📜 ⬆️ ⬇️

Cognitive stimulants and another psychopharma: is it possible to become smarter

Hi% username%!

I would like to talk about all sorts of 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 preparations. Some of them are available, some are available only by prescription, and some are practically prohibited. But, I think, some information from psychopharmacology presented in this post will find its reader.
')
Spoiler : NZT is not yet invented, but has synthesized a number of potentially interesting pieces.

Disclaimer


I must say: I'm not a psychiatrist, I'm crazy. In the truest sense of the word.

Summary of Personal History
He once worked in IT, first in a Russian company, then in an international corporation from Silicon Valley.

And then there were known geopolitical events, relations between the Russian Federation and the United States deteriorated, the US government imposed sanctions on our largest customers, and the company, seeing the rapid decline in the market, almost left our country.

I, like almost all employees, have been reduced, and, behold, I could not find a new job. Because I lost my mind. Why not just put: depression , BAR , OCD , schizophrenia , GAD . I was discharged from a madhouse with f21.8 , then a specialist, with whom I work privately, found a dissociative process that explained the difference in diagnoses.

He lay in a mental hospital twice, was treated on an outpatient basis for quite a long time, but there was no point. Therefore, puzzled by the study of psychiatry, psychopharmacology and other related disciplines. I want to share the acquired knowledge with the audience. Perhaps someone will be interested.


Once again, just in case: I am not a doctor. Before taking anything, consult with a specialist . Do not use drugs. Wash your hands before eating and behave well.

About thinking


I think many would like to be able to think faster and better. Discussion of the goals and psychological attitudes behind this desire will be left next time, and now we will assume that it is quite logical and justified, focusing on the means to achieve it.

So what exactly can we improve? First, the memory. Everything is simple: 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 dumps on the CCIE , someone will try to memorize all the volumes of Knut , and someone will spend on memories of where and how much money they spent.

Improving the short-term and / or working memory (there are different opinions about how they are related) gives us the opportunity to improve the so-called mobile intelligence , 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 focus of activity and perception. Everything is not so obvious here, as in the case of memory, but if you remember your experience (I think everyone has it), when you could not focus on the task (this is not always associated with procrastination), then you will appreciate the ability to selective concentration. And if you, like me, do not let LMM, have attention disorders, then even more so.

And the third aspect is the intellect itself: mobile and crystallized (according to Cattelu) [2]. Here, I think, there is no need to explain: the first is said above, and the second is the ability to use the experience gained.

And one more aspect. Formally, it is offtopic, but I would also turn it on - it is endurance - the ability for a long time to experience high mental (we are interested in them) loads and not to lose at the same time efficiency.

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)


image

There was such a scientist in the 1970s, Dr. Hansl. And he worked including over cognitive enhancers. One of the results of this work was the substance we are talking about.

I will immediately note two very important points: firstly, at the moment, this compound has the status of research chemical: i.e. no clinical trials have been performed, side effects are unclear, hazard class not established, etc. And secondly, the level of evidence, to put it mildly, is very far from the desired.

To be precise, there are only three scientific studies [3, 4, 5] of this substance, the sample is quite small. Nevertheless, 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 subjects' ability to memorize words and numbers. Subjects were offered to memorize words (orally), and then they were asked to repeat them.

It turned out that the effectiveness of the drug depends on how good the memory of the subject was without him.

The most impressive results were shown by those who had obvious memory problems (those who memorized six words or less) - their memory improved by 87.5-105% [3].

Those with better memory medication showed a much more modest result: 7.9-14% [3]

The age aspect is interesting: in people who were over thirty - they demonstrated an increase in the ability to memorize by 108-152% [3].

In addition, an experiment was conducted to determine the effect of PRL-8-53 on the ability to mathematical calculations. The subjects were offered the following task: it was necessary to subtract seven from a given number, then add one, then subtract seven from the result, add two, then subtract seven, add three to the result, etc. until another number given by the experimenter is obtained. And here, too, there were improvements, expressed in the fact that the assignment after taking the drug was faster.

Regarding the mechanism of action of the drug no data. Here it is: there are simply no scientific publications in which this question would be investigated.

Hansl himself believed that the drug somehow affects cholinergic transmission (cholinergy is generally a very promising thing for the development of any brain improvement work), inhibits the action of serotonin ( hello lovers to prescribe SSRIs to everyone ) and potentiates dopaminergic transmission. But this is his personal opinion, not based on anything.

Substance legally in the Russian Federation, it is relatively easy to buy it on the web.

I did not try it myself only because there is no extra money. But I’m ready to become a test experimental rat, I promise a trip report review containing a detailed description of the subjective and objective (I’ve got a certified clinical psychologist from a mental hospital sitting next to it, can take measurements) of the result.

Valproic acid


image

This is a mood stabilizer. The drug used, firstly, to treat epilepsy (prevents seizures), and, secondly, to stabilize mood in affective disorders (does not allow to fall into depression or fly into mania for patients with BAR, schizo-affective disorder and other similar diseases). Sold without a prescription (in some pharmacies may require, this is not a problem *).

But we will consider off-label use. With evidence, this is also not very good (and all cognitive enchheisers are not very good with it), but Dr. Philip Bird from Gosforth Clinic argues that valproic acid can significantly improve attention, and not only in patients with ADHD [6], but in healthy people [5]. And in general, of all the mood workers, valproic acid is the most intellectually friendly [7]. He even tried to give it to dementals with a very encouraging result [8].

The proposed mechanism of action lies, firstly, in the GABA-ergic effect per se, exerted by this substance, and, secondly, in regulating the expression of genes encoding receptor proteins that respond to neurotransmitters in brain cells.

That is why the effect does not come immediately, but in 1-2 weeks (you just need to wait until the whole inert system is reeling: expression changes, new proteins are produced, the brain is rebuilt under the new configuration).

With this thing I have a personal experience, and it is beautiful. Under it, I can read, write and even think long enough. For example, if you measure in the text, then with it I can manage 150 pages of text per day, without it - 70-90 (with the same complexity). Of course, perhaps this is a placebo effect, but I do not have the opportunity to conduct RCTs, so I share what I have. By the way, “Neuroleptics” noted similar effects [9], but this is also not the best source of information.

The only "but" - the dosage should be subtherapeutic, about 100-300 mg. And let the psychiatrists of the old school say that less than 1000 does not work: explain to them that the drug is not for you for BAR or F25, but for concentration.

Amfonelic Acid


image

What will a man from the street say if he is asked about the means to increase stamina? Most likely, he would call cocaine, amphetamine, methamphetamine. But they are prohibited, which means they do not suit us.

But if you think about it, we don’t need them: we are not interested in narcotic intoxication here, but in an opportunity to somewhat “speed up” our thinking, increase endurance and remove drowsiness.

And among research compound'ov there are many substances that are not drugs (in a legal sense), but can give us the desired effect. One of these substances is amphonelic acid.

Technically, it is a dopamine reverse capture inhibitor [11]. Those. In normal mode, dopamine released from vesicles is back tightened with the help of DAT, and under sabzhem substance it is not delayed. Or dragged out much less.

This substance is of interest precisely by the selectivity of its effect: it does not increase aggression [10], does not affect the noradrenergic (it seems this is so written in Russian) transmission [12], and therefore has no 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 meta, it does not have neurotoxicity), and, secondly, reduces the risk of addiction (but does not level him, all the same dopaminku cling!).

And speaking quite simply, this is an ideal stimulant. As an amphetamine, only without a narcotic “arrival”, with preservation of clarity of thinking and the ability to interact adequately with reality.

The 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 multiplies productivity very much. “Reason remains pure” - a motive repeated in the comments. Others compare the effect with caffeine or say 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) sulfonyl acetamide


image

More known under the brand name "Modafinil". Analeptic. In the Russian Federation, it is included in the section “Psychotropic substances” 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 almost impossible to get it legally (the maximum that I managed to do is to get substances from list III, because doctors have such inferior bureaucracy associated with the discharge of such drugs, and they are extremely reluctant to prescribe them ).

It has been proven that at least it has the ability to restore (ie, improve) impaired cognitive abilities after chemotherapy [16]. In addition, it can reduce the onset of depressive symptoms [17]. But it is - in patients with healthy things is not so simple.

Despite the fact that modafinil is quite popular as a “cognitive improver” [18, excitation on the RAMP, the link to which, for obvious reasons, I do not cite], the study [18] shows that its effect is most likely due to a shift in the choice in favor of previously encouraged behavior compared with refusal of behavior, which is associated with negative reinforcement, which is not an improvement.

Meta-research [19] also showed no effect of improving memory and intelligence. So there is no point in perplexing 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", * racetam, hopantenic acid, etc.


Usually, when it comes to preparations for "brain acceleration," someone remembers "Phenibut", "Piracetam", "Fenotropil" and other nootropics.

Well aware that the effectiveness of the preparations presented in the previous sections was proven, to put it mildly, in any way, I would venture to devote a separate chapter to the criticism of nootropics.

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:

1. Immediately remove outdated drugs with unproven efficacy - Cerebrolysin , Trimetazidine, Chondroetin Sulfate, Vinpocetine, Piracetam, Fenotropil, Arbidol, Rimantadin, Validol, Inosin, Valocardin, etc. in the DLO program, which provides drug support in the DLO program. including, over-the-counter;


Piracetam [21, 22], as well as phenylpyracetam (“Fenotropil”) developed on its basis, do not have proven effectiveness in improving the ability to think (in a broad sense) [it’s difficult to refer to missing evidence, I’ll just say that Cochrane is about Phenotropil "silent".

Less reliable sources (for example, [23]) report the presence of a short-term stimulating effect on Fenotropil, but according to reviews from the same RAMP, it passes quickly, and Fonturacetam cannot be used as a stimulant.

As for hopantenic acid (“Pantokalcin”), which one of my psychiatrists loved so much, he also has no proven effectiveness.

And Vinpocetine, which was so actively advertised in the 90s - 2000s, does not help with dementia [26]. And Santa Claus does not exist.

Why do I find fault with Cochrane in the case of these drugs, despite the fact that I did not do this in previous sections? Because PRL-8-53 and amfonelic acids, all there, are not drugs, they are not positioned as nootropic agents anywhere, and therefore they can be forgiven for the absence of large-scale clinical trials. Perhaps they will get it, maybe not.

But if a certain substance is sold as a medicine, and yes even it is included in the VED, then it simply must have proven effectiveness!

B vitamins


Everything is simple: they do not work. Contrary to popular belief, neither B6 [24] nor B12 [25] increase brain productivity.

Training of memory and intelligence


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 healthy eating, exercises to develop memory, and exercise in the short run improved fluency [27], but not memory.

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 methodology that you use, but not in other areas. Smarter in this way to become will not work.

On the other hand, there is a study [29] showing that playing musical instruments improves verbal, working and long-term memory. So - to everyone in the music school!

Well, the saddest news in the end: the training of the intellect as such is also not working [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 constantly synthesize all sorts of interesting things, one of which (or a combination) may someday fulfill my dream of the NZT IRL.

I did not consider here the question of whether such a desire is legitimate at all (after all, the fact that we really want to become smarter can be a symptom of neurosis [31, 32], a consequence of improper organization of the work process, and finally (as in my case) due to mental illness). Perhaps I will return to the consideration of these issues in the following articles.

* About the availability of prescription drugs


As part of the postscript: there is a proven way to legally extract prescription drugs. You'd be surprised, but for this you need 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 admission, show links to studies, explain what you need and why, and get the required recipe.

And the bonus will be the very notorious “consultation with a specialist,” which, if the condition of sanity is met, can really suggest something sensible.

Literature


In order not to be accused of promoting piracy, I give references to magazines, but I think everyone knows how to use sahab;)

  1. Susanne M. Jaeggi, Martin Buschkuehl, John Jonides, and Walter J. Perrig. Improving fluid intelligence with training on working memory. Proc Natl Acad Sci US A. 2008 May 13; 105 (19): 6829–6833. www.ncbi.nlm.nih.gov/pmc/articles/PMC2383929
  2. Cattell, RB (1971). Abilities: Their structure, growth, and action. New York: Houghton Mifflin.
  3. Nikolaus R. Hansl, Beverley T. Mead. It has been shown that the PRL-8-53: Psychopharmacology, January 1978, Volume 56, Issue 3, pp 249–253
    link.springer.com/article/10.1007%2FBF00432846
  4. Donald E. Butler, Ivan C. Nordin, Yvon J. L'Italien, Lynette Zweisler, Paul H. Poschel, John G. Marriott. 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#
  5. Patent US 8957099 B2. Treatment of ADHD. www.google.com/patents/US8957099
  6. Nicole Laporte, Guillaume Sébire, 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#
  7. RA Gillhama, N. Williamsa, KD Wiedmanna, E. Butlera, JG Larkina, MJ 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/092012119090018Q
  8. 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
  9. neuroleptic.ru/forum/topic/231- valproaty-depakin-conculex-convulsofin
  10. 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 in the rat. Pharmacol Biochem Behav. 2005 Aug; 81 (4): 769-85.
    www.ncbi.nlm.nih.gov/pubmed/15996723
  11. AV Juorio. Stimulants on mouse Br J Pharmacol. 1982 Nov; 77 (3): 511–515.
  12. MD Aceto, I. Botton, M. Levitt, R. Martin, HC Bentley, PT Speight. Pharmacologic properties and mechanism of action of amfonelic acid. European Journal of Pharmacology. Volume 10, Issue 3, June 1970, Pages 344-354.
  13. Ben HC 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
  14. www.reddit.com/r/Drugs/comments/1c9rjy/the_holy_grail_of_bizarrely_psychoactive
  15. www.longecity.org/forum/topic/66192-amfonelic-acid
  16. “Doctors are finding it harder to deny 'Chemobrain'”, The Virginian-Pilot, October 2, 2007.
  17. Cochrane evidence. Psychostimulants for depression.
    www.cochrane.org/CD006722/DEPRESSN_psychostimulants-for-depression
  18. A randomized placebo-controlled double blind study in humans. Bellebaum C, Kuchinke L, Roser P. Modafinil alters decision making. J Psychopharmacol. 2016 Sep 20. pii: 0269881116668591.
    www.ncbi.nlm.nih.gov/pubmed/27649777
  19. Avellar AB, Carvalho LB, Prado GF, Prado LB. Pharmacotherapy for CPAP-treated patients with obstructive sleep apnea syndrome: 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
  20. Resolution of the meeting of the presidium of the Formulary Committee of the Russian Academy of Medical Sciences of 2007.
    www.rspor.ru/mods/news/docs/Resolution_Formulary_committee_meeting_16.03.%202007.doc
  21. Cochrane evidence. It has been shown that it has been confirmed that it has been approved.
    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
  22. P.A. Vorobev, L.Yu. Bezmelnitsyna, L.S. Krasnova, M.A. Holovnya Evaluation of the medical technology of using drugs with nootropic and psychostimulating action: Cortexin, Piracetam, Citicoline, Cerebrolysin.
    own.0x3.ru/index.php/s/7TYLfocAyXbajaN#pdfviewer
  23. encyclopatia.ru/wiki/Fit_List_represents
  24. Cochrane Evidence. No evidence of benefit from vitamin B6 or 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
  25. 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
  26. 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
  27. Gary W. Small, MD, Daniel HS, Silverman, MD, Ph.D., Prabha Siddarth, Ph.D., Linda M. Ercoli, Ph.D., Karen J. Miller, Ph.D. Helen Lavretsky, MD Benjamin C. Wright, MD 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 the 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
  28. Melby-LervĂĄg 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
  29. Bugos, JA, Perlstein, WM, McCrae, CS, Brophy, TS, & Bedenbaugh, PH (2007). Individualized Piano Instruction. Aging & Mental Health, 11 (4): 464–471.
  30. David Z. Hambrick. Brain Training Doesn't Make You Smarter. Scientific American. December 2, 2014.
    www.scientificamerican.com/article/brain-training-doesn-t-make-you-smarter
  31. Karen Horney. "Our internal conflicts."
  32. Karen Horney. "Self-analysis".

Source: https://habr.com/ru/post/400681/


All Articles