The first
nootropic prohibited in sport was fonturacetam (4-phenylpiracetam, carphedon) in 1998. Presented here 25 years later is a broad-scale consideration of the history, pharmacology, prevalence, regulations, and doping potential of
nootropics viewed through a lens of 50 selected dietary supplements (DS) marketed as "cognitive enhancement," "brain health," "brain boosters," or "
nootropics," with a focus on unauthorized ingredients.
Nootropic DS have risen to prominence over the last decade often as multicomponent formulations of bioactive ingredients presenting compelling pharmacological questions and potential public health concerns. Many popular
nootropics are unauthorized food or DS ingredients according to the European Commission including
huperzine A,
yohimbine, and
dimethylaminoethanol; unapproved
pharmaceuticals like
phenibut or
emoxypine (
mexidol); previously registered drugs like
meclofenoxate or
reserpine; EU authorized
pharmaceuticals like
piracetam or
vinpocetine; infamous doping agents like
methylhexaneamine or dimethylbutylamine; and other investigational substances and
peptides. Several are authorized DS ingredients in the United States resulting in significant global variability as to what qualifies as a legal
nootropic. Prohibited stimulants or ß2-agonists commonly used in "pre-workout," "
weight loss," or "thermogenic" DS such as
octodrine,
hordenine, or
higenamine are often stacked with
nootropic substances. While stimulants and ß2-agonists are defined as doping agents by the World Anti-Doping Agency (WADA), many
nootropics are not, although some may qualify as non-approved substances or related substances under catch-all language in the WADA Prohibited List. Synergistic combinations, excessive dosing, or recently researched pharmacology may justify listing certain
nootropics as doping agents or warrant additional attention in future regulations.