What to know about memory pills: Safety, effectiveness, choice, and more

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“Memory pills” are a term that someone may use to describe products and dietary supplements that support memory.

Manufacturers sell various products in stores and online that claim to enhance memory and cognitive performance. Sometimes people refer to these products as “smart drugs” or “nootropics.”

How do they work?

Nootropics affect the brain by influencing neurons and neurotransmitters at a cellular level.

Some research indicates that these processes may positively affect amyloid plaques, which scientists believe are responsible for Alzheimer’s disease.

Nootropics can be either prescription drugs, over-the-counter medicines, or dietary supplements.

Doctors may prescribe nootropic drugs such as Donepezil for Alzheimer’s disease.

Additionally, some people take dietary supplements that claim to have nootropic or memory-boosting effects. However, scientific research may not have proven these effects.

The United States Food and Drug Administration (FDA) evaluates the safety and efficacy of medications that doctors prescribe for memory problems.

However, unlike prescription drugs, the FDA does not evaluate supplements. Therefore, it is difficult for consumers to know if a supplement works, if it is of sufficient quality, and if it is safe to take.

The FDA forbids manufacturers to claim that any such product prevents, treats, or cures diseases or health conditions.

In 2018 the FDA issued warning letters to companies illegally selling more than 58 products and dietary supplements which claimed to prevent, treat or cure Alzheimer’s disease and several other serious diseases and health conditions. The FDA noted that these products may be ineffective, unsafe, and could prevent a person from seeking an appropriate diagnosis and treatment.

A 2020 study identified 650 dietary supplements that manufacturers marketed for brain health and cognitive performance. Of 12 products that the researchers selected, the majority had either additional ingredients that the manufacturer didn’t list or listed ingredients that the researchers couldn’t detect by analysis. Additionally, the evidence did not support some of the claims the products made regarding efficacy and safety.

The Office of Dietary Supplements notes that several independent organizations offer quality testing and allow seals to appear on products that pass standards. These organizations include U.S. Pharmacopeia and ConsumerLab.com. People can look for these seals to help them choose a product but should note that they do not constitute a federal endorsement.

The following is a list of supplements that researchers have looked at for supporting memory and brain function and what the evidence says:

Gingko biloba

Traditional cultures and practitioners have used Ginkgo biloba leaves in herbal medicine for centuries.

The active compounds in Ginkgo biloba that can improve blood circulation are antioxidant and neuroprotective.

Manufacturers sell supplements containing an extract of Ginkgo biloba called EGb 761. Some researchers have studied the effectiveness of this extract in dementia.

A 2014 systematic review and meta-analysis and a 2019 review both concluded that while there seem to be positive effects in dementia related to the extract, the limitations in studies mean that scientists are unable to draw firm conclusions about its clinical effectiveness, particularly in different types of dementia.

Flavonoids, cocoa, and caffeine

A 2019 report by the Global Council on Brain Health (GCBH) evaluated supplements for brain health. The report concluded that currently, there is not enough evidence to recommend taking cocoa, flavanols, or resveratrol for brain health.

The authors comment that some studies have found that these compounds may improve blood flow to the brain, attention, and processing speeds, but several studies are industry-funded, which could cause bias.

Additionally, the GCBH advises that although caffeine may provide some short-term benefits in mental alertness and focus, caffeine supplements in the form of energy drinks and pills may carry health risks.

Vitamins and minerals

Some people believe that taking vitamin and mineral supplements supports brain health and function, for example, B vitamins, vitamin E, and antioxidants.

However, the research is currently conflicting and inconclusive.

For example, a 2018 Cochrane review evaluated the cognitive effects on people aged 40 and up of taking vitamin and mineral supplements for at least three months. The researchers concluded that supplementation had little meaningful impact on healthy adults, but said that the evidence doesn’t permit definitive conclusions. Nevertheless, the authors noted that antioxidant vitamins might have positive effects and deserve further research.

Additionally, the 2020 report of the Lancet Commission did not recommend taking additional vitamins, oils, or mixed dietary supplements as a means of preventing dementia because extensive trials did not demonstrate beneficial effects. However, the authors note that evidence suggests a Mediterranean or Scandinavian diet may help prevent cognitive decline.

The GCBH report notes that some people may become deficient in vitamins as they age due to absorption and dental issues, which may affect their brain health. Additionally, people eating restricted diets, such as vegans, may become deficient in vitamin B12, affecting memory and thinking skills. Therefore, groups of people at risk of nutrient deficiencies may benefit from taking a supplement.

Omega-3 fatty acids

The GCBH report concluded that overall, there is insufficient evidence to recommend taking omega-3 supplements derived from fish oil for brain health. The authors noted that fatty fish consumption may benefit cognitive function due to its docosahexaenoic acid (DHA) content, but said this is not conclusive.

There can be some risks with taking dietary supplements for memory, particularly if the person is taking prescription medication or has cognitive impairment or dementia.

For example, a 2017 study of people with dementia attending a Norwegian outpatient memory clinic found that they frequently used dietary supplements. However, caregivers or healthcare service providers did not supervise the participants’ supplement intake, which may potentially have had interactions with other drugs they were taking.

People taking drugs such as blood thinners, heart medications, and drugs that affect the immune system should avoid taking any supplements without informing their doctor.

Some herbal supplements such as Ginkgo biloba, garlic, and ginseng can increase risks for someone who is having surgery. Also, some supplements can reduce the effectiveness of chemotherapy in people who have cancer. People should always make their doctor aware of any supplements they are taking.

Furthermore, the fact that the FDA does not validate dietary supplements for safety and quality is an additional potential risk.

People can support their memory and brain health by taking steps to ensure they have a healthy diet and lifestyle.

Some key messages from the 2020 report of the Lancet Commission and the GCBH report are:

• eat a healthy diet to provide all essential nutrients
• identify any vitamin or mineral deficiencies and talk to a healthcare provider about taking a supplement
• aim to maintain a systolic blood pressure of 130 mm Hg or less in midlife from around age 40 years
• avoid obesity and the risk of diabetes, and maintain an active lifestyle, especially from midlife
• limit alcohol consumption and stop smoking, as this can decrease the risk of dementia
• reduce exposure to air pollution and second-hand tobacco smoke

Experts have linked many risk factors for dementia with social determinants of health and the inequities faced by communities of color and other marginalized groups. Creating environments with physical activity as a norm, reducing blood pressure rising with age through better nutrition, and reducing potential excessive noise exposure may help tackle these risk factors.

Consuming caffeine for short-term concentration may be helpful for some people, but taking memory supplements longer-term may have risks.

The fact that the FDA does not evaluate dietary supplements means that some products may be ineffective, of poor quality, or not contain the ingredients they state on the packaging.

For people with dementia, taking unsupervised supplements could be a risk, especially if they also take prescribed medications. People who have a health condition, are about to have surgery, or take prescribed drugs should always check with their healthcare provider before taking supplements.

Although some research shows beneficial effects of supplements such as Ginkgo biloba or omega-3 fatty acids, the evidence is still inconclusive.

To support brain health and memory, people should maintain a healthy lifestyle and diet and avoid nutrient deficiencies. If a doctor diagnoses a vitamin deficiency, they may advise someone to take a supplement to decrease the risk of cognitive decline.