Currently, there are literally dozens of new "smart drugs" working their way through FDA trials. A year ago, a spokesperson for Johns Hopkins University mentioned that within ten years, she expected to see smart drugs on the market that could boost children's IQ's by as much as 50 points. As the news releases in the Alzheimer's section of Science News show, there is a great deal being learned about the brain and the biochemistry of thinking that may lead to further pharmaceutical agents that might lead to further enhancements to brainpower. In the meantime, there are herbs available at health food stores that may be somewhat effective at boosting intelligence. (See  "Smart pills".).In one recent medical study, the Chinese herbs gingko biloba and ginseng appeared to produce a small (7%) boosting of the intellect. Another over-the-counter Chinese herb, Huperzine-A is reported to be somewhat more effective than the two "smart drugs" approved for Alzheimer's patients as of 1998. Of course, this isn't to say that these herbs are necessarily benign. All medications have side effects, and the side effects associated with these herbs aren't posted on their bottles, assuming that their long-term side effects have even been studied. For the past year, I've been experimenting a little with these herbs .After taking them for a week or so, they seem to make me continuously dizzy. I'm not sure about this, and I'm trying them one at a time now to see if there's a cause-effect relationship. Do they help? That's also hard to tell, but possibly so.
1-4-2001: "Jim" has written in to recommend that I cut back on gingko biloba and ginseng on an intermittent schedule. He thinks that it does seem to boost one's powers of thought, and that its effects might diminish with continued use.
    At the moment, I'm experimenting only with Huperzine-A. I'll try that for a while to see if it causes adverse effects. Then I'll add ginseng, and if that causes no harmful side effects, I'll later add gingko biloba. If anything consistently causes adverse effects (e. g., dizziness, I might fall back to a reduced dose, although I might also quit the offending weed altogether, since I don't really need it... yet.
    In the meantime, Tommie's mother, who has always prided herself on her retentive memory, is losing it. She might also be interested in trying these allegedly-brain-boosting herbs.
    An edition of Scientific American that addresses the topic of smart drugs observes that, at the time the article was written,  the smartest drug of them all was probably a cup of coffee, with sugar.
    This afternoon, I bought a book at Barnes and Noble called, "Mind Boosters" by Ray Sahelian, M. D., St. Martin's Griffin, New York, 2000. It looks good. I'll try to read it tomorrow, and to report back tomorrow night.

2-11-2001: Um... let me see... "tomorrow night" would have been 1-5-2001. I didn't quit make it, did I?
    First, I've been taking Huperzine-A for more than a month now. I've recently added gingko biloba (but not yet ginseng), and so far, I've experienced no dizziness. Am I smarter? Beats me! I don't think I'm any "stupider". Seriously, there's some suggestion that it might be working, but it's really hard to say, shy of standardized tests. Gingko biloba is said to require 4 to 6 weeks to take effect. I'm not "soaring on wings of words", like Joe and Benny, or Polly Fleming, but then, that tale fantasized intelligence improvements beyond the pale... IQ's of several hundred.

    With respect to Dr. Sahelian's book, he delineates detailed nutritional programs to potentiate cognitive functions depending upon whether the patient is hypertensive, hypercholesterolemic, or subject to other ravages of aging, and it's difficult to break out a one-size-fits-all set of dietary recommendations. His
First-Line Therapy 
consists of 100 to 500 milligrams of supplementary vitamin C, 500-to-1,000 mg. of the omega-3 fatty acids eicosapentanoic acid and docosapentanoic acid, and two to three times the recommended daily allowance (RDA) of B-vitamins. He says (on page 218),
    "Remember that the effects of these nutrients are cumulative. If you're not careful, you could get overstimulated and suffer insomnia, which would be counterproductive to good health. As you add more supplements, reduce the dosage of the ones you already take. Ideally, I recommend you learn the effects of each supplement before combining them."
Second Line Therapy::
   " - To improve blood flow to the brain, take 40 mg. of gingko with breakfast or lunch. Energy metabolism can be improved by taking 100 to 250 mg. of acetyl-l-carnitine, 10 to 30 mg. Coenzyme Q-10, or 5 to 25 mg. of lipoic acid. Hormone replacement with DHEA or pregnenolone can potentially benefit bone formation, mood, libido, memory and overall cognition functions. Pregnenolone can, in some individuals, improve hearing and vision, but there are potential side effects to hormone replacement if misused. See Chapter 14 for full details and dosage guidelines.
    "- Melatonin can be used at a dose of 0.3 to 1 mg. one or three times a week, an hour or two before bed, to improve sleep."
Third Line Therapy:
    "You will notice significant improvements from the suggestions provided in the first- and second-line therapies. The majority of individuals will be quite content with these. However, I know individuals who are very curious to learn more about supplements."
    "If you plan to take the following nutrients on a regular basis, I recommend using them only once or twice a week to avoid tolerance." (This would be consistent with Jim Polynya's observation (1-4-2001 above) that effectiveness ofthese agents may dimish with continued use.)
    He mentions 250 mg. of choline a day. If this doesn't work he suggests the activated form, 100 to 250 mg., sold as CDP-choline. He also mentions phospholipids, as well as the omega-3 fatty acids, for neuronal nourishment.
    There are additional nitirents, herbs, and herbal extracts--such as DMAE, SAMe. ginseng, maca, and vinpocetine--that you could exp[lore with time. Whether supplements of PS and lecithin improve cognitive abilities in the aged has yet to be determined."
He says,
    "Human research regarding the manipulation of brain-cell membranes with nutrients is still in its infancy. ...Until we know more, it may be appropriate to supplement with omega-3 oils and small amounts of phospholipids."
Cautions and Side Effects
    "Gingko biloba, feverfew, garlic, ginger, vinpocetine, aspirin and high doses of vitamin E may increase the risk of bleeding in patients taking antithrombotic (blood-thinning) agents.
    "Always take low doses when you combine multiple supplements. This may require that you break a tablet into small portions, or open a capsule to take a fraction of the contents."
Huperzine A
    He mentions Huperzine A. He observes that two drugs, tacrine (Cognex) and donezepil (Aricept), have been approved by the FDA for the treatment of Alzheimer's patients Like huperzine A, both drugs work by blocking the breakdown of acetylcholine. Tacrine is highly toxic to the liver. Donezepil is less toxic, but still problematical. So how about huperzine A? Since it works on the same principle as the other two drugs, would n't we expect it to also be toxic to the liver? He says, "Long term studies with this herbal extract are not available." In other words, caveat emptor! He says, in discussing treatments for Alzheimer's disease,
    "A dosage of 20 to 50 micrograms per day can be tried instead of the standard cholinesterase inhibitors--this must be done under medical supervision. The dosage of huperzine A should be reduced if it is combined with nutrients that elevate acetylcholine levels, such as choline, PC, and CDP-choline."
    We have a tendency to think that because something is an herb that has been used for thousands of years --e. g., St. John's Wort--it's safe. But all medicinally active substances have side effects. In the case of modern pharmaceuticals, the side effects have been investigated, but in the case of herbal remedies, they may not have been. On the basis of what I've learned in writing this up for you, I've decided that I'm going to defer imbibing any more huperzine A until I can learn more about studies of its side effects. In the meantime, I would feel more comfortable about the safety of choline and other phospholipids, especially if ingested in the form of foodstuffs, than I would with huperzine A. Apparently, this might tend to accomplish the same thing. And after all, long as I don't have serious memory problems and can remember that my name is... um... is... um... Rumplestiltskin?..., I don't need aides-memoire.
    Dr. Sahelian conveys the picture that the interactions of the nutrients he describes in his book must be considered. One shouldn't start simply gorging one's self with food components that are concentrated in an unnatural way without considering the possible interactions and side effects that they might cause, just as is the case with medicinal agents.
    It's also the case that some precaution should probably be observed with anyone who already suffers from brain-chemistry irregularities.
    One of the interesting papers that surfaced when I ran a search on Huperzine-A using the National Library of Medicine's "Medline" is a double-blind trial of Huperzine-A versus a placebo, carried out with 34 pairs of matched junior high school students. Over four weeks of Huperzine-A adminstration (50 mg., twice daily) to the experimental group, the experimental arm scored about 11 points of "MQ" higher on the Wechsler memory subtest than the control arm, as well as performing significantly better in their language-learning classes.