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Washington Post’s look at Silicon Valley ‘smart drugs’ needed a stronger shot of skepticism

Rating

3 Star

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Tweaking brains with ‘smart drugs’ to get ahead in Silicon Valley

Our Review Summary

This story about purported brain-boosting pills would have been easier to swallow if it came with a stronger shot of skepticism. The story would have benefited greatly from at least one source who isn’t involved in the cognitive-enhancement movement. It does a better job of describing the availability of these supplements and the hyper-competitive culture that feeds this emerging market.

 

Why This Matters

The term “nootropics” applies to a wide variety of substances that apparently require no safety or efficacy trials, no FDA approval, and no prescription from a doctor. As a result, media coverage is often consumers’ only tool to counter the marketing hype when attempting to determine whether these products will do them good or harm, or simply waste their money. Sadly critical coverage is in short supply.

Back in 2015, HealthNewsReview.org Associate Editor Kathlyn Stone wrote that nootropics were “under the radar” of journalists, despite heavy marketing targeted at students and young professionals. That appears to be changing, but journalists need to be cognizant of their role as consumer watchdogs.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

There’s no discussion of cost. We found one drug cited in this story — piracetam — online for $39.99 for 180 capsules. For those seeking a cocktail of supposed brain boosters, startup Nootrobox charges $135 for “all the nootropics you need to enhance your cognitive state for one month.” The company explains: “Cognitive performance is an active, long-term investment.”

(Notably, piracetam isn’t on Nootrobox’s ingredient list. For more on that, read the section on availability.)

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story doesn’t quantify any known benefits of these brain enhancers, for example if memory increased by a certain percent.

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

Harms are addressed–enough to be Satisfactory for this criteria. But the discussion is confusing. The story initially says nootropics have “supposedly few side effects and low toxicity.” Later it states:

As for newer nootropic drugs, there are unknown risks. “Piracetam has been studied for decades,” says cognitive neuroscientist Andrew Hill, the founder of a neurofeedback company in Los Angeles called Peak Brain Institute. But “some of [the newer] compounds are things that some random editor found in a scientific article, copied the formula down and sent it to China and had a bulk powder developed three months later that they’re selling. Please don’t take it, people!”

In contrast, consider these unequivocal cautions in a similar Mercury News story last fall, starting in the seventh paragraph:

Research into the cognitive benefits of nootropics is still in its early stages, and some experts worry about the long-term health effects of ingesting potent synthetic smart drugs, which are largely unregulated.

Some users have reported side effects including headaches, upset stomach, insomnia, anxiety and depression.

Dr. Reid Blackwelder, past president of the American Academy of Family Physicians, said it concerns him that customers are ordering such drugs online without consulting a doctor, because some of the substances seem to have a powerful impact on the brain. And much of the research on the cognitive benefits of these substances is supported only by studies using animals, Blackwelder said.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

This story falls into the trap of relying on positive anecdotes as evidence, citing an entrepreneur who “credits the regimen with giving him the cognitive edge he needs to thrive in California’s Silicon Valley, where he’s the co-founder of a food service that caters to athletes and fitness devotees,” as well as a physician who said he with experimented with piracetam and found it “helpful.”

Also troublesome is this statement: “Piracetam is well studied and is credited by its users with boosting their memory, sharpening their focus, heightening their immune system, even bettering their personalities.”  Saying it’s “well studied” in the same sentence as giving purported benefits is confusing and may lead readers to assume incorrectly that these benefits were proven in studies.

Lastly, the story quotes advocates of fasting without cautioning that what works in mice may not apply to humans. Comments Mark Mattson, chief of the Laboratory of Neurosciences at the National Institute on Aging: “There’s pretty conclusive evidence from animal studies that intermittent fasting is beneficial for brain function and resistance to aging from neurogenerative diseases.”

In fact, there is no such thing as “conclusive evidence from animal studies.”

To its credit, the story does eventually–but very briefly–explore the quality of the evidence, mainly via this comment from Duke University Health System researcher Murali Doraiswamy: “There’s a sizable demand, but the hype around efficacy far exceeds available evidence.”

Does the story commit disease-mongering?

Satisfactory

There’s no outright disease-mongering here, but the preposterous quote that it is “the few who are getting ahead who are using supplements” should have been challenged. That makes it sounds like “normal” people are in some way deficient.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

The story lacks comment from an independent expert who’s not involved with selling, prescribing or taking nootropics or some other cognition-boosting product.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story doesn’t address proven strategies to improve mental skills such as good nutrition, adequate sleep, social engagement, cognitively challenging activities, and exercise.

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story does a good job here, although it injects confusion when it states that in the U.S. piracetam “can be sold only for research purposes,” but later says that piracetam and similar drugs are available online. In fact, the FDA at least twice warned suppliers, in 2010 and 2012, that piracetam was classified as a drug and could not be sold as a supplement. According to online accounts, that FDA action prompted major retailers to stop carrying it, which could explain why it’s not present in some products marketed as nootropics.

The story also states: “A number of companies now market nootropic ‘stacks,’ or formulas, some of which include piracetam, herbal remedies, amino acids and citicoline, a naturally occurring brain chemical that can be taken orally as a supplement, intravenously or as a shot.”

Does the story establish the true novelty of the approach?

Satisfactory

There story gives perspective, mentioning that piracetam has been around for decades, though newer formulations are on the market, and that companies have recently begun marketing “stacks” with multiple supplements.

Does the story appear to rely solely or largely on a news release?

Satisfactory

The story does not appear to rely on a news release.

Total Score: 5 of 10 Satisfactory

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