As they gain mainstream popularity, we looked at what the science says about the smarts-enhancing potential of nootropic compounds.

Who doesn't want to be smarter, sharper and more focused and creative? Nootropics (pronounced new-traw-picks) promise all of this and more. These "smart pills"—which are a group of natural and synthetic compounds, often found in supplement or prescription form— might sound new, but nootropics have been around since the early 1970s, when Romanian psychologist and chemist Corneliu Giurgea created a synthetic substance called piracetam to improve learning and memory and coined the term.

Nootropics gets its name from the Greek words nous ("mind") and trepein ("bend or turn"). There are more than 130 over-the-counter nootropics—including ginseng, ginkgo, guarana, creatine, caffeine and Bacopa monnieri as well as piracetam—plus Rx versions, such as the ADHD medications Adderall and Ritalin, and Aricept, an Alzheimer's treatment.

Today, nootropics and other brain health supplements are a billion-dollar industry in the U.S. And of the estimated 16 million American adults who use stimulants like Adderall, about 5 million do so off-label, with half of those specifically aiming to enhance their brainpower. "People will jump at any opportunity to try something that might be mentally curative or restorative," says Maya Babu, M.D., M.B.A., a neurosurgeon at Cleveland Clinic Martin Health in Port Saint Lucie, Florida. "Younger people are interested in potential memory and attention benefits, while those who are older are concerned about dementia."

a hand holding a pill with an illustration of a brain in the background

But do OTC nootropics work? The research says: not so much. When scientists reviewed 394 studies for a 2020 Nutrients review on nootropics, they ended up tossing out 73% due to low quality (meaning the results didn't hold up to rigorous scientific scrutiny). After scrutinizing those that remained, they concluded that the only supplement that might be useful was caffeine, showing promise for improving memory, attention, problem-solving and reasoning. And even that was mostly among sleep-deprived people.

There are also safety concerns. Supplements aren't subject to the same clinical trials as prescription drugs, and many of their labels are riddled with unsubstantiated claims. The issue is so problematic that in 2019, the FDA and the Federal Trade Commission sent letters to three nootropic supplement manufacturers demanding them to promptly correct the false or misleading claims on their labels. One ginkgo biloba brand got a slap on the wrist for touting its ability to improve memory. And a purveyor of colostrum supplements got called out for its Alzheimer's prevention claims.

As for prescription nootropics? "For patients with true ADHD or dementia, certain medications can be tremendously helpful for attention, alertness and focus," says Babu. "But for those without these underlying conditions, I haven't seen data that nootropics can increase performance in any way." Indeed, a 2016 American Academy of Family Physicians review found no evidence that Alzheimer's medications do anything to improve mental function in healthy people and that the impact of ADHD medications for those without the condition are modest at best. "In the end, I don't think nootropics can replace sleep, healthy diet, physical activity and memory exercises," says Babu. "I'd hate to see people think they will benefit them in any meaningful way." Next time you're looking for a brain boost? Her advice: Try a strong cup of coffee.

This article first appeared in EatingWell, July/August 2021.