Nootropics: Everything You Need to Know
Getty Images / Akaradech Pramoonsin
SupplementsMedically reviewed by Suzanne Fisher, MS, RD, LDN
Warning
The Food and Drug Administration (FDA) determined that piracetam cannot be sold as a dietary supplement. However, due to limited enforcement, piracetam supplements remain available for sale.
The FDA also does not consider vinpocetine to be a supplement. However, it is still marketed as such.
Nootropics are substances that boost brain and cognitive performance. They are derived from plants or can also be synthetic (artificial).
Supplements known as nootropics range from herbs to stimulants, antioxidants, amino acids, and other supplements with cognitive-enhancing effects. Vitamin B12 appears to fit into such a category as it enhances cognitive performance by ensuring proper brain metabolic function.
Nootropics enhance cognitive health by improving the following functions:
Perceptual-motor functions (cognitive processing during visual perception and reasoning, as well as balance and coordination)
Language-related cognition
Learning and memory
Social cognition (refers to the cognitive process involved in social interactions with others)
Complex attention (refers to the ability to selectively focus on one specific stimulus while ignoring others)
Executive functions (refers to problem-solving, planning, learning, and social interaction)
Supplementation with nootropics has become an area of interest for people across the lifespan.
This article discusses the potential uses of nootropics, side effects, and safety concerns.
Dietary supplements are not regulated like drugs in the United States, meaning the Food and Drug Administration (FDA) does not approve them for safety and effectiveness before products are marketed. When possible, choose a supplement tested by a trusted third party, such as the United States Pharmacopeia (USP), ConsumerLab, or NSF.org. However, even if supplements are third-party tested, that doesn't mean they are necessarily safe for all or effective in general. Therefore, talking to your healthcare provider about any supplements you plan to take and checking in about potential interactions with other supplements or medications is essential.
Uses of Nootropics
The following nootropics have been shown to enhance cognition.
Bacopa (Bacopa monnieri)
An analysis of a group of studies looked at using 300 milligrams (mg) of Bacopa (Bacopa monnieri) for at least 12 weeks in healthy adult volunteers.
It showed a decrease in choice reaction time or an improvement in attention speed.
However, the effect of Bacopa on memory remains to be seen due to conflicting results.
Larger trials are warranted comparing Bacopa with an approved nootropic prescription drug, such as Aricept (donepezil).
Bacopa has improved cognitive function in healthy adults, children, and adolescents.
A systematic review of research participants aged between four to 18 years of age showed improvements in cognition and behavior.
It also improved attention-deficit disorders like attention deficit hyperactivity disorder (ADHD).
Caffeine
Low-to-moderate doses (around 100 to 275 milligrams) of caffeine before and/or during exercise improved attention, energy, and mood in studies of adult athletes. However, in some of the studies, caffeine was taken with carbohydrates. This may have changed caffeine's effects.
One review looked at the effect of short-term caffeine consumption in individuals with sleep deprivation. It revealed caffeine improved cognitive performance and thus appears to counteract the effects of sleep loss.
Another review found that using caffeine before a mentally fatiguing task helped counteract mental fatigue.
However, another group of studies examining the effect of caffeine on mental fatigue in healthy participants aged 18 to 45 found that caffeine did not affect some cognitive tests.
It's essential to get adequate sleep when possible. Replacing rest with caffeine intake is not advised.
Citicoline (CDP-Choline)
Studies have used citicoline (CDP-choline) with acetylcholinesterase inhibitors (ACHEIs), such as Aricept (donepezil).
This combination improved cognitive performance among people with Alzheimer’s disease versus ACHEIs alone.
Further study is needed.
Ginkgo (Ginkgo biloba)
A review of ginkgo (Ginkgo biloba) studies revealed that it significantly benefited research participants with cognitive impairment.
However, ginkgo did not improve cognitive function in healthy subjects.
Further research is needed to clarify the cognitive effect of ginkgo in healthy individuals.
Huperzine A
Huperzine A has been studied for its effects on several cognitive issues. A review of studies looked at data from 1,823 participants with Alzheimer’s disease between 50 and 85 years.
The huperzine A dosage was 0.2 to 0.8 milligrams daily (average dose: about 0.37 milligrams daily).
The studies lasted eight to 36 weeks (average duration: 14.7 weeks).
Huperzine A showed beneficial effects for Alzheimer’s disease, improving cognitive function, compared with placebo (no treatment), psychotherapy, and conventional medicine.
However, the quality of the included studies was not the best.
A different systematic review showed that using huperzine A with antipsychotics improved cognitive function in people with schizophrenia.
Higher quality studies are needed.
L-theanine
A review of a group of studies found that L-theanine in combination with caffeine, was linked to improvements in cognitive tasks such as enhancing attention.
Further research is needed to determine the minimum period that will result in the long-term effects of L-theanine.
Racetams
According to a review of a group of studies, piracetam only improved written language performance in post-stroke people on a short-term basis.
It is important to note that the FDA has prohibited the sale of piracetam as a dietary supplement.
However, piracetam supplements remain available in the marketplace at high doses.
Higher dosages of racetams carry an increased risk of side effects among consumers of cognitive enhancement supplements.
Tyrosine
A review of studies suggested tyrosine helped people doing demanding work in harsh environmental conditions.
Tyrosine prevented or reversed the cognitive performance decreases that these situations created. The review also suggested tyrosine increased working memory, information processing, and mood.
Researchers said tyrosine also improved convergent thinking. They also suggested tyrosine's effects on working memory and information processing speed may be similar to those of methylphenidate, a medication used for attention deficit hyperactivity disorder (ADHD).
ADHD has been associated with neurotransmitter deficiency, specifically dopamine and norepinephrine. Researchers believe L-tyrosine provides the building blocks to make dopamine and norepinephrine.
Further study is needed to confirm whether tyrosine supplementation is equivalent to methylphenidate.
Vinpocetine
The FDA does not consider vinpocetine to be a supplement. However, it is still marketed as such.
A study found that vinpocetine could increase blood flow in the brain and improve cognitive ability in people with stroke.
Another study showed no significant cognitive effects of vinpocetine in healthy volunteers or people with epilepsy.
Future studies exploring higher doses of vinpocetine are needed to determine if such doses can effectively enhance human cognition.
Disclaimer
Supplement use should be individualized and vetted by a healthcare professional, such as a registered dietitian, pharmacist, or healthcare provider. No supplement is intended to treat, cure, or prevent disease.
What Are the Side Effects of Nootropics?
Your provider may recommend you take nootropics for specific reasons.
However, consuming a nootropic supplement, such as bacopa, caffeine, CDP-choline, ginkgo, huperzine A, L-theanine, racetams, and vinpocetine, may have potential side effects.
These side effects may be common or severe.
Common Side Effects
Bacopa monnieri
Side effects of B. monnieri commonly reported in clinical trials include the following:
Gastrointestinal problems (e.g., increased stool frequency, nausea, abdominal cramps, and diarrhea)
Decrease in felt stress
Reduction in the number of dreams
Caffeine
Taking too much caffeine can cause the following side effects:
Restlessness and shakiness
Fast heart rate
Dependency (needing more to get the same results)
Citicoline (CDP-Choline)
Mild side effects of CDP-choline include the following:
Increased appetite
Increased flatulence
Increased burping
Increased thirst
Ginkgo Biloba
Side effects of ginkgo may include the following:
Stomach upset
Increased risk of bleeding
Huperzine A
Huperzine A is associated with some of the following cholinergic side effects:
Excessive daytime sleepiness
Mild bellyache
Tyrosine
Researchers in one clinical trial reported that tyrosine had no side effects.
However, it's a building block for norepinephrine and dopamine.
Theoretically, it may cause symptoms associated with these two neurotransmitters.
Racetams
Potential side effects of piracetam include the following:
Gastrointestinal discomfort
Tiredness
Agitation
Vinpocetine
Mild side effects such as dizziness and diarrhea were reported in one study. Moderate allergic dermatitis was also reported.
Severe Side Effects
Bacopa monnieri
No serious adverse events were reported in several clinical studies.
Caffeine
Rapid consumption of about 1,200 milligrams (mg) or 0.15 tablespoons of pure caffeine can lead to toxic effects, such as seizures.
CDP-Choline
No adverse effects were reported to be serious.
Ginkgo Biloba
Severe allergic reactions have been reported, in addition to arrhythmia.
Huperzine A
No serious adverse events were reported in a collection of studies.
L-theanine
No adverse effects were reported, even with high doses of L-theanine.
Racetams
Severe nausea from piracetam was reported in some trials.
Vinpocetine
No serious adverse effects were associated with vinpocetine.
Precautions
Avoid nootropics if you have a known allergy to them or their components (ingredients or parts).
Ask your pharmacist, registered dietitian nutritionist, or healthcare provider for more information if you need clarification.
Keep the following precautions in mind when using the following nootropic supplements.
Caffeine
You may need to limit or avoid caffeine if you:
Are pregnant or breastfeeding
Have sleep disorders
Have migraine or chronic headaches
Have anxiety
Have irregular heart rate
Have high blood pressure
Take certain medications or supplements (e.g., stimulants, certain antibiotics, asthma medicines, and heart medicines)
Are a child or teen
Ginkgo Biloba
Ginkgo may increase the risk of bleeding and seizures.
It is unknown whether it is safe to use ginkgo while breastfeeding.
However, ginkgo may be unsafe during pregnancy due to the risk of early labor or excessive bleeding during delivery.
Raw or roasted ginkgo seeds and unprocessed ginkgo leaves can be toxic.
Huperzine A
Huperzine A may lower heart rate.
L-theanine
L-theanine should be avoided if you have a green tea allergy. Avoid theanine supplements if you're pregnant or breastfeeding, as there's not enough information about their safety.
Vinpocetine
Do not vinpocetine if you are of childbearing age or are pregnant. Vinpocetine may cause harm to your fetus.
If you have low blood pressure and a history of heart problems or stroke, consult your healthcare provider before using vinpocetine.
Interactions
This is not an exhaustive list. Please speak with your pharmacist, registered dietitian nutritionist, or healthcare provider for more information about possible interactions.
Bacopa monnieri
Bacopa may interact with the following medications:
Alzheimer’s disease medications (e.g., Aricept or donepezil)
Anticholinergic medications (e.g., Ditropan XL or oxybutynin)
Nonsteroidal anti-inflammatories (e.g., Advil or ibuprofen)
Ginkgo biloba
Ginkgo may increase bleeding risk. It may interact with blood thinners, such as Jantoven (warfarin) and aspirin. It may also interact with nonsteroidal anti-inflammatories (NSAIDs), like Advil (ibuprofen).
Huperzine A
Huperzine A should not be used with acetylcholinesterase inhibitors. Acetylcholinesterase inhibitors include Aricept (donepezil), Razadyne (galantamine), and Exelon (rivastigmine). Huperzine A works in the same way as acetylcholinesterase inhibitors. Taking huperzine A with such medication may increase the risk of side effects.
L-theanine
L-theanine relaxes the mind. It may increase drowsiness risk when taken with medications or supplements that cause drowsiness.
Speak with your healthcare provider if you are taking CNS depressant medications such as Ativan (lorazepam), Valium (diazepam), or Ambien (zolpidem).
Tyrosine
Tyrosine is a precursor to thyroid hormones. It may change thyroid medication needs.
Vinpocetine
Do not take vinpocetine if you use the following medications:
Blood thinners (e.g., coumadin, Eliquis or apixaban, aspirin, etc.)
P-glycoprotein substrates (e.g., calcium channel blockers, Eliquis or apixaban, Colcrys or colchicine, etc.)
It is essential to carefully read a supplement's ingredient list and nutrition facts panel to know which ingredients and how much of each ingredient is included. Please review this supplement label with your healthcare provider to discuss potential interactions with foods, other supplements, and medications.
Summary
Nootropics such as bacopa caffeine, CDP-choline, ginkgo, huperzine A, L-theanine, racetams, tyrosine, and vinpocetine have enhanced brain function.
However, caution should be taken. Some supplements should not be used if you have certain medical conditions or take certain medications.
Before using any nootropic supplements, please consult your healthcare provider to ensure they are appropriate for you.
Frequently Asked Questions
What are nootropics?
Nootropics are substances that improve thinking, learning, and memory. They can be derived naturally from plants or made synthetically (man-made).
Some examples of nootropics derived from plants include the following:
Guarana (Paullinia cupana)
Do nootropics work?
While more research is needed to confirm the efficacy of certain nootropics, some nootropics show promising results. For instance, caffeine has been shown to counteract the effect of sleep deprivation. Moreover, the combination of L-theanine and caffeine has been shown to enhance attention.
That said, replacing sleep with nootropics or any supplement is not recommended. Obtaining adequate, high-quality sleep is a vital part of overall health.
Are nootropics safe?
Nootropics should not be used if you have an allergy to such substances, are pregnant, or are breastfeeding.
Some nootropics may interact with certain prescription or non-prescription drugs. Please consult with your healthcare provider before starting a nootropic supplement.
