_{I posted a link to the survey on my Google+ account, and inserted the link at the top of all gwern.net pages; 51 people completed all 11 binary choices (most of them coming from North America & Europe), which seems adequate since the 11 questions are all asking the same question, and 561 responses to one question is quite a few. A few different statistical tests seem applicable: a chi-squared test whether there’s a difference between all the answers, a two-sample test on the averages, and most meaningfully, summing up the responses as a single pair of numbers and doing a binomial test: }

`These days, young, ambitious professionals prefer prescription stimulants—including methylphenidate (usually sold as Ritalin) and Adderall—that are designed to treat people with attention deficit hyperactivity disorder (ADHD) and are more common and more acceptable than cocaine or nicotine (although there is a black market for these pills). ADHD makes people more likely to lose their focus on tasks and to feel restless and impulsive. Diagnoses of the disorder have been rising dramatically over the past few decades—and not just in kids: In 2012, about 16 million Adderall prescriptions were written for adults between the ages of 20 and 39, according to a report in the New York Times. Both methylphenidate and Adderall can improve sustained attention and concentration, says Barbara Sahakian, professor of clinical neuropsychology at the University of Cambridge and author of the 2013 book Bad Moves: How Decision Making Goes Wrong, and the Ethics of Smart Drugs. But the drugs do have side effects, including insomnia, lack of appetite, mood swings, and—in extreme cases—hallucinations, especially when taken in amounts the exceed standard doses. Take a look at these 10 foods that help you focus.`

`Because modafinil works in a manner similar to methylphenidate, it also bears similar risks. The improper dosage or abuse of modafinil may lead to the disrupted development of executive controls like decision-making and working memory. Modafinil’s effects may also depend upon the IQ of the taker. Two university studies determined that in a test of sustained attention, modafinil only improved cognition in the group with “lower” IQs. Although safer than other stimulants due to its milder effect on neurotransmitter levels, there are still risks associated with any kind of drug that affects dopaminergic neurotransmission, mostly because this can lead to addiction and, similar to a pornography user who needs increasingly fringe porn to achieve the same effect, can produce a resistance or lowered sensitivity to dopamine.`

**Microdosing with Ketamine: Ketamine is a general anesthetic that is most commonly used on animals but ironically was originally devised for and tested on humans. Users of ketamine have claimed increased compassion and sensitivity to others, an increase in joy of life, and a reduced fear around death. Finding your ideal microdose of ketamine can be tricky, so it is important to start just a bit below the recommended doses. Taking ketamine sublingually (under the tongue) is the most effective and direct route of administration, and a sublingual microdose is about .75 milligrams per kilogram of body weight, although you can get a significant mood enhancement with as little as 0.2 milligrams per kilogram of body weight. I’d recommend that you never mix ketamine with any drugs that depress breathing such as alcohol, opioids, and tramadol, as it is an extremely calming agent that can produce a heavy sedative effect if you’re not careful or if you combine it with other sedative-like compounds. I’ve found a microdose of ketamine to be best combined with a trip to a float tank, or any other environment that involves sensory deprivation and introspection.**

*l-theanine (Examine.com) is occasionally mentioned on Reddit or Imminst or LessWrong33 but is rarely a top-level post or article; this is probably because theanine was discovered a very long time ago (>61 years ago), and it’s a pretty straightforward substance. It’s a weak relaxant/anxiolytic (Google Scholar) which is possibly responsible for a few of the health benefits of tea, and which works synergistically with caffeine (and is probably why caffeine delivered through coffee feels different from the same amount consumed in tea - in one study, separate caffeine and theanine were a mixed bag, but the combination beat placebo on all measurements). The half-life in humans seems to be pretty short, with van der Pijl 2010 putting it ~60 minutes. This suggests to me that regular tea consumption over a day is best, or at least that one should lower caffeine use - combining caffeine and theanine into a single-dose pill has the problem of caffeine’s half-life being much longer so the caffeine will be acting after the theanine has been largely eliminated. The problem with getting it via tea is that teas can vary widely in their theanine levels and the variations don’t seem to be consistent either, nor is it clear how to estimate them. (If you take a large dose in theanine like 400mg in water, you can taste the sweetness, but it’s subtle enough I doubt anyone can actually distinguish the theanine levels of tea; incidentally, r-theanine - the useless racemic other version - anecdotally tastes weaker and less sweet than l-theanine.)*

^{In 3, you’re considering adding a new supplement, not stopping a supplement you already use. The I don’t try Adderall case has value $0, the Adderall fails case is worth -$40 (assuming you only bought 10 pills, and this number should be increased by your analysis time and a weighted cost for potential permanent side effects), and the Adderall succeeds case is worth $X-40-4099, where $X is the discounted lifetime value of the increased productivity due to Adderall, minus any discounted long-term side effect costs. If you estimate Adderall will work with p=.5, then you should try out Adderall if you estimate that 0.5 \times (X-4179) > 0 ~> $X>4179$. (Adderall working or not isn’t binary, and so you might be more comfortable breaking down the various how effective Adderall is cases when eliciting X, by coming up with different levels it could work at, their values, and then using a weighted sum to get X. This can also give you a better target with your experiment- this needs to show a benefit of at least Y from Adderall for it to be worth the cost, and I’ve designed it so it has a reasonable chance of showing that.) }

^{The available literature on cognitive enhancing practices at times appears to lump together nootropics and “smart drugs.” Smart drugs are not officially defined, but references to this group generally include Provigil (modafinil), Adderall and Ritalin. Any confusion about the addiction potential of different brain-enhancing drugs can spread misinformation about the individual drugs. There are many nootropics on the market, so the best practice is to focus on the addiction potential of each nootropic of interest or concern. }

*I have lots of problems with procrastination and productivity, most likely due to a mild case of ADHD, and recently it's been getting worse and worse. I was a bit hesitant to take Addium at first because I, like most people, had heard about it as a tool for students to use for cramming and it's results sound a little bit like the results of taking Adderall recreationally, which isn't my cup of tea. I was also hesitant to try it because it's marketing just makes it seem like it's a scam pill, and I unfortunately take quality of advertising rather seriously. I changed my mind (after another particularly trying week at work) after a friend of mine actually recommended it for me and told me that she was having great results from it. In my mind, I figured that if a real person,someone I know and trust, tells me in real life that I should maybe try it...then I may as well give it a shot. I ordered the Addium and as soon as I got it, I started taking it immediately. The Addium actually works. I can't believe it. It's helped a lot with my productivity at work. I'm taking just one tablet per day and it seems to be doing the trick. I think the best part about it is that it's not something that you have to continuously take every day.*

^{Alex remains enthusiastic about Adderall, but he also has a slightly jaundiced critique of it. "It only works as a cognitive enhancer insofar as you are dedicated to accomplishing the task at hand," he said. "The number of times I've taken Adderall late at night and decided that, rather than starting my paper, hey, I'll organise my entire music library! I've seen people obsessively cleaning their rooms on it." Alex thought that generally the drug helped him to bear down on his work, but it also tended to produce writing with a characteristic flaw. "Often I've looked back at papers I've written on Adderall, and they're verbose. They're labouring a point, trying to create this airtight argument. I'd produce two pages on something that could be said in a couple of sentences." Nevertheless, his Adderall-assisted papers usually earned him at least a B. They got the job done. As Alex put it: "Productivity is a good thing." }

__Last spring, 100 people showed up at a Peak Performance event where psychedelic psychologist James Fadiman said the key to unleashing the cognition-enhancing effects of LSD — which he listed as less anxiety, better focus, improved sleep, greater creativity — was all in the dosage. He recommended a tenth of a “party dose” — enough to give you “the glow” and enhance your cognitive powers without “the trip.”__

But he has also seen patients whose propensity for self-experimentation to improve cognition got out of hand. One chief executive he treated, Ngo said, developed an unhealthy predilection for albuterol, because he felt the asthma inhaler medicine kept him alert and productive long after others had quit working. Unfortunately, the drug ended up severely imbalancing his electrolytes, which can lead to dehydration, headaches, vision and cardiac problems, muscle contractions and, in extreme cases, seizures.

**New psychiatric drugs have a way of creating markets for themselves. Disorders often become widely diagnosed after drugs come along that can alter a set of suboptimal behaviours. In this way Ritalin and Adderall helped make ADHD a household name, and advertisements for antidepressants have helped define shyness as a malady. If there's a pill that can clear up the wavering focus of sleep-deprived youth or mitigate the tip-of-the-tongue experience of middle age, then those rather ordinary states may come to be seen as syndromes.**

##### More photos from this reportage are featured in Quartz’s new book The Objects that Power the Global Economy. You may not have seen these objects before, but they’ve already changed the way you live. Each chapter examines an object that is driving radical change in the global economy. This is from the chapter on the drug modafinil, which explores modifying the mind for a more productive life.

Cephalon executives have repeatedly said that they do not condone off-label use of Provigil, but in 2002 the company was reprimanded by the FDA for distributing marketing materials that presented the drug as a remedy for tiredness, "decreased activity" and other supposed ailments. And in 2008 Cephalon paid $425m and pleaded guilty to a federal criminal charge relating to its promotion of off-label uses for Provigil and two other drugs. Later this year, Cephalon plans to introduce Nuvigil, a longer-lasting variant of Provigil. Candace Steele, a spokesperson, said: "We're exploring its possibilities to treat excessive sleepiness associated with schizophrenia, bipolar depression, traumatic injury and jet lag." Though she emphasised that Cephalon was not developing Nuvigil as a neuroenhancer, she noted: "As part of the preparation for some of these diseases, we're looking to see if there's improvement in cognition."

**I noticed on SR something I had never seen before, an offer for 150mgx10 of Waklert for ฿13.47 (then, ฿1 = $3.14). I searched and it seemed Sun was somehow manufacturing armodafinil! Interesting. Maybe not cost-effective, but I tried out of curiosity. They look and are packaged the same as the Modalert, but at a higher price-point: 150 rather than 81 rupees. Not entirely sure how to use them: assuming quality is the same, 150mg Waklert is still 100mg less armodafinil than the 250mg Nuvigil pills.**

Research on animals has shown that intermittent fasting — limiting caloric intake at least two days a week — can help improve neural connections in the hippocampus and protect against the accumulation of plaque, a protein prevalent in the brains of people with Alzheimer’s disease. Research has also shown that intermittent fasting helped reduce anxiety in mice.

**Be patient. Even though you may notice some improvements right away (sometimes within the first day), you should give your brain supplement at least several months to work. The positive effects are cumulative, and most people do not max out their brain potential on a supplement until they have used it for at least 90 days. That is when the really dramatic effects start kicking in!**

Microdosing With Psilocybin: Psilocybin, AKA “magic mushrooms”, are naturally occurring fungi, with over 180 different species and research from archaeologist evidence has shown that humans have been using psilocybin mushrooms for over 7,000 years. I’ve personally found microdoses of psilocybin, AKA “magic mushrooms”, to be best for nature immersions, hiking, journaling or self-discovery. Psilocybin primarily interacts with the serotonin receptors in the brain and has been used in therapeutic settings to treat disorders such as headaches, anxiety, depression, addiction, and obsessive-compulsive disorders (See additional studies here, here, here and here). There is limited data to show any adverse drug interactions with the use of psilocybin, and liver function, blood sugar, and hormonal regulation all appear to be unaffected during consumption (although it is best to avoid alcohol and any serotonin-based antidepressants while taking any psychedelics) (See studies here, here and here). A microdose of psilocybin is generally between 0.2 grams and .5 grams, and I’d highly recommend you start on the low end of the dosage range with these or any of the psychedelics mentioned here.

**20 March, 2x 13mg; first time, took around 11:30AM, half-life 3 hours, so halved by 2:30PM. Initial reaction: within 20 minutes, started to feel light-headed, experienced a bit of physical clumsiness while baking bread (dropped things or poured too much thrice); that began to pass in an hour, leaving what felt like a cheerier mood and less anxiety. Seems like it mostly wore off by 6PM. Redosed at 8PM TODO: maybe take a look at the HRV data? looks interestingly like HRV increased thanks to the tianeptine 21 March, 2x17mg; seemed to buffer effects of FBI visit 22 March, 2x 23 March, 2x 24 March, 2x 25 March, 2x 26 March, 2x 27 March, 2x 28 March, 2x 7 April, 2x 8 April, 2x 9 April, 2x 10 April, 2x 11 April, 2x 12 April, 2x 23 April, 2x 24 April, 2x 25 April, 2x 26 April, 2x 27 April, 2x 28 April, 2x 29 April, 2x 7 May, 2x 8 May, 2x 9 May, 2x 10 May, 2x 3 June, 2x 4 June, 2x 5 June, 2x 30 June, 2x 30 July, 1x 31 July, 1x 1 August, 2x 2 August, 2x 3 August, 2x 5 August, 2x 6 August, 2x 8 August, 2x 10 August, 2x 12 August: 2x 14 August: 2x 15 August: 2x 16 August: 1x 18 August: 2x 19 August: 2x 21 August: 2x 23 August: 1x 24 August: 1x 25 August: 1x 26 August: 2x 27 August: 1x 29 August: 2x 30 August: 1x 02 September: 1x 04 September: 1x 07 September: 2x 20 September: 1x 21 September: 2x 24 September: 2x 25 September: 2x 26 September: 2x 28 September: 2x 29 September: 2x 5 October: 2x 6 October: 1x 19 October: 1x 20 October: 1x 27 October: 1x 4 November: 1x 5 November: 1x 8 November: 1x 9 November: 2x 10 November: 1x 11 November: 1x 12 November: 1x 25 November: 1x 26 November: 1x 27 November: 1x 4 December: 2x 27 December: 1x 28 December: 1x 2017 7 January: 1x 8 January: 2x 10 January: 1x 16 January: 1x 17 January: 1x 20 January: 1x 24 January: 1x 25 January: 2x 27 January: 2x 28 January: 2x 1 February: 2x 3 February: 2x 8 February: 1x 16 February: 2x 17 February: 2x 18 February: 1x 22 February: 1x 27 February: 2x 14 March: 1x 15 March: 1x 16 March: 2x 17 March: 2x 18 March: 2x 19 March: 2x 20 March: 2x 21 March: 2x 22 March: 2x 23 March: 1x 24 March: 2x 25 March: 2x 26 March: 2x 27 March: 2x 28 March: 2x 29 March: 2x 30 March: 2x 31 March: 2x 01 April: 2x 02 April: 1x 03 April: 2x 04 April: 2x 05 April: 2x 06 April: 2x 07 April: 2x 08 April: 2x 09 April: 2x 10 April: 2x 11 April: 2x 20 April: 1x 21 April: 1x 22 April: 1x 23 April: 1x 24 April: 1x 25 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October: 2x 04 October: 2x 05 October: 2x 06 October: 2x 07 October: 2x 08 October: 2x 09 October: 2x 10 October: 2x 11 October: 2x 12 October: 2x 13 October: 2x 14 October: 2x 15 October: 2x 16 October: 2x 17 October: 2x 18 October: 2x 20 October: 2x 21 October: 2x 22 October: 2x 23 October: 2x 24 October: 2x 25 October: 2x 26 October: 2x 27 October: 2x 28 October: 2x 29 October: 2x 30 October: 2x 31 October: 2x 01 November: 2x 02 November: 2x 03 November: 2x 04 November: 2x 05 November: 2x 06 November: 2x 07 November: 2x 08 November: 2x 09 November: 2x 10 November: 2x 11 November: 2x 12 November: 2x 13 November: 2x 14 November: 2x 15 November: 2x 16 November: 2x 17 November: 2x 18 November: 2x 19 November: 2x 20 November: 2x 21 November: 2x 22 November: 2x 23 November: 2x 24 November: 2x 25 November: 2x 26 November: 2x 27 November: 2x 28 November: 2x 29 November: 2x 30 November: 2x 01 December: 2x 02 December: 2x 03 December: 2x 04 December: 2x 05 December: 2x 06 December: 2x 07 December: 2x 08 December: 2x 09 December: 2x 10 December: 2x 11 December: 2x 12 December: 2x 13 December: 2x 14 December: 2x 15 December: 2x 16 December: 2x 17 December: 2x 18 December: 2x 19 December: 2x 20 December: 2x 21 December: 2x 22 December: 2x 23 December: 2x 24 December: 2x 25 December: 2x ran out, last day: 25 December 2017 –>**

Panax ginseng – A review by the Cochrane Collaboration concluded that "there is a lack of convincing evidence to show a cognitive enhancing effect of Panax ginseng in healthy participants and no high quality evidence about its efficacy in patients with dementia."[36] According to the National Center for Complementary and Integrative Health, "[a]lthough Asian ginseng has been widely studied for a variety of uses, research results to date do not conclusively support health claims associated with the herb."[37]