The pills that make you smarter actually exist. Most of them are even sold in pharmacies without a prescription. Not like in the movies, of course – you can’t write a book in four days, you can’t make 10 million on the stock exchange in a day … But you won’t die without them.
The common species name is nootropics (from the Greek for “mind-changing”). Usually they are prescribed for the elderly with impaired brain activity and for children with ADHD or enuresis. But young and healthy people also sometimes use nootropics as a brain dope – before exams, before an interview with a new employer, and in general – just in case.
The first nootropic drug (piracetam) appeared in 1963. Since then, the number of “brain pills” invented has been steadily increasing, but there is still no clear classification of them. They tried to divide them by chemical composition, by the principle of action, by effects … But the world medical community has not come to a common denominator. It seems obvious what the drug affects, but it is not entirely clear how. Some doctors even claim that the basis of the action of any nootropics is the placebo effect.
When the Belgians invented piracetam in 1963, they tested it on their own students and rejoiced at how much they improved their learning ability and increased the amount of residual knowledge.
But in 1992, the concept of “evidence-based medicine” arose – and all the observed effects of nootropics were called into question … Or, more correctly, they were referred to the third level of evidence: if the drug was not studied in comparison with placebo, then there is no reason to believe in its effectiveness.
Here are two completely opposite views on the problem – and you yourself decide whether to drink or not to drink.
Nootropics are a large group of drugs with different mechanisms of action. All of them improve cognitive (cognitive) abilities, memory and attention, but the ways to achieve this result are very different.
Racetams (the first nootropics) were invented for healthy people to activate cognitive functions and facilitate learning. These drugs have a very multicomponent mechanism of action. The mechanisms of activation of the vascular-cellular link are not very clear, but the point is that the self-regulation of the brain improves. In principle, racetams can be called brain doping: they increase efficiency, protect against overwork and other stress factors. Tellingly, they do not lead to addiction. And, nevertheless, they should not be taken “preventively” – without indications and a doctor’s prescription.
Another of the numerous group of nootropics are neurotransmitters. They are used to correct behavior (response to a situation), to improve memory in the elderly.
Preparations based on gamma-aminobutyric acid (GABA) are often prescribed for children with ADHD: their task is to restore the balance of inhibition-excitation processes, to force the central nervous system to work in an economical mode.
Nootropics work great for people with speech disorders. Speech function (after strokes, injuries, with developmental delay) is restored faster in those who take piracetam than in those who manage on their own.
And now they started talking about the placebo effect, because the evaluation of the result is really difficult: the mechanisms of the brain are among the most complex in our body, their research is still ongoing. Only the influence of cerebrolysin on the restoration of brain cells has been reliably proven. But a large number of studies and the practical experience of doctors show that nootropics improve brain function.
I rarely prescribe nootropics to my patients. And when I prescribe, I warn you that this is a placebo. The placebo has such an interesting feature: even if the patient knows that it is a dummy, it still works.
A few years ago (around the same time that the ADHD diagnosis came into vogue), the Italians launched a drug to treat children with vague complaints. There are complaints, but it is impossible to make a diagnosis based on them. And they all began to prescribe a drug with minimal side effects called “Obetsalp”. Worked great! The children were recovering. Parents rejoiced … Now read the name of the drug backwards.
There is a possibility that piracetam works, but no one has tested its effectiveness and safety. And it’s weird. According to the rules, clinical trials are the concern of the manufacturer. And in our time, using “long-term experience” as an argument is not solid, a randomized trial is needed. Better – double-blind placebo-controlled – when neither doctors nor patients know until the end of the experiment what they are taking: a medicine or a dummy. If manufacturers refuse to do this, then they have something to hide. And at best, the medicine is useless.