Memory and concentration enhancement

57 drugs

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

CCreatine monohydrateNot recommended · Dietary supplements, sports nutraceuticals (local classification)Creatine monohydrate is an amino acid derivative, a classical sports supplement for muscle strength and performance. In 2023–2024, creatine became popular as a cognitive enhancer among students and in biohacker circles. The Avgerinos 2018 meta-analysis (6 RCTs, n=281) showed significant short-term memory and intellectual performance gains in vegetarians and vegans (whose baseline muscle creatine is lower due to a meat-free diet). In omnivores the effect is not significant. An effect on sleep and reduced fatigue during sleep deprivation has been reported in recent studies (Roschel 2024). Creatine is safe at 3–5 g/day; it can cause water retention and slight weight gain (1–2 kg in the first weeks). With a normal diet, a cognitive effect in omnivores is unlikely.
DAcetyl-L-carnitineNot recommended · Acetylated ester of L-carnitine; supplement with claimed neurotropic effectAcetyl-L-carnitine is marketed to healthy adults as a memory, focus and cognitive support supplement. Data in healthy volunteers are inconsistent: small RCTs, short duration, heterogeneous endpoints, effects within scale noise. EFSA has not approved any cognitive health claim for acetyl-L-carnitine. NIH ODS rates cognitive effects as insufficient evidence. Genuine memory complaints require workup (B12, TSH, depression and sleep screening, neurocognitive testing if indicated), not a supplement.
DBacopa monnieri (brahmi)Not recommended · Plant nootropic adaptogen from Ayurvedic medicine, supplement. Not registered as medicine in EU or AEMPSBacopa is the top-selling «natural nootropic» in the biohacking segment, promising memory, processing speed and learning improvement. Kongkeaw 2014 (J Ethnopharmacol) meta-analysis reviewed 9 RCTs in 437 healthy adults: moderate cognitive test speed improvement after 12 weeks of 300–450 mg/day standardised bacopa extract; effect on memory and attention is ambiguous. No quality RCTs in Alzheimer or vascular dementia. NICE dementia 2018 (NG97) lists cholinesterase inhibitors (donepezil, rivastigmine, galantamine) and memantine first-line for Alzheimer; bacopa is not in guidelines. If bacopa was recommended for cognitive impairment or diagnosed dementia instead of workup and standard therapy, consider seeking a second opinion.
DCholine (umbrella: bitartrate, phosphatidylcholine, lecithin)Not recommended · Essential nutrient-like substance; precursor of acetylcholine and phosphatidylcholineCholine and lecithin are heavily marketed as a «nootropic for healthy people» and «brain activator». The premise is simple: choline becomes acetylcholine, acetylcholine is needed for memory, so more choline means better memory. Clinical confirmation in healthy adults with normal choline status is lacking: randomised trials are few, samples are small and the effect over placebo is weak or absent. NIH ODS 2024 notes that supplementation does not improve cognition in normal-status adults. Wallace 2018 points out that more interesting data exist in pregnancy (fetal neurodevelopment), not in biohacker use in healthy adults. Evidence-based memory protection rests on physical activity, blood-pressure control, sleep and the Mediterranean diet. Before self-prescribing, consider seeking a second opinion.
DCholine bitartrateNot recommended · Essential nutrient, dietary supplement. The basic choline form used in supplements. Not registered as a medicine in the EU or USA; sold as a supplement in RussiaCholine bitartrate is sold as a «natural memory and concentration nootropic» for healthy adults, students and knowledge workers. No evidence base in cognitively healthy people: RCTs with choline bitartrate and memory, attention or processing-speed endpoints showed no clinically meaningful effects. EFSA 2011 did not approve any memory or learning health claim for choline above the adequate intake. NIH ODS 2024 lists adequate intake at 425–550 mg/day from all food sources (eggs, meat, fish, soy); most of the population meets the requirement without supplements. CNS bioavailability for choline bitartrate is lower than for alpha-GPC. If choline bitartrate was recommended for subjective memory decline without workup (rule out anaemia, TSH, depression, sleep apnoea, vitamin B12 and D deficiency), consider seeking a second opinion.
DFisetin (flavonol from strawberries, mangoes and onions)Not recommended · Plant flavonol, supplement. Natural polyphenol from strawberries, mangoes, onions, apples. The biohacking industry positions it as a «senolytic» – an agent that clears senescent cellsFisetin is a plant flavonol (from strawberries, mango, onion) marketed as a supplement for memory and concentration. There is no convincing evidence of benefit for this use; the human data on memory and attention do not back it up. What actually helps cognition: enough sleep, regular physical activity, and treating conditions that make it hard to focus. If memory or concentration worries you, talk it over with your doctor.
DGlycine (as a marketed «nootropic»)Not recommended · Other psychostimulants and nootropics (local classification)Glycine is an amino acid marketed as a nootropic for better memory and concentration. The effect at this use has not been shown: there is no solid evidence that it improves memory or attention in healthy people. When forgetfulness and trouble focusing bother you, sleep, physical activity, and treating the underlying cause help more – for example iron deficiency, thyroid problems, or anxiety. Glycine is safe in this role, but do not take it instead of an approach with proven benefit, so you don't miss the treatment you actually need.
DL-theanineNot recommended · Amino acid from green tea leaves (Camellia sinensis), supplementL-theanine with caffeine is marketed as a «focus stack» (Mind Lab Pro, Alpha Brain and analogues) promising «better focus without jitter». Several small RCTs showed modest improvement in reaction time and attention accuracy with L-theanine 100–200 mg + caffeine 50–100 mg versus caffeine alone in healthy volunteers. The effect is short-lived and comparable to one cup of green tea (about 25–50 mg L-theanine and 30 mg caffeine). EFSA 2011 approved no cognitive claim for L-theanine. No data in ADHD, Alzheimer or vascular dementia. If L-theanine was recommended as a stimulant substitute for ADHD, consider seeking a second opinion.
DL-threonine + pyridoxine (Biotredin)Not recommended · Combined metabolic preparations (local classification). Russian development.Biotredin combines L-threonine and pyridoxine (vitamin B6) and is marketed to improve memory and concentration. There is no convincing evidence of benefit for this use: studies confirming an effect on memory and attention are lacking. What actually helps memory and focus is good sleep, regular physical activity, treating anxiety or depression when present, and managing vascular risk factors; if memory problems persist, see a doctor for assessment.
DLecithin (soy or sunflower phosphatidylcholine)Not recommended · Phospholipid mixture, dietary supplement. A mass OTC «memory drug» and «hepatoprotector» in Russia. Essentiale (Sanofi, essential phospholipids) is a separate regulated medicine, registered by AEMPS and in Russia for NAFLDLecithin is a source of phosphatidylcholine from soy or sunflower, marketed as a supplement for memory and concentration. There's no convincing benefit for this use: studies don't show an effect on memory or attention in healthy people. Sleep, physical activity and managing risk factors like blood pressure and blood sugar do more for memory, and persistent complaints are worth an in-person check with a doctor.
DLion's mane (Hericium erinaceus)Not recommended · Medicinal mushroom, supplement. AEMPS does not register as medicineLion's mane is widely sold as a «natural nootropic» on the NGF stimulation and neurite outgrowth hypothesis. Human evidence is limited to one small RCT Mori 2009 (Phytother Res) in 30 Japanese patients aged 50–80 with mild cognitive impairment: 3000 mg/day lion's mane powder × 16 weeks improved HDS-R (Hasegawa Dementia Scale-Revised) scores vs placebo; effect disappeared after discontinuation. No large international RCTs. MSKCC monograph 2023 classifies the evidence as «preliminary». NICE dementia 2018 (NG97) lists cholinesterase inhibitors (donepezil, rivastigmine, galantamine) and memantine first-line for Alzheimer; lion's mane is not in guidelines. If lion's mane was recommended for cognitive impairment or diagnosed dementia instead of workup and standard therapy, consider seeking a second opinion.
DLion's Mane Mushroom (Hericium erinaceus)Not recommended · Medicinal mushroom; in supplements – dried mycelium or fruiting body of Hericium erinaceus. Marketed on iHerb, Amazon, and in Spanish herbolarios as a «natural nootropic», nerve growth factor (NGF) stimulant, and remedy for dementia, anxiety, and ADHD. AEMPS does not register it as a medicine; AESAN classifies it as a complemento alimenticio without therapeutic indication. FDA has no approved indication.Lion's mane is an edible mushroom marketed as a «natural nootropic» and «nerve growth factor stimulant» for memory, concentration, and productivity. The evidence base is weak. The double-blind RCT by Mori (Phytother Res 2009) in 30 Japanese patients aged 50–80 with mild cognitive impairment showed a 1.3-point improvement on the HDS-R scale after 16 weeks of 3 g/day of dried lion's mane powder and a return to baseline 4 weeks after discontinuation – the clinical significance of this difference is debatable. The open-label Saitsu trial (Biomed Res 2019) in 31 adults aged 50–80 reported cognitive improvement after 12 weeks – without placebo control or blinding. In healthy adults without cognitive decline, in young users for «productivity», or in students before exams, lion's mane has not been studied for memory or concentration – no RCTs. NCCIH lists lion's mane among supplements without proven cognitive benefit. Real evidence-based interventions for memory and concentration are aerobic activity 150 minutes per week, a Mediterranean or MIND diet, 7–9 hours of sleep, treatment of sleep apnoea, correction of B12 and iron deficiency, and alcohol moderation. If lion's mane was bought «for the brain», consider seeking a second opinion – memory complaints warrant ruling out depression, hypothyroidism, B12 deficiency, and sleep disorders rather than taking mushroom powder.
DMagnesium L-threonate (Magtein)Not recommended · Magnesium chelate with L-threonic acid in a specific stoichiometry; the patented Magtein form, developed as a Stanford / MIT spinout; sold as a «magnesium for the brain» supplementMagnesium L-threonate is marketed as «magnesium for the brain», citing preclinical data on raised CSF magnesium and synapse density in rodents. The pivotal human study is Liu 2016: 44 patients aged 50–70 with mild cognitive impairment, open control arm, Magtein-sponsored, 12 weeks, with improvement on a composite cognitive test. The small sample size, conflict of interest and absence of independent replication are serious limitations. NIH ODS maintains a general magnesium monograph but has not issued specific guidance on the L-threonate form. EFSA 2010 approved a generic magnesium health claim for normal nervous function – it applies to every form of magnesium (citrate, glycinate, oxide, threonate), not only Magtein. No head-to-head RCTs of glycinate vs threonate in humans exist. For memory and concentration the evidence supports physical activity, sleep hygiene, BP and glucose control, not an expensive magnesium form.
DN-acetyl-L-tyrosineNot recommended · Acetylated form of L-tyrosine, marketed nootropic supplementN-acetyl-L-tyrosine (NALT) is marketed as a nootropic for memory, concentration and cognitive endurance. In 2011 EFSA did not confirm the cognitive health claim (increased attention) for L-tyrosine; it did accept a role in normal catecholamine synthesis, but that is physiology rather than a memory benefit, and the label claim remains unauthorised. The N-acetyl derivative has no separate assessment. There are no RCTs comparing NALT with placebo or with L-tyrosine on cognitive outcomes in humans. Modest RCTs of free L-tyrosine suggest short-term support for concentration under an acute stressor (sleep loss, cold, multitasking) at roughly 100–150 mg/kg, but those data concern the free amino acid rather than NALT and address acute performance, not memory improvement in the general population. Biologically NALT must be deacetylated to tyrosine before entering the brain. In comparative animal pharmacology NALT was the least effective tyrosine prodrug, and there are no direct human data on how completely this conversion occurs, so the marketing claim of better bioavailability is not supported. If memory bothers the patient, start with sleep hygiene, ferritin, B12 and thyroid checks and discuss the request with a doctor before spending money on NALT.
DNicotinamide mononucleotide (NMN)Not recommended · Dietary supplements, NAD+ precursors (local classification)Nicotinamide mononucleotide (NMN) is a precursor of the coenzyme NAD+, sold as a supplement for memory, focus and "brain rejuvenation". For memory and concentration the benefit has not been proven: there is no good evidence base for this use. Taken this way, NMN is well tolerated and carries no serious risk. What actually helps cognition is sleep, physical activity and treating the underlying cause of the complaints, whether vitamin B12 deficiency, depression or a sleep disorder
DNicotinamide riboside (NR)Not recommended · Dietary supplements, NAD+ precursors (local classification)Nicotinamide riboside (NR) is a form of vitamin B3 and a precursor to the coenzyme NAD+. It is marketed as a supplement for memory, focus, energy, and "anti-aging." For memory and concentration, no convincing benefit has been shown, and there is no good-quality evidence behind this use. If memory or focus is slipping, the cause is worth tracking down with a doctor: sleep loss, stress, thyroid problems, or low B12 or iron are common culprits, and treating the actual cause is what helps. Do not take this supplement in place of evaluation and proven treatment, since that can delay care for a condition that does respond to therapy.
DPanax ginseng (Korean/Chinese ginseng)Not recommended · Plant adaptogen, supplement. In EU – traditional herbal medicinal product (EMA HMPC); OTC tincture in RussiaGinseng is sold as a «natural nootropic» promising memory, attention and cognitive improvement in students and the elderly. Cochrane 2010 (Geng) reviewed 9 RCTs totalling 600 patients: ambiguous effect on cognitive tests; no proven benefit in Alzheimer or vascular dementia. NICE dementia 2018 (NG97) lists cholinesterase inhibitors (donepezil, rivastigmine, galantamine) and memantine first-line for Alzheimer and vascular dementia; ginseng is not in guidelines. If ginseng was recommended for cognitive impairment or diagnosed dementia, consider seeking a second opinion.
DPhosphatidylserineNot recommended · Phospholipid (soy- or bovine-derived) supplement, marketed for age-related memory decline and cognitive biohackingPhosphatidylserine is a cell-membrane phospholipid sold as a supplement for memory, focus, and mental clarity. Studies have not shown convincing benefit for this use, and there is no solid evidence that it improves cognition in healthy people. When memory or attention is a concern, other things help: good sleep, regular exercise, treating anxiety or depression, keeping blood pressure and blood sugar in check, and a medical workup for persistent problems to find the cause. The substance is harmless in this role, but don't take it in place of an approach with proven benefit, or you risk missing real treatment.
DPterostilbene (dimethyl resveratrol analogue)Not recommended · Plant stilbene, supplement. Natural polyphenol from blueberries, grapes and red sandalwood. Often sold combined with nicotinamide riboside (NR) in longevity complexesPterostilbene is a natural polyphenol, a dimethylated analogue of resveratrol. It is marketed as a supplement to improve memory and concentration. So far it has not shown convincing benefit for this use: there is no solid evidence for an effect on cognition in people. What actually helps memory and focus is sleep, regular physical activity, and managing vascular risk factors; for persistent complaints it makes sense to discuss the cause with a doctor.
DPyrroloquinoline quinone (PQQ)Not recommended · Dietary supplements, redox cofactors (local classification)Pyrroloquinoline quinone (PQQ) is sold as a supplement for memory and concentration. In people, no convincing benefit for this use has been shown – the evidence for it is missing. What actually helps memory and attention is sleep, physical activity, treating underlying causes (such as iron deficiency or thyroid problems) and managing vascular risk factors. Do not take PQQ instead of an approach with proven benefit, or you may miss the treatment you need.
DResveratrolNot recommended · Dietary supplements, plant polyphenols (local classification)Resveratrol is a polyphenol from grapes and red wine, sold in supplements for memory and focus. Studies have not shown convincing benefit for this use: it does not meaningfully improve attention or memory in people. What actually supports memory and concentration is sleep, physical activity, and keeping blood pressure and blood sugar in check; for persistent complaints, see a doctor.
DSchisandra chinensis (magnolia berry)Not recommended · Plant adaptogen, supplement. In EU – EMA HMPC assessment 2024; OTC tincture in RussiaSchisandra (Schisandra chinensis) is a herbal adaptogen; extracts of its berries and seeds are sold in supplements as an aid for memory, focus and mental performance. No convincing benefit has been shown for this use: there is no solid human research on its effect on memory or concentration. The plant itself is generally well tolerated at usual doses, but its value as a cognitive enhancer is unproven. Memory and attention respond most reliably to regular sleep, physical activity and treating the conditions that get in the way of focus, such as iron deficiency, anxiety or depression.
DSemax (Met-Glu-His-Phe-Pro-Gly-Pro)Not recommended · Neuropeptides and nootropics (local classification). Russian development.Semax is a synthetic peptide (an ACTH fragment without hormonal activity), sold in Russia as nasal drops and promoted to improve memory and concentration. Clear benefit for this use has not been shown: the data come from small, low-quality studies, and international guidelines do not list the drug. When memory or focus slips, it helps more to find the cause (poor sleep, stress, iron or B12 deficiency, thyroid problems, depression) and to keep up steady sleep and physical activity – worth discussing with your doctor
DSpermidineNot recommended · Dietary supplements, polyamines (local classification)Spermidine is a natural polyamine sold as a supplement for memory and focus, citing its role in autophagy and animal studies. In people, no convincing benefit for memory or attention has been shown, and the evidence for this use is lacking. Cognition is better supported by sleep, physical activity, and controlling blood pressure and glucose, with a medical check-up if memory problems persist.
DSulforaphane (isothiocyanate from broccoli sprouts)Not recommended · Plant isothiocyanate, supplement. Formed from glucoraphanin (Brassica oleracea) by myrosinase. Activator of the Nrf2-Keap1 pathwaySulforaphane is sold as a «natural neuroprotector» and memory/concentration enhancer. Several small RCTs showed moderate reduction of neuroinflammation markers and cognitive scale improvement in patients with schizophrenia and mild cognitive impairment, but sample sizes were 20–40 subjects. NICE dementia 2018 (NG97) lists cholinesterase inhibitors (donepezil, rivastigmine, galantamine) and memantine first-line for Alzheimer and vascular dementia; sulforaphane is not mentioned. In healthy adults no native cognitive function effect is proven. If sulforaphane was recommended for cognitive impairment or diagnosed dementia, consider seeking a second opinion from a neurologist.
DUrolithin A (ellagitannin metabolite, mitophagy activator)Not recommended · Ellagitannin metabolite, supplement. Formed by gut microbiota from ellagitannins in pomegranates, walnuts and raspberries. Synthetic form Mitopure (Amazentis) is patented and sold in EU and USUrolithin A is a metabolite of ellagitannins (gut bacteria make it from pomegranate, berries, and nuts) marketed as a mitophagy activator and a supplement for memory and focus. It hasn't shown convincing benefit for this use: there's no solid human evidence that it improves cognitive function. Memory and attention respond to other things – steady sleep, physical activity, treating anxiety and depression, managing vascular risk factors. The compound is harmless in this role, but don't use it in place of approaches with proven benefit, since that risks missing the treatment you actually need.
FAtomoxetineNot recommended · Centrally acting sympathomimeticsAtomoxetine is a selective norepinephrine reuptake inhibitor. It is prescribed only for attention-deficit/hyperactivity disorder (ADHD) in children over 6 and adults (AAP 2019 and AAFP 2020 guidelines). Healthy students and knowledge workers take atomoxetine as a cognitive stimulant outside an ADHD indication. No clinical studies in healthy adults exist; an effect on cognition in people without ADHD has not been confirmed. The drug has specific risks: FDA boxed warning for suicidal thoughts in children and adolescents, hepatotoxicity with risk of acute liver injury, and elevated blood pressure and heart rate. If atomoxetine is being taken for concentration outside an ADHD indication, consider seeking a second opinion.
FBetahistineNot recommended · Histamine analogue, antivertigo agentBetahistine is a histamine analogue prescribed for Meniere's disease and peripheral vestibular vertigo (AAN 2017 guidelines and AEMPS Ficha Técnica). Evidence quality for Meniere's disease is modest: the Cochrane review by Murdin 2016 found low-quality evidence. For cerebral circulation improvement or cognitive decline in older adults, betahistine is not used: no clinical studies of such use exist. Vascular cognitive dysfunction is managed not by vasodilators but by blood-pressure control, lipid management, smoking cessation, physical activity, and cognitive training. If betahistine was prescribed for memory improvement or brain circulation, consider seeking a second opinion.
FCholine alfoscerateNot recommended · Other nervous system drugs. ParasympathomimeticsAlpha-GPC is sold in the biohacking segment as a «natural memory and focus nootropic» for healthy adults and students. No evidence base in cognitively healthy people without a dementia diagnosis: Fioravanti 2005 and ASCEND-S 2021 RCTs were conducted in patients with already confirmed cognitive impairment, not in healthy participants. EFSA has not approved any memory or concentration health claim for choline compounds in healthy adults. NIH ODS 2024 lists adequate choline intake for adults at 425–550 mg/day from all food sources without rationale for clinical benefit from high doses. If alpha-GPC was recommended for subjective memory decline without neurological workup (MMSE, MoCA, CT/MRI when needed, depression screening, sleep check, TSH), consider seeking a second opinion.
FCinnarizineNot recommended · Calcium channel blocker with antihistamine activityCinnarizine is a calcium channel blocker prescribed widely in Russia to older adults for cerebral malnutrition, cognitive decline, and brain circulation improvement. Cinnarizine is not approved in the US or UK. The AEMPS Ficha Técnica limits cinnarizine to vertigo and Meniere's disease. Cochrane reviews do not support cinnarizine for vertebrobasilar insufficiency as an independent diagnosis. In older adults the drug causes parkinsonian symptoms: tremor, rigidity, slowed movement, depression, sometimes persisting after discontinuation. If cinnarizine was prescribed for brain circulation or memory, consider seeking a second opinion.
FCortexin (bovine brain cortex polypeptides)Not recommended · Other psychostimulants and nootropics (local classification)Cortexin is a peptide preparation derived from cattle cerebral cortex. It is not included in international clinical guidelines (AAN, ESO, NICE), and the FDA and EMA have not approved it. The diagnosis of dyscirculatory encephalopathy, which is the most common reason cortexin is prescribed in Russia, does not exist in international neurology or in ICD-11. There are no convincing independent clinical studies of efficacy in cognitive impairment. For prevention of vascular cognitive impairment: blood-pressure control, lipid management, smoking cessation, physical activity, cognitive training; for confirmed dementia: acetylcholinesterase inhibitors (donepezil, rivastigmine) and memantine. If cortexin was prescribed for memory improvement, after stress, or for dyscirculatory encephalopathy, consider seeking a second opinion.
FDexketoprofenNot recommended · Non-steroidal anti-inflammatory drugs, propionic acid derivativesDexketoprofen is a nonsteroidal anti-inflammatory drug (NSAID). It is prescribed for short-term symptomatic treatment of acute pain (AEMPS Ficha Técnica). For unconfirmed migraine, any headache, or vigor in fatigue, dexketoprofen is not used: for migraine, triptans and other proven options work; for fatigue, NSAIDs do not help (they are not an anti-fatigue drug). Regular dexketoprofen use creates risks of severe gastrointestinal bleeding, perforation, cardiovascular events, and acute kidney injury. If dexketoprofen was prescribed for migraine or vigor, consider seeking a second opinion.
FDextromethorphanNot recommended · Centrally acting cough suppressantDextromethorphan is a cough suppressant and NMDA-receptor antagonist. It is used for symptomatic treatment of dry cough during respiratory infections (AAFP 2020 and CDC guidelines). In biohacker circles, dextromethorphan is taken at high doses as an antidepressant and for altered states of consciousness with empathogenic effects. The FDA issued a 2010 warning about severe side effects with abuse: serotonin syndrome (especially in combination with SSRI or MAOI antidepressants), psychosis, motor disturbances, and acetaminophen-related hepatotoxicity in combination products. High-dose dextromethorphan is a psychoactive substance with abuse potential. If dextromethorphan is being taken for mood or cognition, consider seeking a second opinion: for depression there are drugs with confirmed efficacy.
FDonepezilNot recommended · Selective reversible acetylcholinesterase inhibitorDonepezil is a cholinesterase inhibitor. It is prescribed only for mild-to-moderate Alzheimer's disease (AAN 2018 and NICE NG97 guidelines). In biohacker communities, donepezil is promoted as a cognitive enhancer for healthy students and knowledge workers. Clinical studies in healthy adults have not shown improvement in memory or attention. The drug carries serious risks: bradycardia, syncope, nausea, vomiting, diarrhea, weight loss, and seizures. In healthy people these risks are not justified. If donepezil was recommended for memory improvement in a healthy person, consider seeking a second opinion.
FFlunarizineNot recommended · Selective calcium channel blocker, antivertigo and migraine prophylaxis agentFlunarizine is a calcium channel blocker related to cinnarizine. It is prescribed for migraine prophylaxis and vestibular vertigo (AAN 2012 guidelines and AEMPS Ficha Técnica). For cerebral circulation improvement or cerebral malnutrition in older adults, flunarizine is not used: no clinical studies of such use exist. The drug has serious risks in older adults: extrapyramidal symptoms (parkinsonism, tardive dyskinesia), depression, and pronounced weight gain. If flunarizine was prescribed for brain circulation or cognitive decline, consider seeking a second opinion.
FGalantamineNot recommended · Acetylcholinesterase inhibitor with allosteric nicotinic modulationGalantamine is a cholinesterase inhibitor originally isolated from the snowdrop. It is prescribed only for mild-to-moderate Alzheimer's disease (AAN 2018 and NICE NG97 guidelines). In biohacker circles, galantamine is promoted as a natural nootropic and as an enhancer of lucid dreams. No clinical studies in healthy adults confirm an effect on memory or dreams. Galantamine's availability as a dietary supplement in Eastern Europe does not change its prescription-only status in the EU or its risks: bradycardia, syncope, nausea, vomiting, diarrhea. If galantamine was recommended for memory or lucid dreaming, consider seeking a second opinion.
FGinkgo biloba extractNot recommended · Herbal agents for cognitive disordersGinkgo biloba extract is a popular over-the-counter supplement marketed for memory. Systematic reviews in people without dementia find no convincing effect on memory or attention: either no difference from placebo, or a small effect in heterogeneous studies with high risk of bias. International guidelines (AAN, NICE) do not support ginkgo for age-related memory decline or dementia prevention. For everyday forgetfulness, it is more useful to check sleep, blood pressure, vitamin B12, and thyroid function: the cause is often there. Ginkgo is relatively safe but increases bleeding risk (inhibits platelet aggregation): combining with anticoagulants, antiplatelets, or NSAIDs is dangerous. If ginkgo was recommended for memory improvement, consider seeking a second opinion: the money is likely wasted.
FHopantenic acid (calcium hopantenate)Not recommended · Nootropics (local classification). Russian and Japanese development.Hopantenic acid (Pantogam) is an analogue of pantothenic acid with a GABAergic component, developed in the USSR. It is registered in Russia for cognitive impairment in adults and children. The evidence base is limited to in-house Russian studies. There are no independent international clinical studies with endpoints on validated scales (MMSE, MoCA, ADAS-Cog). After voluntary withdrawal from sale in Japan in 1989, the drug is not used outside the post-Soviet region. International clinical guidelines (AAN, Alzheimer's Association) do not include Pantogam. If Pantogam was prescribed to a child or adult for memory, consider seeking a second opinion.
FHuperzine A (Huperzia serrata)Not recommended · Alkaloid of Chinese club moss (Huperzia serrata, Lycopodium serratum), a selective reversible acetylcholinesterase inhibitor. Registered as a prescription medicine Shuangyiping for Alzheimer disease in China. No marketing authorisation in the EU or USA; sold as a dietary supplementHuperzine A is sold in the biohacking segment as a «natural memory and learning nootropic» for healthy adults and students. No evidence base in cognitively healthy people without a dementia diagnosis: Yang 2013 RCTs were conducted in Alzheimer patients, not in healthy participants. Taking an AChE inhibitor without a cholinergic deficit has no rational basis – the same pharmacological logic as donepezil, with similar potential risks (bradycardia, raised BP, nausea, muscle cramps, sleep disruption). If huperzine A was recommended for subjective memory decline in a young adult without workup (rule out anaemia, TSH, depression, sleep apnoea, vitamin B12 and D deficiency), consider seeking a second opinion.
FKetorolacNot recommended · Non-steroidal anti-inflammatory drugs (NSAIDs)Ketorolac is a short-acting nonsteroidal anti-inflammatory drug (NSAID). It is prescribed for moderate-to-severe acute pain, primarily postoperative, for a maximum of 5 days (AEMPS Ficha Técnica). For unconfirmed migraine and any headache, ketorolac is not used as first-line (NICE NG150 2021, AHS 2021): for migraine, triptans and other proven options work; for tension-type headache, paracetamol or ibuprofen at usual doses. Ketorolac has serious risks: severe gastrointestinal bleeding and perforation, acute kidney injury, and cardiovascular events. These risks are not justified for ordinary headache. If ketorolac was prescribed for migraine or any headache, consider seeking a second opinion.
FLacosamideNot recommended · Antiepileptic – selective sodium channel modulatorLacosamide is an antiepileptic drug prescribed for focal epilepsy (AAN 2018 guidelines). In biohacker circles, lacosamide is sometimes promoted as a nootropic with sodium-channel modulation for healthy adults. No clinical studies in healthy adults exist. The drug has specific risks: PR-interval prolongation and atrioventricular block (especially in people with cardiac disease), dizziness, nausea, and double vision. If lacosamide was recommended for concentration or brain function in a healthy person, consider seeking a second opinion.
FLevetiracetamNot recommended · Antiepileptics (other)Levetiracetam is an antiepileptic drug promoted in biohacker circles as a mild attention stabilizer or anti-anxiety agent for people without epilepsy. The rationale rests on two small studies in patients with mild cognitive impairment due to Alzheimer's disease (Bakker 2012, Vossel 2021) and on its sedative side effect. International guidelines for anxiety disorders (NICE NG87, APA, WFSBP) and for mild cognitive impairment (AAN 2018) do not mention levetiracetam. There are no clinical studies in healthy adults for concentration improvement or anxiety reduction. The side-effect profile (irritability, depression, behavioral disturbances up to suicidal risk, FDA boxed warning) is not justified in people without epilepsy. If levetiracetam was prescribed for concentration or anxiety, consider seeking a second opinion.
FMemantineNot recommended · Non-competitive NMDA receptor antagonistMemantine is an NMDA receptor antagonist. It is prescribed for moderate-to-severe Alzheimer's disease (AAN 2018 and NICE NG97 guidelines; the Cochrane review by McShane 2019 confirms benefit only at these stages). For healthy adults as a nootropic or memory enhancer, memantine does not work: clinical studies in people without dementia have not shown improvement in cognitive function. The drug has specific risks: dizziness, confusion, elevated blood pressure, and headache. If memantine was recommended to a healthy person for memory, consider seeking a second opinion.
FMethylphenidateNot recommended · Centrally acting psychostimulantMethylphenidate is a psychostimulant prescribed for attention-deficit/hyperactivity disorder (ADHD) in children over 6 and adults, and for narcolepsy (AAP 2019 and AAFP 2020 guidelines). Healthy students, programmers, and knowledge workers often take methylphenidate as a cognitive stimulant. The Repantis 2010 meta-analysis showed only a minimal effect on working memory and attention in healthy adults, far less than in genuine ADHD. Methylphenidate is a Schedule II controlled substance in the US because of high abuse potential. Use carries risks of hypertension, tachycardia, insomnia, appetite loss, anxiety, psychosis at high doses, and dependence. If methylphenidate is being taken for work concentration outside an ADHD indication, consider seeking a second opinion.
FMethylthioninium chloride (methylene blue)Not recommended · Antidotes (V03AB17). The drug has one FDA-approved indication – methaemoglobinaemia. Biohacker use is off-label.Methylene blue (methylthioninium chloride) is a dye and a drug approved for methemoglobinemia and, in some countries, for cyanide poisoning. In biohacker channels, methylene blue is taken in low oral doses as a nootropic for memory and concentration and marketed as a mitochondrial support agent. There are no published clinical studies in healthy adults with endpoints on validated cognitive scales (MMSE, MoCA), only one small functional MRI study (Rodriguez 2016, n=26). The FDA, EMA, and AEMPS have not approved methylene blue for these uses. Methylene blue is a monoamine oxidase inhibitor: combining it with SSRI, SNRI, or TCA antidepressants or with triptans can cause life-threatening serotonin syndrome. In people with G6PD deficiency it can trigger hemolytic anemia. If methylene blue was recommended for memory, mitochondria, or stress, consider seeking a second opinion, especially if you take antidepressants.
FNicotineNot recommended · Nicotine replacement therapy for tobacco dependenceNicotine in patches, gum, and snus is taken by healthy non-smoking adults as a cognitive enhancer for concentration. USPSTF 2021 limits nicotine replacement therapy to patients with tobacco dependence for smoking cessation. Nicotine is a highly addictive substance that can produce dependence even in non-smokers, sometimes quickly. Use carries risks of nicotine dependence, elevated blood pressure, increased heart rate, headache, and nausea. In young adults nicotine disrupts prefrontal cortex development. If nicotine is being taken for concentration, consider seeking a second opinion: attention problems usually have other causes (sleep deprivation, ADHD, anxiety) treated per diagnosis.
FNoopept (N-phenylacetyl-L-prolylglycine ethyl ester)Not recommended · Nootropics (local classification). Russian development.Noopept is a Russian synthetic nootropic promoted in biohacker and student communities as a new-generation drug for concentration before exams or deadlines. Outside Russia it is sold through grey-market channels as a dietary supplement. There are no independent international clinical studies in healthy adults: effects on working memory, attention, or productivity have not been confirmed. The FDA, EMA, and AEMPS have not approved noopept. It is not included in any international clinical guidelines. If noopept was recommended for concentration, exam preparation, or after a head injury, consider seeking a second opinion: there is no evidence base for these uses.
FPhenylpiracetam (fonturacetam)Not recommended · Nootropics (local classification). Russian development.Phenylpiracetam (fonturacetam) is a nootropic drug developed in the USSR. It is not included in any international clinical guidelines and has not been approved by the FDA, EMA, or AEMPS. In biohacker and student communities, phenylpiracetam is used as a Russian modafinil alternative before exams, deadlines, and night shifts. There are no independent international clinical studies in healthy adults: effects on productivity, concentration, or reaction time have not been confirmed. Tolerance develops rapidly: the claimed psychostimulant effect fades after 2–3 weeks of regular use. If phenylpiracetam was prescribed for concentration or productivity, consider seeking a second opinion.
FPiracetamNot recommended · Old «nootropics» (local classification)Piracetam is the original nootropic drug, developed in the 1960s. International clinical guidelines (AAN, ESO, NICE) do not include piracetam for age-related memory decline, dementia, or chronic cerebral ischemia. The diagnosis of dyscirculatory encephalopathy, which is the most common reason piracetam is prescribed in Russia, does not exist in international neurology or in ICD-11. For memory complaints without diagnosed dementia, piracetam does not work: there are no convincing clinical studies. For confirmed Alzheimer's dementia, other drugs are used: acetylcholinesterase inhibitors (donepezil, rivastigmine) and memantine. For prevention of vascular cognitive impairment: blood-pressure control, lipid management, smoking cessation, physical activity, cognitive training. If piracetam was prescribed for memory improvement, for dyscirculatory encephalopathy, or after stress, consider seeking a second opinion.
FPiracetam + cinnarizineNot recommended · Combination nootropic (local classification)Phezam is a combination of piracetam and cinnarizine developed for the Russian diagnoses chronic cerebral ischemia, dyscirculatory encephalopathy, and vegetative-vascular dystonia, none of which exist in ICD-11 or international neurology. International clinical guidelines (AAN, ESO, AHA/ASA, NICE) do not mention either the combination or its components for cognitive impairment. In elderly patients, cinnarizine can cause parkinsonian symptoms: tremor, rigidity, slowed movement, which sometimes persist after the drug is stopped. For memory complaints or dizziness attributed to blood pressure, it is more useful to check blood pressure, hemoglobin, B12, thyroid function, and screen for depression. If Phezam was prescribed for memory improvement or dyscirculatory encephalopathy, consider seeking a second opinion.
FPregnenoloneNot recommended · Endogenous C21 steroid precursor; sold as a supplement on iHerb and Amazon; not registered as a drug in the EUPregnenolone is marketed as the «number one nootropic» and a «memory drug». No quality RCTs in healthy adults with memory and cognitive endpoints exist. The Moriguchi 2017 systematic review found only small trials in schizophrenia and bipolar disorder with conflicting results – not a basis for recommending the substance to healthy people. AEMPS and EMA have not registered pregnenolone as a nootropic. Evidence-based options for memory and concentration are physical activity, sleep hygiene, BP and glucose control, learning and anxiety reduction. Memory complaints require in-person evaluation by a neurologist or general practitioner.
FRasagilineNot recommended · Selective irreversible monoamine oxidase B inhibitorRasagiline is a selective monoamine oxidase B (MAO-B) inhibitor. It is prescribed only for Parkinson's disease as monotherapy in early stages or as add-on to levodopa (AAN 2018 and MDS 2018 guidelines). In biohacker circles, rasagiline is promoted as a neuroprotectant for life extension. The ADAGIO 2009 trial did not confirm a disease-modifying effect. There are no clinical studies in healthy adults. The drug has specific risks: orthostatic hypotension, hypertensive crises when combined with tyramine-rich foods at high doses (aged cheeses, fermented foods, soy sauce), and serotonin syndrome when combined with antidepressants. If rasagiline was recommended for longevity, consider seeking a second opinion.
FRivastigmineNot recommended · Acetyl- and butyrylcholinesterase inhibitorRivastigmine is an inhibitor of both acetylcholinesterase and butyrylcholinesterase. It is prescribed only for mild-to-moderate Alzheimer's disease and for Parkinson's disease dementia (AAN 2018 and NICE NG97 guidelines). In biohacker circles, rivastigmine is promoted as a dual cholinesterase inhibitor for memory enhancement in healthy adults. No clinical studies in healthy adults confirm an effect on memory. The drug has serious risks: bradycardia, gastrointestinal effects (nausea, vomiting, diarrhea, marked weight loss), and skin reactions at the patch site. If rivastigmine was recommended to a healthy person for memory, consider seeking a second opinion.
FRizatriptanNot recommended · Selective 5-HT1B/1D serotonin receptor agonistRizatriptan is a triptan with indications similar to sumatriptan. It is prescribed for migraine and cluster headache (NICE NG150 2021 and AHS 2021 guidelines). For severe tension-type headache, premenstrual headache, or hangover headache without confirmed migraine, rizatriptan is not used: regular use for non-migraine pain provokes medication-overuse headache. Triptans are contraindicated in ischemic heart disease, prior stroke, and uncontrolled hypertension. If rizatriptan was prescribed for any severe headache without confirmed migraine, consider seeking a second opinion.
FSumatriptanNot recommended · Selective 5-HT1B/1D serotonin receptor agonistSumatriptan is a triptan (a serotonin 5-HT1B/1D receptor agonist). It is prescribed for migraine and cluster headache (NICE NG150 2021, AHS 2021, and AEMPS Ficha Técnica). For tension-type headache, stress-related headache, hangover, or premenstrual headache, sumatriptan is not indicated and may worsen the picture: regular use for non-migraine headache provokes medication-overuse headache. The drug is contraindicated in ischemic heart disease, prior stroke, and uncontrolled hypertension; coronary vasospasm has been reported in susceptible patients on triptans. If sumatriptan was prescribed for any severe headache outside a migraine or cluster headache indication, consider seeking a second opinion.
FVinpocetineNot recommended · Psychostimulants and nootropics. Other psychostimulants and nootropicsVinpocetine is a derivative of vincamine (a periwinkle alkaloid) sold in Russia and several Eastern European countries as a brain circulation and memory enhancement agent. In 2019 the FDA explicitly excluded vinpocetine from the dietary supplement category and warned of pregnancy-loss risk in women of reproductive age. International clinical guidelines (AAN, NICE, Alzheimer's Association) do not include vinpocetine. For memory complaints in older adults, the evidence-based approach is blood-pressure control, lipid management, smoking cessation, physical activity, cognitive training, depression screening, and review of medication side effects. If vinpocetine was prescribed for memory or vascular support, consider seeking a second opinion.
FVortioxetineNot recommended · Multimodal antidepressantVortioxetine is an antidepressant with a multimodal mechanism of action. It is prescribed for major depression (APA 2022 and NICE NG222 guidelines). The manufacturer promotes vortioxetine as a drug for improving cognitive function in patients with depression, and this idea has spilled over into marketing for healthy adults seeking better concentration. There are no clinical studies in people without depression, and the FDA label does not mention cognitive improvement in non-depressed patients. The drug carries standard antidepressant risks: pronounced nausea (especially in the first weeks), sexual dysfunction, discontinuation syndrome, and increased suicide risk in young adults (FDA boxed warning). If vortioxetine was prescribed for concentration improvement or brain function outside a depression indication, consider seeking a second opinion.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit