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What are your thoughts on people using Nootropics/Smart Drugs (i.e. aniracetam, piracatem, modafinil, hyperzine A, etc)? Seems to be an increasingly popular thing now. Harmless? or playing with fire (if using without medical supervision)?
The world’s population has grown increasingly larger and more competitive for jobs, housing, and opportunities.
The world has become more technologically advanced and complicated.
Society has become increasingly complex, faster and stressful.
Jobs become increasingly more complex and demanding.
Schools become more academically demanding and competitive.People are living longer. The seniors who have higher cognitive function are much more likely to live a fruitful and high quality life later into life than those who are cognitively decline as they age. It may mean the difference between living independently and working to an old age or dying in a nursing home.
Cognitive performance or intelligence has increasingly become a key factor in determining one’s fate and quality of life.
A 10 point improvement in IQ may mean the difference between being capable to get the grade, to excel in an entrance exam, to be admitted to college, to getting a career of your choice, to perform a necessary job skills, to earn enough income to live where you want to live, etc.
With competition, for example, the average grade point average for new students at the University of California Los Angeles is about 4.5. If one’s grade point average is less than 3.5, the chance of entrance to medical school is seriously impaired.
The average medical doctor, lawyer, or PhD has an IQ of 125
The average college graduate has an IQ of 115
The average high school graduate has an IQ of 100
The average professional and technical worker’s IQ is 112.
Managers and administrators’s average IQ is 104
Clerical workers, salesmen, foremen, and craftsman average an IQ of 101.
One cannot enter the US Army if one’s IQ is less than 85.The ones who excel within their fields have much higher cognitive performance than the average.
Thus there is increasingly an interest in foods, supplements and medications that can increase cognitive function. These are called nootropics.
I don’t see a problem with the concept of nootropics or the use of nootropics to enhance one’s cognitive function and intelligence.
As a psychiatrist myself, nootropics are a favorite subject. I am constantly looking for things that may enhance cognitive function.
Improvement in cognitive function is central to treating people with mental illnesses – it means the difference between being totally disabled and unable to live independently versus independent living and work. The biggest reason people with schizophrenia are seriously disabled is not the hallucinations or delusions but the loss of cognitive function. This is why the old term for schizophrenia is “dementia precox”. The dementia of schizophrenia is thus far highly treatment resistant. Depression also impairs cognition. Neurologists called this impairment “pseudodementia”. However, it is a true dementia. Most is reversible if depression is successfully treated. In chronic depression, it is not be the case. And such a person may become permanently disabled.
The primary issue is whether or not any particular “nootropic” actually significantly works. Many don’t and aren’t worth the cost.
Another issue is the risk of using such a substance – because as with anything (including water and food) there are risks. And the benefits vs the risks of using anything needs to be assessed prior to use.
Cognitive function has numerous areas such as:
- attention
- memory
- motivation
- pattern recognition
- predictive ability
- timing
- problem solving
- storytelling ability
- creativity and cognitive flexibility
- rule rigidity
- speed of information processing and storage
- skill of converting behavior from conscious to unconscious
- intuition (unconscious information processing)
- sensory processing skills
- emotional skills
- threat assessment
- visuo-spatial skills
- motor skills
- verbal skills
- interpersonal and social skills
- etc.
Any specific nootropic may only improve function in certain areas. Attention, motivation, speed of information processing are the easiest areas to improve upon. The others are much harder to improve upon.
Before any nootropic agent is considered, I prefer first optimizing physiologic and mental function by optimizing nutrition and hormone function (preferrably with non-artificial products). These are the low lying fruit and the safest areas to address. A nutrient dense diet goes a long way toward improving cognition.
Then I want to assess for problems in nervous system and immune system function – addressing those if possible. For example, adaptive immune system problems causing inappropriate release of auto-immune or anti-food antibodies can frequently cause an increase in inflammatory signaling which impairs cognition. Periodontal disease – e.g. bleeding gums as a sign of a dental infection – can impair cogntion.
Brain training – i.e. behavioral interventions, lifelong learning, learning new languages – should also be considered since they can also improve cognitive function safely. Certainly, they require work. But the nervous system is like a muscle – use it or lose it. One can increase brain cell growth and development by exercising and placing new demands on the brain. When one does not place cognitive demands on the brain, it accelerates atrophy and cognitive decline.
Exercise is also important in brain cell growth and development. Walking regularly alone improves cognitive capabilities.
It’s an example:
If you have optimal hormonal and immune pathways with optimal diet and exercise level and you become to be old, what the best way to improve/protect brain dopamine pathway ? Each decade you lose dopamine level, I don’t known why ?
– may be because there are an increase MAOb ( because you lose your sex hormone level)
– because nitrostress or oxydatif stress increase
– because low grade inflammation increase(infection, leaky gut, dysbiosis…)
– because there are more glycosylation
– because thyroïde, GH, IGF-1 decrease
– it’s only aging (telomere, mitochondriopathy …)I think that a good dopamine pathway, particulary in the prefrontal cortex, is very important to preserve/improve with aging.
I known that exercise, good diet, brain training is the key. But with aging, do you think that some medication like selegiline (IMAOb), modafinil, low dose of valproic acid, metformin, low dose of dexedrine or ritalin, some nicotine gum or pacth have some value or not ?
Scharzenenerger and Eastwood smoke sometime a good cigar, maybe there are some value for the hormesis effect.
@Jean 6743 wrote:
It’s an example:
If you have optimal hormonal and immune pathways with optimal diet and exercise level and you become to be old, what the best way to improve/protect brain dopamine pathway ? Each decade you lose dopamine level, I don’t known why ?I think that a good dopamine pathway, particulary in the prefrontal cortex, is very important to preserve/improve with aging.
I known that exercise, good diet, brain training is the key. But with aging, do you think that some medication like selegiline (IMAOb), modafinil, low dose of valproic acid, metformin, low dose of dexedrine or ritalin, some nicotine gum or pacth have some value or not ?
Scharzenenerger and Eastwood smoke sometime a good cigar, maybe there are some value for the hormesis effect.
I wouldn’t recommend smoking a cigar. It accelerates cellular aging. Schwarzenegger looks old for 65 and already has had heart surgery.
One of the current thoughts in neuroscience is that if a person doesn’t have a specific disease that causes neuronal death, then most, if not all, of the neurons remain healthy until you die. The thought is that age-related changes are primarily from functional changes in the neurons.
Of course, this assumes a lot. And I think it is inaccurate since most people end up having illnesses or health problems which can cause neuronal death. And the functional changes – if they are the primary cause of brain aging – indicate that those neurons are not healthy at all even if they survive.
By the time you reach 85 years old, 45% of people have Alzheimer’s disease. When you include other dementias, then up to 60+% of people over 85 years old have dementia. These are not reversible dementias.
When you look at top athletes, for example, the older 30+ year old athlete is slower mentally than when they were 20 years old. They are certainly more experienced and have better unconscious processing that occurs with many more years of practice. But the reaction times are slower despite excellent or optimal health.
Note that there is heavy emphasis on neurons in the literature. I also pay attention to the glial cells. These cells outnumber neurons 10 to 1 in the brain. They are particularly sensitive to metabolic and signaling problems and physical illness. And when they die, the neurons they support may die. Alzheimer’s disease may be thought of as a glial disease since they are the first to die.Since glial cells contribute to information processing, support the neurons, control the production and activity of neuronal synapses, speed neuronal information processing up to 200 times, determine timing of circuits in the brain, protect the brain from infection and damage, etc. etc. they are particularly important to keep healthy as we age.
Notably, it is the number of glial cells we have that determines our intelligence. On an MRI, one way to determine a person’s intelligence is to determine the amount of white matter there is in the brain, not grey matter. White matter primarily consists of glial cells and neuron axons.
Nerves are often drawn with axons covered by myelin sheaths. What isn’t stated is that the myelin sheath is actually part of a glial cell – the oligodendrocyte – and is not part of the neuron. Neuroscientists often forget the other half of the brain – the glial cells.
The loss of glial cells may contribute a lot to the 10 to 20 % brain mass loss we experience as we age.
Physiologic treatments which improve brain cell growth often mostly increase glial cell growth. With behavioral demand is necessary to also stimulate neuron growth.
We are born with only 50,000 dopamine neurons. Over time, we may loses these neurons gradually, particularly in the motor circuits where they are heavily used. One idea is that we loses some of these neurons because with heavy use, the neuron is unable to keep up with the oxidative stress of producing dopamine. This results in neuronal damage if not neuronal death. Keeping up dopamine function is necessary for numerous purposes.Optimizing nutrition, hormonal status, addressing immune system problems, physical illnesses, exercise, and life-long learning are important in maintaining brain health and help prevent neuron degeneration. Exercise and learning may promote neuronal and glial growth.
Specific nervous system treatment may also be needed as we age to improve function depending on the condition and situation and to address specific nervous system problems.
If targetting dopamine neuron preservation, anti-oxidant and anti-inflammatory treatments (there are too many to list) may be particularly useful to reduce the risk of dopamine neuron damage. Low dose selegiline, lithium, progesterone, etc. may be useful for their neuroprotective effects. Nicotine may improve dopamine signaling but doesn’t prevent dopamine neuronal degeneration. Stimulants (such as methylphenidate, modafanil) help improve dopamine signaling but don’t prevent dopamine neuronal degeneration. One has to separate the treatments into those which are neuroprotective and those which improve signaling but are not neuroprotective.
Dr.mariano theres quite a few neuroprotective therapies out there but is there actually any method to build new neurons, glial cells, brain cells ,ect most neurologist agree that once brain cells die its over and you cannot get them back or build new cells , but some beleive lithium can regenerate new brain cells how much truth is there to this ? is there any studies ?
Neuroscientists agree that new brain cells are made as we age. We cannot completely regenerate the brain. But new glial cells and neurons can be regenerated.
The general subject is Neuroplasticity. A book on this topic is “The Brain That Changes Itself” by Norman Doidge.
Certain substances can help the growth of new brain cells. This include Lithium, Estrogens, and Atypical antipsychotics, antidepressants, thyroid hormone, among others. There are studies which one can look up on MedLine. Substances that increase brain growth factors may help the growth of new brain cells. Certainly setting the stage by optimizing nutrition, hormonal status, immune system status, exercise, and mental exercise through education and other means, also can help the growth of new brain cells. Outside of any physiologic intervention, brain cell growth depends on the demand placed on brain function. If the brain isn’t used then there is no reason for new cells to grow.
Intresting didnt know estrogens play a role that explains a alot besides my messed up immune system contributing to alot of my cognitive difficulties i abused arimidex for years taking 1mg a day not knowing what i was doing ive lived with low estrogen for 3-4 years abusing arimidex , i hope the damage is reversable ill definitely look into that book by norman doidge.
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