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Comment · Fri, January 30, 2015 · Ceretropic

Discrepancy of study outcomes and anecdotal evidence - how much of nootropic effect is placebo?

Original post in this thread

Aretus · 20 points

This has bugged me for a while. I have experimented with a lot of different substances in my time - mostly recreative drugs, prescription medications and some - few - nootropics.
What I have found out by reading studies is that the actual scientific evidence for a profound impact of nootropics concerning cognitive enhancement. For the effects of many nootropics there is no valid scientific evidence anyway. But even in the cases where there is a good foundation of studies, the amplitude of the effects is extremely minor. In many cases very promising animal studies are followed up by extremely disappointing results in human testing. I'd like to illustrate what I mean using two nootropics with strong scientific evidence backing them up, piracetam and bacopa monnieri.

Piracetam has shown extremely promising results in animal testing using rats. There are some studies suggesting it has a memory-enhancing effect in healthy people, although the better and more intricately designed the studies are, the less pronounced these effects become, up to a point where many studies suggest that piracetam has no memory-enhancing effects in healthy people at all. On the other hand, its neuroprotecti…

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Direct reply to the original post — see the thread post above.

u/MisterYouAreSoDumb · Ceretropic

The evidence is going to be skewed toward the older, and arguably safer, substances. Piracetam and Bacopa are going to be subtle in any healthy person. However, they are going to help people with deficits that they might not even know they have. If you have a down-regulated tryptophan hydroxylase enzyme, Bacopa is going to help you a lot more than someone with normal enzymatic expression. So some people could see massive improvements, even if they thought they were perfectly healthy going into it. The same goes for Piracetam, but for different reasons.

You also have to realize that the funding, and consequently the studies, are going to focus on treatment of diseases. There are not a lot of people out there dedicating their studies to improving cognition in healthy humans. So you are left with postulating what might happen in healthy subjects, based on the results of Alzheimer's or Parkinson's research. I mean you have the Russians doing cognitive the enhancement thing a lot, and they seem to keep pumping out the most effective nootropics lately. Or you have people like Nikolaus Hansl, who potentially had a great cognitive enhancing substances, but could not get funding back in the 70s and 80s to bring them to light, or give them the studies needed to confirm their results. I am trying to work with his family now, to potentially bring out his long-sought PRL-8-147.

And of course you have placebo. That is a very valid and measurable effect. Many things are psychoactive, which could trigger the placebo response to make you think you are performing better. The placebo response could even make you actually perform better on its own. If you are measuring it, and you see increases in performance, who really cares if it is placebo or not? Improvement is improvement. If you are not measuring, then you will not know for sure. However, you subjective view of the results is just as valid to you personally, as measurable results are. It may not be valid to those around you, but it's still valid to you.

Then you have some things that are total bullshit, and just profiteering at the expense of under-informed people. Liposomal grass fed colloidal bullshit. There is a lot of that out there too. However, the term nootropics has grown so much in recent years. Just because there is bullshit out there, does not mean it all is. The only way we are going to be able to scientifically weed out the good from the bad, is to fund properly designed studies that investigate the nootropic effects of various compounds on healthy people.

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