nighter or an intense bout of work or study.
Modafinil is a stimulant specifically designed to reduce fatigue and sleepiness. It was approved for treatment of narcolepsy in 1998, and although the exact mechanism behind its effects is not fully understood, most research indicates that modafinil also works by inhibiting reuptake of dopamine, which produces effects similar to those of methylphenidate. It’s also believed that by inhibiting dopamine uptake, more acetylcholine (another neurotransmitter) is released by the hippocampus, which leads to improved cognitive performance, specifically memory.
I’ve spent over a million dollars hacking my own biology. The lion’s share has gone to making my brain produce as much energy as it can. I even wrote a book, Head Strong, about neurofeedback, oxygen deprivation, supplements, deeper sleep, meditation, cold exposure, and about a dozen other brain hacks, and how you can use them to make your brain stronger than you thought possible.

Lucas Baker, a Switzerland-based software engineer with a large tech company, takes nootropics every day. He says it helps him maintain focus, especially on projects he might otherwise put off. “When I find an unpleasant task, I can just power through it,” he says. Baker also makes the coffee comparison: “There’s already a universally-embraced nootropic called caffeine,” he says. “It’s just about making it more widely researched.”
Blueberries. "Brainberries" is what Steven Pratt, MD, author of Superfoods Rx: Fourteen Foods Proven to Change Your Life, calls these tasty fruits. Pratt, who is also on staff at Scripps Memorial Hospital in La Jolla, Calif., says that in animal studies researchers have found that blueberries help protect the brain from oxidative stress and may reduce the effects of age-related conditions such as Alzheimer's disease or dementia. Studies have also shown that diets rich in blueberries significantly improved both the learning capacity and motor skills of aging rats, making them mentally equivalent to much younger rats. Ann Kulze, MD, author of Dr. Ann's 10-Step Diet: A Simple Plan for Permanent Weight Loss & Lifelong Vitality, recommends adding at least 1 cup of blueberries a day in any form -- fresh, frozen, or freeze-dried.
The main concern with pharmaceutical drugs is adverse effects, which also apply to nootropics with undefined effects. Long-term safety evidence is typically unavailable for nootropics.[13] Racetams — piracetam and other compounds that are structurally related to piracetam — have few serious adverse effects and low toxicity, but there is little evidence that they enhance cognition in people having no cognitive impairments.[19]