Focus on Cognitive Enhancement: A Narrative Overview of Nootropics and ‘Smart Drug’ Use and Misuse

Whilst ‘nootropics’ are meant to treat a range of medical disorder-related cognitive impairments, the typically healthy ‘smart drugs’ user ingests a range of drugs/molecules to achieve improved mental performance. Given the increasing levels of related concerns, this study aimed to provide an overview of the clinical pharmaco-logical issues relating to both the most popular nootropics and the vast range of drugs which are being used as putative cognitive enhancers/smart drugs. In terms of the cognitive decline associated with neurological degenerative disorders, a significant variation in research methodology was observed. Therefore, the overall usefulness of these pharmaceuticals in various central nervous system disorders as supple-ments/adjuvant therapy needs to be better established before their widespread use can be recommended. The most popular smart drugs, self-administered to cope with high-perceived stress and academic/work-related pressure, were methylphenidate, modafinil, amphetamine-based compounds, and psychedelics. At present, however, there are relevant levels of uncertainty in terms of smart drugs’ effectiveness in im-proving executive functions. Addressing the health harms associated with cognitive enhancers’ intake remains challenging due to the lack of updated and contextualized epidemiological data. In particular, there appears to be a range of clinical concerns re-lating to the non-prescribed intake of stimulant smart drugs by otherwise healthy in-dividuals. Enhanced training for prescribers, pharmacists and healthcare professionals can strengthen monitoring and early intervention efforts.