Do Nootropics ('Smart Drugs') Actually Work?

pills on a grid — Nootropics are supplements or pills that enhance brain function. They can range from caffeine to ginseng to Ritalin. Ober Ramirez/Getty Images

Nootropics sound like some sort of scary, illegal subset of pharmaceuticals, but chances are you've had one variety or another any time you've popped a can of soda, sipped your daily Starbucks or eaten something made with cocoa.

"Nootropics are substances or compounds that enhance brain function, usually in the higher mental function domains such as memory, attention, concentration, creativity, etc.," emails Dr. Kiran Rajneesh, assistant professor of neurology at The Ohio State University Wexner Medical Center.

Sound familiar? That's because the nootropic most people rely on daily is caffeine, which is known to wake people up, make them sharper and more focused. The fact that it often turns cranky non-morning people into delightful individuals is just an added bonus.

Some nootropics (often referred to as "smart drugs" or "cognitive enhancers") can be purchased over the counter as part of food or drink, like coffee and some types of tea. Others are well-known supplements, such as the ancient medicinal plant ginseng or creatine, which bodybuilders and athletes swear by for boosting energy levels and muscle production. Still others require a prescription. In fact, there are three major categories of nootropics, all with different goals, according to Dr. James Giordano, professor of neurology and biochemistry at Georgetown University Medical Center.

Stimulants like methamphetamine and methylphenidate, both commonly used to treat conditions such as attention-deficit and/or hyperactivity disorders (ADD/ADHD). These promote wakefulness and increased focus. They do this by boosting dopamine levels in the brain, which helps to control energy, attention and alertness. Ritalin and Adderall are well-known prescription versions, but caffeine is the most used day-to-day stimulant nootropic.
Eugeroic drugs are those used to stabilize volatile sleep and wakefulness patterns. Patients with narcolepsy, jet lag or those who do shift work (like surgeons) often turn to such nootropics for help. These reduce the need for sleep and enhance attentiveness. The drug Modafinil would be an example of a eugeroic drug.
Racetams, which are not approved for sale in the United States, were originally developed to treat dementia and are said to affect both working and episodic memory. Piracetam is one name you may come across.

Do Nootropics Enhance Brain Function?

That is the million-dollar question. If we're talking about drugs the medical community has studied and rubber-stamped (like for treating ADHD), then the answer would be "yes." But what about dietary and "natural" supplements?

For those, the evidence is often anecdotal. Rajneesh notes that science has yet to achieve the gold standard of research about such nootropics, meaning that large, randomized, double-blind trials are necessary to provide proof. "However, we can all attest that a cup of coffee, tea or cocoa has enhanced our mental abilities to get through the day sometimes," he says.

"Nootropics may provide a mild benefit, but they won't provide a remarkable improvement to brainpower. They might give some an edge or boost some areas of cognitive, but these supplements are not a magic bill," emails Melissa Morris, a certified sports nutritionist and exercise physiologist, who writes health content for the life insurance site QuickQuote.com. "Regular exercise, a healthy diet, getting plenty of sleep, and cognitive training (like crossword puzzles or reading) are more beneficial in the long run."

In a 2016 press release, the American Medical Assocation (AMA) bluntly stated, "While prescription stimulants carry real risks, they do not make people smarter. The available evidence suggests the cognitive effects of prescription stimulants appear to be highly variable among individuals, are dose-dependent, and limited or modest at best in healthy individuals."

Are Nootropics Safe?

Again, this depends on the type of nootropic and the purpose. Caffeine is safe for moderate consumption, which Morris says equates to between two and four cups per day. "Creatine monohydrate is safe as long as you follow the dosing instructions. Other supplements may or may not be safe," she says.

A lot of the safety issue has to do with your own personal health profile, not to mention potential interactions with other medications and such. "Always talk with your healthcare professional because starting a nootropic," Morris says. "You can discuss the benefits, side effects, and if they interact with any prescription medications."

Unfortunately, some people use prescription nootropics (like Adderall) who don't really need to in order to "get ahead" at school or work. The issue is so prevalent that the AMA put out a policy statement in 2016 discouraging use of these drugs for the purpose of cognitive enhancement in otherwise healthy people.

"Only a limited amount of information is available on the patterns of use for dietary supplements and herbal products that are marketed for cognitive enhancement," AMA said in a press release. "More than 100 substances from amino acids to botanical preparations are advertised on websites as having the ability to improve cognitive performance, and their safety and efficacy have not been systematically examined."

"A nootropic is only as safe as the manufacturing process and the safety guidelines. Just like you wouldn't accept an open drink from a stranger at a bar, don't just take any nootropic," says Vinay Amin, the CEO of the herbal supplement brand Eu Natural, via email. "If a product is clinically tested, FDA approved and can prove their manufacturing process is of premium standard, then these products are safe to use in moderation."