Nootropics

[Horners]

How do you guys feel about nootropics? I’m talking specifically about herbs, not caffeine or amphetamines (Think it’s all BS or potentially dangerous?)

Do you ever get patients who ask about these?

Where do you think they fit in our roles as psychiatrists?

Discuss


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[birchswing]

My opinion on this could change since the technology is not available reliably and safely. If there were theoretically a safe, reliable way to increase intelligence, morality, pleasure, happiness, relationships (any or all of the above), and it were denied to people, I think that would be unethical. If you were able to take a person with mental ******ation and bring them to an average level of intelligence but failed to make that option available, I think that would be unethical. I think the same is true for the current average we have, which I don't think we should suppose is set in stone as animals and humans have evolved over time and so has "average." And production of technology to evolve the average upward even further seems plausible.

I couldn't speak to how psychiatrists fit into that since their role has traditionally been to treat mental illness.

Edit: I used person-first language and the system still censored me. I'm not sure what the correct terminology is. A person with significantly lower than average intelligence?

 

[Old&InTheWay]

Edit: I used person-first language and the system still censored me. I'm not sure what the correct terminology is. A person with significantly lower than average intelligence?

Intellectual disability is the preferred term.

 

[birchswing]

Intellectual disability is the preferred term.

Gotcha.

 

[clausewitz2]

How do you guys feel about nootropics? I’m talking specifically about herbs, not caffeine or amphetamines (Think it’s all BS or potentially dangerous?)

Do you ever get patients who ask about these?

Where do you think they fit in our roles as psychiatrists?

Discuss


Sent from my iPhone using SDN mobile

I've encountered lots of people taking l-theanine, ashwaganda, tumeric and using CBD or Rick Simpson oil. Fewer but sometimes encounter phenibut, some of the -racetams, and a few people who get around insurance restrictions on modafinil by just buying adrafinil, which is totally unregulated. I ask about these things since some (GABA-agonists) can obviously be dangerous.

The ones that are just medications used in Europe but not approved here are obviously a little easier to evaluate (although sometimes translating from Russian is a problem). Otherwise I don't think there is a great deal of evidence about any of these things to make definitive statements. Usually people I encounter who use lots of these don't want to take medications so interactions are less often a problem.

 

[WisNeuro]

Most of the claims that are made by proponents have never really been validated in empirical research on humans. It's possible that there is some benefit with some, at the right doses, but the science isn't there yet. Most of people's "success" with these is most likely placebo effect. At worse, people are buying things off the internet from overseas sources and have no idea what they are actually ingesting. I wouldn't be surprised if 90% of this stuff is just ground up cardboard or industrial castoffs.

 

[whopper]

Something might enhance cognitive function but that doesn't mean it's healthy for your brain. E.g. Stimulants could possibly be very harmful if used and the person doesn't have ADHD. I tell patients to utilize methods outside of medication if and when possible such as exercise, diet, etc. I only recommend supplements if that supplement actually has published data showing it can benefit.

 

[birchswing]

Amphetamines could improve people's quality of life, productivity, and to some degree their intellectual abilities. Yet they have side effects and can be dangerous.

Cosmetic plastic surgery is also said to improve people's quality of life and take a person beyond a normal, healthy state to something beyond that (I personally am not impressed with the results, but that doesn't really matter). But what is interesting to me is looking at the side effects of cosmetic plastic surgery where you have the very real chance of a fatality under anesthesia, you have the very real chance of enabling a mental illness like body dysmorphia, and yet the benefits seem much harder to quantify than the benefits of amphetamines.

I read somewhere recently (paraphrasing) that the law follows society rather than society following the law. That seems to be the case with "enhancing" someone's physical appearance and the risks involved versus enhancing their psyche.

 

[Glyx-13]

I've encountered lots of people taking l-theanine, ashwaganda, tumeric and using CBD or Rick Simpson oil. Fewer but sometimes encounter phenibut, some of the -racetams, and a few people who get around insurance restrictions on modafinil by just buying adrafinil, which is totally unregulated. I ask about these things since some (GABA-agonists) can obviously be dangerous.

The ones that are just medications used in Europe but not approved here are obviously a little easier to evaluate (although sometimes translating from Russian is a problem). Otherwise I don't think there is a great deal of evidence about any of these things to make definitive statements. Usually people I encounter who use lots of these don't want to take medications so interactions are less often a problem.

Can't speak to the rest, but Phenibut is a GABA-B agonist, very similar to Baclofen. I can't imagine that it would have any effect (at least positive) on cognition, but is used very commonly as an immediate acting anxiolytic by people online. It is NOT a supplement and should be treated with care as many people have become addicted and physically dependent on it-saying it has a similar feeling to GHB.

 

[Trismegistus4]

Intellectual disability is the preferred term.

I'm aware of that, but it's ridiculous that the forum censors that. R e t a r d is a perfectly legitimate word in the English language. It means "to slow." In fact, the phrase "mental r e t a r dation" was originally coined as a nonjudgmental, neutral euphemism for the older terms like *****, idiot, and imbecile, which had become insults. Yet the forum isn't censoring those words. (Plus, this is another example of what Steven Pinker calls the "euphemism treadmill." In 20 years kids are going to be calling each other "IDers" on the playground, and we'll have to come up with yet another new term.) What's next, am I not allowed to say that I bred my female dog thus making her a brood bitch? Am I not allowed to quote the King James Bible when it says Jesus rode into Jerusalem on an ass? Are we going to be banned from criticizing people for being niggardly or talking about the nation of Niger?

 

[Old&InTheWay]

I'm aware of that, but it's ridiculous that the forum censors that. R e t a r d is a perfectly legitimate word in the English language. It means "to slow." In fact, the phrase "mental r e t a r dation" was originally coined as a nonjudgmental, neutral euphemism for the older terms like *****, idiot, and imbecile, which had become insults. Yet the forum isn't censoring those words. (Plus, this is another example of what Steven Pinker calls the "euphemism treadmill." In 20 years kids are going to be calling each other "IDers" on the playground, and we'll have to come up with yet another new term.) What's next, am I not allowed to say that I bred my female dog thus making her a brood bitch? Am I not allowed to quote the King James Bible when it says Jesus rode into Jerusalem on an ass? Are we going to be banned from criticizing people for being niggardly or talking about the nation of Niger?

Sure, kids will always be unkind. But language is living and evolves. There are a lot of "legitimate words" in the English language which you can, but perhaps ought not use. And it's not so difficult to use a different word when the original one is painful for people to hear. This change was made after years of people with intellectual disability and their families pushing for it. The site is showing respect for and honoring a group whose voices are almost never heard; there's no (legitimate) reason to be upset or not respect it.

Anyhow, my comment was in reply to a member who admitted that they didn't know the correct term. Perhaps this is an issue to take up directly/privately with the site administrators?

 

[PsyDr]

The history is more interesting.

The terms "*****", "idiot", and "imbecile" were originally technical descriptors of ranges of IQ that did not have inherently negative connotations. This is similar to the term "invalid" in other branches of medicine. As noted by Pinker and Quinn, society tends to adopt technical terms as pejoratives in a progressive manner. This was apparent when Rosa's Law was passed in 2009.

Side note: If you're bored, look at some of the more beautiful antique invalid feeders. There's a lot of care there.

 

[justabanana]

To get a little back on topic, the main issue I have with nootropics currently is how broad the term has become. It used to be mainly racetams and their derivatives. Most of them at were relatively benign with questionable effect in otherwise healthy patients. Now people are putting modafanil, tianeptine, mementine, and even Parkinson's drugs under the nootropic umbrella. A lot of these drugs will interact with and interfere with psychiatric treatment. Some can seriously alter mood and have ridiculous side effects all their own.