The Psychonauts' World of Cognitive Enhancers

Flavia Napoletano; Fabrizio Schifano; John Martin Corkery; Amira Guirguis; Davide Arillotta; Caroline Zangani; Alessandro Vento

doi:10.3389/fpsyt.2020.546796

The Psychonauts' World of Cognitive Enhancers

Front Psychiatry. 2020 Sep 11:11:546796. doi: 10.3389/fpsyt.2020.546796. eCollection 2020.

Authors

Flavia Napoletano^{1

2}, Fabrizio Schifano², John Martin Corkery², Amira Guirguis^{2

3}, Davide Arillotta^{2

4}, Caroline Zangani^{2

5}, Alessandro Vento^{6

7

8}

Affiliations

¹ Department of Mental Health, Homerton University Hospital, East London Foundation Trust, London, United Kingdom.
² Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.
³ Swansea University Medical School, Institute of Life Sciences 2, Swansea University, Swansea, United Kingdom.
⁴ Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
⁵ Department of Health Sciences, University of Milan, Milan, Italy.
⁶ Department of Mental Health, Addictions' Observatory (ODDPSS), Rome, Italy.
⁷ Department of Mental Health, Guglielmo Marconi" University, Rome, Italy.
⁸ Department of Mental Health, ASL Roma 2, Rome, Italy.

Abstract

Background: There is growing availability of novel psychoactive substances (NPS), including cognitive enhancers (CEs) which can be used in the treatment of certain mental health disorders. While treating cognitive deficit symptoms in neuropsychiatric or neurodegenerative disorders using CEs might have significant benefits for patients, the increasing recreational use of these substances by healthy individuals raises many clinical, medico-legal, and ethical issues. Moreover, it has become very challenging for clinicians to keep up-to-date with CEs currently available as comprehensive official lists do not exist.

Methods: Using a web crawler (NPSfinder^®), the present study aimed at assessing psychonaut fora/platforms to better understand the online situation regarding CEs. We compared NPSfinder^® entries with those from the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and from the United Nations Office on Drugs and Crime (UNODC) NPS databases up to spring 2019. Any substance that was identified by NPSfinder^® was considered a CE if it was either described as having nootropic abilities by psychonauts or if it was listed among the known CEs by Froestl and colleagues.

Results: A total of 142 unique CEs were identified by NPSfinder^®. They were divided into 10 categories, including plants/herbs/products (29%), prescribed drugs (17%), image and performance enhancing drugs (IPEDs) (15%), psychostimulants (15%), miscellaneous (8%), Phenethylamines (6%), GABAergic drugs (5%), cannabimimetic (4%), tryptamines derivatives (0.5%), and piperazine derivatives (0.5%). A total of 105 chemically different substances were uniquely identified by NPSfinder^®. Only one CE was uniquely identified by the EMCDDA; no CE was uniquely identified by the UNODC.

Conclusions: These results show that NPSfinder^® is helpful as part of an Early Warning System, which could update clinicians with the growing numbers and types of nootropics in the increasingly difficult-to-follow internet world. Improving clinicians' knowledge of NPS could promote more effective prevention and harm reduction measures in clinical settings.

Keywords: cognitive enhancers; early warning systems; nootropics; novel psychoactive substances; screening.