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Jonathan_Graehl comments on Nootropics and Cognitive-enhancement Discussion Area - Less Wrong
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Comments (31)
Are you taking choline? I'd suggest reading up at the imminst forums if you haven't. There's some really good stuff there, including lists of synergistic nootropics and warnings about bad stacks. Also, they have a lot of info about diets and vitamins. Highly recommended. (Edit: Sorry, didn't see the links in your post. Ha.)
I saw such comments. Is there any study demonstrating a need for choline supplementation, or do we just have anecdotes? I know dietary choline intake is necessary (but it seems most normal diets have plenty).
I'm taking Piracetam and generally feel great except when I don't sleep >8hrs. Since eggs have quite a lot of choline, I've been eating 2/day. But I imagine the amount of choline people supplement is much higher than normal dietary levels.
I also haven't quit caffeine (<150mg daily from espresso); is there any known negative interaction w/ Piracetam?
No studies that I know of. But all of the most experienced nootropic experimenters at ImmInst seemed to heavily recommend it. In one case it was even suggested a guy add it to his stack despite eating 6 raw eggs a day. At any rate, I think choline is stored in your body, so you should be able to go for months on piracetam without noticing choline depletion. In the meantime, though, you should probably read up on it, and make sure to check for weird effects.
I don't remember any such interaction from what I've read, which is quite a bit. If there is, it must have been incredibly mild or I think I would've remembered.
Thanks. This response is incredibly valuable to me, because it saves me from spending a lot of time reading (another) forum.
6 raw eggs/day? That's got to be about 1 day of unpleasant food poisoning per year :) I cook mine in butter.
Agree that eating raw eggs is a bad idea because of the possibility of infectious organisms. (Exception: you get the eggs from your own chickens or some such, and you know what you are doing.)
How much effort did it take for you to learn which ones were experienced?
When I looked, I found a lot who didn't take choline supplementation.
No real effort; I just read comments for 6 hours straight or so and paid attention to people who were referenced as high status or knowledgeable, then paid extra attention to the stacks or suggestions of those people, and came away with the impression that choline was recommended. It was by no means scientific and it could be that choline supplementation isn't necessary. Hopefully there's some literature on the subject; I plan on looking a lot closer in a few weeks when I start to really do some research into nootropics and other IA.
The anecdotes IMO were persuasive and universal enough that when I first tried piracetam and got the headaches, I instantly assumed they were the 'choline headaches' and ordered some (since 2 or 3 eggs wasn't doing the trick). Personal experience is a powerful persuader.
But you wanted references, so here's some: http://en.wikipedia.org/wiki/Piracetam#Side_effects
On 50 (full text) - a study of old people in a mental hospitol whose psychiatric illness was considered to be in 'remission' - 2.4g/day and 4.8g/day both improved intelligence, but 4.8g/day slightly degraded "verbal IQ" (which includes working memory) and some "memory quotient" (table 3, pg103).
They speculate that other studies showed no significant benefit for N=20 only because the dose was too low or the timeframe too short (2.4g/day showed P<0.5 improvements after more than 8 weeks (not yet significant at 4 weeks), but 4.8g/day gave significant improvements after 4 weeks and 8 weeks, with a decline at 12 weeks, though not in all measures erasing all the benefit compared to the placebo group).
The analysis seems competently done; the 3 groups (N=20 each) were purely randomly chosen, not balanced for other traits, so for instance the 2.4g/day group was dumber than the other groups before intervention; they corrected for this in analysis.
In table 2 (pg 102), higher scores are worse for SCAG and BPRS, and the opposite (higher=good) for nurse CGI (Clinical Global Impression - some subjective measure of "is the patient doing better") and CGRS. Placebo group had no CGI improvement; both 2.4 and 4.8 had a huge improvement. As for negative effects, 4.8g/day had slightly more diziness (P>.1 however), and 2.4g/day had significantly worse cooperation and sleep. It seems like everyone had worse sleep, so I don't know what to make of that, but they claim it's significant after ANOCovariance.
They also claim an anecdotal dose-dependent decrease in parkinsonian-like facial tremor symptoms (i.e. 4.8g/day was more effective), which seems contrary to 51's claim of 'tremor' as a common piracatem side effect.
Anyway, piracatem definitely helps old and/or in-'remission' schizo/affective people think better (not sure if it's and or or).
Since the net benefit at week 12 of 2.4g/day was much more than 4.8g/day, I really want to know if there's some longer term (e.g. 50 weeks) where an even smaller dose (including none at all) of piracatem is better than 2.4g/day.
There's nothing about headaches or choline in this study either, except in the discussion section, they cite Bartus 1981 (rat study) and Friedman 1981 and Ferris 1982 (senile dementia improved more w/ choline+piracatem than with either alone).
I've gotten a couple serious headaches that wouldn't go away with 2 aspirin since I started taking Piracetam. I attributed one of the headaches to oversleeping, but Piracetam might have been the cause in retrospect.
On 51:
5g/day to severe concussion victims
weak evidence for some side effects: anxiety, insomnia, nervousness, tremor (I haven't experienced any of those; these seem hard to separate from the concussion symptoms)
no change in blood pressure or heart rate
gradual and significantly better than placebo improvement over 8 weeks in headache/vertigo symptoms post-concussion. insignificantly more improvement than placebo in memory, tremor, and fainting-from-standing ('orthostatic symptoms'). placebo patients reported 2.1 side effects on avg; 5g piracetam reported 2.3 on avg.
no mention of headaches caused by piracetam or choline
'Headache' is kind of a vague term; wouldn't surprise me if 'anxiety' or others subsumed it.
That would be very strange. I don't believe it.
Here's what I think: the study was of people with ongoing post-concussion headaches. Therefore it made no sense to ask if they were getting headaches as a side effect. The 5g/day piracatem group reported a significantly larger improvement (decrease) in headaches than the placebo group.
That seems plausible. Maybe you should complain on the piracetam talk page.
Yeah; it's shocking how badly a Wikipedia-cite can fail at living up to what's promised (sentence is edited without checking that cite supports the edited version?). I thought about making a correction but will probably pass.
By the way, I don't doubt that the Wikipedia sentence you quoted me is true; it's just that the cites (required by Wikipedia policy) are inappropriate - to our mutual surprise.
Probably what happened is the sentence grew by accretion, and that cite about concussion victims being helped by piracetam was originally being used for something other than choline alleviating problems. There are tools to search through history, but I don't care enough to refind them.
Thanks. That was my plan also. One confound for me, though, is that I can get a mild headache on the 1st or 2nd day of not having caffeine. Now I have an excuse to ensure I have my daily latte.