"George Burke has a talent for tossing back his daily cocktail  which contains vitamins minerals musclebuilding compounds some littleknown research drugs and a microdose of LSD  in almost a single gulp. Its a weird but handy trick for someone who swallows  pills a day most of them purchases off the Internet. Burke credits the regimen with giving him the cognitive edge he needs to thrive in Californias Silicon Valley where hes the cofounder of a food service that caters to athletes and fitness devotees. He used to get his edge from Adderall but after moving from New Jersey to San Francisco he says he couldnt find a doctor who would write him a prescription. Driven to the Internet he discovered a world of cognitionenhancing drugs known as nootropics  some prescription some overthecounter others available on a worldwide gray market of private sellers  said to improve memory attention creativity and motivation. Its not like every tech worker in Silicon Valley is taking nootropics to get ahead Burke acknowledges. Its the few who are getting ahead who are using supplements to do that. The word nootropic was coined in  by a Romanian scientist Corneliu Giurgea httponlinelibrary.wiley.comdoi.ddr.abstract who combined the Greek words for mind and bending. Caffeine and nicotine can be considered mild nootropics while prescription Ritalin Adderall and Provigil modafinil a drug for treating narcolepsy lie at the far end of the spectrum when prescribed offlabel as cognitive enhancers. Even microdosing of LSD is increasingly viewed as a means to greater productivity. But when aficionados talk about nootropics they usually refer to substances that have supposedly few side effects and low toxicity. Most often they mean piracetam httpsen.wikipedia.orgwikiPiracetam which Giurgea first synthesized in  and which is approved for therapeutic use in dozens of countries for use in adults and the elderly. Not so in the United States however where officially it can be sold only for research purposes. Piracetam is well studied and is credited by its users with boosting their memory sharpening their focus heightening their immune system even bettering their personalities. But its only one of many formulations in the racetam drug family. Newer ones include aniracetam phenylpiracetam and oxiracetam. All are available online where their efficacy and safety are debated and reviewed on message boards and in podcasts. Using stacks A number of companies now market nootropic stacks or formulas some of which include piracetam herbal remedies amino acids and citicoline a naturally occurring brain chemical that can be taken orally as a supplement intravenously or as a shot.  Because they are sold as nutritional supplements and natural products that refrain from making health claims they avoid close government scrutiny. When Burke began ordering piracetam online five years ago it arrived in baggies filled with white powder. It was as if I was buying coke off the street he recalls. These days he buys his stack from Nootroo a San Francisco company. But selfexperimenters such as Burke often dont restrict themselves to medication alone. Dedicated brain hackers as they call themselves are willing to exploit their own biology to try to sharpen their mind. Their methods include meditation coldwater plunges periodic fasting and highfat lowcarbohydrate ketogenic diets. Who doesnt want to maximize their cognitive ability Who doesnt want to maximize their muscle mass asks Murali Doraiswamy httpsdibs.duke.eduscholarsmuralidoraiswamy who has led several trials of cognitive enhancers at Duke University Health System and has been an adviser to pharmaceutical and supplement manufacturers as well as the Food and Drug Administration. He attributes the demand to an increasingly knowledgebased society that values mental quickness and agility above all else. But while some studies have found shortterm benefits Doraiswamy says there is no evidence that what are commonly known as smart drugs  of any type  improve thinking or productivity over the long run. Theres a sizable demand but the hype around efficacy far exceeds available evidence notes Doraiswamy adding that for healthy young people such as Silicon Valley gogetters its a zerosum game. Thats because when you up one circuit in the brain youre probably impairing another system. Shortterm benefits Early studies attributed a lot of shortterm benefits to nootropics  so much so that in  Russian scientists turned to phenylpiracetam to boost the physical and mental performance of cosmonauts during space flight httpsurldefense.proofpoint.comvurluhttpA__onlinelibrary.wiley.com_doi_._j.D...x_fulldDwMFgcRAhzPLrCAqeJdrcQiUVEwFYoMRqGDAXQ_puwtYjgrGgivkKNHTVnLjjXizEdTOTAeiQkcgtAvxxZaomIMJ_YuLraqaxvnQKBkGEFvPBVupjoAxgCIsRaoPRrzPeUlBvVxkYtkwUATSCwMMwQUCoChQoe.  A  study  https that piracetam had beneficial effects on the hippocampal membranes of patients with Alzheimers disease. The hippocampus an area of the brain that plays a key role in the formation of new memories typically shows severe shrinkage with Alzheimers. The idea that piracetam might reverse that effect was exciting. Although piracetam has a history of relatively few side effects it has fallen far short of its initial promise for treating any of the illnesses associated with cognitive decline according to Lon Schneider a professor of psychiatry and behavioral sciences at the Keck School of Medicine at the University of Southern California. We dont use it at all and never have. As for newer nootropic drugs there are unknown risks. Piracetam has been studied for decades says cognitive neuroscientist Andrew Hill the founder of a neurofeedback company in Los Angeles called Peak Brain Institute. But some of the newer compounds are things that some random editor found in a scientific article copied the formula down and sent it to China and had a bulk powder developed three months later that theyre selling. Please dont take it people For Burke and other brain hackers the evidence for nootropics is strong enough. Burke who begins each morning with a Bulletproof  httpsblog.bulletproof.comhowtomakeyourcoffeebulletproofandyourmorningtoocoffee  a rich brew of caffeine with dollops of butter and coconut oil  has created a San Francisco meetup group called Peak Performance to teach all my friends in the tech space about life hacks so they can kick abetter every day. Last spring  people showed up at a Peak Performance event where psychedelic psychologist James Fadiman said the key to unleashing the cognitionenhancing effects of LSD  which he listed as less anxiety better focus improved sleep greater creativity  was all in the dosage. He recommended a tenth of a party dose  enough to give you the glow and enhance your cognitive powers without the trip. Burke says he definitely got the glow. The first time I took it I was working on a business plan. I had to juggle multiple contingencies in my head and for some reason a tree with branches jumped into my head. I was able to place each contingency on a branch retract and go back to the trunk and in this visual way I was able to juggle more information. The effects of fasting Not all brain hacking involves taking a pill though. Nootrobox a San Francisco company that markets a nootropic mix of vitamins minerals and amino acids promotes fasting as a way to energize brain and body. We stumbled upon fasting as a way to optimize cognition and make yourself into a more efficient human being says Manuel Lam an internal medicine physician who advises Nootrobox on clinical issues. He and members of the companys executive team have implanted glucose monitors in their arms  not because they fear diabetes but because they wish to track the realtime effect of the foods they eat. Fasting forces your body to deplete its glucose storage and trains it to look inside for fuel Lam enthuses. Its like being strapped to a solar panel. The sun is always shining on you. Nootrobox employees are encouraged to fast every Tuesday then meet for breakfast on Wednesday at a local diner. Founded by two Stanford University computer graduates the company has initiated an international fasting group on Facebook at last count there were  members. Research on animals  http shown that intermittent fasting  limiting caloric intake at least two days a week  can help improve neural connections in the hippocampus and protect against the accumulation of plaque a protein prevalent in the brains of people with Alzheimers disease. Research has also shown that intermittent fasting helped reduce anxiety in mice. Mark Mattson chief of the Laboratory of Neurosciences at the National Institute on Aging has overseen a lot of the animal studies on fasting and is impressed with the evidence  so much so that he has personally adopted a regimen of intermittent fasting. Theres pretty conclusive evidence from animal studies that intermittent fasting is beneficial for brain function and resistance to aging from neurogenerative diseases he says. Fasting has been deployed since the ancient Greeks to fasttrack learning. As Plato is said to have stated I fast for greater physical and mental efficiency. The philosopher Pythagoras reportedly demanded that his students fast  days before attending his lectures. Far easier to take a pill. Looking for an edge Vinh Ngo a San Francisco family practice doctor who specializes in hormone therapy has become familiar with piracetam and other nootropics through a changing patient base. His office is located in the heart of the citys tech boom and he is increasingly sought out by young male tech workers who tell him they are interested in cognitive enhancement. Ngo has experimented with piracetam himself The first time I tried it I thought Wow this is pretty strong for a supplement. I had a little bit of reflux heartburn but in general it was a cognitive enhancer. ... I found it helpful and the neurotransmitter DMEA You have an idea it helps you finish the thought. Its for when people have difficulty finishing that last connection in the brain. But he has also seen patients whose propensity for selfexperimentation to improve cognition got out of hand. One chief executive he treated Ngo said developed an unhealthy predilection for albuterol because he felt the asthma inhaler medicine kept him alert and productive long after others had quit working. Unfortunately the drug ended up severely imbalancing his electrolytes which can lead to dehydration headaches vision and cardiac problems muscle contractions and in extreme cases seizures. There is that culture here in Silicon Valley that relies on being smarter than your own self Ngo says. People want to find an edge over their competitor  thats how they got their position in the first place. Im trying to give them a little more wiggle room  but in a safe way. He says he screens his patients for addiction and cardiovascular problems and creates individual treatment plans based on their health histories and blood tests. Theres no onesizefitsall approach. I dont have a rubber stamp for everyone and not everyone is a candidate for cognitive enhancement says Ngo who requires that his patients sign waivers acknowledging possible health risks in taking nootropics. If for example someone decides to go on medication  be it Adderall albuterol or piracetam  the patient must understand that there is a risk for high blood pressure and heart problems. I want to empower them Ngo says but theres a fine line between empowering them to make their own health decisions and staying healthy."