Neurology and Neurosurgery

Brain health supplements: What you need to know

drugs in brain

By Dr. Paul Wright, Senior Vice President and System Chair of the Nuvance Health Neuroscience Institute


A study published in the medical journal Neurology: Clinical Practice found that over-the-counter (OTC) dietary supplements that claim to improve cognitive health may contain unapproved pharmaceutical drugs — some of which may not be listed on supplement labels.

As a result, individuals who use “brain-boosting” supplements that are marketed to improve memory, focus, and attention may be inadvertently exposed to combinations or dosages of medications that have never been tested in humans and could increase the risk of harmful drug interactions or side effects.

Common, but potentially dangerous

Adults age 50 and older spend more than $93 million a month on supplements marketed for brain health according to an American Association of Retired Persons (AARP) analysis of spending on just six different types of supplements.

The use of cognitive health supplements is especially common among patients with neurological diseases, particularly when patients are recovering from a stroke or are living with a condition that doesn’t have a cure — such as Alzheimer’s disease, amyotrophic lateral sclerosis (ALS), or multiple sclerosis (MS). Just as with supplements, some patients may also turn to homeopathic remedies to find a treatment or a cure.

Related article — Dementia risk factors: What you need to know

The truth is that supplements and homeopathic remedies have not been proven to work, and there are currently no cognitive health supplements approved by the Food and Drug Administration (FDA). Unfortunately, the advertising of supplements and homeopathic remedies may mislead some people, causing them to be taken advantage of, either financially or emotionally, with promises of a treatment or a cure.

Further, because supplements are not FDA-approved, medical experts and consumers can’t know for sure what is actually in these products and if they’re safe and effective. Supplements could contain toxins, which could pose additional health risks related to side effects and drug interactions.

For example, in the 10 supplements that were studied and included in the Neurology: Clinical Practice report, researchers found five drugs that are used in other countries but are unapproved for use in the United States — including omberacetam, aniracetam, vinpocetine, phenibut, and picamilon. The study stated that these drugs could cause side effects such as high or low blood pressure, insomnia, agitation, sedation, and dependence (addiction), which could potentially lead to hospitalization.

These side effects can cause some patients to feel unwell and believe that their symptoms are related to their neurological condition. Feeling worse may lead patients to take more supplements, which aggravates their symptoms further. In many cases, patients feel better after they stop taking supplements and begin pursuing lifestyle changes that may help alleviate their original symptoms — such as quitting smoking, getting more exercise, or modifying their diet.

Talk with your clinician

Although there are no FDA-approved medications to improve memory or reverse the symptoms of dementia, there are medications to slow dementia and Alzheimer’s disease progression. Today, there are also more FDA-approved medication options for the treatment of MS, and as a result, we’re seeing fewer patients who have MS taking supplements.

If you or a loved one is already taking a supplement or is thinking about taking one, it’s important to let a clinician know. Supplements could cause interactions with prescribed medications or could contain unpredictable combinations or doses of unapproved drugs.

Talking with your clinician may also help you to resolve a concern you’re having without turning to supplements. Your clinician may recommend that you focus on lifestyle changes, such as getting the right amount of nutrients from your diet. Supplements such as vitamin D or calcium may be necessary if your clinician identifies a deficiency — but you should only take them if your clinician recommends them.

If you still decide to take a supplement, your clinician can update your medical record and make sure there are no interactions with other medications you’re taking. You should also make sure the company that makes the supplement is reputable.

Finally, it’s important for individuals to know that many clinicians are not against supplements or homeopathic remedies. If something is proven to work with no adverse reaction, we’d be happy to recommend that for our patients. That’s why we encourage patients to speak with their clinician about their health concerns; we can develop an appropriate care plan together.

The bottom line: Research shows that cognitive health supplements may contain unpredictable combinations and doses of unapproved drugs, which could pose health risks to consumers. Talk with your health care clinician before using supplements or homeopathic remedies.

Dr. Paul Wright has more than 20 years of experience in neurology. Board certified in psychiatry and neurology, Dr. Wright has extensive research experience including studying the effectiveness of novel therapies such as electroceuticals to treat neurological diseases.

Paul Wright