Agent name | Alternative name(s) listed on supplement label | Proposed mechanism of activity | Potential adverse effects |
Vinpocetine | Lesser periwinkle, Vinca minor, Cavinton, apovincaminic acid, creeping myrtle | Vasodilator | Flushing, headaches, and decreased blood pressure[1,2] |
Picamilon | N-nicotinyl-y-aminobutyric acid, pikamilon, pikamilone, pikatropin, pycamilon | GABA agonist; derived from GABA | May be similar to gabapentin[3] |
Phenibut | B-phenyl-y-aminobutyric acid, phenigam, PhGaba, Phenigamma, Phenygam, phenyl-GABA | GABA-B agonist (also hypothesized to inhibit voltage-dependent calcium channels similar to gabapentin) | Lethargy, agitation, tachycardia, confusion, dependence. With overdose, delirium, psychosis, and coma.[4-6] |
Huperzine A | Huperzia serrata extract, HupA, Huperzia selago extract, Sealgine | Anticholinesterase inhibitor | Similar to prescription cholinesterase inhibitors (eg, GI [nausea, diarrhea, vomiting], increased urination, muscle cramps). Avoid concomitant use of prescription cholinesterase inhibitors as this increases the risk of adverse effects.[7,8] |
Piracetam | Barcan, Noostan, Nootrop, Nootropil, Nootropyl, Normabraïn, pyrrolidone acetamide | Antimyoclonic; modulates CNS neurotransmission (eg, cholinergic and glutamatergic) | Anxiety, insomnia, agitation, sleepiness, weight gain, depression[9,10] |
Omberacetam | Noopept, N-phenylacetyl-L-prolylglycine ethyl ester, ethyl phenylacetyl-Pro-Gl | Activation of HIF 1 | Unknown[11] |
Aniracetam | Draganon | Ampakine, potentiates neurotransmission via AMPA-type glutamate receptors | Unknown[11,12] |
Meclofenoxate | Centrophenoxine | Cholinergic agent | Unknown[13,14] |
Levodopa | L-dopa, Mucuna pruriens extract,[15] cowhage | Dopamine precursor. NOTE: Limited entrance of levodopa into CNS without co-administration of peripheral dopa-decarboxylase inhibitor (eg, carbidopa). | Nausea, vomiting, sleepiness, orthostatic hypotension, confusion, hallucinations |
Tianeptine | Coaxil, Stablon | Atypical antidepressant with various CNS receptor actions | Dependence and abuse potential. Agitation, drowsiness, confusion, sweating, rapid heartbeat, high blood pressure, nausea, vomiting, slowed breathing, coma, and death.[16] |
Kratom | Mitragyna speciosa | CNS mu-opioid receptor agonist properties | Dependence and abuse potential, respiratory depression, anorexia, depression, psychosis, seizures[17] |
CBD | Cannabidiol | Unknown; appears to inhibit CNS neurotransmission; may mimic effects of endogenous cannabinoid compounds | Diarrhea, somnolence, decreased appetite, increased transaminases. Potential THC and synthetic cannabinoid exposure.[18,19] |
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