What’s Behind the Nootropic Buzz?

Supplements promising to sharpen memory, enhance focus, and boost cognitive performance are lining pharmacy shelves. Here’s what you need to know.

“Nootropics,” sometimes called “smart drugs,” originally described synthetic cognitive enhancers. Today, the term is broadly applied to natural herbs and supplements marketed for brain health benefits like improved memory, focus, creativity, and motivation.

Bacopa is one of the most popular nootropics. It is a plant commonly used in Ayurvedic medicine, but explain that the evidence for cognition is mixed. Several clinical studies show no improvement in healthy adults, patients with mild cognitive impairment, or Alzheimer disease. However, some subgroup analyses and smaller clinical studies suggest possible benefits including improved reaction time, verbal learning, visual motor function, and memory recall in healthy adults and children 6-8 years old. It’s important to point out that evidence is conflicting regardless of whether bacopa is taken alone or in combination with other ingredients. For safety, bacopa is generally well tolerated but can cause abdominal cramps, diarrhea, dry mouth, headache, and nausea.

Ginkgo is another common nootropic and has been used in traditional Chinese medicine for centuries. However, the evidence for cognitive function is unclear. Some studies show that ginkgo might improve working memory, attention, information processing, and recall in healthy adults but other studies show no benefit. Combination products including ingredients like Panax ginseng also have conflicting evidence. Importantly, remind patients that ginkgo can interact with several medications including anticoagulants, anticonvulsants, and diabetes medications.

Lion’s mane mushroom is gaining traction but may be less familiar to patients. It grows on dead hardwood trees and has been used as food and medicine in East Asia. Despite the hype, evidence for cognition suggests no benefit. Several studies show no improvement in most cognitive measures - and one study actually reported reduced word recall accuracy. Additionally, a single study in patients with mild cognitive impairment suggested that lion’s mane mushroom improved cognitive function, but any benefit disappeared within 4 weeks of stopping. If patients want to try it, advise those with autoimmune diseases to use caution due to the possibility of disease exacerbation.

The bottom line is, while the idea of a cognitive boost is appealing, the evidence is still limited and mixed. Encourage patients to focus on healthy lifestyle choices like better sleep, a balanced diet, and regular physical activity. And remind them to discuss any supplements they’re considering with a healthcare provider before starting.

For more information on other therapies for cognitive function, check out our “Effectiveness by Condition.”