Mind the gap: Navigating the Risks and Realities of Integrating Nootropics in Psychiatry

Abstract:

Background: Nootropics or smart drugs are dietary supplements or medications that improve cognitive performance. These include caffeine, nicotine, melatonin, stimulant medications, and herbal medicines, like Gingko biloba and Ginseng, that are often used in complementary and alternative medicine. There is evidence of nootropics being able to improve cognition in various medical conditions, including dementia, schizophrenia, and cerebrovascular accidents. As some nootropics possess neuroprotective, anxiolytic, and sedating properties, they have also been used to improve mental health and sleep and improve cognition and fatigue in the general population and also in patients undergoing treatment for cancer. They are often found in over-the-counter herbal medications, and there has been a rise in the use of nootropics overall in the general population. This has led to a concern for the inappropriate use of nootropics in healthy individuals, including students and athletes, to improve cognitive performance. Many nootropics can cause drug-drug interactions with psychotropic medications and life-threatening side effects.



Approach: This Neuropsychiatry SIG-sponsored general session will explore the rising use of nootropics in the general population about mental health. We will discuss the various classes of nootropics and the current evidence in their use as a part of complementary and alternative medicine in enhancing cognitive performance, improving symptoms of dementia, sleep, cognitive dysfunction, and fatigue in patients undergoing treatment for cancer. Our general session will also review the various side effects, drug-drug interactions, and potential misuse of nootropics to be considered by psychiatrists when it is integrated into the management of patients for their mental health.



Format:

15 min: Dr. Badr Ratnakaran, an early-career geriatric psychiatrist, will introduce the group and the subject matter, explaining the definition and historical evolution of nootropics and the current evidence for their use in improving cognition and dementia.

15 min: Dr. Timothy Kiong, an early-career consultation-liaison psychiatrist working in the psycho-oncology setting, will review the use of nootropics in improving cognition and fatigue in patients undergoing treatment for cancer.

15 min: Dr. Abhishek Reddy, an early-career child and adolescent psychiatrist trained in sleep medicine, will summarize the literature on using nootropics to improve sleep and wakefulness.

15 min: Dr. Annelise Bederman, a PGY4 resident in psychiatry, with the help of reported cases, will discuss the side effects, drug-drug interactions, and misuse related to the use of nootropics. She will conclude the presentation with considerations to be taken when nootropics are utilized in patients for improving mental health.

15 min: Questions and Answers with the audience.

Conclusion: Many nootropic medications can help improve mental health during the treatment of various medical conditions, including cancer and dementia. However, psychiatrists will need to consider the strength of evidence of the use of multiple nootropics, their side effects, and drug-drug interactions when incorporating them into the treatment of the mental health of patients.