[ExI] Which nootropics work best?

[Anders Sandberg]

On 2011-03-14 22:28, Bryan Bishop wrote:
> I don't think extropy-chat has the critical mass of nootropic knowledge
> any more. From what I've read in the responses, there's been the
> standard drugs and pills mentioned. Immortality Institute's forum has a
> ridiculous amount of nootropics-related activity; from what I can tell,
> this might be due to a lower average age of their posters and more
> disposable income-- some of their regiments seem to be upwards $50/day
> in some cases.

But maybe that is also because we do a bit more critical thinking?

A regimen of lots of pills makes sense if you think you know how they 
are going to interact, or you have reason to think the combination gives 
you such an edge that it is worth the risk and inconvenience. But the 
real evidence for most of the enhancers discussed there is slim - sure, 
you can always find a few Pubmed abstracts that look good, but actual 
solid evidence based medicine is very scarce for cognitive enhancers. 
There will be significant placebo effects. Since normal medications and 
supplements have interactions and side effects we should expect them for 
the enhancers too.

Just look at an apparently well-regarded post like
http://www.longecity.org/forum/topic/36691-ten-months-of-research-condensed-a-total-newbies-guide-to-nootropics/
It is crammed with claims that are problematic because they are 
unsupported (where is the evidence for the safety of chronic use?) or 
wrong (no, increasing ACh levels does not do the same thing as 
inhibiting AChE!) This is a mixture of wishful thinking and guesswork. 
Not necessarily wrong, but seriously overconfident.

I have collected a library of papers on cognitive enhancement, and I 
think that only sugar and *maybe* caffeine has good enough data to pass 
a Cochrane review. Stimulants could probably pass for their stimulating 
effects (duh) but proper characterization of their cognitive enhancing 
functions is limited. This is of course demanding a high level of 
evidence, but I'd rather do that than waste money, time and risk on 
something that is unlikely to give an enormous benefit even if it works 
as advertised.

Check out
http://www2.cochrane.org/reviews/en/subtopics/56.html
In particular
http://www2.cochrane.org/reviews/en/ab006220.html (memory training +)
http://www2.cochrane.org/reviews/en/ab005381.html (exercise +)
http://www2.cochrane.org/reviews/en/ab005379.html (PUFA vs dementia -?)
http://www2.cochrane.org/reviews/en/ab003122.html (HRT vs dementia -)
http://www2.cochrane.org/reviews/en/ab005993.html (Procaine -)
http://www2.cochrane.org/reviews/en/ab004514.html (B12 vs dementia -)
http://www2.cochrane.org/reviews/en/ab006221.html (DHEA -)
http://www2.cochrane.org/reviews/en/ab003120.html (Ginkgo vs dementia -)

Not too encouraging, but then again, most medicine is not too 
encouraging once you start to scrutinize it closely.

-- 
Anders Sandberg
Future of Humanity Institute
Oxford University