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Nootropics

Nootropic is a specific category of drugs that prevents excessive somnolence such as narcolepsy by targeting sleep mechanisms in the brain.

They are used to treat excessive sleepiness that is associated with sleep apnea, obstructive sleep apnea (OSA), narcolepsy, or shift work disorder (SWD). Such drugs include Modafinil, Armodafinil, Solriamfetol, etc. 

Narcolepsy is a condition in which you experience severe sleep attacks during the daytime or you fall asleep in inappropriate situations because you lose control. While in shift work disorder you feel sleepy during working hours and feel difficult to fall asleep during sleeping hours.

These are prescription-only medicines (POM) in the UK and schedule IV-controlled substances (a category of drugs that has less abuse potential) in USFDA.

These drugs are also called:

  • Stimulants
  • Eugeroics
  • Wakefulness Promoting Agents
  • Cognitive enhancers
  • Brain boosters
  • Psychoanaleptics
  • Nootropics
  • Alertness Drugs
  • Psychostimulant, etc.

Nootropics are prescribed to narcoleptic patients but are also commonly used by healthy individuals to enhance their mental alertness and also to mitigate fatigue.

Nootropics are also used to enhance mental alertness, wakefulness, boost your energy level and improve your memory. These medicines are also called “cognitive enhancers” or “smart drugs”. They work like sympathomimetic drugs and keep you awake and alert. They alter the levels of neurotransmitters, hormones, and enzymes that are available to the brain and enhance oxygen supply to the brain and also stimulate nerve growth. In this way, they improve the cognitive power of your brain.

There are natural and synthetic nootropics and almost everyone is using some nootropic in daily life, for example, caffeine is a stimulant.

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Uses of Nootropics

Stimulants are psychoactive drugs that improve the functioning of the brain. These are used to enhance learning acquisition, develop resistance to impairing agents, facilitate inter-hemispheric information transfer, etc. If you are a student hoping to ace your exam or you are a professional working hard for a promotion, or you are an older patient with problems of dementia then Nootropics are the drug of choice for you to boost your brainpower.

They are also used to treat certain brain disorders like narcolepsy, sleep apnea, shift work disorder, etc. Many people who do night shifts find it difficult to maintain sleep-wake balance as they become unable to awake during working hours and then remain unable to sleep during sleeping hours, so nootropics help them to keep their sleep-wake balance.

These drugs are used by a wide variety of individuals who are seeking to enhance:

  • Cognitive abilities
  • Memory
  • Focus
  • Concentration
  • Stamina
  • Productivity
  • Problem-solving

Mechanism of action

The exact mechanism of action of such drugs is unknown but its activity is similar to sympathomimetic agents. Some studies showed that they work by increasing the blood flow to the brain, which allows the brain to use more oxygen.

Some drugs work by increasing the adrenalin levels in the body and produce effects similar to drinking large amounts of caffeine, hence people can stay awake for extended periods of time.

Some drugs increase the amount of certain chemicals or neurotransmitters such as dopamine, which are released in the part of the brain associated with dependence.

Warnings and precautions

Do not take Nootropics:

  • If you are allergic to API such as armodafinil or modafinil
  • If you have serious rash including Stevens-Johnson Syndrome
  • If you have hypertension i.e., high blood pressure
  • If you are experiencing irregular heartbeats or cardiac arrhythmias
  • Discontinue Nootropics if you experience angioedema or anaphylaxis reaction

You must consult your doctor or pharmacist before taking Nootropics:

  • If you have cardiac issues or suffering from high blood pressure as in this case regular screening of heart performance and check on blood pressure would be required
  • If you have heart muscle or heart valve disorder
  • If you have mental illness or psychosis
  • If you have severe renal or hepatic issues as dose adjustment is required in this case
  • If you ever suffered from depression, anxiety or bipolar disorder, etc. as such drugs exaggerate the situation or reoccurrence of the disease happen
  • If you have a history of drug abuse or alcoholism

You must immediately contact your doctor or pharmacist if you experience suicidal thoughts, aggressive behavior or depression, upon using nootropic medications.

Stop taking Nootropics if you have a skin rash or allergic reaction and immediately tell your doctor.

If you use nootropic medications for a longer duration of time then you may develop dependency as they are habit-forming medications.

Do not drink alcohol if you are taking such medications.

Children and adolescents

Nootropic medications are not meant for children less than 18 years of age.

Nootropics and food interaction

Such medications can be taken with or without food. However, intake of food can delay the response.

Pregnancy and breastfeeding

If you are a pregnant or breastfeeding mother then you must consult your doctor before taking nootropic medications as these can be harmful to the baby.

Effect on the ability to drive or operate machines

Such medications can cause blurred vision or dizziness and also change your cognitive functioning. If you feel dizziness or blurred vision or you still feel sleepy after taking stimulants, then do not drive or operate machinery.

Avoid other dangerous activities until you know how these medications will affect your level of wakefulness.

Side effects

Every drug comes with some side effects along with benefits. Stimulants have a high potential for addiction and dependency. Some of the acute side effects are anxiety, headache, nausea, agitation, insomnia, and cardiac problems.

If you feel any problem or side effect while using such medications you must immediately stop taking medication and consult your doctor.

Signs of Abuse of Nootropics

Signs of abuse related to the use of such medications are:

  • If you are intensely focused on obtaining the drug or becoming distressed at the idea of not having it available
  • If you feel difficulty with cognitive tasks and function in absence of the drug
  • A significant change in sleep-wake cycles or waking hours
  • Anxiety, nervousness, agitation
  • Excess energy and the ability to work for hours without a break

Health Risks associated with abuse of Nootropics

Nootropics carry a wide range of health risks due to the dysregulation of dopamine in the brain as well as the inherent risks associated with stimulants, such as cardiac problems, insomnia, mood changes, dependency, addiction, and related functional impairments. Minor side effects associated with the non-stimulant nootropics include headache, nausea, agitation, etc.

Withdrawal symptoms

The withdrawal symptoms associated with the use of such medications are lethargy, irritability, mood changes, sleep disturbance, and relational difficulties. Other signs of withdrawal include changes in sleep/wake cycles, mood changes, decreased productivity or changes in focus and concentration, anxiety, depression, etc.

Further information

Always follow all directions on your prescription label. Read all patient information, medication guides, and instruction sheets provided to you. Ask your doctor or pharmacist if you have any questions.

Always remember to keep such medications and all other medications out of the reach of children, never share your medicines with others, and use all the medications only for the indication prescribed.

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References:

https://pubmed.ncbi.nlm.nih.gov/32447354/

https://adf.org.au/drug-facts/cognitive-enhancers/

https://www.medicines.org.uk/emc/files/pil.4320.pdf

https://www.accessdata.fda.gov/drugsatfda_docs/label/2007/020717s020s013s018lbl.pdf

https://go.drugbank.com/categories/DBCAT0011

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