A lot of people made the same bad joke on Twitter when Senator John McCain seemed confused during former FBI Director James Comey’s senate testimony last week. “Get John McCain some Prevagen!” The joke makes no sense unless you know what Prevagen is—which you probably don’t, unless you frequently watch one of the major news networks. It’s a nootropic dietary supplement, aka a “smart drug,” mostly marketed to baby boomers on TV as a memory enhancer. “Prevagen is a dietary supplement that has been clinically shown to help with mild memory problems associated with aging,” its marketing materials say.
The thing is, though, there’s no evidence the drug works.
In January of this year, the New York State Attorney General sued the makers of Prevagen for false advertising claims, since there’s no evidence its jellyfish-based formula can help improve memory as it claims. “We sent letters to at least five major networks who were airing these ads,” says Bonnie Patton, director of the consumer watchdog group Truth in Advertising. “And guess what? Prevagen ads are still airing.”
Prevagen is hardly alone. Though it’s targeting the 59-and-older set who watch cable news, Prevagen is just one of many nootropics on the market, each aimed at a different kind of audience. There’s Brain Dust, made by spiritual hippie foodie guru Amanda Chantal Bacon, which targets the Gwyneth Paltrow-admiring Goop set. There’s Qualia, made by a group called Neurohacker Collective, that appears targeted at professionals and emphasizes its scientific approach, and Nootrobox, which offers a whole cocktail of different brain enhancers and a complete guide to biohacking—to name just three. As baby boomers hit the age that memory normally starts to fade, and as Silicon Valley pours money into the biohacking fad, the market for chemical cognitive enhancers like these is booming.
And while demand for such miracle pills is high, the laws about supplement advertising are incredibly lax. “If I were looking for opportunities to make a lot of money while deceiving people, I think going into the brain supplement business would be real high on my list,” says Pieter Cohen of Harvard Medical School, a leading expert in the efficacy and risks of dietary supplements. “You can make a lot of money, do something entirely legal, and you’re good to go.”
Like sports or dietary supplements, these brain supplements are not regulated by the FDA. Almost no research has been done into their exact formulations. And there’s no real oversight of how much of any given ingredient they contain. The potential for deception plagues the supplement industry as a whole, thanks to a 1994 law that classified supplements as food rather than medication. According to a study from 2015, dietary supplements lead to at least 23,000 emergency room visits a year in the US.
“The regulatory framework is all set up for this. You can advertise pills as if they support or improve brain function even if you don’t have one bit of research in humans to demonstrate that’s true,” Cohen says. “The law is pretty much clear: You can say pretty much anything short of saying this is a cure for Alzheimer’s.”
Neurohacking by Another Name
None of this is to say that users don’t think these drugs help them out. The chemicals in these formulations may not have proven cognitive effects, but their presentation clearly is doing something to customers’ brains.
As demand for cognitive enhancers increases, VC money is flooding the market. The supplement industry as a whole brings in $30 million a year, according to Cohen, and Silicon Valley appears to want to get in on it—VC firm Andreesen Horrowitz, for instance, invested $2 million in Nootrobox. All that money could fund research—but more immediately, it buys a slick website, which can do a lot to sell the promise of a brain boost.
Go to Qualia’s website, and you’ll see a neatly organized list of its ingredients, which range from neuro-vitamins to adaptogenic compounds to amino acids. This medicalese lends the pills an air of credibility, as do the links to scientific studies about each ingredient. Really, though, “it’s an over-the-counter supplement that they’ve thrown everything in the kitchen sink at,” says Kimberly Urban, a scientist at the Children’s Hospital of Philadelphia, who has studied brain-enhancing medicines.
Also on the list of ingredients in most of these? Caffeine. Part of the reason caffeine is so often found in dietary supplements—weight loss, cognitive, or otherwise—is because you feel it. And when you feel it, you think it’s working. “The same reason that caffeine in weight loss drugs makes you feel that it’s doing something: It wires you up,” says Urban. Many supplements don’t contain enough of any of their given molecules to actually produce an effect, so they rely entirely on the placebo effect to work.
The overlap with diet pills is what most worries Cohen about the trend of memory supplements. He and his research team have long studied the illegal inclusion of amphetamines or methamphetamines in diet pills. (You thought caffeine made you feel sped up?) Though he hasn’t tested nootropics, he sees no reason to believe companies won’t try to sneak the same tweaked amphetamines into them, compounds which are both incredibly addictive and very hard to test and find.
But even without illegal drugs snuck into the formulations, supplements can be dangerous on their own. Though they are ostensibly made with only natural ingredients, lots of natural things are deadly—and without oversight, you’ll never know exactly how much of each compound you’re getting. You should be especially careful if you are sensitive to caffeine or take other medications, since many of the natural ingredients found in supplements can interact with prescription medications. (Did you know that St. John’s Wort can render oral contraceptives less effective? Me neither! But if you are taking the pill, that’s something you’d want to bear in mind before taking Qualia.)
Most of these nootropics also contain amino acids and plant extracts. Some of these things may be beneficial to the brain, say Cohen and Urban. Urban points to one nootropic listed in Qualia, phosphatidylserine, as something preliminary research has shown interesting results on. On Qualia’s website, under a section of the FAQ headlined “Is Qualia a scam or snake oil?” the company writes this:
Qualia is not a scam. We have a non-proprietary formulation—we publish exactly what’s in our product, with the exact amounts. We publish links to the research that support their safety and efficacy, which includes Phase II & III university and clinical trials, strong quantified self research data, and over 40+ years international research on nootropic stack formulation.
But most of those studies are basic research into individual compounds done in animals or with animal cells in petri dishes. The leap from there to “this specific formulation is helpful to the human brain” is huge. (WIRED reached out to Neurohacker Collective for comment but didn’t hear back before publication.) Neuroscientists are only beginning to understand how memory even functions in the human brain, let alone how a specific compound might affect it. “This is not about science,” says NYU professor of nutrition Marion Nestle. “It’s about wishful thinking.”
Wishing to be smarter, better, more productive is natural. Unfortunately, even as most things in 2017 are available at the click of a button, maintaining brain health is still complicated. Doctors recommend you get a good night’s sleep, limit your caffeine and alcohol consumption, exercise regularly, and keep your brain stimulated. None of that’s as easy as popping a pill, but hey, at least it works.