The Nootropics Thread

[diachi]

It's a "new" old drug. Currently it can be ordered legally, here in the US, without issues.

With modafinil, I do have a valid prescription, but to fill 30 200mg pills I was given a price of $870 or $38 per pill... idk why per pill is more, but either way that's far too much for a generic that has been around for decades.

Took a 50-60mg dose this morning, just about 5 hours ago. As of right now I'm quite happy with the effects. Have not had any caffeine, or adderall which I usually take, and I am a little low on sleep, 6.5 hours, which is enough, but not perfect.

I'm not a fan of the side effects of ritalin or adderall, more so of the ritalin. There's also a new formulation called evekeo, which is in effect, imo, exactly the same as adderall, with slightly slower initial effect.

Will see what I can find, never tried Modafinil, just Adrafinil, it wasn't quite what I was hoping for.

That's very expensive! Ouch!

I find Caffeine, L-Theanine, B-12 and Cod Liver Oil are great on a daily basis, they provide a good boost of energy. The Modafinil may have a better effect on focus though.

Agreed on the side effects of Ritalin at least (haven't taken Adderall). Definitely not the most pleasant experience, although the intended effects are good, very clean and functional I find. I've had 4F-MPH and IPH too, but MPH is the more suitable chemical for functional use IMO.

 

[InfinitusEquitas]

Well, just ordered myself a proper scale and capsules to fill with this, to test it out properly.

I take escitaploram 20mg, and 450mg bupropion daily as well, so need to be somewhat careful with what else I consume, but modafinil or analogue should not be an issue.

Thinking of adding Oxiracetam, noopept, and gaba to the mix. Already take a multivitamin, 8000iu vitamin D, fish oil, and zinc.

On occasion 1-2mg of clonopin too, but I don't want to become reliant on it.

4F-MPH is interesting, but seems like fairly controlled substance that is likely to flag positive as an amphetamine.

 

[paul1598419]

I know without having to look them up that Adderall is four related salts of Amphetamine and are Schedule II by the DEA. Modafinil is the racemic form of Armodafonil, so it is half as effective as the R enantiomer, though I have never heard of it being so very expensive. All of these are either amphetamines or are substitutes for them. My daughter took the Armodafonil for awhile, but quit due to the expected side effects associated with it. All in all, they are speed or speed substitutes. If you are young and haven't taken them for a long period of time, you may be in the honeymoon phase of these drugs, but the bad effects are coming.

Edit: it is esticalopram, not escitaploram. I had a hard time trying to find the latter. The former is an SSRI antidepressant.

 

[InfinitusEquitas]

Adderall is schedule 3, Ritalin schedule 2. Chemically, ritalin is actually more like cocaine than meth. Adderall is a combination of four amphetamines.

Adrafinil, modafinil, and other afinils are quite different. Modafinil is schedule 4, and does require prescription, the other afinils do not.

@RC - I'm sorry about your uncle. It is unfortunately a fact that many people experience severe mood swings, especially as they first begin to SSRIs. That said, chemical imbalances do exist, and they can be treated.

Heroin itself is rather awful, and crokodil is just scary in what it does to people over time. It was largely as a result of the crokodil epidemic in russia that codeine containing medications started to require prescriptions.

My cousin died from a heroin overdose. Now in the US fentanyl is on the rise as well, and so are a number of other drugs. Until the question of drugs is treated as a medical issue rather than a criminal one, things will not get better or change. Where there is a demand, a supply will exist to fill it. The conundrum to me, is what separates the recreational or one time user from a junkie. What it is that leads one person to try say cocaine, and say, yeah this feels pretty good, but not turn into a habitual user and junkie needing the next fix just to get by.

As for myself, I see a doctor monthly for my prescriptions, only two are daily, and I am perfectly aware that going cold turkey would probably put me into a coma, however halving the dosage every two weeks for two months should allow me to taper off safely if there are any significant side effects.

 

[paul1598419]

@ IE: Double check the DEA schedule for Adderall. Like all amphetamines it is and always has been a schedule II. Ritalin has similar effects as amphetamine and cocaine. They are both sympathetic stimulants, though cocaine has a much shorter half life. Ritalin was introduced about 50 years ago as a modulator for ADD, later it was renamed ADHD. It doesn't work nearly as well as amphetamine, but if you take it for the "clarity of mind", it's side effects will eventually catch up with you. Taking chemicals to feel good has been shown to have a downside, with one exception that I personally don't use and that is marijuana. I have known many people over my life who have used marijuana and have yet to find anyone who has suffered serious side effects from it. I personally don't like it because it makes me stupid. That is a side effect that I have observed in many people who use it consistently. But, stupidity aside, it seems to have more benefits than harmful effects.

 

[Benm]

With modafinil, I do have a valid prescription, but to fill 30 200mg pills I was given a price of $870 or $38 per pill... idk why per pill is more, but either way that's far too much for a generic that has been around for decades.

I'll just presume you are in the US with crazy prices like that. Generic modafinil is sold on the darknet for someting in the order of <<$1 a tablet - real generics at that, no vague pill mill fake things.

To give you an idea on realistic prices: Dutch pharmacy prices (proper prescription required to buy) are 15 cents per 100 mg tablet, so $0.33 or so for a 200 mg dose equivalent. Pharmacies do charge $6 for dispensing medication, so getting 60 100 mg tablets would cost you around $16 instead of $870 for the exact same stuff, perfectly legal.

 

[InfinitusEquitas]

Not familiar with any darknet pharmacies, but I have familiarized myself with crypto currency since our last discussion on the subject.

Medical prices in the US are completely absurd, and even when patents expire US pharma colludes to both keep out exports and either switching to slightly different formulations, or as is the case with modafinil and many other meds, just charge whatever they want to.

 

[Vision]

Diachi, PM me, need to talk to you.

I get my modafinil box from India through a friend, he gets them at local pharmacies(no prescription needed) and its $30 for 100 pills of either 200 or 100 mg. If you have a prescription, try and find someone to bring some from abroad where it's much cheaper and legal, none of that Scheduled 4 bullshit.

Modafinil works totally different from Ritalin or adderal. It's much safer without the side effects. But yeah daily use will lead to receptor down regulation just like coffee. You need to get off it and reset. All other substitutes and generic versions are usually slow acting or just don't work as good.

 

[InfinitusEquitas]

Day two of flmodafinil... so far effect had been identical to modafinil, but with no dry mouth side effect. BP and pulse are also within normal range. I'm somewhat guessing on dosage, should be about 100mg, my scale seems to have decided to stop working, but I'll have a replacement today. Will confirm the doses from yesterday and today tonight.

One reason I am exploring afinils is that I do not want to develop a tolerance, and want to be able to cycle combinations of safe options that do work well.

Ritalin for example does work, but I am especially weary of using it, currently don't have prescription for it anymore so it's not a consideration, but imo it has greater potential for developing tolerance than even amphets.

Edit: I do consult with a psychiatrist, and have valid prescriptions for everything I take.

 

[Andrew124C41]

I have been involved with nootropic agents professionally since the early 90s after reading two books written by a collegue, Dr. Ward Dean and John Morgenthaler Smart Drugs I and II. I was also involved with the Cognitive Enhancement Institute (CERI) started by Steven Wm. Fowkes. CERI used to put out a news letter. While the news letter is no longer published, there is a tremendous amount of information which has been archived. CERI

While it is true that many of these agents have not been put through full, three phase clinical trials, that does not mean there is not a place for using them. Wihout the off label use of drugs on an empirical basis, I think we would never learn anything new. There is risk inherent in everything we do. Sure, one wants to mimize it to the best extent possible. But, it can never be eliminated. From a clinical perspective, that is if any of these agents are suggested to a patient, as long as proper inofrmed consent can be give, I see nothing wrong with trying them if the patient voices a need. Interestinly, a nootropic that has been approved, Modafinil, (Provigil) is one that I have seen patients have adverse reactions to the most. I tried it once and I would never take it again!

There are a couple of other sites that are interesting and offer information about nootropic agents. Smarter Nootropics - Cognitive Enhancement Through Smart Drugs https://nootriment.com/

Finally, I used to work for the Life Extension Foundation. The link I will provide to their health protocols has been in the making since the 80s and is a free, valuable resrouce for many health issues. (I have no financial interest in the Foundation.) They do make high quality vitamins and supplements which I recommend to those who are interested. Life Extension

 

[InfinitusEquitas]

Well the issue as I see it, is in a lot of cases doctors are just plain afraid of deviating from the norm, especially as a consequence of the opioid epidemic.

With a patient expressing a need, with full disclosure, and consent, I don't see an issue with the use of just about any drugs. Titrate to effect, if no effect is observed, or there are adverse issues, stop, or lower at a safe pace, discontinue, and try something else.

With regard to modafinil, the only side effect that I experience when I was taking it in large quantities around 2007, was dry mouth, and some irritability, but the irritability could have been attributed to the fact that I also wasn't sleeping nearly enough. IMHO it should really be given initially in a dose of 50mg, not 100mg, or 200mg, as it is currently done.

 

[Andrew124C41]

Nootropics are not exactly the province of conventional docs. I had a friend, really brilliant guy, owned a compounding pharmacy. He taught me a lot of stuff. I had already studied acupuncture and herbal medicine for a couple of years after my IM residency. He introduced me to Ward Dean. Then I became involved with the Americn College For Advancement of Medicine which for want of another way of putting it, deals with alternative, non-main stream stuff. I think this complimentary stuff selects for shall we say, a more adventurous sort of doc. Personally, I think empirically working with new things is exciting...especially if it helps someone. Additionally, in this day and age, you have to be really open to learning from your patients who may know about things that you don't. A lot of conventional guys can't handle that. It really is stupid because knowledge grows exponentially....no way to keep up. I used to ASK my patients to give me whatever articles, anecdotes...whatever stuff they found. It really is a lot more enjoyable that way What was funnty was that Dr. Dean was writing a book about GHB which we were prescribing for sleep back in the 90s. He asked me to write a Forward to it which I did. I warned him that I thought it had the potential to be addictive in the 15 to 20 percent that were suseptable. He did not think so. Unfortunately, it can be. That said, addicts can be addicted to anyting. That does not mean docs should live in fear of opiates and such. They just need to understand dependence and the difference with addiction understanding the risks and use them when they are called for. Nootropics are not known to be addictive. At least I have not run into it.

 

[Benm]

You can awlays break pills in havles or quarters to see the effect of a lower dose before trying the full one, and this is probably a wise precaution.

Addiction is sometimes difficult to define, and calling it that often depends more on the nature of the substance than on actual dependence.

I would say i am addicted to having my morning coffee: not having it makes me crave it, and produces withdrawal effect such as headaches. Given how commonly available (and affordable) coffee is anywhere it the world i don't see much of a probem with it.

If all caffeine were to disappear in a poof i might have a bit of a problem. I'll probably be very cranky for a month but would be physically okay.

This is vastly different from severe addiction to substances like opiates, benzodiazepines or alcohol, where sudden cessation of use can cause physical harm or even death.

I'd reckon that substances like modafinil fall more into the 'coffee group' if you look at dependence, you are not likely to die if you suddenly stop using them for whatever reason.

In fact, suddenly stopping much more commonly prescribed anti-depressants can be a lot more dangerous, even if you don't really crave them at all. Lack of the substance itself will not kill you directly, but stupid actions taken during withdrawal (such as blindly crossing multi-lane highways and not even caring about being hit by a car) could easily get you killed.

 

[InfinitusEquitas]

Yes, one danger of SSRIs that I don't think is given nearly enough attention, is just how crucial it is not to stop taking them abruptly. I personally had a light brush with a lack serotonin after forgetting to take my pills on a 4 day camping trip. Days one and two without medication I didn't experience any side effects, however on day three... oh boy.

Addiction is a complicated subject because the nature of the dependence is often extremely different, running the gamut from the guy who watches too much ****, a seemingly harmless behavior, all the way to the tweaker on the street who'll do anything for the next high. Personally I believe for most it stems from a desire to simply escape in some form from their current reality, rather than treat actual pain or physical dysfunction. At the same time, adults, and by that I mean people over 25, or even 30, should be able to make their own choices, but accept with them the potential side effects.

Most substances that produce an immediately noticeable change can lead to addiction. For myself, a big reason I am exploring now nootropics now is to avoid developing a dependence that is both habitual and physical.

Andrew, I started reading a bit about anti aging initiatives and research, and have to say it is fascinating. It also seems that with a higher budget just about any substance, regardless of where it falls in terms of regulation, is available legally.

 

[Andrew124C41]

First of all, one has to have an understanding of the difference between dependance and addiction. The former is a state which arrises as a product of the properties of biologically active agents with each individual's agent specific, receptor regulatory properties. I am excluding the fact that people can be considered dependent upon certain agents to maintain life such as insulin.

An example is a patient hospitalized for trauma. The patient is placed on 30 mg of morphine given sub qutaneously evey 3 to 4 hours. It is inevitable that over the course of a number of days which the amount being person specific, that the patient will require a higher dose to alleviate pain. Back in the 60s, Candice Pert identified the opiode receptor. This recepotor is stimulated by endogenous endorphines. Morphine mimics endorphines and is far more potent. As a result of continued stimulation, the receptor is down regulated....thus more morpine is required.

The paint recovers and it is time to stop the morphine. All, patients if given morphine long enouigh will experience what I call pharmacological adaptation which I beleive is a more precise descriptin that dependence. As a result if the morphine is discontinued abruptly, all patients will experience withdrawal symptoms. With opiods there is a characteristic pattern....the details are not important. Suffice it to say, it is very uncomfortable. It can be minimized by weening and today, an agent for which I conducted research is available which is very helpful because it is mixed agonist-antagonist opiode, buprenorphine. It has a very high affinity for the mu receptor and when serum levels fall, some remains attached to the receptor smoothing symptoms. It was approved by the FDA I think in 1993.

After the Vietnam war, the Robins study was the first to shed light on the difference between addiction and dependence. When it was reported that 15 percent of vets were addicted to heroin, a study was conducted in which they were forced to dry out in Vietnam before returning. After one year, only 5% relapsed.

The long and short of it is that 85% of patients who are opiod naive, once haviing been exposed then detoxed in hospital, will never ever have the desire to take opiates again. That means that about 15% of these patients will have the recurring desire to use narcotics despite the fact that they know it will cause life unmanageabilty. Furthermore, they are not taking it to treat pain. This recurring desire coupled with life unmanageability, is the sina quo non of addiction. A better definiton preposed by a collegue is that an addict cannot use mood altering drugs safely. He called this an illness. MAD disease. Personally, I have seen people who have one drink a day...yet they are alcoholic for the simple reason that it changes their mood. I am not talking about the predictable effects...their mood becomes disphoric, angry...Such people are alcoholic.

While a locus in our DNA has been found for alcoholism sesepibility, there is not test for who will become an addict after using opiods.

Opiods are an example. Many other agents can do this. Lyrica, benzodiazapines....even SSRIs.

Additionally, indiviual response cannot be predicted. The very first patient for whom I prescribed Prozac called me after a week and told me he could not get out of bed. He became very, very weak. Since then I only saw this a few times. It happens. People can have withdrawal symptoms from abrupt cessation of SSRIs.

Yes, people do have problems with abruptly stopping caffeine intake.

I would not consider people who cannot start the day without coffee addicts. Perhaps dependence...but not addiction. I have seen people who are addicted to collecting things, you name it. This sort of thing is mediated through the limbic/pleasure system. Certain behaviors stimulate endorphines. Generally or perhaps hopefully life unmanageability is not attendant with them.

 

[Benm]

It's a pretty fine line. I'd speak of addiction when someone actively seeks a substance, and of dependence when someone develops unpleasant symptoms upon cessation of using a substance, but possibly not really relating those.

Opiods and opiates clearly create a craving for them when someone stops taking them, giving users the idea of 'needing a fix' and often exactly knowing what that fix could be (a tablet, injection, or whatever they were used to).

SSRI's don't really do that when someone stops using them. You'll probably never find a person that is desperate to take a tablet of prozac, citalopram or anything like that. Sudden cessation of use can certainly cause severe problems, but the direct relation between taking the pill and feeling better aren't really there, probably because the onset of action is pretty slow. People can, obviously, know that their unpleasant feeling is caused by lack of the SSRI, but do not crave it like opiate addicts to in any way.

Benzodiazepines can go both ways i suppose: sudden cessation will propably cause unpleasant effects in anyone that has been taking them for some time, though it does not always cause cravings. Since benzodiapines generally have a pretty fast onset of action people will however -learn- that taking the pill will make the unpleasant symptoms subside, so they could crave it after a few rounds of cessation.

The line between people seeking a high and those trying to prevent unpleasantry is very fine though.

It also cannot always be explained by just biochemistry: some people get addicted to cannabis while others do not, taking the exact same doses and all. There is no mechanism for dependence, but some people become dependent on it regardless, whilst most people do not.