July 31, 2018
Almost everything you put in your mouth, including medications, food, and supplements, will interact with each other inside the body.
Think about it, when you take your medications or supplements, they hang around in the gut together until they are absorbed, then they float around in the bloodstream together awaiting breakdown by the liver, and elimination from the body.
The chances of these chemicals interacting together is very high.
Sometimes this is a good thing, other times it’s a bad thing.
Knowing how these interactions work can help you understand when its okay to take nootropics with your medication, and when it’s not.
In many cases chemical interactions are a good thing, such as the case with synergy.
Synergy is what we call any interaction that produces stronger effects of 2 or more chemicals than they would have produced on their own. Many nootropic formulas are designed to leverage synergy to produce greater effects overall.
An example of a synergistic interaction is L-Theanine with caffeine. The negative effects of the caffeine are eliminated by the effects of the L-Theanine, making the benefits of the caffeine more pronounced than it would have been if taken on its own.
Unfortunately, chemical interactions can also be negative, increasing our risk of developing side effects, neutralising the benefits of the medication or supplement, or causing a new set of undesired symptoms.
Learning to understand how these interactions work makes them more predictable, and allows you to know what nootropics you can take with your medications, and which ones you can't.
There are 3 main types of interactions that can happen when you mix nootropics with your medications:
Additive interactions happen when the effects of a medication and a supplement produce the same results and are “added” to each other.
These interactions can push the body too far in one direction. A good example of this is antidepressants. If combined with other antidepressant nootropics like 5-HTP, it can result in too much serotonin in the brain, leading to negative side effects like serotonin syndrome (for more information on serotonin, have a look at our blog post on The Science Behind 5-HTP)
Antagonistic interactions are the opposite of additive interactions.
They happen when the effects of a nootropic directly counteracts the effects of the medication. This makes the medication less effective, which can result in suppressed symptoms appearing again as the medications effects wear off.
An example of this is GABA and ADD/ADHD medications. GABA directly opposes the effects of the ADD medications. This is likely to make both the supplement and the medication less effective overall and therefore should not be combined.
Whenever we talk about drug interactions, we need to consider side effects. This is because in many cases, when drugs and supplements interact, it causes increased risk of their usual side effects.
Dr. Corneliu Giurgea, the man who first coined the term Nootropics, created a set of criteria that a substance needed to meet before being considered a nootropic.
Take note of that last one.
Although nootropics don’t often come with side effects there are some minor side effects that can come along with nootropic use. Most of these are dose-dependant, meaning that if you experience side effects, they can usually be avoided by simply reducing the dose the next time.
There are so many different medications and supplements available, each with unique effects on the body that it is nearly impossible to list every interaction possible.
Luckily, interactions with nootropics and medications are rare, and tend to appear only when using certain drug classes. Some common culprits include antidepressants, anti anxiety medications, bipolar medications, Parkinson's medications, and blood thinners.
For other types of medications, it’s recommended that you discuss potential interactions with your doctor.
Although rare, there are some interactions between nootropics and medications that are more common than others.
Caffeine is a stimulant. It works by blocking adenosine, which is a chemical in the brain that builds up throughout the day to make us feel tired. When adenosine is blocked, nerve transmission increases, making us feel more alert, and hyperactive.
ADD medications have a similar effect, but on other parts of the brain that make us feel hyperactive (glutamate). When the 2 are combined, it can put us into a state of hyperactivity. We develop jitteriness, anxiety, and in some cases diarrhea and paranoia.
The interaction taking place here is an additive interaction because the stimulating effects to these two chemicals are adding together to produce effects that are too strong to be beneficial.
Most antidepressants work by increasing serotonin concentrations in the brain. They are specifically dialed in on an individual basis because the range between an effective dose, and too high of a dose, is very small.
When we combine this with nootropics that increase serotonin as well, such as 5-HTP, this can push us over the edge. We can accumulate too much serotonin, leaving us with a series of negative side effects, some of which can be very severe.
Blood thinners are a common class of medications, which often include Warfarin, or low dose Aspirin. Thin blood is the term used to describe blood that doesn’t form clots as easily. Doctors prescribe these medications to reduce the chances of developing a stroke or heart attack in susceptible people.
When we combine this with other supplements that cause blood to thin, such as the herbal nootropic ginkgo biloba, we can develop bleeding disorders. Symptoms of this includes frequent bruising, nosebleeds, or more serious side effects of internal bleeding or haemorrhaging.
In the vast majority of cases, there are no side effects between nootropics and medications. However, due to the possibility of having an interaction, it’s recommended that you take a conservative approach to trying new nootropic supplements (or any supplement for that matter).
If you’re taking medications and want to start taking nootropics, it’s important to discuss it with your doctor to ensure there are no major side effects.
When taking nootropics for the first time with a medication, it’s useful to titrate the dose.
This involves slowly increasing the dose over time, rather than starting out from the begining with a standard dose.
Start with something very low, then increase slightly day by day until you reach the recommended dosage. If side effects are encountered, dial the dose back and lock it in.
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