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Best Nootropics for ADD & ADHD: 10 Alternatives to Adderall®

WARNING: The substances mentioned in this article are not approved by the FDA, we only list them for information purposes. They should NOT, and I repeat NOT, be used as replacements for a true and tested ADHD treatment. Our website and all the websites listed in this article are not responsible for errors, omissions, or for any outcomes related to the use of the contents of this article.

Attention Deficit Disorder with or without hyperactivity (ADD, ADHD) is one of the most commonly diagnosed disorders in children between 6 and 12 years of age. It is especially problematic for those attending school, as it adds an extra barrier that both students and teachers must overcome. There are various popular forms of medication in the amphetamine class used to treat these attention disorders. These medications are typically quite effective in alleviating attention deficits, but they carry with them the possibility of addiction and dependence.[1]

Attention Deficit Disorders

Two of the most commonly used drugs for the treatment of ADHD in children and adolescents are Adderall (amphetamine/dextroamphetamine) and Ritalin (methylphenidate).[2] Many people seek alternatives to classical stimulants because they know of potential adverse effects or want to avoid using potent phenethylamine derivatives on their own children or themselves. For this reason, we will investigate the potential benefits of nootropics in the treatment of attention disorders.

The most common nootropics that people use as alternatives to amphetamines are racetam drugs, modafinil and noopept. These nootropics have been demonstrated to have positive effects on cognition, but it is necessary to personalize treatment for each individual, evaluating if the course of treatment is actually working for them. It should be noted that the onset and duration of action of nootropics (as well as their effectiveness) can vary greatly. It would be wise to keep a journal where you take notes about the dosage and administration of nootropics you are using. Many nootropic drugs can take more than a week to establish their full effect, and dosages may need to be adjusted to achieve maximum effect.

Not all nootropics will ultimately be beneficial to those who suffer from attention deficits. However, many nootropics are well-known for their ability to improve cognition, motivation, and concentration.[3] Always consult your doctor before making adjustments to medication. Because most cognitive supplements and nootropics are stable and safe to use indefinitely, individuals who fear health risks or addiction to amphetamines may want to consider using nootropics as an alternative form of treatment.

Top 10 Nootropics for ADD & ADHD

These are the best nootropics for Attention Deficit Disorder with or without Hyperactivity, according to scientific studies and our anecdotal experience. As we frequently say in the nootropics community, your mileage may vary.

Piracetam

piracetam nootropic adhdPiracetam is considered by many to be the father of all nootropic drugs. It has a history of being used to treat dementia, Alzheimer’s Disease and other cognitive diseases that come with old age. Most research conducted on piracetam has come to the consensus that it does not have much effect on individuals who are not experiencing cognitive decline. For this reason, piracetam does not seem like an ideal alternative treatment for attention deficits. However, piracetam is extremely safe to take, and supplementation by anyone will help prevent cognitive decline before it even starts. Thus, it might be worthwhile to take piracetam alongside another medication on this list. One small study mentions a combination of atomoxetine (an ADHD medication) and Piracetam.[4][5]

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Noopept

Noopept11Noopept is a favorite among nootropic users due to its ability to improve cognition and increase the ability to focus. Although it is not technically a racetam, due to the fact that it does not contain a pyrrolidone nucleus, it is still quite similar in structure and effects. Noopept is commonly touted as having an effective dose 1000 times smaller than that or piracetam.[6] There is not very much information out there about noopept as a treatment for ADD, but experts at the Second International Congress on ADHD noted that noopept may be a very good alternative medication for attention deficits.[7] Many anecdotal reports from users have found that noopept is helpful for maintaining focus and concentration for extended periods of time.

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Phenylpiracetam

Phenylpiracetam nootropic for adhdPhenylpiracetam is a derivative of piracetam that has an additional phenyl group. It is noticeably more stimulating than piracetam, as well as more potent. An 800 mg dose of piracetam is comparable to about 100 mg of phenylpiracetam. It has been found to be effective at improving cognition and produces stimulation that may translate to improved focus.[8][9] One drawback of phenylpiracetam is that it cannot be used indefinitely, as tolerance develops relatively quickly. However, this might make it useful to cycle with another nootropic compound, or to use a few times a week alongside something else like noopept.

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Pramiracetam

pramistar-nootropic-pramiracetamPramiracetam is another derivative of piracetam. It is not as well researched as some of the more popular racetams, but it has a lot of potential as a cognitive enhancer. While there is no research that specifically addresses the issue of attention in the traditional sense, pramiracetam demonstrated and ability to help reverse scopolamine-induced attention deficits in humans[10], and anecdotal experiences on the web show that it’s effective in young subjects with ADD, but not in those with normal “baseline” performance. Even though pramiracetam still needs to see more research before anything definitive can be said, the fact that it is considered safe to use opens up the possibility of personal experimentation.

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Memantine

Memantine NootropicMemantine is another drug commonly used to treat cognitive decline, such as moderate and severe Alzheimer’s Disease. Memantine works on the glutamatergic system as an antagonist to NMDA receptors, which works to combat excitotoxicity. One of the benefits of Memantine is that it avoid the development of tolerance to a number of substances, including stimulants, caffeine, cannabis, alcohol and so on. It is therefore frequently combined with stimulants to reduce their neurotoxic effects as well as reducing tolerance to the positive effects of Adderall and Ritalin. Some research has been done on memantine’s possible effectiveness in treating ADHD (by itself, not in combination). One study found that memantine was fairly beneficial for alleviating symptoms of ADHD, but concluded that there is not enough evidence to draw any real conclusions.[11] Because of this, memantine could be a good choice to use in low doses alongside another substance on this. It must be noted that memantine acts as a dissociative at supratherapeutic doses, so proceed with caution.

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Modafinil

provigil-modafinilModafinil is a wakefulness-promoting (eugeroic) drug that is classified in many places as a prescription medication. Armodafinil, a closely related drug, consists of only the active (−)-(R)-enantiomer of modafinil, meaning it is theoretically more potent. Because of this, both drugs work in a similar fashion. Modafinil has shown a good amount of promise as an alternative treatment of ADD/ADHD. One study conducted on children found that 48% of the participants felt a significant improvement in attentive skills while on modafinil.[12] Multiple other studies have found that modafinil provides moderate increases in cognition, memory, and motivation.[13] Although modafinil’s mechanism works through modulation of dopamine, it does not seem to carry an addiction potential to the same degree as amphetamines.

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Selegiline

selegiline adhd nootropicSelegiline (L-deprenyl) is a substituted phenethylamine drug commonly used to treat Parkinson’s disease and dementia. It has also seen some use as an alternative treatment for depression. There has not been a significant amount of research done on its efficacy in treating ADHD, but one study done on a small group of 28 children with ADHD studied the treatment effects of selegiline in comparison to methylphenidate. The children treated with selegiline displayed fewer symptoms of ADHD than those treated with methylphenidate while also displaying fewer side effects.[14] This research is preliminary, but it demonstrates the selegiline displays promise as an ADHD treatment.

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Supplements

These supplements are not strong enough to treat ADD/ADHD on their own, but they can potentiate and work synergistically with the nootropic drugs mentioned above.

Choline

acetylcholineCholine is an essential nutrient and precursor to acetylcholine that can be obtained in various ways in different foods. However, the easiest way to consume ideal amounts of choline is through a supplement. CDP-Choline and Alpha GPC are generally considered to be the two most effective sources of choline for nootropic use. Because racetam drugs and noopept work through modulation of acetylcholine, taking them alongside a choline source can make them more effective.

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L-Tyrosine

L-Tyrosine is an amino acid that acts as a precursor to the neurotransmitters noradrenaline and dopamine. One study found that supplementation of both Tyrosine and 5-HTP (a serotonin precursor) helped improve ADHD symptoms in 77% of the participants.[15] Taking these supplements can help improve attention deficits by increasing levels of neurotransmitters that play a significant role in attention. Tyrosine should be taken on an empty stomach to prevent it from competing for absorption with other amino acids found in food.

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Uridine

uridineUridine is a nucleotide base that has been found to improve memory, attentiveness, cognition, and learning.[16] The majority of uridine’s cognitive benefits appear to occur with its supplementation alongside other nootropics, such as racetams and noopept. It is considered a safe substance to combine with other nootropics and medications. Although uridine can be found naturally in liver, fish, and beer, it is most commonly supplemented through a uridine compound like uridine monophosphate or triacetyluridine.

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Conclusion

There are many nootropics, pharmaceuticals, and supplements that show significant promise for treating attention deficits. These substances are definitely worth looking into for those who are wary of amphetamines and the side effects and addictive potential they entail. In the end, the efficacy of each of these substances will vary between each individual and cautious experimentation will maximize the potential of finding an effective treatment regimen.

References   [ + ]

1. What is Attention Deficit Hyperactivity Disorder (ADHD, ADD)?
2. Methylphenidate
3. Gouliaev, A. H., & Senning, A. (1994). Piracetam and other structurally related nootropics. Brain Research Reviews, 19(2), 180–222.
4. Zavadenko, N. N., & Suvorinova, N. I. (2008). [Atomoxetine and piracetam in the treatment of attention deficit hyperactivity disorder in children]. Zhurnal Nevrologii I Psikhiatrii Imeni S.S. Korsakova / Ministerstvo Zdravookhraneniia I Meditsinskoi Promyshlennosti Rossiiskoi Federatsii, Vserossiiskoe Obshchestvo Nevrologov [i] Vserossiiskoe Obshchestvo Psikhiatrov, 108(7), 43–47.
5. Baumgaertel, a. (1999). Alternative and controversial treatments for attention-deficit/hyperactivity disorder. Pediatric Clinics of North America, 46(5), 977–992.
6. [The original novel nootropic and neuroprotective agent noopept].
7. Thome, J., & Reddy, D. P. (2009). The current status of research into Attention Deficit Hyperactivity Disorder: Proceedings of the 2nd International Congress on ADHD: From Childhood to Adult Disease. Attention Deficit and Hyperactivity Disorders, 1(2), 165–74.
8. Piracetam and piracetam-like drugs: from basic science to novel clinical applications to CNS disorders.
9. Investigation into stereoselective pharmacological activity of phenotropil.
10. Pramiracetam effects on scopolamine-induced amnesia in healthy volunteers.
11. Memantine: a review of possible uses in child and adolescent psychiatry.
12. Efficacy and safety of modafinil film-coated tablets in children and adolescents with attention-deficit/hyperactivity disorder: results of a randomized, double-blind, placebo-controlled, flexible-dose study.
13. Examine.com Modafinil
14. Selegiline in the treatment of attention deficit hyperactivity disorder in children: a double blind and randomized trial
15. Treatment of attention deficit hyperactivity disorder with monoamine amino acid precursors and organic cation transporter assay interpretation
16. Cognitex supplementation in elderly adults with memory complaints: an uncontrolled open label trial.
Categories
Nootropics Piracetam Racetams

The Story and Science of Piracetam

Piracetam, the original Racetam was created as a cognitive enhancer. It is similar to GABA, a neurotransmitter from which it is derived, and it has been used to treat cognitive decline. A fair amount of evidence shows that it can enhance cognition in people who have had a decline in such. However, there is not much in the way of studies of piracetam in people who haven’t experienced such a decline.[1]

Piracetam was created in 1964 by a Belgian pharmaceutical company named UCB. The lead scientist was Dr. Corneliu E. Giurgea, who came up with the term nootropic to describe piracetam and other similar compounds. In the 1970’s, UCB released Nootropil, the trade name for Piracetam. Nootropil is currently used in Europe.[2]

Mechanisms of Action

The basic mechanism of piracetam is not well established. However, it does appear to be non-sedative and non-stimulatory.[3] The following are some seeming mechanisms of action.

Oxygen and glucose consumption

Piracetam increases the brain’s oxygen and glucose consumption, which may be responsible for the cognitive enhancement seen in those who are impaired. [4]
A study that looked at patients with Alzheimer’s Disease and unclassified dementia showed that piracetam increased brain glucose consumption by 8-10% in people with Alzheimer’s. No such increase was seen in the group who had unclassified dementia. [5] [6]

Glutamate receptors

Chemical structure of Piracetam

Neurotransmitters carry information between neurons. The part of the neuron that receives neurotransmitters is called a “receptor.” The glutamate receptor, as the name implies, is the receptor for the neurotransmitter, glutamate. Glutamate is not only our main excitatory neurotransmitter, but it is also the precursor of GABA, our main inhibitory neurotransmitter. In very simple terms, an inhibitory neurotransmitter has a calming effect on the brain, while an excitatory neurotransmitter has a stimulant effect, and the body needs both in the right quantities to operate correctly.

Glutamate receptors are important for forming memories and learning. AMPA receptors are a type of glutamate receptors that are involved in memory storage. Piracetam acts upon the Glu2 and Glu3 AMPA glutamate receptors. Acting upon the Glu2 subtype of AMPA receptors seems to be a unique site for Piracetam. [7] Piracetam does not seem to interact with the Kainate and NMDA glutamate receptors.[8]

GABA receptors

As you may have guessed, GABA receptors are the neuronal receptor sites for the neurotransmitter, GABA. Despite being a GABA derivative, Piracetam does not interact with GABA receptors as best we know. [9] [10]

Increase in cellular membrane fluidity

Nootropil (Piracetam)Piracetam may restore brain mitochondrial cell membrane fluidity [11] and presumably enhance brain cell function.

Mitochondrial dysfunction may have a causative role in Alzheimer’s Disease [12] [13]. One in-vitro study looked at the hippocampus membranes of Alzheimer’s patients and noted that the fluidity of these cells improved with Piracetam. [14] Findings that Piracetam may improve the fluidity of mitochondrial membranes and thus mitochondrial function have been supported in animal models of Alzheimer disease and aging. These findings may explain some of Piracetam’s cognitive effects in aging and brain dysfunctions. [15]

It is still unclear what this means to healthy young people. Piracetam seems to improve cell membrane fluidity in the brains of aged rats, but not in young rats.[16]

Anti-platelet effect

Piracetam seems to have an antiplatelet effect [17][18][19] [20] [21] [22] [23] when administered in doses that have been used for cognitive improvement [24] [25] [26] [27]. The mechanism for such is not clear.

Conditions for which it has been used

Memory & Cognition in the Elderly

There appears to be a fair bit of evidence that Piracetam may improve memory and cognition in those who are cognitively impaired.

  • A meta-analysis of 19 double-blind, placebo-controlled trials using Piracetam in 1,488 elderly patients with cognitive impairment or dementia showed that the amount of individuals who improved was 112% higher with Piracetam vs. placebo. The studies included in this meta-analysis looked for clinically meaningful improvement. Waegemans et al concluded that this meta-analysis provided compelling evidence of piracetam’s efficacy in a diverse group of aged cognitively impaired people.[28]
  • However, Flicker et al concluded that there was not enough evidence to support the use of Piracetam for dementia or cognitive impairment and that many of the piracetam trials for dementia were flawed.[29]

Memory & Cognition in Healthy Subjects

nootropicsThere is weak evidence of cognitive benefit in young and healthy adults. Such benefit seems more apparent where cognition is not optimal, but there is not frank impairment (e.g., age-related decline). [30]

  • One small double-blinded study showed that Piracetam improved backward word recall, which implies short-term memory enhancement.[31]
  • Another study showed that healthy people improved their verbal learning by 8% vs. placebo over 21 days.[32]
  • Yet another study seemed to indicate that Piracetam improved cognition in 18 people over age 49 who had no sign of cognitive impairment. [33]

Dyslexia

Piracetam has been associated with improvements in verbal learning and comprehensive in boys with dyslexia or learning disorders.

  • A review of 11 double-blinded studies with nearly 600 boys aged 8 to 13 who had learning disorders or dyslexia showed that Piracetam improved comprehension and verbal learning.[34]
  • In one study, Piracetam improved verbal learning by 15%. [35]

Coronary Artery Bypass Surgery

Piracetam seems to prevent reduced cognition associated with coronary bypass surgery in some [36] [37] [38] but not all [39] studies.

Stroke

Human evidence is mixed on whether Piracetam can benefit recovery from stroke. [40] [41] [42] [43][44]

Safety

Piracetam appears fairly non-toxic. Adverse effects seem to be rare and of limited duration and limited to agitation, anxiety, clinical depression, drowsiness, headache, hyperkinesia, hypersexuality, insomnia, irritability, libido increase, nervousness, somnolence, tremor, and weight gain [45]. Piracetam appeared to be safe for as much as 18 months in Alzheimer’s patients. The LD50 is 5.6 grams/kg of body weight for rats and 20g/kg for mice.

Summary

A fair amount of evidence shows that Piracetam can enhance cognition in those who are impaired and that it has an excellent safety profile. However, clinical studies of Piracetam in people who haven’t experienced cognitive decline is scant.

Although how Piracetam works is not entirely clear, interaction with AMPA receptors may be one of the routes of actions. Besides, there is evidence that it increases acetylcholine production as well as enhance the brain’s consumption of glucose and oxygen and improve fluidity of mitochondrial cell membranes.

Piracetam
7
Focus
6
Mood
7.5
Memory
6
Stimulation
6
Relaxation
10
Safety
Reviewer 7.5

References   [ + ]

1, 2. S. D. Shorvon (2004). “Piracetam”. In Simon D. Shorvon, David Fish, Emilio Perucca, W E Dodson. The treatment of epilepsy. Wiley–Blackwell. pp. 489–495
3. Piracetam: physiological disposition and mechanism of action (1986)
4, 8, 30, 34, 45. Examine.com article on Piracetam
5. Effect of piracetam on cerebral glucose metabolism in Alzheimer’s disease as measured by positron emission tomography (1988)
6. Piracetam improves mitochondrial dysfunction following oxidative stress. (2006)
7. Piracetam defines a new binding site for allosteric modulators of alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA) receptors. (2010)
9. Piracetam–an old drug with novel properties? (2005)
10. Piracetam and other structurally related nootropics. (1994)
11. Piracetam: a review of pharmacological properties and clinical uses. (2005)
12. Mitochondrial dysfunction: common final pathway in brain aging and Alzheimer’s disease–therapeutic aspects. (2010)
13. Mitochondrial dysfunction: the first domino in brain aging and Alzheimer’s disease (2007)
14. Piracetam reverses hippocampal membrane alterations in Alzheimer’s disease (1999)
15. Improved mitochondrial function in brain aging and Alzheimer disease – the new mechanism of action of the old metabolic enhancer piracetam (2010)
16. Effects of piracetam on membrane fluidity in the aged mouse, rat, and human brain. (1997)
17. In-vivo platelet inhibition by Piracetam (1979)
18. Inhibitory effect of piracetam on platelet-rich thrombus formation in an animal model (1998)
19, 24. Platelet anti-aggregant and rheological properties of piracetam. A pharmacodynamic study in normal subjects. (1993)
20, 25. Treatment of Acute Ischemic Stroke With Piracetam (1997)
21. Piracetam and platelets–a review of laboratory and clinical data. (1999)
22, 26. Piracetam versus acetylsalicylic acid in secondary stroke prophylaxis. A double-blind, randomized, parallel group, 2 year follow-up study. (2000)
23, 27. Effects of acetylsalicylic acid in stroke patients. Evidence of nonresponders in a subpopulation of treated patients. (1991)
28. Clinical efficacy of piracetam in cognitive impairment: a meta-analysis (2002)
29. Piracetam for dementia or cognitive impairment. (2001)
31. Increase in the power of human memory in normal man through the use of drugs. (1976)
32, 35. Piracetam as an aid to learning in dyslexia. Preliminary report. (1979)
33. Piracetam-induced improvement of mental performance. A controlled study on normally aging individuals. (1976)
36. Effect of piracetam on cognitive performance in patients undergoing bypass surgery (2003)
37. Cerebroprotective effect of piracetam in patients undergoing coronary bypass burgery. (2008)
38. Piracetam prevents cognitive decline in coronary artery bypass: a randomized trial versus placebo. (2006)
39. Cerebroprotective effect of piracetam in patients undergoing open heart surgery. (2011)
40. Piracetam in acute stroke: a systematic review. (2000)
41. A systematic review and meta-analysis of the efficacy of piracetam and piracetam-like compounds in experimental stroke. (2008)
42. Does long term use of piracetam improve speech disturbances due to ischemic cerebrovascular diseases. (2011)
43. Piracetam improves activated blood flow and facilitates rehabilitation of poststroke aphasic patients. (2000)
44. Restitution of alpha-topography by piracetam in post-stroke aphasia. (2001)