Questions and Answers

Answer: Most smart drugs, especially the ones that you mention, will have no adverse drug interactions with the medications you are taking. However, if your memory and alertness are failing rapidly, it is possible that you have an as-yet undiagnosed illness that may be causing these changes. Too often, older people experiencing rapid mental changes are written off by their family, friends and physicians as just getting older when, in fact, it is a treatable illness which is causing these changes. Hypothyroidism is one of the most common causes of memory impairment. See the section on thyroid hormone in Smart Drugs & Nutrients. ——WD

Answer: If you are clinically depressed, you certainly should be under the care of a knowledgeble physician. There are a number of causes, and a number of potential treatments. As with smart drugs, there is no “magic bullet,” and the theraputic approach is often empirical (i.e. guesswork). First, there are the obvious causes: either environmental (i.e., situational), or medical (e.g., hypothyroidism). Often, depression is caused by a neurotransmitter deficiency lack or imbalance which can be corrected by nutritional or pharmacological manipulation. For example, if there is a deficit of the stimulatory neurotransmitter dopamine, this may be corrected by supplementation with amino acids like tyrosine of phenylalanine (up to 2,000 mg per day). On the other hand, a mild reversible monamine oxidase (MAO) inhibitor like Gerovital (see chapter in Smart Drugs & Nutrients), or a MAO type-B inhibitor like deprenyl (see SDN v1n1, v1n6) may help. Improving your sleep patterns using a chrono-regulator like melatonin may improve your sleep and increase your mental and physical energy common symptoms of depression. Finally, drug therapy with anti-depressants like prozac is sometimes required. Again, we strongly advise medical supervision of all anti-depressant therapies. ——WD

Answer: This is a question we’re frequently asked. The answer is, “it depends.” Unfortunately, there is no magic bullet smart drug that works well for everyone. Nor is there any known way to test in advance who will respond best to which smart drug. Therefore, the use of smart drugs remains empirical, and the choice of which drug/substance to start with is a very individualized one. For example, many users of cognitive enhancing substances prefer to use natural (non-drug) substances. For them, the best substances to start with are 1) over-the-counter nutrients from health food stores, like dimethylaminoethanol (DMAE), Gingko biloba, or phenylalanine, or 2) preprepared combination products containing neurotransmitter precursors like choline, tyrosine, phenylalanine, pyroglutamate, etc. For those that have a cooperating knowledgeable physician, Hydergine and vasopressin may be tried initially. For those who live close to the Mexican border, or who can order from overseas pharmacies, well-tested drugs that can be highly recommended for first-time include piracetam and deprenyl. ——WD

Answer: We think it’s tragic. Thank you for sharing your experience with your mother. Your observations, while anecdotal, are encouraging and serve to illustrate that smart drugs shouldn’t be easily dismissed as useless. You may find it interesting that the pharmaceutical company Warner-Lambert is conducting studies of piracetam for the treatment of Alzheimer’s disease. Hopefully, this research will confirm your observations regarding your mother and help make piracetam available for the millions of Americans who might benefit from its use. ——TMH

Answer: You’re welcome. However, our answers are not intended to be advice but rather information. We provide this information to assist you and your physician in evaluating as many possible approaches that we think may be useful given what you tell us in your letters. Although the distinction between advice and information may seem subtle, it is fundamentally important. Advice is a professional recommendation towards a specific treatment option, and as such, it takes away some of your responsibility. Information is merely providing knowledge of a treatment option, of historical practices, of somebody else’s experiences, etc. You (and your doctor) still have the responsibility to evaluate that information within the narrow context of your health situation and your personal values (of which we are basically ignorant). As information, we stand behind what we say. But people are different. As we often say, biochemical individuality reigns supreme. It is up to you to decide whether the suggestions we make are appropriate courses of action for you. ——SWF

Answer: GHB is an extremely hydrophilic (water loving) substance which will absorb large amounts of water from the air if given the opportunity. Although water does not effect GHB’s potency, it will encourage molds and other microorganisms to grow. If you have a large amount of GHB, try dividing it into multiple smaller airtight containers, each of which you can use up more quickly. You can also dissolve a few-days supply of GHB in a small amount of water which can be stored in the refrigerator for several days. For instance, if you dissolve 25 grams of GHB in 25 tablespoons of water, one tablespoon of the liquid will give you approximately 1 gram of GHB. Since this liquid can mold, make only as much as you will use in a few days to a week. If you need to store it longer, try adding more water and freezing it in ice-cube trays. If you freeze 25 grams of GHB into 25 ice cubes, each will contain approximately 1 gram of GHB. Put the frozen ice cubes into a heavy duty plastic freezer bag for storage. If the GHB solution will not freeze, either turn down the temperature of your freezer or dilute the liquid with more water (250 mg per ice cube?). Salt solutions are more difficult to freeze that pure water; most GHB is actually sodium GHB (NaGHB). You can even add fruit juice instead of water to make your GHBsicles taste better! ——JRR

Answer: In the 80s, there were a number of non-standardized formulations of ergoloid mesylates which used various proportions of the three drugs which compromise Hydergine. Since that time, however, the formulations have been standardized, and now all forms of Hydergine have the same ratio of active ingredients. The bioavailability of the generics may be slightly less (10-20%?), however, taking a bit more of the generic is still much more economical considering the substantial cost differential. I use generic Hydergine. For those for whom price is no object, I recommend Hydergine Liquid Capsules (liquid Hydergine). The liquid capsules have even higher bioavailability than the sublingual tablets (which are themselves better than the oral tablets). ——WD