Stimulants are being used with increasing frequency by students across college campuses (see ‘Harvard Students: Reaching for drugs to boost brain power). Many of them, however, probably aren’t well aware of the various side effects. In addition to chronic cognitive problems, amphetamines can also induce catastrophic acute events.

An article in the December 2006 issue of Neurology [Reference here] describes a couple of cases of carotid artery dissections following amphetamine use. The carotid arteries are two of the major blood vessels that travel up the neck and supply blood to the brain. When these arteries dissect (tear), strokes often ensue. A stroke is a focal area of permanent brain death due to lack of blood flow.

Cocaine, another sympathomimetic (drug that mimics the effects of sympathetic nervous system stimulation), has also been reported to cause tears in major blood vessels.

It is also important to note that amphetamines and cocaine can also lead to strokes via another mechanism: inflammation of blood vessels in the brain [click here for reference]. The medical term for this process is Vasculitis.

Since the vast majority of strokes are "silent", I suspect the prevalence of strokes due to stimulants is much higher than officially reported or recognized.

As far as more common chronic side effects, an earlier smartkit post details how just 3 months of Ritalin use (an amphetamine) can significantly damage the very blueprint of cell architecture- DNA.

In future posts, I’ll discuss oxidative damage as well as cardiac side effects.

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Can certain smells boost brain power? Let’s first take a look at what else certain odors can do:

• Stores are now using special odors to make customers buy things and spend more money
• The leathery smell of a new car is an artificial odor sprayed on to enhance buyer satisfaction
• Casinos are using odors to make people gamble more
• London’s Heathrow Airport has used the scent of pine needles to reduce passenger tension and stress
• Bad odors can make people more aggressive.
• Olympic weight lifters have used smelling salts before competition to boost their strength
• Although going for a closed MRI scan can make people feel as if they’re getting buried alive, a vanilla-like odor has been shown to reduce anxiety by 63 percent in patients going for such a test. [Reference 1]

As you can see, smells are powerful forces that can change your mood and mindset. They have a surprising power to make us aggressive, happy, relaxed, anxious, focused, or aroused.

How can smells wield such power over us?

Odors can affect basic biologic processes. “Smell receptors” in your nose connect directly to the limbic area of the brain. (The limbic area is sometimes referred to as the “emotion center” of the brain.) The limbic area, in turn, connects to special brain regions that have major influences over basic bodily processes: (References 2-4)

• Heart rate
• Brain wave patterns (EEG)
• Blood pressure
• Muscle tension
• Skin temperature

Importantly, the limbic area also houses the hippocampus—the memory engine of the brain. Since smell signals project into the limbic area, it should not be too surprising, therefore, that smell can also affect memory. This leads us to the field of aromatherapy.

Aromatherapy seeks to capitalize on this nose-limbic system connection to enhance mental and physical well-being. Typically, its practitioners use essential oils (volatile organic oils derived from plants) to bring these changes about. While I am skeptical of many of the bold claims made for aromatherapy, certain studies have actually shown some real benefits and results.

Special odors can boost cognition

A study done in 2003 showed that rosemary could increase alertness. Additionally, it produced a “significant enhancement of performance for overall quality of memory and secondary memory factors”. (Reference 5)

Research out of the Neurological Clinic at the University of Kiel in Germany demonstrated that the essential oils of peppermint and eucalyptus increased cognitive performance. These same oils also had a muscle-relaxing and mentally relaxing effect. (Reference 6)

A survey of the aromatherapy literature also reveals this anecdotal evidence:

• Jasmine has been linked with an alert and awake mental state.
• Lavender may be good for reducing test anxiety or anxiety right before you give a speech. It may also be useful for reducing excess stress that may get in the way of studying.
• Vanilla lifts a person’s mood.
• Ginger is thought to promote alertness and stimulate cognition.
• Citrus is also felt to be energizing. Some companies are using lemon essential oils in offices to negate the effects of the post-lunch dip on alertness

Some cautions, however:

Odors may influence different people differently.

Just because essential oils come from plants does not mean that they are automatically safe. Be well informed before you use any essential oil. When not used properly, essential oils can do more harm than good.

"Aromatherapy for Dummies" by Kathi Keville is a good book to consult for more information on how to use essential oils responsibly.

Reference 1: Redd WH, Manne SL, Peters B, et al. Fragrance administration to reduce anxiety during MR imaging. J Magn Reson Imaging. Jul-Aug 1994;4(4):623-626.

Reference 2: Bensafi M, Rouby C, Farget V, et al. Autonomic nervous system responses to odours: the role of pleasantness and arousal. Chem Senses. Oct 2002;27(8):703-709.

Reference 3: Sanders C, Diego M, Fernandez M, et al. EEG asymmetry responses to lavender and rosemary aromas in adults and infants. Int J Neurosci. Nov 2002;112(11):1305-1320.

Reference 4: Kim YK, Watanuki S. Characteristics of electroencephalographic responses induced by a pleasant and an unpleasant odor. J Physiol Anthropol Appl Human Sci. Nov 2003;22(6):285-291.

Reference 5: Moss M, Cook J, Wesnes K, et al. Aromas of rosemary and lavender essential oils differentially affect cognition and mood in healthy adults. Int J Neurosci. Jan 2003;113(1):15-38.

Reference 6: Gobel H, Schmidt G, Soyka D. Effect of peppermint and eucalyptus oil preparations on neurophysiological and experimental algesimetric headache parameters. Cephalalgia. Jun 1994;14(3):228-234; discussion 182.

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If you’ve ever tried to chew Vivarin instead of swallowing it, you’re well aware of the fact that caffeine- as available in its raw form- has a horrible, bitter taste.

A molecular biologist who owns a coffee shop in North Carolina, however, has figured out a way to turn caffeine into small, flour-like particles and eliminate the bad taste so it can be added to baked goods like donuts, cakes, and pastries.

Currently, he’s getting a patent on the process and trying to see if Starbucks and Krispy Kreme might be interested.

Is this something you’d eat?

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Over the past 4 years, I’ve eaten a lot of dark chocolate, and some of the world’s best bars have made their way through our kitchen. Amedei, Valrhona, Michel Cluizel, El Rey, Domori, Bonnat. The nice thing about chocolate is that it is a very affordable luxury. You can grab yourself the world’s finest bar for less than $20.

Besides tasting great, there’s been a bunch of research over the past couple years showing dark chocolate may actually have some health benefits. For example, studies have shown dark chocolate can lower the “bad” LDL cholesterol, as well as blood pressure in patients with hypertension. And for those interested in improving cognitive performance, please see an earlier Smartkit post about how dark chocolate can boost brain power by improving verbal and visual memory, as well as reaction time. What I haven’t really posted about yet, however, is chocolate’s ability to induce euphoria. All varieties can do it, but I believe dark chocolate does it best. The numerous feel-good chemicals include:

• theobromine (a stimulant)
• anandamide (marijuana like substances)
• phenethylamine (aka PEA, “love drug”)
• caffeine
• and cocoa flavanols

This brings me to CocoaVia, a new chocolate bar put out by the Mars Company that is just starting to become readily available.

What is special about CocoaVia? Out of all the bars I’ve ever eaten, I’m close to concluding it packs the greatest feel-good punch. Thought it was a fluke the first time I tried it, but after having eaten about 10 over the past few weeks, I’m basically convinced.

What is unique about CocoaVia’s composition? The thing that made me want to go out and give it a try is that it’s processed differently from normal chocolate. Under normal manufacturing conditions, almost all of the health-giving plant chemicals (flavanols) are stripped right out. The Mars Company has apparently spent a fortune trying to figure out a way to create chocolate that still retains all these healthy flavanols. In the last year or two, they’ve succeeded, and their top-secret, specially processed flavanol-rich chocolate is called CocoaPro.

And CocoaVia is the world’s first chocolate bar made with CocoaPro.

If any of you chocoholics out there give it a try, I’d be very curious to hear if you notice a similar effect. Please feel free to let me know in the comments section what you think.

A note of caution, though: I personally don’t think CocoaVia tastes very good. Additionally, I’ve noticed a few pimples and zits eating CocoaVia- something that also commonly occurs with other Mars chocolates like Dove and M&M’s.

If you really want all the brain and health benefits that chocolate flavanols confer, you may prefer to go straight to the raw cacao beans. Most health food stores now sell these chopped in the form of cacao nibs.

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One of the greatest misunderstandings people have about the brain is their belief in “free energy”.

Hundreds of millions of students and workers all over the world consume drinks and pills in the hopes of magically relieving fatigue and boosting their energy levels without suffering any downside. Hence the popularity of Red Bull, Monster, Mountain Dew, Coke, Pepsi, energy pills, caffeine pills, amphetamines, cocaine, and of course coffee.

I’m a firm believer that when it comes to brain circuitry and energy metabolism, Newton’s Third Law still holds: Every action has an equal an opposite reaction.

Based on my years of studying the brain and expertise as a neurologist, I am deeply convinced that, on a fundamental level, the consequences of a chemical energizer are twofold:

• As high up as the drug brings you, you will afterwards sink to an equally commensurate low
• Pushing neural circuits into overdrive stresses the hardware, and leads to cumulative wear-and-tear type brain damage

In life, there are always tradeoffs, and everything has a benefit and a risk. Surely, there are times when it is worthwhile to consume a chemical energizer. The important point is to realize there is a downside to taking it, and therefore only use the minimal amount needed to get the job done.

Taking a large dose initially doesn’t mean the beneficial effect will last longer. It just means your handgun gun just magically became a nuclear bunker buster.

Back in college, I never thought twice about downing an oversize vanilla cappuccino to help get in the studying mood. In actuality, all that was probably needed was a few sips at the start and maybe another couple sips an hour or two later.

Just because Monster Energy shoves 16 ounces of caffeinated sugar into a can doesn’t mean you need to drink all of it.

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Sometimes, a picture really is worth a thousand words…

(Noever, R., J. Cronise, and R. A. Relwani. 1995. Using spider-web patterns to determine toxicity. NASA Tech Briefs 19(4):82. Published in New Scientist magazine, 27 April 1995.)

Nevertheless, over the next week, I have 2 informative commentaries on caffeine I’m getting ready to post

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A new study reveals that both green and black tea have the ability to inhibit the enzyme acetylcholinesterase (AChE). This enzyme is important, because it breaks down the acetylcholine, a key neurotransmitter in the brain.

Why is this relevant? It turns out the main prescription drugs which are used to improve memory and cognition (while treating dementias like Alzheimer’s disease) operate via the same exact mechanism.

Additionally, the study found that both green and black tea also inhibits the enzyme butyrlcholinesterase (BuChE), another important enzyme involved in acetylcholine metabolism. The pharmaceutical reps who push the prescription drug Exelon (generic name: Rivastigmine- also used to treat memory loss) like to tout this mechanism of their drug too.

Interestingly, the study further noted that:

Green tea went one step further in that it obstructed the activity of beta-secretase, which plays a role in the production of protein deposits in the brain which are associated with Alzheimer’s disease. Scientists also found that it continued to have its inhibitive effect for a week, whereas black tea’s enzyme-inhibiting properties lasted for only one day (from www.50connect.co.uk)

The above study was done by lead researcher Dr. Ed Okella out of the University of Newcastle upon Tyne, and published in the journal Phytotherapy Research

An earlier post I made discussed research about the catechins in tea as being brain protective in that they strongly block the death of brain cells. (Please see “Tea is Brain Protective“)

You may also want to read another related post “Green Tea Keeps Brain Sharp” which describes tea’s beneficial cognitive effect on 1,003 Japanese adults.

Chinese club moss also boosts acetylcholine in the brain by inhibiting enzymes that break it down.

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Researchers at the UCLA Neuropsychiatric Institute found Gingko Biloba triggers significant improvement in verbal memory in subjects with age-associated memory impairment compared to placebo.

Many earlier studies with Ginkgo Biloba have produced conflicting results. According to this article, however, most previous studies involving Gingko lasted less than 3 months. The current study is felt to be rather unique because of its longer duration (6 months). The UCLA is also notable in that it tracked brain changes via PET scans.

Unfortunately, however, the study size was quite small (10 patients).
The dose utilized was 120mg of Ginkgo twice a day.

You may be interested in an earlier post which describes how Ginkgo Biloba was found to be as effective as one of the regular prescription drugs (Aricept) used to treat Alzheimer’s disease.

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Have been reading lately about a substance derived from the Chinese club moss: Huperzia serrata- Huperzine A.

For many years, this compound has been used in China to treat patients with memory decline and Alzheimer’s disease.

Huperzine A appears be the natural equivalent of the prescription Alzheimer drugs Aricept, Exelon, and Razadyne. It is similar in that it boosts the presence of acetylcholine in the brain. Amazingly, Huperzine A may be more effective and better tolerated, and since it is a natural compound may also be thousands of dollars cheaper.

Even more amazing, however, is that Huperzine A may also have additional unique effects that could slow down the progression of Alzheimer’s disease (at least according to Dr. Paul Aisen, the neurologist who is leading the new study at Georgetown University Medical Center).

Although it is currently being studied in the U.S. in a phase II trial, you can easily find it for purchase in your local Natural Food Market.

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In the 1950s, apparently all kids in England got daily cod liver oil capsules at school.

Not sure when this stopped, but a recent article notes England is now considering giving every child a capsule of omega-3 oil before class.

Based on the overwhelming amount of research that’s been published over the last 5 years showing how beneficial omega-3 fats from fish oil are for your brain, I’d say this isn’t a bad idea. For reference you may want to read an earlier post I made about how fish oil improves learning and memory in children, as well as how omega 3 fish oil can improve focus and concentration.

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Ritalin, Adderall, Strattera, Concerta, Metadate, Dexedrine, Focalin, Cylert, Attenade. All are stimulants used to treat Attention Deficit Disorder (ADD/ADHD). They are also all drugs that have been tried or used by 15-30% of college students to get ahead academically.

Now a new warning about these drugs comes from Health Canada: All of these stimulant drugs can cause psychotic reactions. A psychotic reaction is characterized by one or more of the following:

• Hallucinations
• Paranoia
• Delusions
• Disordered Thought

In March 2006 in the U.S., the FDA learned that as many as 6% of children may develop a psychotic reaction to these drugs- including cases of “hallucinations, both visual and tactile, involving insects, snakes, worms”. There was even a case of a 6 year old boy who started licking the table one day after his treatment started.

Health Canada is therefore mandating that the labels for all the above drugs be changed by December.

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A number of case reports have cropped up recently documenting an absolutely shocking discovery:

Zolpidem, a common sleeping pill, can miraculously awaken some patients from a Persistent Vegetative State or “semi-coma”.

“Across three continents, brain-damaged patients are reporting remarkable improvements after taking a pill that should make them fall asleep but that, instead, appears to be waking up cells in their brains that were thought to have been dead”.The remarkable story of this rather common pill can be found here.

From an article SA Fam Pract 2005;47(3):49-50 “There is increasing evidence for an important role of zolpidem in the treatment of the sequelae of a wide range of brain pathology, based on its reversal of dormant neural tissue after brain damage. A number of brain injured patients may benefit from this treatment”.

From an article published in the journal Neurorehabilitation (2006): Zolpidem appears an effective drug to restore brain function to some patients in the permanent vegetative state.

This is a stunning development in the field of neurology. Chances are most neurologists aren’t familiar with these new developments. If you have family members or friends that have suffered severe brain injury, you may want to bring this to your doctor’s attention.

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Came across a study published in the September 2006 issue of the European Journal of Neurology that compares Ginkgo Biloba to Aricept in the treatment of mild to moderate Alzheimer’s disease.

Aricept is a cholinesterase inhibitor- it boosts the amount of acetylcholine available in the brain for nerve cell communication. Reminyl and Exelon are also used to treat Alzheimer’s disease, and work in a similar fashion

There aren’t many studies that compare the two head to head, but this one shows Ginkgo Biloba is clinically as effective as Aricept.

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As pharmaceutical companies come out with newer, more effective brain boosting pills (see an earlier post on ampakines), more and more people will be chiming in on the ethics of brain enhancement.

Just came across an article that says the UK’s chief scientific advisor “urges brain pills for all”. The article states that Sir David King has called for a removal of restrictions on “cognitive enhancers”. According to the article, he believes “smart drugs to make people think faster, improve their memory, and reduce tiredness will be commonplace within 20 years.”

Within 20 years? Studies of college students on U.S. campuses already show as many as 25% are using stimulant drugs like Ritalin, Adderall, and Dexedrine to improve their concentration and get better grades.

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