Can Smart Drugs Help With Alzheimer’s, Parkinson’s, and Dementia?

With our aging population, disorders such as Alzheimer’s, Parkinson’s, and other dementia are rising annually. While we have prescription medications to treat but not cure the actual disease, is there a way that we can prevent these disorders from affecting cognition or even treat a diagnosed disorder? Let's delve into some of the research behind nootropics and their health implications for cognitive decline.

What are nootropics?

Nootropics (NT) are a combination of prescription and non-prescription medications and supplements endorsed to enhance brain function. The word nootropic comes from the Greek words for "mind" and "bend."

Many people will research the medications and remedies their healthcare provider (HCP) recommends. During that research, there may be references to alternative therapies called nootropics. But are they practical for preventing and treating disorders affecting cognition and mental abilities?

Non-prescription preparations and supplements may show some positive effects but be aware that they do not have the same rigorous criteria for use in the US as prescription medications. Before considering or taking any NT preparation, you must discuss it with your healthcare provider to determine if this is the best option for you.

Prescription nootropics:

Most of these preparations are stimulants to treat other conditions, such as narcolepsy (sleep disorder) and ADHD (Attention Deficit Hyperactive Disorder). In some cases, they also enhance cognitive and mental abilities in those conditions.

Adderall

Adderall is a well-known "stimulant" primarily used to treat ADHD and narcolepsy. This drug contains amphetamine and dextroamphetamine; its action increases the activity of neurotransmitters dopamine and norepinephrine. There are no recommendations for using Adderall outside of ADHD or narcolepsy.

While they can improve concentration for someone with ADHD, there is no evidence that Adderall improves cognitive or mental abilities in a healthy adult. Unfortunately, students have used this drug illegally to increase their academic performance. Adderall is a controlled substance, so if acquired without a prescription, it is illegal, There are potential cardiac side effects, and the tendency toward addiction is dangerous.

Methylphenidate

Methylphenidate (Ritalin) is a stimulant that can manage symptoms of narcolepsy and ADHD. The UK Dementia Research Institute finds some benefits to using noradrenergic drugs like Ritalin and other stimulants to treat general cognition and apathy, specifically in dementia.

Modafinil

Modafinil (Provigil) is a stimulant primarily used to treat narcolepsy, sleep apnea, and shift work sleep disorder by increasing dopamine and norepinephrine levels. In addition, Modafinil is a controlled substance used to treat ADHD in an off-label capacity.

Memantine

Memantine (Namenda)is a medication for treating Alzheimer's and other dementias in the middle to late stages. Memantine is helpful to the brain by reducing excessive glutamate, which can damage brain cells by blocking the chemical from attaching to the NDMA receptors. Memantine can also help the brain by improving blood flow and reducing inflammation, but not for use as a prevention. In addition, Memantine helps reduce responsive behaviors in people without sedating effects with more advanced stages of dementia.

Non-prescription nootropics:

In addition to prescription nootropics, there are a variety available to purchase over-the-counter.

Caffeine

You know that cup of coffee you have in the morning makes you feel more awake, right? Therefore, caffeine is a nootropic. Caffeine is a stimulant and blocks the transmitter called adenosine responsible for inducing sleep. It also stimulates the release of neurotransmitters such as dopamine and norepinephrine, which can increase alertness and cognitive function.

Too much caffeine can be dangerous and cause severe cardiac issues. Therefore, the FDA recommends no more than 4–5 cups of coffee daily or about 400 mg of caffeine. Do not use caffeine pills, as they can be very hazardous due to their higher levels of caffeine.

L-theanine

L-theanine is a fatty acid found in green and black teas and supplements. A study by the University of Canberra noted that cognition in people improved with teas containing L-theanine. Part of this reason is that it increases alpha waves in the brain that have a relaxing effect on the individual. Another study found that L-theanine also has a neuroprotective effect in the brains of older adults.

Creatine

Creatine is an amino acid that is 95% stored in skeletal muscles and 5% in the brain. It is popular with athletes to improve their performance in high-intensity workouts and is an ingredient in most sports and energy drinks. In addition, Creatine supplies energy to tissues when there is a greater demand.

One study published in Experimental Gerontology found that oral creatine improved the tasks associated with memory and cognition. However, the study also notes that there needs to be further research. Creatine studies are also ongoing for treating Parkinson's and depression but require more research.

Omega-3 fatty acids

Omega-3 fatty acids are polyunsaturated fatty acids (PFUA) in fatty fish and fish oils. They promote brain function by building membranes around neurons. A study published in 2017 shows that a protective component found in PFUA protects and supports the brain in aging.

This same study showed some benefits of PFUA in preventing and treating depression and dementia. However, there is conflicting research that demonstrates the need for more analysis. Omega-3 fatty acids are relatively safe, but you should still contact your HCP before adding any medication or supplement to your routine.

Gingko biloba (GB)

There is much hype about using GB, but is it beneficial for improving cognition and preventing dementia? GB originates from the ginkgo tree native to China, Japan, and Korea, and its leaves serve as a herbal supplement for its antioxidant properties. Some studies find this supplement can benefit cognitive impairment, Alzheimer's disease, and Parkinson's, but results are inconsistent, so it requires more research. The theory is that GB enhances cognition by increasing blood flow and reducing inflammation in the brain.

Research also suggests that GB may benefit people with anxiety, depression, and Parkinson's, but studies have variable results, requiring more research. Additionally, GB may react with some medications, so you must consult your HCP before adding this supplement.

Panax ginseng

This type of nootropic found in China provides an antioxidant supplement from its root that reduces inflammation and protects neurons. Panax ginseng is beneficial in some cases of treating people with brain disorders such as dementia, Parkinson's, and Huntington's, but the findings are still considered inconclusive.

Rhodiola

Rhodiola is a herbal root found mainly in China and Europe and referred to as rose root or golden heart. There is evidence that this popular Chinese herbal medicine has therapeutic properties for age-related diseases due to its antioxidant, anti-inflammatory, and neuroprotective properties. However, this requires more research, as the results are inconclusive. You must consult your HCP before starting this or any supplements, as medications can have adverse effects.

Nootropics are becoming quite popular as they claim to enhance cognition. However, preventing cognitive disorders such as Alzheimer's, Parkinson and other dementias comes down to lifestyle. Maximizing diet, exercise, and remaining physically and socially active are still the best prevention against most diseases. Before you take any supplement, you must check with your HCP, as some supplements may interact with certain medications.