Wednesday, March 24, 2010

Nootropics: Smart Drugs

Nootropics is a term used by proponents of smart drugs to describe medical drugs and nutritional supplements that have a positive effect on brain function.

Below is a list of some of the commondrugs and supplements

AMPAKINE
Effects: A drug developed from ampakines, a class of biochemicals, has been found to enhance communication between brain cells. Subjects have been shown to have enhanced performance on memory tests, and it may show promise in helping those with such disorders as Alzheimer's disease and schizophrenia, in which the high-speed electrical signals that link the brain's complex neural circuits are failing.

ANIRACETAM
AKA: Draganon, Ro 13-5057, Sarpul. Chemically similar to piracetam, but is about ten times stronger and treats more symptoms. How it works is still unknown.

Effects: Has been shown to protect the brains of lab animals.

Precautions: Toxicity and side effects seem minimal, but it has not been adequately tested on humans as yet.

Dosage: The most effective cognitive-enhancing dose is 1000 mg/day, though this is based only on one study.

BD
AKA: Enliven, GHRE, NRG3, 1,4 butanediol, Revitalize Plus, Serenity, Somatopro, Thunder Nectar, Weight Belt Cleaner.

Effects: Increases energy and promotes sleep. When taken orally, it is converted by the body into

GHB.
Precautions: Products containing BD have been associated with over 120 cases of adverse side effects, including three deaths. Side effects include dangerously low heart rate and breathing, vomiting, seizures, unconsciousness, and coma.

BEMEGRIDE
Effects: May increase learning ability and slow the advance of senility.

Precautions: Causes convulsions.

CENTROPHENOXINE
AKA: Brenal, Cellative, Clocete, 4-chlorophenoxyacetic acid 2-dimethy-laminoethyl ester, Helfergen, Lucidril, meclofenoxate, Marucotol, Methoxynal, Proserout. It is very similar structurally to the important neurotransmitter acetylcholine. In the bloodstream, it breaks down into DMAE and supplies the same basic building blocks as DMAE for manufacturing acetylcholine and speeding nerve transmissions across synapses.

Effects: It is believed to improve memory, increase mental alertness, improve mood, increase learning ability, protect against aging (has been shown to increase the life span of lab animals 30 percent), remove lipofuscin deposits (it may be better than DMAE in this respect, though some say that this is just speculative), repair synapses, attack free radicals, protect animal brains from the effects of hypoxia (in this respect, it may be useful to those who could suffer loss of oxygen to the tissues, such as some victims of angina, atherosclerotic dementia, intermittent claudication [severe pain in the calves when walking due to restricted blood flow in the legs], and stroke), and increases the rate of synthesis of RNA and the manufacture of new proteins. Despite this, it probably has no effect on Alzheimer's. In Europe, it has been used to treat reading problems, dysfunctions in speech and motor skills, and various age-related mental problems.

Precautions: Centrophenoxine may be dangerous to those who suffer from severe hypertension (high blood pressure), convulsions or involuntary musculoskeletal movements, hyperexcitability, insomnia, tremors, motion sickness, paradoxical drowsiness, and depression. Toxicity is uncommon in therapeutic doses; side effects are also rare, but include depression, dizziness, headaches, hyperexcitability, insomnia (especially if taken later in the day), motion sickness, sleepiness, and tremors.

Dosage: Some say 1000 to 3000 mg/day, though others say that such doses are unnecessarily high, and that 80 mg/kg of body weight (the dosage most often used in clinical trials) is sufficient. It takes effect very fast. DlAZADAMANTOL

Effects: May increase learning ability and slow the advance of senility.

Precautions: Causes convulsions.

DMSO
AKA: Dimethyl sulfoxide, RIMSO-50. Legally, it is only prescribed for interstitial cystitis and bladder inflammation, and is not recommended for any other use, though many use it to treat arthritis and sports injuries. It appears to be an all-purpose solvent, and has been used as a degreaser, paint thinner, and anti-freeze.

Effects: It works, not by lubricating joints or by deadening pain, but by scavenging free radicals. It has been shown to increase circulation; protect against the effects of radiation and freezing; reduce keloids, scars, and the effects of burns; help protect against fungus, bacteria, and viruses; be a beneficial supplement to cancer therapy; stimulate immunity; stimulate wound healing; and useful in treating such eye problems as cataracts, macular degeneration, and glaucoma, among others. It has been found to reduce the severity of paraplegia in cats subjected to crushing spinal cord injuries, and the San Francisco General Hospital Brain Trauma and Edema Center has used it to treat brain injuries. Anecdotal evidence indicates it may provide benefits to those with Down's syndrome, learning disabilities, and senile dementia, as well as those with other forms of brain damage and dysfunction. Because it has so many benefits, proponents tout it as the wonder drug of the 21st century.

Precautions: It may be dangerous for those with a bladder malignancy, kidney or liver problems, diabetes, or who is allergic to DMSO. Those with fair skin use no more than a 50 percent concentration, as they are more sensitive to DMSO. Concentrations of 40 percent or more may prolong bleeding, and concentrations greater than 50 percent are not applied to the face and neck, as they are more sensitive to DMSO than the rest of the body. It should be dabbed on, not rubbed in, and any excess wiped off after half an hour; toxicity may occur if it is inhaled, as it evaporates slowly. It may exacerbate the effects of some allergens. Injections should only be administered by a physician. It is difficult to perform double-blind studies on DMSO; it imparts to the breath and skin an immediate garlic odor. A common side effect is a harmless garlic taste that can persist for up to three days. Less common side effects are vision problems (these have occurred quite frequently in lab animals, but are undocumented in humans), and possibly nausea, headaches, and skin rash, along with redness, itching, burning, discomfort, or blistering on the areas where it has been applied. Rare side effects include nasal congestion, itching, hives, and facial swelling. One life-threatening symptom is breathing difficulties. No overdose symptoms are known, though W. Nathaniel Phillips reports that concentrations greater than 70 percent can cause the skin problems, along with headaches, nausea, diarrhea, a burning sensation when urinating, photophobia (light intolerance), and disturbances in color vision. When combined with any other bladder medication, the effects of both drugs maybe intensified. As it can carry other substances directly into the blood, DMSO should not be applied to the skin where skin medications, cosmetics, lotions, bath oils, or soaps have already been applied. Most of the industrial grade, or solvent grade, solutions contain acetone, which is readily carried into the blood by DMSO, and which can cause liver damage and death. According to Pearson and Shaw, much of the DMSO sold over the counter or by mail order contains unwanted impurities such as dimethylsulfone, dimethylsufide, nitrogen oxides, and benzene. In addition, after it has scavenged the hydroxyl radicals from the body, it converts to a sulfoxide free radical. While this new free radical is less damaging than the one removed and can be counteracted with the various vitamin, mineral, and amino acid antioxidants, impurities can be carried directly into the bloodstream.

Dosage: The typical oral dose is 1 to 2 teaspoons a day, mixed with tomato or grape juice to mask its foul taste. The effects appear to be cumulative, so that the dosage can be reduced over a period of time. The drug appears crystal clear and has a very distinct sulfur or garlic odor; a cloudy or discolored appearance indicates impurities. It is not used for more than 30 days at a time, with a 30-day interval between periods of use. It is dabbed on, never rubbed in, and it is always stored in its pure state, with the bottle securely capped to prevent the absorption of moisture which might deteriorate the solution. The amount needed is mixed at the time of application.

POET
A substitute phenylalanine.

Effects: Said to greatly increase the creativity in people who are already creative, it contributes nothing to people who are not so inclined.

ETIRACETAM
A nootropic drug similar to piracetam. FlPEXIDE AKA: Attentil, BP 662, Vigilor.

Effects: Can enhance dopamine to a certain degree. In one study, forty older people with advanced cognitive disorders improved their scores on a number of various tests after taking it. It may improve learning, but not recall; improved learning may be attributed to the higher levels of dopamine, which can improve motor coordination, strengthen the immune system, and promote a sense of well-being, thus providing a better atmosphere for learning to take place.

Precautions: No side effects, toxi-city, or contraindications known, though more research is needed.

Dosage: Studies to date have used 600 mg/day in three divided doses.

GEROVITAL
AKA: Gerovital H3, GH-3. Gerovital is a chemical mixture of procaine hydrochloride, potassium metabisulfate, disodium phosphate, and benzoic acid. In the body, procaine breaks down into the B vitamin paraminobenzoic acid (PABA) and diethylaminoethanol (DEAE), a chemical relative to DMAE that is, in turn, converted into choline by the cells. While the work of Dr. Ana Asian has made it a very famous and popular anti-aging drug, it is also very controversial — its promoters claim that it can cure over 200 diseases and ailments associated with premature aging.

Effects: May improve memory by promoting better utilization of oxygen in the brain. It is an antidepressant as a result of it's being an MAO inhibitor. The Gerovital product PABA helps in forming blood cells, metabolizing protein, and performing the various functions of the skin. It also aids the intestinal bacteria in producing the vitamins folic acid, pantothenic acid, biotin, and vitamin K. Symptoms of deficiency include constipation, depression, digestive disorders, fatigue, gray hair, headaches, infertility, and irritability. By itself, it is not very effective, but produces good results when taken with procaine hydrochloride. Composed of choline and acetylcholine, the Gerovital product DEAE is an antidepressant.

Precautions: Other researchers have been unable to duplicate discoverer Ana Asian's positive results; some claim it is because they used straight procaine rather than GH-3, but there is much evidence to suggest that they are virtually identical. Additionally, Dr. Asian's research has been attacked for not being well-designed and controlled, and critics assert that most of the improvements are merely the result of its anti-depressant properties. A review of the scientific literature seems to back these criticisms. Dr. Stuart Berger states that PABA is not a vitamin, but a sunblock, and that it can severely deplete the body's white blood cells, and create adverse fatty changes in the heart, liver, and kidneys if taken internally in significant amounts. According to Prevention magazine and Dr. Ronald Klatz, the "active ingredient" is evidently the anesthetic novacaine, which begins to break down as soon as it enters the blood. Side effects, though not common, are life-threatening: allergic reactions, a sudden drop in blood pressure, respiratory problems, and convulsions. Because it is a weak MAO inhibitor, it does not elicit the side effects normally associated with these types of substances. There are rare allergic reactions, but otherwise no adverse effects have been reported, mainly because PABA and DEAE are quickly excreted by the body. Use of GH-3 and related formulations is avoided by anyone on MAO inhibitors, sulfa drugs, sulphonamide drugs, or combinations like cotrimoxazole.

Dosage: One tablet/day for 25 days, followed by a 5 day period of abstinence.

GHB
AKA: Alcover, 4-hydroxybutyrate, gamma hydrate, gamma-hydroxy-butyrate, gammahydroxybutyrate sodium, Gamma OH, Liquid Ecstasy, Liquid X, sodium oxybate, sodium oxybutyrate, Somatomax PM. A natural component of every cell in the body, GHB is found in the greatest concentrations in the kidneys, heart, skeletal muscles, brown fat, hypothalamus, and basal ganglia. It is a precursor to the neurotransmitter GAB A, and may be a neurotransmitter itself. Unlke GABA, it can cross the blood/ brain barrier. It rapidly metabolizes to carbon dioxide and water.

Food Sources: Meat.

Effects: It produces a mild high, with feelings of bliss, placidity, euphoria, and sensuality. It stimulates the release of growth hormone in the body and, unlike drugs with a similar effect, GHB also increases levels of prolactin. Other physiological effects include a slight elevation of blood sugar, a significant decrease in cholesterol, a mild slowing of the heart, a slight lowering of body temperature, and a stimulation of the release of acetylcholine in the brain (which may improve memory and cognition, though this is, as yet, unproven). Sleep induced by GHB tends to be slightly deeper and somewhat shorter than sleep attained without the use of drugs; unlike other remedies for insomnia, it often does not produce grogginess upon waking. It may be useful in treating alcoholism, anxiety, and sleep disorders. Anecdotal evidence indicates it may reduce fat and help build lean muscle tissue, possibly because of its effect on growth hormone. Some speculate it may have aphrodisiac and life-extension properties.

Precautions: It should not be used by anyone suffering from epilepsy, convulsions, slowed heartbeat arising from conduction problems, Cushing's syndrome, severe cardiovascular disease, severe hypertension, hyperprolactinemia, or any kind of severe illness. Before it was banned by the FDA in 1990, it had been studied for 25 years, with the result that it has shown extremely low toxicity. Of 10 known cases of individuals who have suffered side effects, the dosages taken were not known; four of those cases involved combining it with alcohol, two involved individuals with a history of epilepsy or grand mal seizures, and two involved combining it with tranquilizers or such central nervous system depressants as Vicodin and diphenhydramine hydrochloride. Bodybuilders who had taken GHB switched to GABA after the ban. It remains a popular "rave" drug, with many deaths attributed to it, though how many of these are due to impurities, misidentification, and combining with other drugs is unknown. Common side effects include abrupt sedation, loss of coordination, sleepwalking, unarousability, and decreased inhibition in those taking 2 to 6 teaspoons (approximately 5 to 15 grams) twice nightly over a period of several years. Mild side effects include a numbness of the legs, headache, lethargy, dizziness, a tightness in the chest, extreme ebullience, intense drowsiness, breathing difficulties, and uncontrollable muscle twitches. Severe side effects include confusion, nausea, diarrhea, incontinence, temporary amnesia, sleepwalking, uncontrollable shaking, vomiting, seizures, and brief (one to two hours) non-toxic coma. Complete recovery from even the most severe side effects, however, appears to occur within a few hours and with no apparent long-term side effects. In a 1992 report, epidemiologist Ming-Yan Chin and Richard A. Kreutzer, M.D., both working for the California Department of Health Services, concluded, "there are no documented reports of long-term [adverse] effects. Nor is there any evidence for physiological addiction." Others report that there has been one documented case of addiction, though there is no evidence of withdrawal symptoms. Because it may deplete levels of potassium in the body, GHB is often administered with a potassium supplement in which the elemental form is equal to 10 percent of the weight of the GHB consumed. It is not combined with central nervous system depressants such as benzodiazepines (e.g., Valium, Xanax), phenothiazines (e.g., Thorazine, Stellazine), various painkillers (e.g., opiates, barbiturates), alcohol, or over-the-counter allergy and sleep remedies. Food can dissipate or delay its effects, and caffeine can block its dopamine-related effects.

Dosage: In various studies doses of 6 to 8 g/day for eight to ten days, 20 to 30 g/day for a week, and 2.5 g/day for several years produced no adverse side effects. The initial dosage is small —an eighth to a fourth of a gram — and dissolved in water, increasing gradually to the desired dose (one level teaspoon equals approximately 2.5 grams). The dosage is adjusted according to body weight, though Ward Dean, M.D., etal, published the following general doserelated expectations: less than 1 gram gives rise to mild relaxation, reduced anxiety, and increased sociability; 1 to 2 grams, strong relaxation; 2 to 4 grams, sleep of three to four hours; 4 to 8 grams — very deep sleep of three to four hours; 10 to 30+ grams, a prolonged, very deep sleep of up to 24 hours. It is taken on an empty stomach (preferably three to four hours after the last meal) to avoid nausea, vomiting, and a delayed onset of effects. About three-quarters to one and a half grams produces a high, while 2.5 grams induces sleep. Illicit GHB invariably contains dangerous — even toxic — impurities. Pure GHB powder has a salty/ licorice taste, turns from a chalky texture to a greasy one when rubbed between the fingers, will fully dissolve in water, and will easily absorb water and turn liquid overnight.

GRISEOLI£ACID
Derivatives are known metabolic brain-enhancers.

HYDERGINE
AKA: Circanol, Deapril-ST, dihydroergotoxine, ergoloid mesylates, ergot alkaloids dihydrogenated, Hydroloid, Niloric. Hydergine is one of a class of drugs called ergoloid mesylates, which are a combination of three substances produced by the ergot fungus. It was discovered by Albert Hofmann, the chemist who discovered a more famous ergot derivative, LSD-25. The exact method by which it works is unknown, as ergot — a deadly poisonous dark purple or black fungus which thrives on wet grains such as rye — generally causes hallucinations, convulsions, gangrene, and death. Similar in chemistry to LSD, but non-hallucinogenic, it is — paradoxically — one of the easiest smart drugs to obtain. It is also one of the most widely researched and prescribed. It is generally prescribed to slow age-related memory loss and impaired concentration. In Europe, it is used routinely on accident victims — those suffering from shock, hemorrhage, strokes, heart attacks, drowning, electrocution, and drug overdose can sometimes be revived by intravenous injection— and on hospital patients just before standard surgeries (it gives doctors more time to handle any medical emergencies should they arise in the course of the operation).

Effects: Has been claimed to be an "all-purpose brain booster," as it improves blood flow to the brain, improves the oxygen supply to the brain, increases brain cell metabolism, protects the brain from hypoxia, decreases the development of age pigment (lipofuscin) in the brain, protects brain cells from free-radical damage, keeps a proper balance of several major neurotransmitters in the brain, normalizes systolic blood pressure, and decreases cholesterol levels. It is believed to improve memory, learning, intelligence, and recall. It may also increase the levels of some transmitters in the brain and may promote the growth of some dendrite nerve fibers. Some obscure French studies done in Africa may indicate it is an effective treatment for sicklecell anemia. Works synergistically with piracetam.

Precautions: It is not taken by individuals who are allergic to ergot or any of its derivatives, who suffer from any kind of psychosis, whose heartbeat is less than 60 beats per minute, or whose systolic blood pressure is below 100. It may be dangerous to individuals with low blood pressure, liver disease, or psychosis. It could result in a reduced ability of the body to adjust to cold temperatures. Common symptoms include runny nose, skin flushing, and headache. Less common symptoms are a slow heartbeat, tingling fingers, and blurred vision. Rare symptoms include fainting, rash, nausea, vomiting, stomach cramps, dizziness when arising, drowsiness, soreness under the tongue, and loss of appetite. Overdosing can cause agitation, headaches, flushing in the face, nasal congestion, nausea, vomiting, a drop in blood pressure, blurred vision, weakness, collapse, coma, and amnesia. Many doctors are not convinced of its efficacy. It is rather expensive. When combined with other ergot preparations or sympathomimetics, it may result in decreased circulation to the limbs, which could be serious. It could greatly intensify the effect of caffeine, cause an excessive drop in blood pressure when combined with alcohol, lead to overstimulation when combined with cocaine, and decrease the ergoloid effect when combined with marijuana or tobacco.

Dosage: The recommended dosage in the U.S. is 3 mg/day; in Europe, it is 9 mg/day in three divided doses, but 4.5 to 6 mg/day appears to produce good results. Sublingual tablets are ineffective if swallowed intact. It may take at least half a year before the effects are noticeable, but one study has shown that healthy young people taking 12 mg/day saw greater alertness and mental abilities after only two weeks. It works synergistically with piracetam; when the two are combined, smaller doses of each are just as effective as a larger dose of one.

ISOPRINOSINE
AKA: Methisprinol. Two of the ingredients in isoprinosine are inosine, which is used by the body to make RNA, and dimethy-laminoethanol (DMAE), which assists the inosine in penetrating the blood-brain barrier. It is chemically similar to DMAE.

Effects: Assists the brain in certain key functions relating to memory formation and promotes RNA synthesis in brain cells. It promotes RNA synthesis in brain cells; is an immune stimulator which may have antiviral properties; and has been shown to increase the effectiveness of Interferon, render some herpes viruses inactive, and reduce the severity of some AIDS symptoms.

Precautions: It should not be used by those with gout or who are predisposed to developing it.

K.H.3
A procaine formula similar to Gerovital and Vitacel, it comes in gelatin capsule form, where it is coupled with hematoporphyrin, which increases the effectiveness of procaine.

Effects: Allegedly improves alertness, concentration, and recall, along with a host of physical disorders.

Precautions: It is not taken by those allergic to procaine or who are taking sulfa drugs or MAO inhibitors. The precautions that apply to Gerovital also apply to K.H.3.

Dosage: 1 or 2 capsules a day with meals for five months, followed by a period of two to four weeks of no K.H.3. MlLACEMIDE AKA: 2-n-pentylaminoacetamide.

Effects: A few studies have shown it to improve certain aspects of memory in normal people, while having no effect on memory on those afflicted with Alzheimer's or schizophrenia. Much more research needs to be done.

Precautions: Possible side effects include elevated liver enzymes, nausea, diarrhea, and disorientation. It is not combined with any MAO-B inhibitor drug, such as deprenyl, as it may have a negative effect on memory and brain function.

Dosage: The optimal dosage seems to be 400 to 1200 mg/day. Since it apparently has an inverted Ushaped dose-response curve, smaller doses (unless used in combination with other smart drugs) and larger doses may have insignificant, or even negative, results.

NAFTIDROFURYL
A metabolic brain-enhancer.

NDD-094
Effects: A compound said to stop, and even reverse, memory loss, apparently by regrowing nerve cells that create acetylcholine. patients taking NDD-094 have registered improved brain activity levels on PET scans.

Precautions: There may be side effects, including nausea. Much more research needs to be done.

NEFIRACETAM
Effects: Like piracetam, it is derived from pyrrolidone, which is believed to enhance the nervous system's ability to utilize acetylcholine as a neurotransmitter.

NOOTROPYL
AKA: 2-oxo-pyrrolidine acetamide. An analogue of gamma-aminobutyric acid, a neurotransmitter.

Effects: It apparently stimulates the flow of information between the two hemispheres of the brain in rats and mice.

OXJRACETAM
AKA: CT-848, hydroxypiracetam, ISF-2522, Neuractiv, Neuromet. An analogue of piracetam that is about two to three times more potent.

Precautions: It appears to be nontoxic, with no ill effects in doses as high as 2400 mg/day. Little research has been done on healthy individuals, however.

Dosage: Doses of 1200 to 2400 mg/day seem to produce the greatest improvement in cognitive function, though some recommend 800 to 2400 mg/day.

OXPRENOLOL
A beta-adrenergic blocking agent prescribed to reduce angina attacks, stabilize an irregular heartbeat, lower blood pressure, and reduce the occurrence of vascular headaches.

Effects: It has been shown to reduce phobias and eliminate anxiety.

Precautions: It is not taken by anyone with an allergy to any beta-adrenergic blocker; by those with hypotension, as it lowers blood pressure, aggravates any condition of congestive heart failure, produces tingling in the extremities, and light-headedness; by those with asthma, pollen allergies, upper respiratory disease, or arterial spasms; or by those who have taken MAO inhibitors or other psychiatric or psychotropic drugs within the preceding two weeks. It is used by those who have chronic obstructive pulmonary diseases (e.g., asthma, bronchitis, hay fever, or emphysema), diabetes or hypoglycemia, kidney or liver problems, heart disease or poor circulation in the limbs, an overactive thyroid function, or surgery within the previous two months (including dental surgery) that requires general or spinal anesthesia. For those over age 60, the side effects maybe more severe and frequent. Prolonged use can weaken the heart muscles, and it may mask symptoms of hypoglycemia or alter the results of some medical tests. Common side effects include a pulse rate slower than 50 beats per minute, diarrhea, dizziness, drowsiness, fatigue, nausea, numbness or tingling in the fingers and toes, weakness, cold hands or feet, and dryness of the eyes, mouth, and skin. Less common side effects include hallucinations, nightmares, insomnia, headaches, breathing difficulties, joint pain, anxiety, chest pain, confusion, lack of alertness, depression, impotence, abdominal pain, and constipation. Rare symptoms include rash, sore throat, fever, unexplained bleeding or bruising, and dry burning eyes. There is an enhanced beta blocker effect when combined with betaxolol eyedrops or Levobunolol eyedrops, and a diminished beta blocker effect when combined with Dextrothyroxine or Indomethacin. It can intensify the effects of antidiabetics, antihypertensives, barbiturates, insulin, and narcotics, and can lessen the effects of antihistamines and beta-agonists. It can decrease the effectiveness of Digitalis if taken for congestive heart failure, but increase its effectiveness if taken for any other medical reason. There is an increased drop in blood pressure when taken with alcohol, calcium channel blockers, Clonidine, Diazoxide, or Guanabenz. When combined with angiotensin-converting (ACE) inhibitors or nonsteroidal antiinflammatory drugs (NSAIDS), it could increase the antihypertensive effect of one or both drugs; with Encainide, it could damage the heart muscle; with Molindone, there could be an increased tranquilizer effect; with MAO inhibitors, there could be a rise in blood pressure if the latter is discontinued; with cocaine, there could be an irregular heartbeat and a decreased betaadrenergic effect; with daily marijuana use, there could be circulation problems in the hands and feet; and with tobacco, there could be an irregular heartbeat. It may also interact with certain ingredients in over-the-counter cold, cough, and allergy remedies.

PENTYLENETETRAZOL
AKA: Metrazol.

Effects: Stimulates theta rhythms in the brain, which are associated with periods of creative thinking, and may increase learning ability and slow the advance of senility.

Precautions: Causes convulsions.

PHENYTOIN
AKA: Dilantin (extended action), Diphenylan (prompt acting), Diphenylhydantoin (DPH), Ditan (prompt acting), Ethotoin, Mephenytoin, Mesantoin, Peganone, Phenytex, PHT. The most commonly prescribed drug for epilepsy, it has been the subject of at least 8000 papers. The exact mechanism by which it works is still not understood, but it is believed to influence the electromagnetic fields, polarizing the electrically charged elements of the cells.

Effects: Though it is mainly used as a treatment for epilepsy, it has a number of other various effects: it can normalize electrical activity in the cell membranes; it can stabilize behavior by suppressing obsessive thoughts, fear, anger, violent behavior, and passivity; it can supposedly improve intelligence, concentration, learning, long-term memory, comprehension, and speed of visual-motor coordination; it has some anti-aging effects, including restoring the homeostasis of the neuroendocrine system; in small doses, it increases the "good" form of cholesterol, called high density lipo-protein (HDL).

Precautions: It is not taken by anyone who is allergic to hydantoin anticonvulsants, has liver damage or impaired liver functioning, has had surgery within the last two months that has required general or spinal anesthesia, has diabetes, or a blood disorder. Those over 60 should realize that adverse reactions and side effects will occur more often and much more strongly than they do in younger individuals. Common side effects include constipation; mild dizziness; drowsiness; gums that are bleeding, swollen, or tender; nausea; increased susceptibility to sunburn; and vomiting. Less common side effects include agitation, breast swelling, confusion, diarrhea, an increase in facial and body hair, hallucinations, headaches, insomnia, muscle twitches, rash, slurred speech, staggering, vision changes. Rare symptoms include abdominal pain, an increased chance of bleeding or bruising, fever, jaundice, and sore throat. Other symptoms cited by some sources include anemia, balding, chest pains, depression, mental confusion and learning disability, conjunctivitis, nervousness, numbness of the hands and feet, nystagmus, retention of water, sensitivity to bright lights, swollen glands, tiredness, irritability, and weight gain, though these also disappear as time goes on and dosage is reduced. A severe allergic reaction could be life-threatening, and could include such symptoms as fever, rash, swollen glands, and kidney failure. Use of phenytoin may even cause liver damage, including hepatitis. If stomach upset occurs, it should be taken with meals. Long-term effects may be weakened bones, gum overgrowth (though this occurs mainly in children and is rare in instances where the lower, cognitive-enhancing doses are taken; still, good oral hygiene is recommended), constant eye movements, liver damage, lymph gland enlargement, and numbness and tingling in the hands and feet. An overdose can cause problems in maintaining balance, a drop in blood pressure, slow, shallow breathing, coma, drowsiness, spastic eye movements, decreased intelligence, slow reaction time, slurred speech, and staggering. There have been reports of insomnia, tremors and in some cases, liver toxicity in the first month or so of use. It is not habit-forming, but abrupt cessation could trigger severe epileptic seizures. Phenytoin may deplete the body's stores of B-12, lead to a heightened need for thyroid hormone, interfere with the absorption of vitamin D and folic acid (supplements of calcium should be taken along with vitamin D and folic acid, though calcium will decrease the amount of Phenytoin the body absorbs from the small intestine). The effects of Phenytoin can be increased when taken with alcohol (small amounts), Allopurinol, salicylate drugs such as aspirin, benzodiazopine tranquilizers and sedatives, Chlorphi-ramine, Cimetidine, Ibuprofen, Metro-nidazole, Miconazole, Molindone, Nizatidine, Omeprazole, Phenacemide, succinimide antiseizure medicines, tri-cyclic antidepressants, Trimethoprim, or Valproic Acid. The anticonvulsant effect can be enhanced when taken in combination with Amiodarone, Carba-mazepine, Chloramphenicol, Disul-firam, Fluconazole, Isoniazid, Methylphenidate, Nicardipine, Nimodipine, Oxyphenbutazone, Para-aminosalicylic acid (PAS), Phenothiazines, Phenylbutazone, Sulfa drugs, or Warfarin. The anticonvulsant effect is diminished when Phenytoin is taken with alcohol (habitual use), antacids, anticancer drugs, barbiturates, Carbamazepine, charcoal tablets, Diazoxide, Glutethimide, influenza virus vaccine, Loxapine, marijuana (with attendant drowsiness and unsteadiness), Nitrofurantoin, Paroxitine, Pyridoxine, Rifampin, Sucralfate, or Theophylline. When taken in combination with anticoagulants or Propafenone, the effects of both drugs are intensified, and when taken with Xanthines, the effects of both drugs are weakened. Phenytoin can amplify the effects of Estrogen, Griseofulvin, Methotrexate, Propranolol, Quinidine, sedatives, and Warfarin, and curtail the effects of Amiodarone, Carbamazepine, corticosteroids, cortisone drugs, Cyclosporine, Dicumarol, Digitalis preparations, Disopyramide, Doxycycline, Furosemide, Haloperidol, Hypoglycemics, Itraconazole, Methadone, Metyrapone, Mexiletine, oral contraceptives, potassium supplements, Probenecid, Quinidine, Sotalol, Theophylline drugs, and Valproic Acid. Phenytoin can interact unpredictably with Clonazepam, Dopamine, levodopa, Levonorgestrel, Mebendazole, Phenothiazine antipsychotic medicines, or oral antidiabetic medications. The severity of side effects and adverse reactions increases when taken with Felbamate, there is an increased risk of toxicity when taken with Cimetidine, and an increased risk of liver toxicity when taken with Acetaminophen. The anticonvulsant dose may need to be adjusted when taken with tricyclic antidepressants; there may be a changed seizure pattern when taken with barbiturates; there is a greater chance of bone disease when taken with carbonic anhydrase inhibitors; there could be oversedation when taken with central nervous system depressants; the incidence of seizures increases when taken with cocaine or oral contraceptives; corticosteroid drugs could hide any Phenytoinsensitivity reactions; there could be an increase in drug levels in the blood when taken in combination with gold compounds; and Leucovorin could counteract the effects of phenytoin. When taken with Lithium, it can increase the toxicity of the latter drug; when taken with MAO inhibitors, it could result in an increased polythiazide effect; when taken with Meperidine, it can decrease the painrelieving effects of the latter while increasing its side effects; when taken with nitrates, it could result in an excessive drop in blood pressure; when taken with Omeprazole, there could be a delay in the excretion of phenytoin with a resultant excess remaining in the blood; when taken with Phenacemide, it could result in an increased risk of paranoia; and when taken with Valproic acid, it could result in seizures.

Dosage: Adult epileptics are generally given doses of 200 to 400 mg/day in two to four divided doses. About an eighth of that, or 25 to 50 mg/day are given for cognitive-enhancing effects, though some recommend as much as 100 mg/day in two to four divided doses. PlCROTOXINE

Effects: May increase learning ability and slow the advance of senility.

Precautions: Causes convulsions. PlRACETAM AKA: Cerebroforte, Dinagen, Gabacet, Nootropil, Normabrain. Its chemical structure is very close to the amino acid pyroglutamate, a substance found in meat, vegetables, fruits, and dairy products.

Effects: Protects the brain against — and helps it recover from — hypoxia; protects against metabolic stress related to low oxygen flow to the brain resulting from intense athletic performance, high altitude conditions, and smoking; steps up the rate of metabolism and level of energy in the brain cells by increasing the production of adenosine triphosphate (ATP) and improving the blood flow within the brain; improves memory, alertness, and some kinds of learning in normal humans (probably by helping the brain synthesize new proteins); prevents memory loss caused by physical injury and chemical poisoning; and facilitates the flow of information between the two hemispheres of the brain, an important component of creativity, insight, and peak performance. May contribute to the growth of more cholinergic receptors in the brain. It has been used in the treatment of dyslexia, stroke, alcoholism, vertigo, senile dementia, and sickle-cell anemia, among other conditions. Works synergistically with centrophenoxine, choline, Deaner, DMAE, gingko biloba, Hydergine, or lecithin; for improving memory, the combination of Piracetam and choline is particularly effective.

Precautions: Though piracetam is derived from pyrrolidone, a substance that is believed to enhance the nervous system's ability to utilize acetylcholine as a neurotransmitter, the exact mechanism by which it works is still not fully understood. There is some evidence that it increases the number of receptors in the brain, but it also seems to increase blood flow to the brain. Still other theories suggest that it improves protein synthesis in the brain, improves the function of nerve fibers in the corpus callosum (thereby assisting the flow of information between the two halves of the brain), or that it reduces free radicals. It is avoided by those with severe kidney failure and those taking anticoagulant drugs. In rare cases, it may cause gastrointestinal distress, diarrhea, headaches, insomnia, nausea, and psychomotor agitation. It may result in acetylcholine's being used up more rapidly in the body, so a choline supplement may be needed. It may also increase the effects of such drugs as amphetamines, psychotropics, and Hydergine. It is not believed to be toxic or addictive, and has no contraindications.

Dosage: 800 to 1600 mg/day after an initial daily dose of 1200 to 2400 mg/ day taken in the morning for the first two days. Others recommend 2400 to 4800 mg/day in three divided doses, while still others a more modest dose of 500 to 600 mg/day for a healthy person and 1000 to 2000 mg/day for an elderly person with mild to moderate memory impairment.

PRAMIRACETAM
AKA: CI-879, Neupramir. A variant of piracetam, it stimulates the functioning of the cholinergic system, but at much lower doses (it is approximately 15 times stronger than piracetam). It is not as fully tested and researched as piracetam.

Precautions: Toxicity is rare, and known side effects are few.

Dosage: 75 to 1500 mg/day.

PRL-8-53
Effects: An experimental drug that has been shown to increase recall in subjects by as much as 150 percent.

PROPANIRACETAM
A nootropic drug similar to piracetam.

PROPRANOLOL
AKA: Inderal, Inderal LA (long acting), propranolol hydrochloride. A beta-andrenergic blocking agent medication prescribed for high blood pressure patients and used in the treatment of angina, hypertension, specific tremors, and certain cardiac arrhythmias.

Effects: Reduces fear and stress by blocking the muscle's receptor sites for adrenaline; it also reduces the oxygen requirements of the heart and reduces the contractions of the blood vessels in the heart, scalp, and other areas. Taking it a half hour before an anxiety- or fear-inducing event may help an individual overcome his or her aversion to that situation.

Precautions: Most studies have been short term (six weeks or so), and more recent evidence does not support the claim that it works consistently over the long run. There is also evidence that it controls the physical symptoms of anxiety, but not the psychological ones. It is not taken by anyone with an allergy to any beta-adrenergic blocker; by those with hypotension, as it lowers blood pressure, aggravates any condition of congestive heart failure, produces tingling in the extremities, and light-headedness; by those with asthma, pollen allergies, upper respiratory disease, or arterial spasms; or by those who have taken MAO inhibitors or other psychiatric or psychotropic drugs within the preceding two weeks. It is prescribed for those who have chronic obstructive pulmonary diseases (e.g., asthma, bronchitis or emphysema), diabetes or hypoglycemia, kidney or liver problems, heart disease or poor circulation in the limbs, an overactive thyroid function, or surgery within the last two months (including dental surgery) that requires general or spinal anesthesia. Common side effects include a slow pulse rate (fewer than 50 beats per minute), a coldness in the hands and feet, diarrhea, dizziness, drowsiness, a dryness of the mouth, eyes, and skin, fatigue, and numbness or tingling in the fingers and toes. Less frequent symptoms include abdominal pain, a loss of alertness, anxiety, difficult breathing, chest pain, confusion, constipation, depression, hallucinations, headache, impotence, insomnia, joint pain, and nightmares. Rare side effects include excessive bleeding and bruising, eyes that are dry and burning, fever, rash, sore throat, vomiting, and emotional instability. Other possible side effects include short-term memory loss, visual disturbances, weakness, and paranoia. Overdose symptoms include a drop in blood pressure, bronchial muscle spasms leading to breathing difficulties, convulsions, fainting, heart failure, a slow or weak pulse, cold and sweaty skin, and weakness. Toxic psychosis will occur when the dosage is high (i.e., thousands of milligrams a day). Use is discontinued by decreasing the dosage gradually over a period of two weeks, as abrupt cessation could damage the heart. For those over age 60, the side effects may be more severe and frequent. Prolonged use can weaken the heart muscles. It may mask symptoms of hypoglycemia or alter the results of some medical tests. There is an enhanced beta blocker effect when combined with betaxolol eyedrops or Levobunolol eyedrops, and a diminished beta blocker effect when combined with Dextrothyroxine or Indomethacin. It can intensify the effects of antidiabetics, antihypertensives, barbiturates, insulin, and narcotics, and can lessen the effects of antihistamines and beta-agonists. It can decrease the effectiveness of Digitalis if taken for congestive heart failure, but increase its effectiveness if taken for any other medical reason. There is an increased drop in blood pressure when taken with alcohol, calcium channel blockers, Clonidine, Diazoxide, or Guanabenz. When combined with angiotensin-converting (ACE) inhibitors or non-steroidal anti-inflammatory drugs (NSAIDS), Propranolol could increase the antihypertensive effect of one or both drugs; with Encainide, it could damage the heart muscle; with Molindone, it could increase tranquilizer effect; with MAO inhibitors, it could raise blood pressure if the latter is discontinued; with cocaine, it could lead to an irregular heartbeat and a decreased beta-adrenergic effect; with daily marijuana use, it may promote circulation problems in the hands and feet; and with tobacco, it could lead to an irregular heartbeat. It may also interact with certain ingredients in overthe- counter cold, cough, and allergy remedies.

Dosage: Some recommend 10 to 30 mg a half hour before the trauma-inducing event, though the usual prescribed dosage is 5 to 10 mg. Propranolol will have a greater effect if taken with meals. RlBAMOL AKA: 2-hydroxytriethylammo-nium ribonucleate.

Effects: May enhance memory and learning. RlVASTIGMINE The first in a new class of drugs known as acetylcholinesterase inhibitors.

Effects: A study has shown that it may improve the brain functioning of those with mild to moderate forms of Alzheimer's disease, enabling them to perform normal activities again.

RN-13
AKA: Regeneresen. Developed by Hans J. Kugler, it is a mixture of RNA from twelve organs (placenta, testes, ovaries, hypothalamus, adrenal cortices, pituitary, thalamus, spleen, vascular walls, cerebral cortex, liver, and kidneys), along with yeast-derived nucleic acid.

Effects: Said to double the life span of dwarf mice, have a rejuvenating influence on the human body, and improve learning, memory, and general brain function.

ROLZIRACETAM
Effects: Like piracetam, it is derived from pyrrolidone, which is believed to enhance the nervous system's ability to utilize acetylcholine as a neurotransmitter.

SABELUZOLE
Effects: Preliminary evidence indicates that it may prevent Alzheimer's from progressing, and may improve memory and learning in normal individuals.

STRYCHNINE SULFATE
Effects: May increase learning ability and slow the advance of senility. Precautions: Causes convulsions.

SULBUTIAMINE
AKA: Arcalion. A compound similar to Hydergine, but stronger.

Effects: Promotes alertness, strengthens long-term memory, improves reaction time, fights fatigue, lowers anxiety, and improves resistance to stress.

Precautions: More than three 200 mg tablets a day may result in severe headaches.

Dosage: 400 mg/day with breakfast for 20 days.

SYGEN
AKA: GM1 ganglioside.

Effects: In use in Italy as a treatment for Alzheimer's and memory disorders.

TACRINE
AKA: Cognex, tacrine hydrochloride, Tetrahydroaminoacridine, THA.

Effects: Has a good track record for improving memory in Alzheimer's patients, especially when taken with deprenyl and lecithin, though it does not help other damage caused by this disease. It is most effective for those whose memory problems are the result of too little acetylcholine, as it is the only drug proven to raise levels of acetylcholine in the brain.

Precautions: It is not taken by those allergic or sensitive to Tacrine or acridine derivatives. A doctor should be consulted first if any one of the following conditions are present: heart rhythm problems, ulcers, liver disease, bladder disease, seizure disorders, asthma, or a previous reaction to tacrine that has caused jaundice or elevated bilirubin. Women are likely to retain more of this drug in their blood and suffer side effects. It could be hepatotoxic (toxic to the liver) and should only be taken under a physician's guidance. It is used as a "smart drug" only by those with Alzheimer's, and even then it loses its effectiveness after only a few months. Common side effects include headaches, sore throat, dizziness, fainting, chills, sweating, fever, stomach gas, skin rash, lack of coordination, diarrhea, nausea, vomiting, swelling in the legs and feet, a tingling in the hands and feet, difficulty urinating, joint pain and inflammation, spasticity, hyperactivity, nervousness, sinus inflammation, bronchitis, pneumonia, difficulty breathing, convulsions, liver inflammation, conjunctivitis, blood pressure changes, and broken bones. Less common side effects include loss of appetite, changes in taste, drowsiness, eyes that are dry or itching, eye pain, sties, double vision or other vision problems, glaucoma, cataracts, earache, ringing or buzzing in the ears, deafness, infections of the middle or inner ear, a flushing in the face, facial swelling, a sickly appearance, indigestion, insomnia, muscle aches, runny nose, rash, stomach pain, heavy sweating, dehydration, greater chance of tiredness or weakness, and weight gain, heart failure, heart attack, angina pains, stroke, vein irritation, cardiac insufficiency, heart palpitations, abnormal heart rhythms, migraines, slow heart rate, blood clots in the lung, elevated blood cholesterol, inflamed tongue swollen gums, dry mouth and throat, mouth sores, upset stomach, excess saliva, difficulty swallowing, esophagus and stomach irritation, bleeding or ulcers in the stomach or intestines, hemorrhoids, hiatal hernia, bloody stools, diverticulitis, loss of bowel control, impacted colon, gallbladder irritation or stones, increased appetite, diabetes, anemia, osteoporosis, tendinitis, bursitis, abnormal dreams, speaking difficulties, loss of memory, twitching, delirium, paralysis, slow muscle movements, nerve inflammation or disease, Parkinson's-type movements, apathy, heightened sex drive, neurosis, paranoia, nosebleeds, chest congestion, asthma, rapid breathing, respiratory infection, acne, hair loss, skin rash, eczema, dry skin, herpes zoster (shingles), psoriasis, skin inflammation, cysts, furuncles, cold sores, herpes infections, blood and puss in the urine, kidney stones and infections, sugar in the urine, frequent urination, urinating at night, cystitis, vaginal bleeding, genital itching, breast pain, impotence, and prostate cancer. Rare side effects include heat exhaustion, blood infection, very abnormal heart rhythms, bowel obstruction, duodenal ulcer, convulsions, lack of coordination, thyroid changes, a reduction in white blood cell and platelet counts, muscle disease, some loss of the senses (particularly touch), severe uncontrolled movements of the face, loss of muscle tone, changes in liver function (resulting in yellow skin or eyes, changes in stool color), inflammation of the brain and possibly the central nervous system, Bell's palsy, suicidal thoughts, hysteria, psychosis, vomiting blood, fluid in the lungs, lung cancer, sudden choking, skin peeling, oily skin, skin ulcers, skin cancer, melanoma, bladder or kidney tumors, kidney failure, urinary obstruction, breast cancer, ovarian cancer, inflammation of the male reproductive tract, blindness, drooping or inflamed eyelids, and disturbances or inflammation of the inner ear. Overdose symptoms include a decrease in blood pressure, collapse, convulsions, decreased heartbeat, muscle weakness (leading to respiratory failure and death), severe nausea and vomiting, increased salivation, and heavy sweating. Cimetidine can increase the amount of Tacrine in the blood, and tobacco can increase the rate at which it is broken down in the liver. Theophylline could intensify the effect of this drug, and anticholinergics could diminish the effect of this drug. It could also strengthen the effects of muscle relaxants during surgery. Tacrine is taken at least one hour before or two hours after eating.

Dosage: Subjects with Alzheimer's showed the best improvement when given doses of 120 to 160 mg/ day, but improvements in memory and the ability to think and reason lasted for only 24 weeks, after which the decline in mental abilities resumed.

2-MEA
AKA: Cysteamine, 2-mercapto-ethylamine.

Effects: An antioxidant. It bolsters the immune system and may increase life span. It is used as a treatment for radiation sickness in the former Soviet Union, and can remove heavy metals such as cadmium, lead, and mercury from the body.

Precautions: May actually shorten the life span if a very high dosage is combined with a very high dosage of vitamin E.

Dosage: John Mann recommends 200 mg/day for life extension. VlNCAMINE AKA: Oxicebral. Made from an extract of the periwinkle plant.

Effects: A vasodilator (improves blood flow to the brain and enhances the brain's utilization of oxygen). Users claim it improves memory and cognition, but sufficient scientific research is lacking for normal, healthy people.

Precautions: It may cause a reduction in white corpuscles and a degeneration of muscle tissue. In rare cases, it causes gastrointestinal problems.

Dosage: 60 mg/day in two divided doses. VlNPOCETINE AKA: Cavinton. A close relative of vincamine believed to elicit more benefits and fewer side effects.

Effects: Reportedly a strong enhancer of memory and concentration. It improves the brain's metabolism by increasing the blood flow, speeding up the rate at which ATP is produced by the brain cells, and improving the use of glucose and oxygen in the brain. It is particularly effective for disorders caused by poor or impaired circulation, such as stroke, headaches, recurring dizziness, macular degeneration, and certain ear problems.

Precautions: No toxicity or contraindications. Side effects, which include dry mouth, hypotension, tachycardia, and weakness, are rare.

Dosage: 5 to 10 mg/day. It takes a year for the drug to reach its peak efficiency. VlTACEL 3 The tablet form of GH-3, it has the active PEN ingredient as Gerovital. Vitaeel 4 has the addition of bee propolis for its antibacterial and antiviral qualities, and royal jelly for its high levels of vitamins B-5, B-6, and C. Vitacel 7 has replaced the bisulfite and benzoic acid with vitamin-complexing agents to prevent allergy problems; according to creator Dr. Robert Koch, this last formulation helps the procaine hydrochloride stay active in the body for several hours. Precautions: See the entries under Gerovital and Royal jelly.

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