There were quite interesting statements made by Anders, such as "modafinil is probably the closest thing we have to a intelligence enhancer at the moment" and "there are virtually hundreds of substances that have been shown to induce better memory retention." I think everyone shoud check it out.
I agree. Everyone SHOULD check this out; Dr. Sandberg reinforces what has been my position on this issue for the past several months...except he did not include Aricept as a well documented cognition enhancer...although Aricept has many unknowns about side effects for an otherwise healthy person, there is a LOT of VERY strong evidence (at least on par with
modafinil or methylphenidate -- at least according to my references) supporting its use as a cognition enhancer.
Need a new Basic Q&A?, Questions from a beginner
What is most important is that folks get accurate information; such as: facts about clinical efficacy of cognitive enhancers. Although nootropic vendors could earn larger profits by presenting false and misleading information that could contend that modern nootropics (the Piracetam family, pyritinol, centrophenoxine, idebenone, deprenyl, etc.) are effective memory enhancers in healthy individuals, that wouldn't go over very well with intelligent folks whom have reviewed the literature.
Many individuals whom are first exploring the possibility of cognition enhancement have an untreated attention and/or depressive disorder and are seeking something they won't find in the unregulated dietary supplement type nootropics available in the USA. These individuals should first be pointed to a qualified health care professional.
What I will paraphrase is this previously posted information:
Don't go searching the web for solutions until modern medicine has failed you. At least half of the folks I interact with who inquire into nootropic therapies really have ADD or ADHD and don't really benefit from the deregulated nootropics that are sold on the web as dietary supplements. They have never been proven to work in healthy people so you are taking a gamble that what (barely) works for elderly subjects will work for an otherwise healthy individual.
Anyone interested in cognition enhancers should investigate and question the research supporting the use of compounds for which we have strong evidence of their efficacy in healthy subjects first rather than take the latest snake oil.
While there may be some evidence that suggests that these dietary supplement products may be effective in elderly or demented subjects, there is zero solid evidence that the conventionally accepted nootropics would affect memory functions of an individual with a perfectly functioning memory in the same manner. It is theoretically possible, but unproven nonetheless.
On the other hand, we do have solid evidence from randomized, double blind, placebo controlled trials in healthy subjects that suggest that prescription-only drugs such as Provigil AKA modafinil, Aricept AKA donezepil HCL, and Ritalin AKA Concerta AKA methylphenidate can improve short and long term memory functions -- once again -- in healthy subjects...
Bacopa has also been researched in healthy subjects: the following two double blind studies suggest benefits for healthy subjects as well:
This and this too
Yes, it seems some of the Bacopa research might be weak...however, considering its cost and record of safety, I don't think it could hurt anyone -- just don't expect it to work on first dosage administration (like methylphenidate or
modafinil)
The strongest published studies (that would pass a peer review) are the following (note they are both from Cambridge University -- among the VERY TOP elite learning/research institutions in the WORLD):
Psychopharmacology (Berl). 1997 May;131(2):196-206.
Effects of methylphenidate on spatial working memory and planning in healthy young adults.
Elliott R, Sahakian BJ, Matthews K, Bannerjea A, Rimmer J, Robbins TW.
Department of Experimental Psychology, University of Cambridge, UK.
Previous studies of the effects of the psychomotor stimulant, methylphenidate, have concentrated on vigilance and reaction time tasks. In this study, the effects of methylphenidate on more complex aspects of cognition were studied using tasks from the CANTAB battery and related tests which have been shown to be sensitive to frontal lobe dysfunction. Twenty-eight young healthy men participated in a counterbalanced, double-blind, placebo-controlled study of the effects of methylphenidate. Cognitive assessment included tests of spatial working memory, planning, verbal fluency, attentional set-shifting and sustained attention. Methylphenidate had significant effects on performance of the tests of spatial working memory and planning but not on the attentional and fluency tests. When the drug was taken on the first test session, performance on the spatial tests was enhanced by the drug compared to placebo. However, when the drug was taken second, performance accuracy was impaired whereas response latencies were decreased. These results are consistent with a hypothesis that methylphenidate influences performance in two conflicting ways; enhancing executive aspects of spatial function on novel tasks but impairing previously established performance. This pattern of effects is discussed within the framework of dual, interacting arousal mechanisms.
Publication Types:
* Clinical Trial
* Randomized Controlled Trial
PMID: 9201809 [PubMed - indexed for MEDLINE]
Psychopharmacology (Berl). 2003 Jan;165(3):260-9. Epub 2002 Nov 1.
Cognitive enhancing effects of modafinil in healthy volunteers.
* Turner DC,
* Robbins TW,
* Clark L,
* Aron AR,
* Dowson J,
* Sahakian BJ.
Department of Psychiatry, University of Cambridge, School of Clinical Medicine, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK.
RATIONALE: Modafinil, a novel wake-promoting agent, has been shown to have a similar clinical profile to that of conventional stimulants such as methylphenidate. We were therefore interested in assessing whether modafinil, with its unique pharmacological mode of action, might offer similar potential as a cognitive enhancer, without the side effects commonly experienced with amphetamine-like drugs. OBJECTIVES: The main aim of this study was to evaluate the cognitive enhancing potential of this novel agent using a comprehensive battery of neuropsychological tests. METHODS: Sixty healthy young adult male volunteers received either a single oral dose of placebo, or 100 mg or 200 mg modafinil prior to performing a variety of tasks designed to test memory and attention. A randomised double-blind, between-subjects design was used. RESULTS: Modafinil significantly enhanced performance on tests of digit span, visual pattern recognition memory, spatial planning and stop-signal reaction time. These performance improvements were complemented by a slowing in latency on three tests: delayed matching to sample, a decision-making task and the spatial planning task. Subjects reported feeling more alert, attentive and energetic on drug. The effects were not clearly dose dependent, except for those seen with the stop-signal paradigm. In contrast to previous findings with methylphenidate, there were no significant effects of drug on spatial memory span, spatial working memory, rapid visual information processing or attentional set-shifting. Additionally, no effects on paired associates learning were identified. CONCLUSIONS: These data indicate that modafinil selectively improves neuropsychological task performance. This improvement may be attributable to an enhanced ability to inhibit pre-potent responses. This effect appears to reduce impulsive responding, suggesting that modafinil may be of benefit in the treatment of attention deficit hyperactivity disorder.
PMID: 12417966 [PubMed - indexed for MEDLINE]
Evidence for Aricept (the bottom two references are publishings from Stanford University (Yesavage, Jerome) -- also one of the elite learning/research institutions in the world -- not to mention, Yesavage is a VERY well respected researcher):
Psychopharmacology (Berl). 2005 Oct;182(1):170-9. Epub 2005 Sep 29.
Cholinergic enhancement of episodic memory in healthy young adults.
* Gron G,
* Kirstein M,
* Thielscher A,
* Riepe MW,
* Spitzer M.
Department of Psychiatry, University of Ulm, Leimgrubenweg 12, 89075 Ulm, Germany. georg.groen@medizin.uni-ulm.de
RATIONALE: Acetylcholine esterase (AchE) inhibitors are known to remediate symptoms of Alzheimer's disease. However, only few systematic data exist on the effects of cholinergic treatment on cognitive functions in normal subjects. OBJECTIVE: This study evaluated the effects of donepezil, an inhibitor of AchE, on cognitive performance in young and healthy subjects. METHODS: We used a randomised double-blind parallel group placebo-controlled repeated measures design to investigate changes of cognitive functions in a group of 30 young healthy male subjects (mean age 23.9 years+/-2.24 SD) upon application of donepezil or placebo for 30 days. Attentional and executive functions, visual and verbal short-term and working memory, semantic memory, as well as verbal and visual episodic memory were investigated using an extensive neuropsychological test battery. RESULTS: Time-by-group interactions demonstrated significant drug effects that were specific to episodic memory in both the verbal and visual domain. Additionally, donezepil significantly improved long-term visual episodic recall. In none of the other functions under investigation any significant treatment effects were observed. CONCLUSION: Given this specific drug effect and the well-known relevance of the hippocampal region for episodic memory, we conclude that this region appears to be the major target of cholinergic enhancement in healthy subjects due to long-term inhibition of AchE.
PMID: 16021483 [PubMed - indexed for MEDLINE]
Neurology. 2002 Jul 9;59(1):123-5.
Comment in:
Neurology. 2003 Sep 9;61(5):721; author reply 721.
Donepezil and flight simulator performance: effects on retention of complex skills.
* Yesavage JA,
* Mumenthaler MS,
* Taylor JL,
* Friedman L,
* O'Hara R,
* Sheikh J,
* Tinklenberg J,
* Whitehouse PJ.
Palo Alto Veterans Affairs Health Care System, Stanford University School of Medicine, Stanford, CA 94305-5550, USA. yesavage@stanford.edu
We report a randomized, double-blind, parallel group, placebo-controlled study to test the effects of the acetylcholinesterase inhibitor, donepezil (5 mg/d for 30 days), on aircraft pilot performance in 18 licensed pilots with mean age of 52 years. After 30 days of treatment, the donepezil group showed greater ability to retain the capacity to perform a set of complex simulator tasks than the placebo group, p < 0.05. Donepezil appears to have beneficial effects on retention of training on complex aviation tasks in nondemented older adults.
PMID: 12105320 [PubMed - indexed for MEDLINE]
Neuropsychopharmacology. 2003 Jul;28(7):1366-73. Epub 2003 May 14.
Psychoactive drugs and pilot performance: a comparison of nicotine, donepezil, and alcohol effects.
* Mumenthaler MS,
* Yesavage JA,
* Taylor JL,
* O'Hara R,
* Friedman L,
* Lee H,
* Kraemer HC.
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA 94305, USA. msm@stanford.edu
The cholinergic system plays a major role in cognitive abilities that are essential to piloting an aircraft: attention, learning, and memory. In previous studies, drugs that enhance the cholinergic system through different pharmacologic mechanisms have shown beneficial effects on cognition; but dissimilar cognitive measures were used and samples were not comparable. A comparison within the same cognitive tasks, within comparable samples appears desirable. Toward this aim, we compared effect sizes (ES) of performance-enhancing doses of nicotine (a nicotinic receptor agonist) and donepezil (an acetylcholinesterase inhibitor) as found in our prior work on pilot performance. We also compared cholinergic ES to those of performance-impairing doses of alcohol. In three randomized, placebo-controlled trials, we assessed the flight performance of aircraft pilots in a Frasca 141 simulator, testing I: the acute effects of nicotine gum 2 mg; II: the effects of administration of 5 mg donepezil/day for 30 days; and III: the acute and 8 h-carryover effects of alcohol after a target peak BAC of 0.10%. We calculated the ES of nicotine, donepezil, and alcohol on a flight summary score and on four flight component scores. Compared to placebo, nicotine and donepezil significantly improved, while alcohol significantly impaired overall flight performance: ES (nicotine)=0.80; ES (donepezil)=1.02; ES (alcohol acute)=-3.66; ES (alcohol 8 h)=-0.82. Both cholinergic drugs showed the largest effects on flight tasks requiring sustained visual attention. Although the two tested cholinergic drugs have different pharmacologic mechanisms, their effects on flight performance were similar in kind and size. The beneficial effects of the cholinergic drugs on overall flight performance were large and the absolute (ie nondirectional) sizes were about one-fourth of the absolute ES of acute alcohol intoxication and roughly the same as the absolute 8 h-carryover ES of alcohol.
PMID: 12784106 [PubMed - indexed for MEDLINE]
Do you think Dr. Sandberg would consider aricept an effective cognition enhancer based on the available evidence?
Edited by nootropikamil, 06 September 2006 - 10:57 PM.