Humans have long been searching for a “magic elixir” to make us smarter, and improve our focus and memory. This includes traditional Chinese medicine used thousands of years ago to improve cognitive function.

Now we have nootropics, also known as smart drugs, brain boosters or cognitive enhancers.

You can buy these gummies, chewing gums, pills and skin patches online, or from supermarkets, pharmacies or petrol stations. You don’t need a prescription or to consult a health professional.

But do nootropics actually boost your brain? Here’s what the science says.

What are nootropics and how do they work?

Romanian psychologist and chemist Cornelius E. Giurgea coined the term nootropics in the early 1970s to describe compounds that may boost memory and learning. The term comes from the Greek words nӧos (thinking) and tropein (guide).

Nootropics may work in the brain by improving transmission of signals between nerve cells, maintaining the health of nerve cells, and helping in energy production. Some nootropics have antioxidant properties and may reduce damage to nerve cells in the brain caused by the accumulation of free radicals.

But how safe and effective are they? Let’s look at four of the most widely used nootropics.

1. Caffeine

You might be surprised to know caffeine is a nootropic. No wonder so many of us start our day with a coffee. It stimulates our nervous system.

Caffeine is rapidly absorbed into the blood and distributed in nearly all human tissues. This includes the brain where it increases our alertness, reaction time and mood, and we feel as if we have more energy.

For caffeine to have these effects, you need to consume 32-300 milligrams in a single dose. That’s equivalent to around two espressos (for the 300mg dose). So, why the wide range? Genetic variations in a particular gene (the CYP1A2 gene) can affect how fast you metabolise caffeine. So this can explain why some people need more caffeine than others to recognise any neurostimulant effect.

Unfortunately too much caffeine can lead to anxiety-like symptoms and panic attacks, sleep disturbances, hallucinations, gut disturbances and heart problems.

So it’s recommended adults drink no more than 400mg caffeine a day, the equivalent of up to three espressos.

2. L-theanine

L-theanine comes as a supplement, chewing gum or in a beverage. It’s also the most common amino acid in green tea.

Consuming L-theanine as a supplement may increase production of alpha waves in the brain. These are associated with increased alertness and perception of calmness.

However, it’s effect on cognitive functioning is still unclear. Various studies including those comparing a single dose with a daily dose for several weeks, and in different populations, show different outcomes.

But taking L-theanine with caffeine as a supplement improved cognitive performance and alertness in one study. Young adults who consumed L-theanine (97mg) plus caffeine (40mg) could more accurately switch between tasks after a single dose, and said they were more alert.

Another study of people who took L-theanine with caffeine at similar doses to the study above found improvements in several cognitive outcomes, including being less susceptible to distraction.

Although pure L-theanine is well tolerated, there are still relatively few human trials to show it works or is safe over a prolonged period of time. Larger and longer studies examining the optimal dose are also needed.

3. Ashwaghanda

Ashwaghanda is a plant extract commonly used in Indian Ayurvedic medicine for improving memory and cognitive function.

In one study, 225-400mg daily for 30 days improved cognitive performance in healthy males. There were significant improvements in cognitive flexibility (the ability to switch tasks), visual memory (recalling an image), reaction time (response to a stimulus) and executive functioning (recognising rules and categories, and managing rapid decision making).

There are similar effects in older adults with mild cognitive impairment.

But we should be cautious about results from studies using Ashwaghanda supplements; the studies are relatively small and only treated participants for a short time.

4. Creatine

Creatine is an organic compound involved in how the body generates energy and is used as a sports supplement. But it also has cognitive effects.

In a review of available evidence, healthy adults aged 66-76 who took creatine supplements had improved short-term memory.

Long-term supplementation may also have benefits. In another study, people with fatigue after COVID took 4g a day of creatine for six months and reported they were better able to concentrate, and were less fatigued. Creatine may reduce brain inflammation and oxidative stress, to improve cognitive performance and reduce fatigue.

Side effects of creatine supplements in studies are rarely reported. But they include weight gain, gastrointestinal upset and changes in the liver and kidneys.

Where to now?

There is good evidence for brain boosting effects of caffeine and creatine. But the jury is still out on the efficacy, optimal dose and safety of most other nootropics.

So until we have more evidence, consult your health professional before taking a nootropic.

But drinking your daily coffee isn’t likely to do much harm. Thank goodness, because for some of us, it is a magic elixir.

Nenad Naumovski, Professor in Food Science and Human Nutrition, University of Canberra; Amanda Bulman, PhD candidate studying the effects of nutrients on sleep, University of Canberra, and Andrew McKune, Professor, Exercise Science, University of Canberra

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Occupational therapists (OTs) have been in the spotlight this month after the National Disability Insurance Agency (NDIA) froze NDIS payments for these services at $193.99 per hour for the sixth year.

The NDIA also cut travel payments for OTs who visit people in their home and community by 50%.

Health Minister Mark Bulter says it’s important people on the NDIS aren’t paying more for therapy and support than they would pay in the health or aged care system.

But OTs are concerned this could affect therapists’ viability, including their ability to support people with disability in their homes and communities.

But what can OTs actually do? And why is it often better to do this in a person’s home and community?

Who might see an OT?

Imagine trying to get back to your daily life after a major health setback, such as a car accident or stroke, or an episode of a long-term condition or disability, such as depression or arthritis. The things you used to do with ease can become difficult and exhausting.

After such a setback, your home or community can also feel like an obstacle course. Maybe you can’t carry the laundry basket out to the line anymore, or you’re struggling to keep up with your children.

This is where occupational therapy can make a real difference. OTs are health professionals that enable people to do the things they need, want and love to do in daily life, from getting dressed to cooking dinner, gardening to driving.

Occupational therapists work with people of all ages. They overcome barriers by changing the environments and objects we use, teaching new skills, rehabilitating old ones and tweaking the way we tackle tasks.

What can OTs do in the home and community?

Seeing people in their own homes and communities allows the therapist to get a more accurate picture of a person’s strengths and abilities, which can be difficult to understand in a clinic.

OTs use their skills and creativity to provide personalised care, tailored to individual needs and circumstances.

An older person with dementia might, for example, cause alarm by putting a plastic kettle on the stove of a hospital kitchen. But they could make their cup of tea perfectly safely at home with their stove top kettle.

OTs can support home and community mobility, such as checking a wheelchair passes smoothly through doorways and can manoeuvre in tight spaces such as bathrooms.

But they can also advise on kitchen aids and seating to save energy for people with conditions such as multiple sclerosis, to support them continuing to cook family meals.

In their work with neurodivergent people of different ages, an OT might help an autistic teen develop sensory strategies to deal with their busy and noisy school day.

For other people, OT support might help them navigate their local public transport system. Learning and practising skills where they’re used makes it easier to carry them over into everyday life.

What does the research say?

Research shows home and community OT can lead to better activity and participation than clinic-based therapy. It’s also cost-effective.

For stroke survivors, OT makes everyday tasks like showering or getting dressed easier.

OT at home eases burden and stress for the parents of children with cerebral palsy and carers of people with dementia.

OT at home helps older people with ongoing health issues to be more actively involved in their communities.

Community OT is also effective in supporting recovery for people with mental health problems, enabling them to enjoy community and leisure activities, seek and maintain employment and enhance physical activity.

OT focuses on helping you do the things that keep you well and independent, which means fewer trips back to the hospital. OTs can spot and solve trip hazards within homes, for example, before a frail person has a fall.

People who get OT at home soon after leaving hospital are less likely to be readmitted. Emerging research also suggests OT can work jointly with paramedics when someone falls at home by visiting and offering immediate treatment that prevent avoidable hospital stays.

There are some downsides, such as limited access in disadvantaged communities. While telehealth can address some barriers, it is not suitable in every case.

How do Australians access OTs?

There are many pathways to access OT services, but the complexity of the health-care system means the process is challenging to navigate.

OT services can also be costly, due to severely limited funding, equipment and transport costs.

OT is available as part of Home Care Packages and the Commonwealth Home Support Programme for older people.

OT has also played a key role in supporting NDIS participants since the scheme’s inception. However, waiting lists often stretch for many months and not everyone knows about what OT can offer.

You can also access community OT through Medicare Chronic Disease Management plans, local community health centres and councils and through private health insurance rebates.

Thanks to Lana O’Neil (Occupational Therapist at Western Health in Victoria) and Sarah McCann (Senior Occupational Therapist at Western Health) for sharing their clinical expertise for this article.

Danielle Hitch, Senior Lecturer in Occupational Therapy, Deakin University

This article is republished from The Conversation under a Creative Commons license. Read the original article.