Adderall and caffeine reddit
Out of Adderall? Tips and Advice During an ADHD Medication Shortage
- Research
Dosage and Drug Shifts, Generics, and Caffeine Can Help Kids with ADHD in a Pinch
By Jess Berthold
Without his medication, my son, who has ADHD, is a boat adrift on choppy seas. He bumps around, spilling drinks and food, unable to control his limbs and impulses. He can’t sit still; he won’t stop talking – loudly. His emotions run wild. Learning at school and engaging in many public activities are out of the question.
Adderall, my son’s medication, has been in short supply for months. This week, I spent five hours calling pharmacies and doctors to find 10 pills. Meanwhile, in online ADHD forums, parents are brokering medication swaps.
In October, the FDA announced a shortage of Adderall. Other ADHD drugs have followed, as patients switch to alternate medications such as Ritalin and Concerta.
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Meet the Experts
Neal Rojas, MD, MPH
Developmental-behavioral pediatrician at UCSF Benioff Children’s Hospital San Francisco who specializes in ADHD.
Jamie Romani, RN
Pediatric nurse with UCSF Benioff Children’s Hospital
What’s the cause of the shortage?
Rojas: It has to do with supply chain issues and a spike in demand from adults, especially during COVID-19 when ADHD symptoms got worse for many and the drug could be prescribed online for the first time. Meanwhile, the Drug Enforcement Agency, which controls the supply of Schedule II drugs, hasn’t increased manufacturing quotas.
What should parents do if their pharmacy is out of their child’s meds?
Rojas: First of all, let your child’s clinician know.
They may be able to prescribe a brand-name version if your child normally takes a generic, or a different dosage level. Since these are controlled substances, the pharmacy needs a script for the precise drug and dosage. This can mean some back-and-forth between clinician and pharmacy. If your clinician is not offering to do these things for you – ask them to do it.
Romani: Parents can try calling around to different pharmacies because supply varies place by place. Be aware, though, that pharmacies may be reluctant to give out information about supply over the phone because these substances are prone to abuse. Also, the pharmacies themselves don’t know what their stock will be tomorrow for these drugs in shortage because manufacturers don’t tell them. So, you have to call them every day.
Should children switch to a different ADHD medication?
Rojas: If the child has taken a different medication in the past and tolerated it, it should be okay to switch.
Otherwise, definitely talk to your clinician because ADHD drugs are not equivalent. There are few head-to-head studies, but we have a lot of clinical experience that, for example, shows Adderall is more potent than a methylphenidate like Ritalin, so you need to consider that with dosing. Also, dosing and medication fit are idiosyncratic with stimulants. I have 45-pound kids who run circles around us and need high doses, and 150-pound linebacker teens who feel faint on low doses. You must start low and build up, and not necessarily dose by weight.
Should parents ration pills? How?
Rojas: With the guidance of your prescribing physician, it’s reasonable to play around with lower doses and different schedules. I have patients who take lower or no doses of stimulants on weekends, saving them for school days. Some children will only take the pills on the days when they have their hardest classes. Parents of children with ADHD know very well what they can get away with – whether they can skip on Wednesday afternoon when there is math homework or Sunday when there is church.
Older kids can tell us if, for example, they have finals coming up or some other important factor.
Is caffeine a good substitute or supplement for ADHD meds during the shortage?
Rojas: I’ve always called caffeine the poor man’s Ritalin. There is clear evidence that it helps with focus. The problem is that it’s more habit-forming than stimulants that are prescribed and taken appropriately. I’d suggest parents try tea with their children first, and on a weekend morning, to see how their child reacts. Be aware that caffeine can increase the heart rate, unmask arrhythmias and cause gut issues. You also need to be careful about combining higher-caffeine products with stimulants because that can increase side effects. Caffeine use should always be discussed with clinicians.
What can parents do to manage the side effects, like anxiety and depression, that might result from a shortage of medication?
Rojas: We know there is a lot of secondary anxiety for kids when ADHD symptoms are undertreated.
It’s important for parents to keep a sharp eye on mental health and report any changes to their clinicians. Try to promote good sleep, exercise, healthy eating and social opportunities – always, but especially during a medication shortage.
Reddit user ranks how good different drugs are for making music - News
A reddit user has described what it's like to make music on different types of drugs.
Posting to the platform this week, SeedEater-1o1 details the affect that caffeine, nicotine, cannabis, alcohol, LSD, magic mushrooms and amphetamine, taken in the form of prescription drug Adderall, have on them while producing beats.
The user has provided a description for each as well as a creativity score out of 10.
Nictone ("it’s nice to hit a vape while listening to the beats I've made throughout the day. But it’s really addictive and it only lasts for a few minutes") and alcohol ("I’ve only had a few experiences with producing while drunk and never really finished anything") score lowest on the creativity scale, with 3/10 and 1/10 respectively.
Read this next: Madlib "If I didn't do magic mushrooms, I'd probably just be doing hip hop"
Magic mushrooms score highly thanks to the profound effect they have on SeedEater-1o1 but often result in them exploring nature rather than making music. Magic mushrooms make them "feel like a kid again, it doesn’t do anything for music production. I always end up going on a walk and enjoying nature while thinking about my life. I’m gonna give shrooms 9/10 because it makes me thankful for who I am and made me wanna start taking care of myself."
Marijuana can also lead to creative work being sidetracked but used in the right way can unlock a "creative zone": "If my tolerance is low then I’ll get too stoned and just end up watching a movie lol. But if I smoke daily then weed helps me relax and it gets me in this creative zone. I loved to smoke and drinking a cup of coffee while producing, it’s a nice combo. 8/10 because of the creativity boost."
SeedEater-1o1 ranks amphetamine second highest for creativity, mainly due to the productivity that it helped them achieve.
However they warn people about how addictive it is and that using it can be "a very slippery road" and that "it makes the person using them rely on a substance to enjoy their passion."
Read this next: "Tripping revived me" Students are using LSD and magic mushrooms to get through lockdown
Given that scientists have been studying its potential to enhance creativity since the 1950s and that microdosing has become commonplace everywhere from Silicon Valley to the British suburbs, it's no surprise that LSD comes in highest in SeedEater-1o1's list, helping them enter what they call "the music dimension": "I take small amounts of [LSD] before I’m going in for a long session. This drug makes me enter what I call “the music dimension”. It’s a place where it’s just me and the music, no thoughts. It helps me break my old thought patterns and come up with new ideas and new ways to do stuff. On higher doses I’m not able to produce music, it’s more like a therapy session with myself.
It has made me realize that everything is possible in life and we are all on this earth together, you can achieve anything with faith. This drug also helped me realize that I was an addict and I needed to get my life together. 10/10 because it probably saved my life and helped me to reach new levels of creativity in music production."
The user signs off by saying "take care of yourself no matter if you are using drugs or not. And remember that there is so much more to life than just making music."
The above is purely anecdotal and not part of a scientific test. For honest information about any of the substances mentioned in this article visit Talk To Frank.
Read this next: Get the best of Mixmag direct to your Facebook DMs
how Silicon Valley got hooked on smart pills - RBC
Silicon Valley got carried away with biohacking: people are trying to "hack" themselves to turn into supermen, and venture capital funds are already investing millions in the growing market of drugs to improve brain function
Photo: BSIP / UIG via Getty Images
In the fall of 2017, world-famous best-selling author Dan Brown shared one of his secrets to his productivity with The New York Times.
Before sitting down at his writing desk at 4:00 a.m., the novelist brews what is known as bulletproof coffee, rich in special fats called medium-chain triglycerides. According to Brown, this enhances brain function.
Bulletproof coffee is launched by Bulletproof, a startup that sells dozens of drugs and food products. The company claims that their products help you think faster and achieve better results. In the spring of 2017, Bulletproof received $9 million from venture capital fund Trinity, and this is proof of the interest that American investors are showing in the growing biohacking market.
Two years earlier, in 2015, Andreessen Horowitz venture capital fund invested $2 million in Hvmn, a startup developing nootropics, “smart” drugs that, as the founders of the company promise, help you think faster and work more productively. The amount for Silicon Valley is small, but the news was a signal for other investment funds. Andreessen Horowitz is known for his ability to open startups with huge commercial potential - the fund has invested in Skype, Facebook and Twitter when others have not yet heard about these projects.
Over the next two years, 17 smart drug startups received $460 million in investments from venture capitalists. Will the biohacking epidemic now cover the whole world?
adv.rbc.ru
Do you want to get smarter?
adv.rbc.ru
Hvmn's products look like the usual food supplement kits - plastic jars with several kinds of pills. Each pill under the commercial name Nootrobox, according to startup founders Michael Brandt and Jeffrey Wu, helps to improve two to four intellectual, mental and physical indicators at once. In total, Hvmn chemists are working on six indicators: concentration, memory, mood, stress resistance, general health, sleep. Brandt explains his goal this way: “We want to make better people. We take technology and apply it to a person as a system that has input and output channels - productivity, reaction time, a sense of happiness from life.
It is no coincidence that Brandt talks about man in terms of cybernetics: he is a Stanford graduate and a former Google employee.
Many of the founders of the most famous startups working in the biohacking niche are not biologists, but engineers and IT specialists. And the most dedicated nootropic users are tech entrepreneurs, engineers, and developers who hope to “hack” their own brains to become geniuses and outperform the competition. Among them are investor and consultant Tim Farris, who worked with Uber and Evernote, serial entrepreneur, founder of Bulletproof and a number of other projects Dave Esprey, co-founder of the Ostrovok hotel search engine Sergey Fage (translation of his article “I am 32 years old and I spent $200 thousand . to biohacking" on the Vc.ru portal collected about 300 thousand views) and many others. Biohackers call the human body wetware by analogy with hardware and software: it is not a temple for them, but a workshop.
When the company first started in 2014, Jeffrey Wu experimented with the formulation of nootropics, ordering ingredients from Alibaba.com and the dark web. Now he legally produces them at a plant near Los Angeles.
The creators of Hvmn managed to find ingredients that are approved in the US for use as food additives. As a result, the sale of smart drugs did not require approval from the U.S. Food and Drug Administration.
Partners managed to get Silicon Valley interested in their pills thanks to personal connections and marketing in the spirit of Herbalife: they offered to try their pills to friends, former colleagues, and their own employees. Hvmn pills began to be discussed in online magazines popular among tech entrepreneurs. The Hustle columnist, for example, took "smart" pills for a month, after which he concluded: it's better to spend that $50 a month on something else. But the deed was done: obsessed with the problem of personal effectiveness, the Valley learned about a new fashionable hobby. In addition to Andreessen Horowitz's money, the company managed to raise another $500,000 from business angels and managers of large companies, among which, for example, was Marissa Mayer, then CEO of Yahoo!.
Photo: hvmn.com
Investors' belief that the miracle pill will be able to conquer not only Silicon Valley, but possibly all of America, was greatly facilitated by the interest in the novelty from retail chains. Since this summer, Nootrobox pills can be purchased at all 7-Eleven stores operating in San Francisco. A monthly course of "smart" pills costs only $135. According to Wu, his company's revenue for 2016 increased by 300%, and the number of buyers of products is measured in tens of thousands. Even if Wu exaggerates his success, the estimate of the audience showing interest in nootropics is probably close to reality: for example, the smart pill page on the social news site Reddit has over 75,000 subscribers.
Garage Biology
Hvmn isn't the only Silicon Valley company doing brain and body upgrades, of course. Back in 2005, scientist and entrepreneur Rob Carlson, founder of Bioeconomy Capital, wrote in Wired magazine: “The era of garage biology is open.
Do you want to participate? Buy a lab on eBay." The reduction in the cost of applied chemistry methods, the increase in the amount of scientific knowledge about the body, coupled with the ability to order almost any ingredient from China, allow companies to create their own miracle drug after spending several months on experiments.
Startup Modern AlkaMe three years ago created a new niche in the newly emerging biohacking market for personalized intake of nootropic drugs: the user fills out an electronic questionnaire, after which he receives recommendations on what exactly and according to what scheme he needs to take.
Bigger challenges are set by Rosa Food, which has fulfilled a dream of science fiction writers: it has created a water-soluble Soylent powder, which, according to the developers, contains all the substances necessary for good nutrition. In 2014, crowdfunding company Soylent raised about $1.5 million through pre-orders of its powder. In 2015, she raised $20 million from the same Andreessen Horowitz, and in May of this year she held a new round of investments, having received $50 million (mainly from Google Ventures).
According to the developers, switching to eating their products will not only allow people to get the most out of their physical and mental abilities, but will also reduce the amount of food wasted (because Soylent supposedly allows you to accurately calculate the dose required for satiety) and, thus, will contribute to the fight with hunger.
Photo: soylent.com
This positioning takes biohacking products to a new level. According to the US Food and Drug Administration, the nutritional supplement market is estimated at $40 billion a year and the share of products for biohacking is tenths of a percent, but this may change in the near future. The fashion for nootropics is gradually going beyond the boundaries of Silicon Valley, "smart" pills are beginning to be ordered by residents of large US cities.
More technological trends like "gene therapy in the garage" preached by the biophysicist Josiah Zainer keep aloof. At the SynBioBeta conference in early October 2017, he injected an enzyme solution into his bloodstream that blocks a specific gene that inhibits muscle growth.
As Zainer told the public, earlier studies by Chinese scientists showed that dogs treated with this method doubled their muscle mass in a short time. The scientist is sure that the solution he prepares in five minutes will turn him into a superman. However, only a few biohackers dare to experiment on themselves so bravely, and turning it into a commercial service is out of the question.
The Future That Never Came
While companies like Hvmn and Bulletproof have achieved a lot in a matter of years, the concept they promote has a lot of critics. One of the vulnerabilities is that there is almost nothing new in biohacking. The most popular components of smart pills traded by biohackers have been known for decades. Piracetam, which helps the brain form new neural connections, was synthesized by Belgian pharmacists back in 1960s as a drug for recovery after a stroke. Since the 1990s, American doctors have been treating children with attention deficit disorder with the psychostimulants Adderall and Ritalin, which are part of many brain-hacking pills.
The fact that the nootropic industry is primarily marketing, not science, is confirmed by further familiarity with the composition of its products. The main active ingredient in one of Hvmn's most popular products, Go Cubes, is regular caffeine. The fact that this alkaloid tones up and improves performance for a while is not a discovery. Most Bulletproof products contain no ingredients other than long-established culinary and sports nutrition ingredients such as coconut oil, cocoa beans, vanilla, etc.
Many other biohacking methods fashionable in Silicon Valley were invented even millennia ago. In 2015, Brandt and Wu founded the WeFast movement (We Fast). The founders of Hvmn and dozens of their followers (among them, for example, former Evernote CEO Phil Libin and Y Combinator partner Daniel Gross) engage in therapeutic fasting - periodically refuse food for a period of several days to two weeks. When the body does not receive food, it minimizes the production of special hormones and proteins, which, on the one hand, help tissues grow, on the other hand, contribute to the development of cancer and diabetes.
Deprived of food, the body begins to actively “repair” cells and renew the immune system, supporters of fasting say. This process slows down the aging of the body and prolongs life. Everything would be fine, but we are talking about practices used by Hindus and Buddhists even before our era.
There are more serious issues: doctors have repeatedly accused nootropic manufacturers of not paying attention to the side effects for the health of consumers. By the way, in Russia, the free sale of Adderall, Ritalin and a number of other components of nootropic drugs is prohibited, since they are highly addictive in patients. Rosa Food has been repeatedly accused of its powder causing dizziness, nausea and indigestion, and the non-profit organization As You Sow has alleged that the company publishes inaccurate information about the lead and cadmium content of its drinks.
David Shen Ventures founder David Shen, a former executive at Apple and Yahoo!, thinks it's impossible to hack your genes in a garage.
The technology is still too complex and requires a lot of research on the part of the developers. Moreover, the consumer himself cannot limit himself to taking miracle pills: he must constantly monitor his condition, which means that he also has medical knowledge. “A simple product can attract consumers in the short term. But one of the problems of companies that have succeeded is that they have neither the competencies nor the knowledge to develop the product further,” Shen writes.
He predicts that most bioactive IT companies will follow the fate of near-bankrupt biotech start-up Theranos: technologies unsupported by research are doomed to failure. It is significant that in December 2016, the founders of Hvmn, on the air of the Shark Tank TV show (a popular American TV show during which startups try to interest investors in their ideas), not only failed to attract the declared $40 million in investments, but were also severely criticized by the host: “You come and bring us sugar cubes.
"
Apparently, the era of real biohacking will not come soon. An analogy with virtual reality technologies is appropriate here: experts expected their ubiquitous distribution back in the early 1990s, while they began to be widely used only a quarter of a century later, today.
Pros and cons
“Long-term consequences for fans of pills for the brain will be disappointing”
Alexander Khalyavkin, Scientific Secretary of the Moscow Branch of the Gerontological Society of the Russian Academy of Sciences
“Some pills for the brain can really speed up the pace of nervous processes, improve memory, attention, intelligence, efficiency, etc. They unauthorizedly connect the existing reserves of the human psyche, which the body uses in case of emergency. Recall, for example, the reports of test pilots who found a way out of an emergency in a split second. At that moment, it seemed to them that consciousness was expanding, and the passage of time slowed down sharply, and therefore they managed to find the right solution.
However, one must always remember that excessive stress exhausts the nervous system and accelerates aging. Therefore, artificial stimulation of brain activity increases the rate of age-related decline in this activity. For quite a long time, a stimulated brain can work more productively than usual, but in the elderly, everything will become the other way around. And this difference will only increase with age. Some studies have shown that people who are diagnosed with Alzheimer's disease reach the final stages of the disease faster than patients who had higher mental abilities in their youth. The long-term consequences for fans of brain pills are likely to be disappointing.”
“A competent biohacker will give odds to a simple individual”
Evgeniy Kuznetsov, director of RVC subsidiaries
“I got into biohacking five years ago. The reason for my interest is the need to constantly be in shape amid high stress and uncertainty. In the course of consultations with doctors, it became clear that a lot of systemic distortions had accumulated in the body: here there is a lack of a microelement, there a vitamin, here eating habits harm the microflora.
It became clear that the body must be taken seriously. I started with diets, sports and some medicines according to indications. As a result, I began to notice a significant improvement in performance. Well, now it has become a habit and a need.
Just as an athlete runs faster than an ordinary person, so a competent biohacker will give an ordinary individual a head start in terms of working capacity, stress resistance, concentration, mood stability and many other important social and cognitive functions. A huge layer of problems familiar to the middle class (anxiety, poor sleep, chronic fatigue, “burnout”) is a manifestation of the beginning dysfunctions of the body. They are opposed by competent management of one's own state - "hacking" the natural processes of aging.
What exactly to take, the doctor should tell. Each person has their own metabolism. Non-targeted biohacking is as dangerous as using stimulants before a race instead of regular workouts. You can get very seriously hurt.
Therefore, it is possible to maintain and develop your body only in a complex way. If you overclock only one system, then others may not withstand the overload and start to fail. For example, the brain can consume up to 25% of the entire energy of the body, and if the whole body does not work as a good supplier of energy resources, then the brain can easily drive it into a state of breakdown.
“Some of us will become immortal”
Sergey Fage, CEO of Stealth AI Company, founder of Ostrovok.ru hotel booking service
closed meetings, soldered computer boards. Today, Apple, born from those meetings, is the most valuable company in the world, and eight of the top 10 most valuable companies in the world are in IT.
Biohacking looks like a bunch of crazy people doing stupid things. But in 50-100 years it will lead to the fact that some of us will become immortal, this is the next stage of evolution. My goal is to gain a competitive advantage over other people.
Over the past five years, I've optimized my sleep, food, exercise, and mental health to help keep me as healthy as possible.
In addition, under the supervision of experienced doctors from Stanford and Harvard, I do thousands of tests and take many dietary supplements and medications. This made it possible to reduce the mass of adipose tissue by 16%, reduce the risk of strokes and heart attacks in the next 50 years to almost zero (this can be seen from biomarkers) and just be very productive, satisfied with life and happy.
Biohacking and optimization of human abilities are now becoming mainstream. In 2016, the US Food and Drug Administration recognized that aging is not a natural process, but a disease, and began testing metformin (a diabetes drug) as the first anti-ageing drug. And this is just the beginning. Therefore, I advise you to gradually educate yourself in terms of biohacking. Otherwise, you risk being left behind, like those who have not learned how to use computers.
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is it possible to become smarter / Sudo Null IT News
Hi %username%!
I would like to talk about various pharmacological ways to improve memory, thinking, attention and other qualities necessary for successful professional and other activities.
In this post I will try to give information about some interesting drugs. Some of them are available, some are available only by prescription, and some are practically prohibited. But I think some of the information from psychopharmacology presented in this post will find its reader.
Spoiler : NZT hasn't been invented yet, but has synthesized a number of potentially interesting things.
Disclaimer
I must say right away: I am not a psychiatrist, I am a psycho. In the truest sense of the word.
Brief summary of personal history
Once worked in IT, first in a Russian-level company, then in an international corporation from Silicon Valley.
And then the well-known geopolitical events happened, relations between the Russian Federation and the United States worsened, the US government imposed sanctions on our largest customers, and the company, seeing the rapid decline in the market, practically left our country.
I, like almost all employees, was made redundant, but now I couldn't find a new job. Because he went crazy. What they didn’t put: depression, bipolar disorder, OCD, schizophrenia, GAD. I was discharged from the madhouse with f21.8, then the specialist with whom I work privately found a dissociative process that explained the difference in diagnoses.
Twice I was in a psychiatric hospital, I was treated on an outpatient basis for quite a long time, but there was no sense. Therefore, I was puzzled by the study of psychiatry, psychopharmacology and other related disciplines. I want to share my knowledge with the audience. Perhaps someone will be interested.
Once again, just in case: I am not a doctor.
Consult a specialist before taking anything. Don't do drugs. Wash your hands before eating and generally behave yourself.
Thinking
I think many would like to "be able to think faster and better." We will leave the discussion of the goals and psychological attitudes behind this desire for another time, and now we will consider that it is quite logical and justified, focusing on the means to achieve it.
So what exactly can we improve? First, memory. Everything is simple here: the better our long-term memory, the greater the amount of necessary information we can remember. What to do with it - everyone will decide on their own: someone will remember the CCIE dumps, someone will try to memorize all the volumes of Knut, and someone will spend on remembering where and how much money he spent.
Improving short-term and / or working memory (there are different opinions about how they are related) gives us the opportunity to improve the so-called.
fluid intellect, i.e. the ability to think logically and solve problems without having similar previous experience.
In general, increasing memory is good.
The second aspect that can be pumped is the improvement of attention, i.e. ability to selective orientation of activity and perception. Here everything is not as obvious as in the case of memory, but if you remember your experience (it seems to me that everyone has it), when you could not concentrate on a task (this is not always associated with procrastination), then you will evaluate your ability to this very selective concentration. And if, like me, LMM forbid, you have attention disorders, then even more so.
And the third aspect is the intellect itself: mobile and crystallized (according to Kettel)[2]. Here, I think, there is no need to explain: the first is mentioned above, and the second is the ability to use the accumulated experience.
And one more aspect. Formally, it is offtopic, but I would also include it - this is endurance - the ability to experience high mental loads (we are interested in them) for a long time and not lose working capacity.
Now that we have decided on what we will improve, we can proceed to the direct consideration of drugs.
PRL-8-53 (methyl 3-(2-(benzyl(methyl)amino)ethyl)benzoate)
There was such a scientist in the 1970s, Dr. Hansl. And he worked, incl. over cognitive enhancers. One of the results of this work was the substance we are now talking about.
I will immediately note two very important points: firstly, at the moment this compound has the status of research chemical: i.e. clinical trials have not been conducted, side effects are not clear, the hazard class has not been established, etc. And secondly, the level of evidence, to put it mildly, is very far from what is desired.
To be precise, there are only three scientific studies [3, 4, 5] of this substance, the sample is quite small. However, the results are so encouraging that I decided to include this molecule in the list.
In one of them, a statistically significant effect was established by this substance on the ability of the subjects to memorize words and numbers.
The subjects were asked to memorize words (orally), and then asked to repeat them.
It turned out that the effectiveness of the drug depends on how good the subject's memory was without it.
The most impressive results were shown by those who had obvious memory problems (those who memorized six words or less) - their memory improved by by 87.5-105% [3].
Those who had better memory without medication showed a much more modest result: 7.9-14% [3]
An interesting age aspect: in people who were over thirty, they showed an increase in memorization ability by 108-152% [3].
In addition, an experiment was conducted to determine the effect of PRL-8-53 on the ability to calculate mathematically. The subjects were offered the following task: they had to subtract seven from a given number, then add one, then subtract seven again from the result, add two, then subtract seven, add three to the result, and so on. until another number given by the experimenter is obtained.
And here, too, there were improvements, expressed in the fact that the completion of the task after taking the drug was faster.
No data available on the mechanism of action of the drug. Like this: there are simply no scientific publications that have explored this issue.
Hansl himself believed that the drug somehow affects cholinergic transmission (cholinergics are generally an extremely promising thing for developing all sorts of improvements in brain function), inhibits the action of serotonin ( hello to those who like to prescribe SSRIs to everyone in a row! ) and potentiates dopaminergic transmission. But this is his personal opinion, not based on anything.
The substance is legal in the Russian Federation and can be purchased online relatively easily.
I haven't tried it myself just because I don't have extra money. But I’m ready to become a test guinea rat, I promise trip report review containing a detailed description of the subjective and objective (I have a certified clinical psychologist from a psychiatric hospital sitting next to me, he can take measurements) result.
Valproic acid
This is a mood stabilizer. A drug used, firstly, to treat epilepsy (prevents the occurrence of seizures), and, secondly, to stabilize mood in affective disorders (prevents patients with bipolar disorder, schizoaffective disorder, and others from falling into depression or flying into mania) similar diseases). It is sold without a prescription (some pharmacies may require it, this is not a problem *).
But we will consider off-label use. The evidence here is also not very good (and all cognitive enhancers are not very good with it), but Dr. Philip Bird from the Gosforth Clinic claims that valproic acid can significantly improve attention, and not only in patients with ADHD [6], but also in healthy people. And in general, of all normotimics, valproic acid is the most friendly to the intellect [7]. They even tried to give it to dementias with very encouraging results[8].
The proposed mechanism of action is, firstly, in the GABAergic effect of this substance itself, and, secondly, in the regulation of the expression of genes encoding receptor proteins that respond to neurotransmitters in brain cells.
That is why the effect does not come immediately, but after 1-2 weeks (you just need to wait until this whole inert system is swayed: expression changes, new proteins will be produced, the brain will reorganize to a new configuration).
I have personal experience with this thing, and it is wonderful. Under it, I can read, write and even think for a long time. For example, if measured in the text, then with it I can master 150 pages of text in a day, without it - 70-90 (with the same complexity). Of course, this may be a placebo effect, but I do not have the opportunity to conduct an RCT, so I share what I have. By the way, similar effects were noted on Neuroleptic [9], but this is also far from the best source of information.
The only “but” is that the dosage should be subtherapeutic, about 100-300 mg. And let the old-school psychiatrists say that less than 1000 does not work: explain to them that the drug is not for BAD or F25, but for concentration.
Amfonelic Acid
What would a person on the street say when asked about endurance supplements? Most likely, he will name cocaine, amphetamine, methamphetamine.
But they are forbidden, which means they are not suitable for us.
But if you think about it, we don't need them: we are not interested here in drug intoxication, but in the possibility of somewhat “speeding up” thinking, increasing endurance and removing drowsiness.
And among the research compounds there are many substances that are not drugs (in the legal sense), but can give us the desired effect. One such substance is amphonelic acid.
Technically, it is a dopamine reuptake inhibitor[11]. Those. in the normal mode, the dopamine released from the vesicle is pulled back with the help of DAT, but under the subject substance it is not pulled back. Or it drags on much less.
This substance is of interest precisely because of the selectivity of its effect: it does not increase aggression[10], does not affect the noradrenergic (it seems to be written in Russian) transmission[12], and therefore does not have unpleasant vegetative side effects. Moreover, it does not lead to the release of dopamine [13], which, on the one hand, makes it safe for neurons (unlike the same meth, it does not have neurotoxicity), and, secondly, reduces the risk of addiction (but does not eliminate we still cling to his dopamine!).
Simply put, it's the perfect stimulant. Like amphetamine, only without the narcotic "arrival", while maintaining the clarity of thinking and the ability to adequately interact with reality.
Reviews on it are different [14, 15, etc.] - for some, this substance is “like a lubricant for gears in the brain”, according to some users, it increases productivity MANY times. “The mind remains pure” is a recurring motif in reviews. Others compare the effect with caffeine or say that they did not feel anything.
But there is one powerful “but”: technically, this thing is an antibiotic from the quinolone group, and the constant use of antibiotics, as we all remember from the school biology course, is not very good.
(±)-2-(diphenylmethyl)-sulfinylacetamide
More commonly known under the brand name Modafinil. Analeptic. In the Russian Federation, it is included in the “Psychotropic substances” section of the list of narcotic drugs and psychotropic substances, the circulation of which in the Russian Federation is limited and for which control measures are established in accordance with the legislation of the Russian Federation and international treaties of the Russian Federation (List II).
In practice, this means that it is practically impossible to obtain it legally (the maximum that I could manage was to obtain substances from list III, because doctors have some absolutely hellish bureaucracy associated with prescribing such drugs, and they are extremely reluctant they are assigned).
It has been proven to at least have the ability to restore (ie improve) impaired cognitive abilities after chemotherapy[16]. In addition, it can reduce the manifestation of depressive symptoms [17]. But this is in patients, with healthy people, not everything is so simple.
Although modafinil is quite popular as a “cognitive enhancer”[18, RAMP discussion, which I am not citing for obvious reasons], research[18] shows that its effect is more likely to be related to choice bias in favor of previously rewarded behaviors compared to abandoning behaviors that are associated with negative reinforcement, which is by no means an improvement.
A meta-study[19] also showed no effect on memory and intelligence.
So it makes no sense to be puzzled by the search for this drug as a means for overclocking the brain.
But, like many stimulants, it helps fight sleep and fatigue. And in this capacity it may well be useful (if used correctly).
Phenibut, *racetams, hopantenic acid, etc.
Usually, when it comes to drugs for “overclocking the brain”, someone remembers Phenibut, Piracetam, Phenotropil and other nootropics.
Being well aware that the effectiveness of the preparations presented in the previous sections has been proven, to put it mildly, in no way, I would venture to devote a separate chapter to the criticism of nooprops.
Let's start with the fact that we are interested in the ability to improve memory, attention and mental abilities and are not interested in other effects. For example, the same Phenibut has some sedative effect, but this is not what we need.
So, the first thing that interests us is the Resolution of the meeting of the Presidium of the Formulary Committee of the Russian Academy of Medical Sciences of 2007[20], in which the following is written in Russian:
DLO, obsolete drugs with unproven efficacy - cerebrolysin , trimetazidine, chondroetin sulfate, vinpocetine , piracetam , phenotropil , including cardiodine, rimantadine, validol;
Piracetam [21, 22], as well as the phenylpiracetam (Phenotropil) developed from it, do not have proven effectiveness in improving the ability to think (in the broad sense) [it is difficult to refer to the missing evidence, I will just say that Cochrane about "Phenotropil" is silent].
In less reliable sources (for example, [23]), Phenotropil has a short-term stimulating effect, but according to reviews from the same RAMP, it quickly passes, and phenylpiracetam cannot be used as a stimulant.
As for hopantenic acid (Pantocalcin), which one of my psychiatrists loved so much, it also has no proven efficacy.
And "Vinpocetine", which was so actively advertised in the 90s - 2000s, does not help with dementia[26]. And Santa Claus does not exist.
Why am I so picky about having good meta-reviews on Cochrane for these drugs when I didn't do that in the previous sections? Because all kinds of PRL-8-53 and amphonelic acids are not drugs, they are not positioned anywhere as nootropic agents, and therefore they can be forgiven for the lack of large-scale clinical trials. Maybe they'll get it, maybe they won't.
But if a certain substance is sold as a medicine, and even included in the Vital and Essential Drugs list, then it simply must have proven effectiveness!
B vitamins
It's simple: they don't work.
Contrary to popular belief, neither B6[24] nor B12[25] increase brain performance.
Memory and intelligence training
Some might say that pharma is the wrong way and you just need to train your memory/intellect and everything will be ok. Well, let's check.
We have a study that shows that a healthy diet, memory exercises and physical activity improved speech fluency[27] but not memory in the short term.
However, this effect is not generalized[28] - if you train short-term memory in a certain way, then your progress will be only within the framework of the technique that you use, but not in other areas. You can't get smarter this way.
On the other hand, there is research[29] showing that playing musical instruments improves verbal, working and long-term memory. So - everyone to the music school!
Well, and the saddest news in the end: the training of the intellect as such does not work either[30].
Conclusion
On the one hand, everything is sad.
Nothing that could make a person smarter is not sold in pharmacies. Yes, and with independent work and self-development - not everything is so simple either.
On the other hand, chemists are constantly synthesizing all sorts of interesting things, one of which (or a combination) may someday make my dream of NZT IRL come true.
I did not consider here the question of whether such a desire is generally legitimate (after all, the fact that we really want to become smarter can be a symptom of neurosis [31, 32], a consequence of the incorrect organization of the work process, and, finally (as in my case) as a result of mental illness). Perhaps I will return to these issues in future articles.
*About the availability of prescription drugs
In the framework of the postscript: there is a proven way to legally obtain prescription drugs. You will be surprised, but this requires a sane psychiatrist (which, at least in our province, is rare, but I managed to find one).
Then everything is simple: go to him for a paid appointment, show links to studies, explain what and why you need, and get the required prescription.
And that notorious “consultation with a specialist” will be a bonus, which, if the sanity condition is met, can really suggest something sensible.
Literature
In order not to be accused of promoting piracy, I give links to magazines, but I think everyone knows how to use saihab ;)
- Susanne M. Jaeggi, Martin Buschkuehl, John Jonides, and Walter J. Perrig. Improving fluid intelligence with training on working memory. Proc Natl Acad Sci U S A. 2008 May 13; 105(19): 6829–6833. www.ncbi.nlm.nih.gov/pmc/articles/PMC2383929
- Cattell, R. B. (1971). Abilities: Their structure, growth, and action. New York: Houghton Mifflin.
- Nikolaus R. Hansl, Beverley T. Mead. PRL-8-53: Enhanced learning and subsequent retention in humans as a result of low oral doses of new psychotropic agent.
Psychopharmacology, January 1978, Volume 56, Issue 3, pp 249–253
link.springer.com/article/10.1007%2FBF00432846 - Donald E. Butler, Ivan C. Nordin, Yvon J. L'Italien, Lynette Zweisler, Paul H. Poschel, John G. Marriott. Amnesia-reversal activity of a series of N-[(disubstituted-amino)alkyl]-2-oxo-1-pyrrolidineacetamides, including pramiracetam. J. Med. Chem., 1984, 27 (5), pp 684–691
pubs.acs.org/doi/abs/10.1021/jm00371a023# - Patent US 8957099 B2. Treatment of ADHD. www.google.com/patents/US8957099
- Nicole Laporte, Guillaume Sebire, MD, PhD, Yves Gillerot, Renzo Guerrini, MD, PhD, Sophie Gharianicorrespondence. Cognitive epilepsy: ADHD related to focal EEG discharges. Pediatric Neurology, October 2002Volume 27, Issue 4, Pages 307–311
www.sciencedirect.com/science/article/pii/S0887899402004411# - R.A. Gillhama, N. Williamsa, K.D. Wiedmanna, E. Butlera, J.G. Larkina, M.J. Brodie. Cognitive function in adult epileptic patients established on anticonvulsant monotherapy.
Epilepsy Research
Volume 7, Issue 3, December 1990, Pages 219–225
www.sciencedirect.com/science/article/pii/0920121190Q
- Alan M. Mellow, MD, PhD Carlos Solano-Lopez, MD Sue Davis, BS. Sodium Valproate in the Treatment of Behavioral Disturbance in Dementia. Journal of Geriatric Psychiatry and Neurology. October 1, 1993
- neuroleptic.ru/forum/topic/231-valproate-depakin-convulex-convulsofin
- Johns JM, Joyner PW, McMurray MS, Elliott DL, Hofler VE, Middleton CL, Knupp K, Greenhill KW, Lomas LM, Walker CH. The effects of dopaminergic/serotonergic reuptake inhibition on maternal behavior, maternal aggression, and oxytocin in the rat. Pharmacol Biochem Behav. 2005 Aug;81(4):769-85.
www.ncbi.nlm.nih.gov/pubmed/15996723 - A.V. Juorio. The effects of amfonelic acid and some other central stimulants on mouse striatal tyramine, dopamine and homovanillic acid. Br J Pharmacol. 1982Nov; 77(3): 511–515.
- M.D. Aceto, I. Botton, M.
Levitt, R. Martin, H.C. Bentley, P.T. Speight. Pharmacologic properties and mechanism of action of amfonelic acid. European Journal of Pharmacology. Volume 10, Issue 3, June 1970, Pages 344-354. - Ben H.C. Westerink, Geert Damsma, Jan B. De Vries, Hylko Koning. European Journal of Pharmacology. Volume 135, Issue 2, 17 March 1987, Pages 123–128
www.sciencedirect.com/science/article/pii/0014299987906030?np=y - www.reddit.com/r/Drugs/comments/1c9rjy/the_holy_grail_of_bizarrely_psychoactive
- www.longecity.org/forum/topic/66192-amfonelic-acid
- "Doctors are finding it harder to deny 'Chemobrain'", The Virginian-Pilot, October 2, 2007.
- Cochrane evidence. Psychostimulants for depression.
www.cochrane.org/CD006722/DEPRESSN_psychostimulants-for-depression - Bellebaum C, Kuchinke L, Roser P. Modafinil alters decision making based on feedback history — a randomized placebo-controlled double blind study in humans. J Psychopharmacol.
Sep 20, 2016. pii: 0269881116668591.
www.ncbi.nlm.nih.gov/pubmed/27649777 - Avellar AB, Carvalho LB, Prado GF, Prado LB. Pharmacotherapy for residual excessive sleepiness and cognition in CPAP-treated patients with obstructive sleep apnea syndrome: A systematic review and meta-analysis. Sleep Med Rev. 2016 Dec;30:97-107. doi: 10.1016/j.smrv.2015.10.005.
www.ncbi.nlm.nih.gov/pubmed/27865102 - Resolution of the meeting of the Presidium of the Formulary Committee of the Russian Academy of Medical Sciences from 2007.
www.rspor.ru/mods/news/docs/Resolution_Formulary_committee_meeting_16.03.%202007.doc - Cochrane evidence. Evidence for the efficacy of piracetam for dementia or cognitive impairment is inadequate for clinical use but sufficient to justify further research.
www.cochrane.org/CD001011/DEMENTIA_evidence-for-the-efficacy-of-piracetam-for-dementia-or-cognitive-impairment-is-inadequate-for-clinical-use-but-sufficient-to-justify-further -research - P.
A. Vorobyov, L.Yu. Bezmelnitsyna, L.S. Krasnova, M.A. Holovnya. Assessment of medical technology for the use of drugs with nootropic and psychostimulant effects: cortexin, piracetam, citicoline, cerebrolysin.
own.0x3.ru/index.php/s/7TYLfocAyXbajaN#pdfviewer - encyclopatia.ru/wiki/Shot_list_of_drugs
- Cochrane Evidence. No evidence of benefit from vitamin B6 supplementation on mood or cognition of older people with normal vitamin B6 status or with vitamin B6 deficiency.
www.cochrane.org/CD004393/DEMENTIA_no-evidence-of-benefit-from-vitamin-b6-supplementation-on-mood-or-cognition-of-older-people-with-normal-vitamin-b6-status-or -with-vitamin-b6-deficiency - Cochrane Evidence. No evidence of the efficacy of vitamin B12 supplementation for cognitive function.
www.cochrane.org/CD004394/DEMENTIA_no-evidence-of-the-efficacy-of-vitamin-b12-supplementation-for-cognitive-function - Cochrane Evidence. Insufficient evidence of benefits of vinpocetine for people with dementia.
www.cochrane.org/CD003119/DEMENTIA_insufficient-evidence-of-benefits-of-vinpocetine-for-people-with-dementia - Gary W. Small, M.D., Daniel H.S., Silverman, M.D., Ph.D., Prabha Siddarth, Ph.D., Linda M. Ercoli, Ph.D., Karen J. Miller, Ph.D. Helen Lavretsky, M.D. Benjamin C. Wright, M.D. Susan Y. Bookheimer, Ph.D., Jorge R. Barrio, Ph.D., Michael E. Phelps, Ph.D. Effects of a 14-Day Healthy Longevity Lifestyle Program on Cognition and Brain Function. The American Journal of Geriatric Psychiatry. Volume 14, Issue 6, June 2006, Pages 538–545.
www.sciencedirect.com/science/article/pii/S1064748112616753 - Melby-Lervåg M, Hulme C. Is working memory training effective? A meta-analytic review. Dev Psychol. 2013 Feb;49(2):270-91. doi: 10.1037/a0028228
www.ncbi.nlm.nih.gov/pubmed/22612437 - Bugos, J. A., Perlstein, W. M., McCrae, C. S., Brophy, T. S., & Bedenbaugh, P. H. (2007). Individualized Piano Instruction enhances executive functioning and working memory in older adults.
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