Nootropics—also referred to as “cognitive enhancers,” “smart drugs,” “memory enhancers,” or “brain boosters”—are substances intended to improve mental performance. The term “nootropic” originally referred to a chemical that met very specific criteria: enhances memory, helps brain function, protects the brain, and is relatively safe. No evidence exists to show that any dietary supplement product can satisfy all (or any) of these criteria. Today, however, the term is used more loosely and often refers to any naturally-occurring or synthetic (that is, created in a lab) substance that might act as a “cognitive enhancer.”

Nootropic dietary supplements sometimes contain drugs and other ingredients that have not gone through the appropriate regulatory framework. Many lack sufficient reliable evidence to show they are either safe or effective.

Some dietary supplements marketed as nootropics contain ingredients prohibited for use by Service Members.

Nootropic products fall into two general categories: dietary supplements and drugs (prescription and over-the-counter). They contain substances (foods, herb, botanicals, dietary ingredients, pharmaceuticals) marketed to improve mental performance or functions—including memory, focus, motivation, concentration, and attention—and for overall brain health.

The problem with nootropic dietary supplements is that they might contain drugs (approved, unapproved, or both) or potential “new dietary ingredients.”

Nootropic dietary supplements

Dietary supplements for brain health marketed as “natural” or “herbal” nootropics might include ingredients such as ashwagandha, Bacopa monnieriGinkgo biloba, ginseng, huperzine A, omega-3 fatty acids, rhodiola, and valerian. Even some vitamins and minerals are marketed as nootropics, such as the B-complex vitamins and magnesium. Although such ingredients seem to be safe when taken in low doses and for the short term, so far the evidence to show whether any non-drug substance can improve cognitive performance is insufficient.

Some nootropic dietary supplement products contain multiple or mixtures of ingredients, with no evidence of how these ingredients might interact. Many contain proprietary blends that leave the consumer unaware of how much of each individual ingredient is in a product. And remember: More is not always better.

Nootropic drugs

Prescription nootropic drugs are FDA-approved for specific medical purposes, such as to treat attention deficit hyperactivity disorder (ADHD) or Alzheimer’s disease. For example, modafinil, methylphenidate, and various drugs for Alzheimer’s would be classified as nootropics. These drugs have been proven to be safe and are intended only for use under medical supervision.

Over-the-counter drugs, like prescription drugs, must be approved by FDA, and several could be considered nootropic. For example, the product NoDoz® is marketed to maintain alertness.

Unapproved drugs are drugs that have not yet been approved by FDA, so we don’t know whether they are safe or effective. Ingesting these substances, either knowingly or unknowingly, poses a risk to any individual. Currently, racetam drugs are not approved by FDA for use in the U.S. as drugs or dietary supplement ingredients, although some are approved drugs (currently or in the past) in other countries. Vinpocetine, sulbutiamine, phenibut, and huperzine A have been approved as drugs in countries outside the U.S., so they are additional examples of unapproved drugs often found in nootropic dietary supplements.

Nootropic dietary supplements sometimes contain drugs

FDA regulates dietary supplements differently than prescription drugs. Dietary supplements do not require FDA approval prior to marketing, so dietary supplement products can be misbranded or adulterated. FDA also has found some nootropic dietary supplements to be tainted with drugs or other ingredients that have not gone through the FDA regulatory pathway. Sometimes these ingredients are “hidden”—that is, they aren’t disclosed on the product label.

Some nootropic dietary supplements are marketed with questionable claims. For example, some nootropic and cognitive-enhancing dietary supplement products claim they can enhance mental performance and make your brain healthier. By law, however, a dietary supplement cannot claim to treat or prevent any medical condition. When a dietary supplement product makes such claims, according to FDA, the ingredients are considered “new drugs,” and the product cannot be sold without going through FDA’s pre-market approval process required for drugs.

Many consumers believe dietary supplement products are “natural”—and therefore safe—but this isn’t necessarily the case, especially when they contain drugs.

Ingredients to watch out for

Some ingredients in nootropics marketed as dietary supplements have not gone through the FDA regulatory pathway to actually be used in dietary supplements. Some of these could actually be drugs. Examples of some ingredients to watch out for and reasons for concern are noted below.

Ingredients on the DoD Prohibited Dietary Supplement Ingredients List

  • adrafinil* (Olmifon, Noofon)
  • DMHA (octodrine)*
  • DMAA*
  • higenamine*
  • methylphenidate* (Ritalin, Concerta)
  • modafinil* (Provigil)
  • phenibut
  • racetam drugs: piracetam, aniracetam, oxiracetam, omberacetam (Noopept), phenylpiracetam* (Phenotropil), pramiracetam (Nootropil), etc.
  • sulbutiamine
  • vinpocetine

Other questionable ingredients (“natural” and “herbal” ingredients)

  • B-PEA (b-phenylethylamine or beta-phenethylamine)*
  • halostachine (N-methyl phenylethanolamine)
  • huperzine A

*On the World Anti-Doping Agency Prohibited List

For a look into the evidence about some of the ingredients marketed for brain health mentioned above, read the OPSS articles on ashwagandhaBacopa monnieriGinkgo bilobahuperzine Aomega-3 fatty acidsphenibut, and vinpocetine.

 

Updated 12 May 2023

References

Baker, B., & Forbes-Ewan, C. (2017). Military effectiveness of five dietary supplements purported to aid cognitive and physical performance. Journal of Military and Veterans’ Health, 25(2), 35–47. Retrieved from https://jmvh.org/article/military-effectiveness-of-five-dietary-supplements-purported-to-aid-cognitive-and-physical-performance

Butler, M., Nelson, V. A., Davila, H., Ratner, E., Fink, H. A., Hemmy, L. S., . . . Kane, R. L. (2017). Over-the-counter supplement interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia. Annals of Internal Medicine, 168(1), 52–62. doi:10.7326/m17-1530

Cohen, P. A. (2018). The FDA and adulterated supplements—Dereliction of duty. JAMA Network Open, 1(6), Article e183329. doi:10.1001/jamanetworkopen.2018.3329

Cohen, P. A., Wen, A., & Gerona, R. (2018). Prohibited stimulants in dietary supplements after enforcement action by the US Food and Drug Administration. JAMA Internal Medicine, 178(12), 1721–1723. doi:10.1001/jamainternmed.2018.4846

Cohen, P. A., Zakharevich, I., & Gerona, R. (2019). Presence of piracetam in cognitive enhancement dietary supplements. JAMA Internal Medicine, Article 5507. doi:10.1001/jamainternmed.2019.5507

Crawford, C., Boyd, C., Avula, B., Wang, Y.-H., Khan, I. A., & Deuster, P. A. (2020). A public health issue: Dietary supplements promoted for brain health and cognitive performance. The Journal of Alternative and Complementary Medicine, 26(4), 265–272. doi:10.1089/acm.2019.0447

Crawford, C., & Deuster, P. A. (2020). Be in the know: Dietary supplements for cognitive performance. Journal of Special Operations Medicine, 20(2), 132–135.

Crawford, C., Wang, Y.-H., Avula, B., Bae, J.-Y., Khan, I. A., & Deuster, P. A. (2020). The scoop on brain health dietary supplement products containing huperzine A. Clinical Toxicology, Online, Article 171337. doi:10.1080/15563650.2020.1713337

FDA. (2019). FDA takes action against 17 companies for illegally selling products claiming to treat Alzheimer’s disease. Retrieved 10 February 2020.

Giurgea, C., & Salama, M. (1977). Nootropic drugs. Progress in Neuro-Psychopharmacology, 1(3-4), 235–247. doi:10.1016/0364-7722(77)90046-7

Global Council on Brain Health. (2019). The Real Deal on Brain Health Supplements: GCBH Recommendations on Vitamins, Minerals, and Other Dietary Supplements. AARP, Washington, DC, Retrieved 26 January 2021 from: https://www.aarp.org/content/dam/aarp/health/brain_health/2019/06/gcbh-supplements-report-english.doi.10.26419-2Fpia.00094.001.pdf

Malykh, A. G., & Sadaie, M. R. (2010). Piracetam and piracetam-like drugs. Drugs, 70(3), 287–312. doi:10.2165/11319230-000000000-00000

National Center for Biotechnology Information. PubChem Database: Piracetam, CID=4843. Retrieved 30 April 2019 from https://pubchem.ncbi.nlm.nih.gov/compound/piracetam

Rutjes, A. W. S., Denton, D. A., Di Nisio, M., Chong, L.-Y., Abraham, R. P., Al-Assaf, A. S., . . . McCleery, J. (2018). Vitamin and mineral supplementation for maintaining cognitive function in cognitively healthy people in mid and late life. Cochrane Database of Systematic Reviews(12), Article CD011906. doi:10.1002/14651858.CD011906.pub2

Tucker, J., Fischer, T., Upjohn, L., Mazzera, D., & Kumar, M. (2018). Unapproved pharmaceutical ingredients included in dietary supplements associated with US Food and Drug Administration warnings. JAMA Network Open, 1(6), Article e183337. doi:10.1001/jamanetworkopen.2018.3337

U.S. Food & Drug Administration. (2018). Unproven Alzheimer’s disease products. Retrieved 30 April 2019 from https://www.fda.gov/consumers/health-fraud-scams/unproven-alzheimers-disease-products