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Cognitive Enhancers (nootropics): Modafinil, Piracetam, Herbs, Drugs?

Discussion in 'Allopathic' started by donkeyboy, 07.25.09.

?

Cognitive enhancers?

  1. Use/have used nootropics with postive results

    19 vote(s)
    17.6%
  2. Have used nootropics but without positive results

    2 vote(s)
    1.9%
  3. Haven't used but curious/interested in trying

    28 vote(s)
    25.9%
  4. Caffeine or nicotene are sufficient, and no interest in experimenting

    59 vote(s)
    54.6%
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  1. donkeyboy

    donkeyboy

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    SDN Members don't see this ad. (About Ads)
    I've noticed that nootropics are gaining popularity these days especially for off label use. Modafinil a drug used to treat narcolepsy and shift work sleep disorder has become popular among students who want to pull all-nighters or just get an some extra help in concentration. I'm curious about the prevalence of use of nootropics and recreational drugs among medical students. These topics of discussion are often avoided among classmates because of the ethical ambiguity of using off label drugs to get an edge.

    To be honest I got some modafinil (http://en.wikipedia.org/wiki/Modafinil) from a classmate and tried it over a three day period because I was curious about the effects and I wanted to determine if I was at a disadvantage to those who were using off label drugs regularly. For me modafinil had no beneficial effects, in fact made me anxious, but others have swore that it helped them focus for long periods of time.

    Has anyone else used nootropics or other drugs and how was the experience? Or what's your view on whether this is unfair or not in medical school?
  2. Tolip

    Tolip

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    Caffeine is my drug of choice. I may start experimenting with it, though.
    Chocolate-covered coffee beans probably won't have too many side effects.
  3. reedman

    reedman

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    nicotine gum
  4. Random Resident

    Random Resident Random Resident

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    Does anyone else find these threads disturbing? nicotene and coffee are one thing, but to discuss illegally obtained and illegal use of prescription drugs is a bit much.

    If you consistently can't get at least an avg. 6 hours of sleep, seek help. There's no reason during your first 2 years (save exam periods) you shouldn't willingly try to get sleep.
  5. sarsmon

    sarsmon

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    disturbing? nah, such things are commonplace but probably more so in undergrad or law school. but i think more med students smoke marijuana than take nootropics. i feel sorry for the people that need to take cognitive enhancers to get by, but among a group of competitive individuals there will always those who will accomplish their goals by any means necessary. then again probably only a handful of medical students resort to this, the others have been weeded out long ago
  6. mq123

    mq123 Blah username =/= blah me

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    Agreed.

    Like drinking coffee every hour in the morning from 8 to noon during lecture breaks (but only because it's there... and it's free... and it works)
  7. nitecrawler

    nitecrawler

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    i use the one thats called having an asian parent bearing down on you
  8. Droopy Snoopy

    Droopy Snoopy

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    The perception that it's more common in undergrad may be due in part to the larger sample size, but you gotta remember that med students don't talk about this stuff because of the stigmas involved. Program directors, deans etc. don't let it known when they catch someone prescribing themselves provigil or doing coke in the bathroom. Practicing physicians are wealthy enough to hit the rehab facilities that offer some modicum of privacy, and the communities in which they practice have no interest in exposing the dirty secrets of their leading citizens.

    We as a profession have got all kinds of brains, integrity, and dedication, but we've also got pressure both external and internal and tremendous access to these kinds of substances. It's naive to underplay the prevalence of drugs both illicit and Rx at every level of training, and while it may be disturbing to some I think it's important to openly discuss these issues that have been and still are part of the soft underbelly of this field.
  9. njbmd

    njbmd Guest Moderator Emeritus

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    None of this stuff is either necessary or will give any advantage in terms of getting through medical school/residency. What you describe as "off label" is actually misuse of the pharmaceuticals. Misuse of anything just doesn't work. If these drugs have been prescribed for a true cognitive deficit, then you need them for normal work. If not, they don't do anything other than adding a chemical that you may have to deal with at a later time (who has time for this).

    Tens of thousands of medical students get through school successfully without more than a cup of coffee from Starbucks. Many don't even drink coffee. There are no "cognitive enhances" out there. There are chemical pharmaceuticals that are expensive and give you something to have to deal with (side effects) that WILL take away from what you need to do to be successful at every level; Just get the work done.

    There are no "magic pills" out there. If you buy into the "vibe" that always runs through undergraduate institutions this time of year, you are setting yourself up for more problems than solutions down the line. Medical school can be done with dead average intelligence and disciplined study skills. I know because I was very successful (AOA) in getting through medical school/surgical residency with an IQ of 100, on a bit of coffee from Starbucks, Bodo's bagels and a quiet place to study and nap.
  10. Therapist4Chnge

    Therapist4Chnge Neuropsych Ninja Faculty Moderator Emeritus

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    Unfortunately many students succumb to the believe that they need "an edge". There was a good article on SDN's front page about stimulant use/abuse in medical school, I think towards the end of last year.
  11. Random Resident

    Random Resident Random Resident

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    I think my initial reaction was to the OP outright saying he abuses someone else's prescription and wants to know if anyone else has done the same.

    I would think that if it didn't disturb me on some level, that would be a problem too.
  12. jettavr6

    jettavr6

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    Very good post... From what I've seen, it's not just a handful of medical students taking cognitive enhancers; it's a fairly large number and they do their fair share of other illicit substances as well. By far the vast majority of students have tried Adderall or Ritalin at some point during medical school.

    I'm not criticizing the above poster who found this topic disturbing. However, I will say that it would be disturbing if this topic never was openly discussed. Is there too much pressure? Should there be more tutoring available? There are a lot of questions to consider.
  13. Random Resident

    Random Resident Random Resident

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    Let's explore this:

    What are some contributors that would lead a medical student to abuse prescription drugs to try to gain an advantage in medical school?
  14. Doublecortin

    Doublecortin

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    No, tutoring or too much pressure is not the point. It's really rather simple. You have a class of full of type-A personalities with gigantic egos and so people will do anything within their power to get ahead and satisfy their ambition
  15. bad virus

    bad virus

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    Performance enhancers Drugs that are used to cross the blood brain barrier for any reason other than a legitimate psychosis or serious ass pain, are for *******. Sorry, but that’s it. Its nothing more than just a ******* way of escape from reality and/ or laziness. America is by far the most medicated society on the effing planet. All of us are pansies in one way or another, but god dang it, we can’t be all that depressed and/or inattentive can we?

    We got a pill for everything here. Too Sad? Too Shy? Too sleepy? Too restless? Too fat? Too lazy? Can’t get an erection? Lousy eating habits gave you the sugar, the cholesterols and the hypertensions?

    Well here ya go, solve it with a pill.

    Why am I going into medicine again? I guess its just so I can be another drug dealer pushing this crap on you too.
  16. afugazzi

    afugazzi

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    I feel ambivalent about it. I have no desire to try any prescription performance-enhancing stimulants, but then again I never use caffeine to stay awake either. I'm having difficulty pinpointing in some of your arguments the moral difference between using caffeine and using prescription stimulants. Yes one is illegal and one is not, but that doesn't imply a moral difference in using them, only a practical difference if you get caught.

    On the other hand, the risks associated with these drugs, and their addictive potential, make them worth worrying about. But were they shown to be no more harmful than caffeine, I don't see why one should judge a student for using those to stay awake studying, but not a student who uses coffee for the same purpose.
  17. OPPforlife

    OPPforlife

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    I am one of those that believe coffee (caffeine for that matter) make you stupid. I also believe that any kind of external chemicals are probably really bad for your system. However, I have to agree with your statement 100%. Its just like marijuana vs. alcohol.
  18. donkeyboy

    donkeyboy

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    okay i agree to take a prescription drugs not prescribed to you is technically against the law. but to say that it disturbs you says you have a moral objection to it. if you consider everything written in the law strictly based on moral principles than youre justified. but in my mind, i dont see testing out a prescription drug not prescribed to me for three days disturbing or "abuse." if it wasn't against the law what would be your reasoning for not doing it. by that same reasoning you should be equally disturbed by people smoking weed or even jaywalking since they are also against the law. sure, such a law is in place to prevent people from abusing medicine and causing harm to themselves and others. and i am well aware of my limits and have zero potential for abuse so really there is no danger of me causing harm to myself or anyone else. in fact, i should have made it clear that I really have no interest in taking nootropics to help me get through medical school, because i understand that it would probably hurt more than it helps me and there is also the unanswered ethical question of whether it's fair to my classmates. i simply wanted to test it to see if it gave those who used it regularly an unfair advantage so i could have my own personal argument on whether or not i think it can be considered wrong. after i tried it for three days i felt it didnt benefit me at all, so i would say that those who want to use it, it's their choice, but if it's really saving them from failing out of medical school or helping them desperately hang on by the skin of their teeth then they will probably have other problems down the road.
  19. sarsmon

    sarsmon

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    yes medical school is unnecessarily stressful and competitive. but by my estimation competition should steadily drop as Obama's healthcare plan is put in motion. in the near future, specialists salaries will decrease, while medical tuition will continue to increase. less pay + 300K mortgage = less people wanting to pursue medicine, or in other words less competition, less mental and physical anguish for the uber ambitious.

    healthcare obviously needs to be revamped in this country as well as how medicine is taught and we'll be seeing changes in the future whether we like it or not. maybe one day medical education will be subsidized by the govt, but not before salaries begin decreasing. too bad for us poor suckers still in medical school paying exobitant costs for our education while seeing our future potential earnings diminish before our eyes. maybe i should start taking off label anti-depressants to mask my sentiments since getting a prescription is like admitting to failure, and we all know that among elite professional students we can't show weakness ;)
  20. masterofmonkeys

    masterofmonkeys Should Have Been A Cowboy

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    WTF? Adderall, Ritalin, and Modafinil improve cognitive performance in the vast majority of people who try them. Period.

    So if you satisfy DSM-IV-TR criteria for ADHD, and gain a cognitive boost from Adderall, that DOES work. But if you don't satisfy criteria, and gain a cognitive boost from Adderall, that DOESN'T work?

    FWIW I've never even been tempted to try a nootropic, but back in my HS competitive nerdery days (UIL/TMSCA, academic decathlon, etc), people were doing all kinds of stuff. One rival school even got in trouble because their coach (an academic competition coach, mind you) had stooped to buying his non-smoking students nicorette gum.

    This is the problem with an over-medicated society. Lines start to blur. I easily meet 15 out of the 18 'A' criteria for ADHD. Obviously I did just fine. The majority of people with a 'valid prescription' for ADHD can't even touch my pathologicalness:rolleyes: Yet they 'need' their pharmaceutical grade crack? Yeah. Right.

    If we make the case for people who really could do just fine without ADHD meds (some people on them really do need them--just not most). Then we open the door for people who are already doing fine. After all, how do we define 'significant impairment'? You were making As and Bs before. Ritalin could probably push you to straight As. That's pretty 'significant' especially for pre-meds and med students wanting the toughest specialties.

    Feel free to apply the same thinking to the application of the disease label to obesity.
  21. reedman

    reedman

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    I wonder if there has ever been a med student who used drugs to get an edge, did great in school, landed a great residency, and became an extremely competent, compassionate, and an all -around good doctor. I guarantee his patients and peers don't care about him taking modafinil in med school, they care about what he knows now. I'm not saying that I advocate drug use, but I don't judge it either. There are many ways to achieve a goal, and different paths work for different people.
  22. HTxFrog

    HTxFrog

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    I agree with the previous poster. I think it is perfectly fine if you use a drug that helps you study if it makes you into a better doctor. I have a prescription for adderall and it works incredibly well for me. Before getting the prescription I would resort to drinking massive amounts of caffeine which would help me study, but it made me really jittery and it would make me feel like my heart was pounding. I think it is probably better for me to take the adderall than to load up on that much caffeine. They are both drugs with similar effects, so I don't see how the caffeine is any better. I know that there is an ethical question over whether this is the equivalent of taking academic steroids, and I know a lot of people feel that way but its not really my problem if they are jealous that I am able to study more easily with the prescription. It makes me a better student and eventually a better doctor so I really could care less what other people think about it. If anything I think adderall should be more widely available for medical students. I don't see much downside in having a bunch of doctors that concentrated really well in med school...
  23. rahulb

    rahulb nutritional facelift

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    i've been using piracetam for about 3 years now. it's definitely made an observable difference in my ability to focus and work ethic. i can't offer any tangible proof but i did go from a mediocre 29S on my mcat to a more decent 247/99 on my step1 last month if standardized test scores float your boat.

    http://en.wikipedia.org/wiki/Piracetam
  24. Diksha

    Diksha Special Cake Censor

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    These drugs, just like caffeine, are not without side effects. So the thing you've gotta ask yourself is if you start depending on them to function, will they always be as readily available to you and will you always be able to function/ stay healthy if you stay on them?

    I'm not weaning myself off coffee though. So yay for hypocrisy!
  25. psipsina

    psipsina Senior Member

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    I'm torn about posting this but I think its important. I have always excelled in school and would have never thought of myself as someone with a learning disability. During my first year of medschool I was so stressed out that I actually ended up extremely sick and needing multiple surgeries! The only reason for this was stress according to the surgeons. I still didn't think I needed to see a psychiatrist and tried to meditate more, do yoga, and accept my mediocrity during second year. It wasn't until my mom passed away in the midst of finals this May that I finally sought out help from a psychiatrist because I just couldn't focus. I thought it was a reaction to mourning but it turns out I have ADHD. I've always just compensated for it. As we discussed all the techniques I use to study and pay attention in class it became clear that this is what I've been doing. A small dose of stimulants normalizes me. I'm less anxious and I sleep better and I can focus on my work more easily. It doesn't give me superhuman study skills. I still get worn down and I still need sleep, its just the time I spend studying is used more efficiently. Anyway if you find yourself really thinking about using a stimulant to get by in medschool maybe its worth exploring if you actually need it with a physician. I was opposed to using it illegally and didn't think I could possibly have ADHD having made it into medschool without it being diagnosed. I wish I had asked for help earlier when I felt so overwhelmed by the workload. I studied for the step 1 medicated and my level of stress was sooooo different. It still sucked and was hard (studying for 5 weeks straight should be) but I wasn't a basket case through it and I managed to keep sleeping, eating well and working out. Anyway thats my 2 cents and I hope it helps someone in a similar situation.
  26. Doublecortin

    Doublecortin

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    OBamacare is R.I.P. in case you haven't been following the news.

    Specialists' pay might decrease but it will never be in the same range as primary care, and medicine for many people is not only about $$$, it's also about prestige and status.
  27. jettavr6

    jettavr6

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    It's great that all of you guys are talking about this. Not everyone is going to agree, and not every path is correct for everyone. FWIW, my specialty is Psychiatry and I'm headed to into a Pain Medicine fellowship. I have a lot of experience in addiction medicine, substance abuse and pain.

    Substance abuse and addiction is a major problem in the medical field with alcohol, benzo's and opiates being some of the major culprits. Mental illness is also a major problem in the medical field mainly depression, anxiety, bipolar disorder as well as certain flavors of personality disorders. If you get these under control early, your life will be an easier path.

    It's sad horrible feeling to have to admit a physician to a ward for depression, drugs, or other problems. I've admitted more than a few anesthesiologists, interists, surgeons, psychiatrists and even medical students.

    Talking about these things now is a great thing!
  28. 450med

    450med

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    Really? Maybe I'm just naive to the whole thing but using drugs to help me study has just never even crossed my mind (aside from a few cups of coffee). You can make all the excuses about morals etc, but when it comes down to it, anyone who is taking non-prescription drugs to help them study needs to suck it up and stop being such a pansy. How about working hard and you know, studying? IMHO, if you have to take drugs to get through med school you are likely to have problems down the road MUCH bigger than failing a med school exam. If you are looking for an "edge" in med school, how about going to see a movie with a few friends and relaxing a bit? The lower levels of stress would probably make up for more than the "cognitive enhancement" you received from any pill. Med school is brutal at times, but drugs are only going to add more problems to your life. At least to me, life is way too short to start damaging your body for a few extra marks on an exam...
    And yes, I do find this thread disturbing. I agree, it is good for people to be open to discussion on the topic, but moreso, it is imperative for people to get their heads out of their assess...
    Last edited: 07.27.09
  29. afugazzi

    afugazzi

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    450med, although I see a difference between caffeine and these meds, I don't see the difference popping up anywhere in your argument. I can't see any statement you make that can't also apply to caffeine.
  30. masterofmonkeys

    masterofmonkeys Should Have Been A Cowboy

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    one word. excitotoxicity.
  31. 450med

    450med

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    I thought the differences are so obvious that they need not be stated. To even compare the two is pathetic. I don't think that drinking coffee will likely "lead to more serious problems down the road" the way a good old illegally obtained Ritalin addiction will. There is also the subject of intention. I drink coffee because I like the taste and to help wake me up in the morning. I don't drink coffee to "give me a cognitive edge" (quite the contrary, while hopped up on caffeine I feel less focused). If someone was abusing caffeine pills it also wouldn't be a great thing IMO, although, once again, there is still a huge difference between caffeine pills and Ritalin. Additionally, there are reasons that you need a prescription for Ritalin and not caffeine! I also feel like such drugs are "gateway drugs" to more serious abuse.
    Overall, while no one is perfect, as health care professionals, we should try to be positive examples of optimal health. If you need illegally obtained prescription drugs to succeed in medicine, then maybe a career in medicine is not for you. You can't rely on the pills forever! In the end, is it worth the countless risks (to your career, your health, etc) that comes with such abuse? Anyone who tries to rationalize such abuse is just kidding themselves. To compare such abuse to caffeine (at least recreational caffeine) at all is foolish.

    The saddest comment on this post is the person who commented that these drugs will make them a better doctor... if you actually think that abusing drugs to increase your marks (or a marginal increase in marks in general) will result in more positives then negatives in many aspects of your life, I shudder to think you will providing patients with medical advice.
    If you actually have a medical need or condition that requires such a prescription then that is a completely different thing. The previous has been targeted at those (and the sad thing is that there are many) who are taking the drugs just to get an edge...
    Last edited: 07.27.09
  32. Random Resident

    Random Resident Random Resident

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    I hope you take your DEA # more seriously when (if) you get one.
  33. Random Resident

    Random Resident Random Resident

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    Discussion is one thing, thinking it's appropriate to abuse prescription meds is another thing.
  34. TopSecret

    TopSecret

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    Caffeine is okay especially in the morning. It's not so good in the evening, though.

    I usually stick with magnesium to facilitate long-term potentiation according to an MIT study a few years ago and the B-vitamins since they're pretty cheap.
  35. 450med

    450med

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    :eek:Yeah, it would be an amazing idea to over-medicate medical students in hopes of helping them focus.:rolleyes: Let's make the drugs MORE available so students can feel free to abuse drugs more! I guess we should all just ignore some of the potential lethal side effects of drugs such as Adderall. I mean, I just can't WAIT to suffer from potential side effects such as :
    high blood pressure
    heart attacks
    Sudden death
    Abuse
    Severe withdrawal symptoms
    Worsening mental health
    Stunted growth
    substantial weight loss
    These are serious drugs and should not be abused. To suggest that they should be made available to student to help them study is not only ignorant, but sad.
  36. TopSecret

    TopSecret

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    Yeah, it's better to stay away from them and stuff like Hydroxycut.
  37. TooSharp7

    TooSharp7 Uzi

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    Adderall helps concentration and someone prescribed to it, like me, who has ADD. Case closed.
    But for those nonprescribed to the drug improve concentration. If I were someone who was not prescribed and has trouble concentrating while studying for long hours then would think it would be okay for them to take it. Taking it only a couple times isn't gunna mess. It is a wonder drug but I emphisize it is not to be abused or depended on!
    Sometimes it's hard to concentrate and everyone knows it.
  38. virie

    virie

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    -
    Last edited: 11.05.09
  39. AlexMorph

    AlexMorph

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    u made an account to post this in the middle of the nite?
    really???
  40. Concubine

    Concubine PDE5 inhibited

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    :laugh:
  41. RunningKing

    RunningKing

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    The irony is that a bunch of Med Students are getting on soapboxes about misuse of drugs. Taking a safe and effective drug like piracetam is a far better use of pharmacology than ingesting massive combinations of Rx prescriptions for a bunch of maladies that they have marginal benefits for. Doctors overprescribe drugs all the time. At least people taking cognitive enhancers are actually getting a tangible benefit from them.
  42. virie

    virie

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    -
    Last edited: 11.05.09
  43. MadEvans

    MadEvans is a warm gun

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  44. 450med

    450med

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    So because drugs are potentially being overprescribed by physicians, that makes student drug abuse more acceptable?? keep telling yourself whatever you have to justify such abuse, but in the end, people who take these drugs are doing so because they just can''t hack it normally. People should grow a pair and just study without doping... it not that hard! if you need drugs to pass medical school then you probably shouldn't be in medical school!
  45. RegularNihilist

    RegularNihilist

    Joined:
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    112
    Yeah, that is what's freaking me out as well... I have a demented grandma, and I'd kill myself getting alzheimer's at 30, turning into a vegetable like her due 2 excessive piracetam/ritalin/adderall/donepezil use. Why couldn't ppl have started cheating a bit earlier? Egotistical pigs not thinking about longitudinal studies for the next gen docs, lol. :D
  46. ColeAsIce

    ColeAsIce

    Joined:
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    Yeah, I can't really understand why but Modafinil seems to have become a very popular drug to enhance performance and concentration. I am quite sure that some students take it to write papers or study for an exam all night. I found an interesting article about Modafinil as study drug on the internet. I would never take medication like this just to improve my concentration. I won't do things to my body that are likey to harm it.
  47. NSKyau

    NSKyau

    Joined:
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    SDN 2+ Year Member
    Piracetam + some choline source
    Aniracetam is nice but sometimes people get sleepy due to choline depletion, supplementation with CDP choline
    CDP is > AGP choline pricewise and value

    modafinil is kindof speedy but you will get through the grunt work. my focus became so sharp

    okay now..
    what is time?
    you have better memory of those things which happen for shorter durations
    than the same repetitive ****, which became a blur

    you probably wont take drugs everyday so youre more likely to remember the content

    PLACEBO effect

    piracetam increases the potency of almost any drug.
    it is cheap and legal amazon or cerebral health.com

    piracetam is great for cannabis users as it clears the 'brain fog'
    piracetam may actually increase longetivity
    1st time i tried piracetam i could remember a good amount of my train of thought backwards
    i have more interest, motivation, and stamina from cannabis
    but remember if the strains have a high THC:CBD ratio youre more prone for memory impairment. High CBD content= less memory impair
    use a vaporizer too b/c or crcinogens

    imminist.com
    if you want to learn more & maybe try these to see if you actually perform better


    oh yeah and i had semi-photographic memory on pramiracetam
    ALCAR and huperazine are good for stamina & energy

    ginko biloba is a load of BS

    personally the racetams are very clean
    mod, ritalin, etc are kindof too speedy
    blackmarble likes this.
  48. Bellette

    Bellette

    Joined:
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    Pre-Medical
    Good man. Thanks for the Bodo's reference. And thanks for the "dead average intelligence" statement. I decided to try getting into med school after a UVa kid lost his Neuroscience text on my UTS bus. It was totally written in English. Blew my mind.


    But anyway, to the thread in general, I just started taking Choline and Inosotil a week ago. Just 250mg of each per day (I'm not a vegetarian, so I assume I'm getting the rest naturally). I already feel more alert and able to attentively read for longer periods of time: it's obviously premature to be saying they're helping all that much, but I've simultaneously been able to quit the coffee, which normally places me in a mental funk for weeks.

    I'm thinking seriously, now, of adding Piracetam to the mix (just 800mg per day, none of the clinical dosages that a lot of med students claim to be taking). It's over the counter, which hardly makes it safe, and I get the fear of excitotoxicity. Is there anyone who would be able to recommend his or her own daily intake of Piracetam, on the minimum end whilst still experiencing some effect?
    Last edited: 08.24.11
  49. ensuii

    ensuii PGY1

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    SDN 7+ Year Member
    I had no idea this stuff even existed...wtf?
  50. Jolie South

    Jolie South is invoking Domo. . . Moderator Emeritus

    Joined:
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    Physician Air Force SDN 5+ Year Member
    Discussion of illegal activities is not permitted on SDN. Closing.
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