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Notes for this blog post: 

This is a very rough edit right now, because I’m optimizing for posting content as quickly as possible and being “so prolific you don’t recognize yourself” rather than optimize for perfect editing. The reason for this is that my perfectionism and desire to talk about EVERYTHING all at once, is leading to procrastination. So, in the interest of actually getting this off the ground, I will make many posts/attempts and edit them continuously, reaching a final edit by successive approximation. Some of these posts might be quite bad and illegible – that’s okay if you don’t read them! If you like something in particular, send me an email and I’ll evolve my writings to focus on the things I like to talk about and my readers like to learn about. Thanks! – Nick

Best nootropics for ADHD, and quick explanation of what ADHD is.

The best nootropics and drugs I’ve taken for ADHD have been, in no particular order, vyvanse, phenylpiracetam, modafinil, caffeine, nicotine, kratom and oxiracetam. Obviously not all of these fall under the strict definition of “nootropic” but that discussion is for a different post. For one of the best resources into learning about nootropics, including research, quick summaries and personal accounts on experiences with many, you should check out the /r/nootropics subreddit, especially the sidebar FAQ. Here’s a quick breakdown of the pros and cons I’ve found of each:

Vyvanse: Expensive and potentially tricky to get prescribed. Vyvanse is a pro-drug of  methamphetamine which makes the experience smoother up and down unlike ritalin which feels very “methy”. Can acutely reduce libido, potential to hyperfocus on wrong thing. 

Phenylpiracetam: Need to take with a choline source, works really well if you cycle it frequently. Unfortunately tolerance builds fast. Some of my best “inspirations” or flow state of ideas came from phenylP. Easy to get from places like Nootropics depot. 

Modafinil: Takes forever to ship from India, some evidence that the pills don’t contain as much active ingredient as claimed. Will screw up your sleep cycle if it’s taken too late in the day. Some evidence it’s as effective for ADHD as stimulants without the downside of addictive potential. Can find it here: https://sharkmood.com/ (previously afinil express)

Caffeine: It’s amazing and I’m obsessed with espresso. But caffeine is easy to get addicted to and it stops working. I recommend alternate sources like Yerba Mate which has other theobromines as well as caffeine, which yields a smoother stimulation. Stack with Theanine for nice relaxing ride at the peak of the “stimulant curve”.

Nicotine: Cigarettes are extremely addicting and pleasant if you are naturally ADHD and or anxious. Risk of cancer is X, which is bad. Nicotine chewing gum could be a safe alternative, as well as vaping. Interesting drug, wish the health risks were lower. Possible to engineer safer strain?

Kratom: Almost single handedly got me through chemistry undergraduate at the Kava and Kratom bar in Asheville. Technically a mild opioid, but increases dopamine in brain which is what ADHD needs. Can make you dizzy/nauseous if you take too much. Downside is cost, easy to get addicted to and build tolerance, withdrawals can be uncomfortable if you’re not used to them. 

Oxiracetam: Less stimulating than phenylpiracetam but can be taken daily. Good start point if you don’t know anything about nootropics and don’t have access to pharmaceuticals. Non-addictive, but also not super strong. Take with a choline source. Can also stack with other racetams. Can find many nootropics here: https://nootropicsdepot.com/

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ADHD is a disorder characterized by a lack of dopamine (DA) in the prefrontal cortex, the center of the brain responsible for “Executive Action”, such as attention, focus and decision-making. The most common prescription medications are stimulants: methamphetamine salts, such as Ritalin and Adderall. Stimulants work by binding to XXXX receptors and directly increasing DA in the brain. 

Genes associated with ADHD:

Dopamine related: D2, D5, 

Like almost all other entries in the DSM-IV, ADHD is primarily diagnosed by comparing a checklist against a patient and ticking off boxes that fit. If the person has a high enough number, they can earn their diagnostic code. However, there is a much cooler way to self-diagnose: by reaction to stimulants such as caffeine. Most people have a normal amount of DA in their PFC, so adding a stimulant boosts that and they become hyperactive and possibly anxious. Those with ADHD however, finally, have enough DA in the right place to chill out. They’ll relax, sit still, do their work mostly without interruption. If you know someone who can have 8 cups of coffee and then fall asleep, congrats – I’m not a doctor and can’t diagnose people over the internet, but it sounds like a paradoxical reaction. Paradoxical reactions are opposite of what usually happens when someone takes a drug – for stimulants that means someone relaxing, less locomotion, perhaps falling asleep. But they can occur for all kinds of drugs for reasons not well understood, GABAergics can give bad anxiety, antidepressants can make you suicidal, antipsychotics can well, make you more psychotic. If you think of it in terms of the fact that drugs are like assembly programming for the brain, the really surprising thing is that these compounds have consistent effects at all rather than that they occasionally do the opposite of what we want. 

Headings Practice:

1. Introduction should be TL;DR of nootropics with clickable links to elsewhere in the essay, also include honorable mentions or “hope to try soon”.
   1. Top summary should be most important takeaways (cuz adhd remember)
   2. For honorable mentions, list maybe top 3, others buried in section
2. What is ADHD?
   1. Simple explanation: lack of DA in PFC means that Executive Actions are trickier for us.
   2. Diagnosis:
      1. Taking a history, DSM-IV or DSVM-V (should post requirements) 
      2. Paradoxical reaction to stimulants
      3. Can SPECT work? Lightly touch on Dr. Amen’s work? Basically I like the idea of using brain imaging equipment > just DSM-IV especially if it can resolve “sub-types” of psychiatric disorders in a way that improves treatment course. But the $ making makes him a bit of a pariah
      4. Genetic screens
   3. Are there “types” of ADHD?
      1. Hyperactive, Inattentive or mixed
      2. Dr. Amen 7 wacky types: Classic, Inattentive, Overfocused, Temporal lobe, Ring of Fire, Anxious, Limbic.
      3. Co-morbid as fuck with like 80 other things
   4. How often do stimulants work?
3. Medication, supplements, Nootropics:
   1. Classic stimulants for treating ADD. New drugs on the market, can tell cool story about Vyvanse prodrug. Include other medication like Concerta, wellbutrin etc
   2. What are nootropics? Quick summary
   3. Supplements
4. List of things I’ve found helpful:
   1. Vyvanse
   2. Phenylpiracetam 
   3. Modafinil 
   4. Caffeine
   5. Nicotine
   6. Kratom
   7. Oxiracetam
5. Honorable Mentions and “wish to try”
   1. Examine: https://examine.com/topics/adhd/
      1. Modafinil, Fish Oil, PS, Ginkgo, L-Car
   2. Bromantane: cool fucking structure and works VERY differently in that it upregulates DA receptors! Possibly inducing TR? Also long term effects, and very safe. 
   3. Melatonin for sleep