With the exception of racetams in some countries (such as Australia), most nootropics are completely legal for purchase by the general public.
Popular choices like L-theanine, bacopa, and the vast majority of nootropics can be bought freely online, and in store.
What many people don’t know however, is that there are several classes of powerful nootropics that have strict controls limiting who can buy them, and who can’t.
What Are The Prescription Nootropics?
Modafinil is by far one of the most popular prescription-only nootropics available.
It’s produced under the brand name Provigil® by the US-based pharmaceutical company Cephalon Inc. Other companies based out of India like Sun Pharmaceuticals and HAB Pharmaceuticals make generic versions of the drug as well (Modalert & Modvigil respectively).
Modafinil works by increasing dopamine levels in the brain, and by interacting with our orexin system. This system is responsible for regulating wakefulness and appetite.
Modafinil and its close relative Armodafinil are prescription-only medications used for treating ADD/ADHD and narcolepsy (a neurological disorder that causes people to fall into deep sleep suddenly and without warning).
The Main Side Effects of Modafinil:
- Skin rashes
- Easy bruising
- Chest pain
- Fast heartbeat or heart palpitations
Adderall is one of the main prescription nootropics. It’s an amphetamine, related to both crystal meth and MDMA, though with far less side effects.
Adderall is prescribed by doctors in the treatment of ADD/ADHD, and narcolepsy for its ability to increase dopamine levels and stimulate the brain.
Dopamine is an essential component of our brain’s reward center. This is the region of the brain that makes us feel pleasure after certain habits, and is also the cause for many addictions.
People suffering from ADD and ADHD are thought to have lower dopamine levels overall. With less dopamine, the reward center needs an extra push to deliver its effects. This causes them to constantly seek extra stimulation in order to activate the reward center in the brain.
By increasing dopamine with Adderall, the reward center is activated more easily, allowing people suffering from attention deficit disorders to concentrate longer without having to seek additional stimulation.
In healthy people, this increased dopamine helps trigger flow states that can boost concentration and overall productivity.
Unfortunately, there are a number of negative side effects associated with this medication, some more severe than others.
The Main Side Effects of Adderall:
- Reduced capacity for social interaction
- Low appetite
- Poor libido
- Hair loss
- Nausea & vomiting
Nicotine, the chemical in cigarettes that gives us a buzz, is also considered a nootropic. Our body has a series of receptors aptly named the nicotinic receptors. It is through these receptors that nicotinergics cause their effects.
These receptors are connected to acetylcholine, which is a common target for nootropic substances. This is because acetylcholine is one of the major neurotransmitters involved with the formation and retrieval of memories.
Activation of the nicotine receptors causes a release of acetylcholine. With additional acetylcholine available to the brain cells, information can be transferred more efficiently, giving us the feeling of improved memory, concentration, and learning.
Doctors rarely (if ever) prescribe nicotine however. Instead, they prescribe other, less toxic compounds as medicine like Wellbutrin (Bupropion).
Wellbutrin is prescribed to help smokers quit smoking, and as an antidepressant. Some people use this medication outside its prescribed range to boost memory and concentration.
The Main Side Effects of Wellbutrin:
- Dry mouth
- Nausea & vomiting
- Ringing in the ears
- Low libido
- Joint pain
Galantamine is an Alzheimer’s disease medication. The compound is isolated from a small flower known as Caucasian snowdrop (Galanthus caucasicus).
It works in the same way as many other popular nootropic compounds, by inhibiting the enzyme responsible for breaking down acetylcholine after its release. By inhibiting this enzyme, known as acetylcholinesterase, we can increase the concentration of acetylcholine in the brain.
Alzheimer’s disease sufferers have been shown to have lower levels of this neurotransmitter overall, resulting in gradual memory loss.
Galantamine is also used to treat symptoms of autism spectrum disorders.
Although Galantamine is also taken as a nootropic drug outside of its prescribed range, it comes with a series of negative side effects. However, there’s little evidence that it offers any improvements in people not suffering from altered acetylcholine levels already.
The Main Side Effects of Galantamine:
- Nausea and vomiting
- Slowed heart rate
- Poor digestive function
Selegiline is a prescription MAO inhibitor. MAO stands for monoamine oxidase, which is an enzyme that breaks down neurotransmitters like norepinephrine, serotonin, and dopamine.
By inhibiting this enzyme we can increase total concentrations of these neurotransmitters in the brain.
Doctors prescribe Selegiline for Parkinson’s disease, which is characterised by low dopamine levels. It’s also used to treat depression for its ability to boost both serotonin and dopamine.
There are many other MAO inhibitory medications that people sometimes take as nootropics, but the long list of negative side effects and prescription-only status makes these compounds questionable as a daily cognitive enhancement supplement.
The Main Side Effects of Selegiline:
- Loss of balance
- Licorice root
Are Non-prescription Nootropics Better?
Although there are some potent pharmaceutical nootropics available, each with highly specific effects on the brain, they come with a trade off in the form of side effects.
The effects these compounds have on various chemical reactions in the brain, such as acetylcholinesterase, nicotinic receptors, or dopamine reuptake, makes them useful and predictable in their effects, but also increases the chances for pushing the brain further out of balance.
Non-prescription nootropics, especially those made by plants tend to have much broader actions on the brain’s chemistry. Although this reduces their potency and often means longer waiting times before results are noticed, they also tend to be much safer and come with less side effects.
Natural nootropics also tend to promote balance in various processes in the brain rather forcing them to move in a particular direction. L-Theanine for example, has effects on dopamine, but doesn’t force it to go out of balance even with high doses. It would be very difficult to overdose on L-theanine, but it is very easy to take too much Modafinil or Adderall and push our dopamine system into a dangerous imbalance.
There are a number of prescription nootropics available, however, they are very rarely, if ever, prescribed for improving cognitive function in healthy individuals.
The majority of these medications are reserved for those suffering from ADD/ADHD, narcolepsy, depression, Alzheimer’s Disease, or Parkinson’s Disease. People using them for cognitive enhancement are doing so outside of the recommended use by their doctor.
For healthy people (those not suffering from the conditions listed above), it’s better to opt for the natural forms sold freely in stores and on the internet. This is because they have a much higher level of safety, fewer side effects, and offer very similar benefits overall.
These versions of nootropic compounds are also much more suitable for maintaining long-term health of the brain.