Adderall is a mixture of amphetamines used to treat ADHD. It works well, but not without some serious side effects. There are many alternatives to adderall that provide similar benefits, but without the side effects. The best nootropics for ADHD improve focus, concentration, and attention while not causing any serious side effects.
These adderall alternatives all work via different mechanisms and in theory can all be combined to produce a synergistic effect, with the exception of ginseng. However, caution should be taken when combining them as too much dopaminergic activity can result in not only the worsening of ADHD symptoms but potentially psychosis.
Many of these nootropics have been proven to be effective for treating ADHD. Some have numerous studies demonstrating a significant effect in ADHD patients. Others, like phenylpiracetam and bromantane, are just hypothesized to help ADHD, but nonetheless have many positive anecdotes.
|Nootropic||Mechanism of action||Taken||Dosage|
|Modafinil||Inhibits dopamine reuptake||Either acutely or chronically. Studies found no tolerance||100 mg to 400 mg|
|Fasoracetam||Modulates glutamate activity||Chronically - Benefits increase the longer it's taken||50 mg twice a day|
|Bromantane||Increases dopamine production||Chronically - benefits build up over time||50 mg to 100 mg|
|Selegiline||Inhibits MAO-B preventing some dopamine breakdown||Chronically - Dopamine accumulates after a few weeks of treatment||5 mg sublingually|
|Phenylpiracetam||Upregulates dopamine receptors and may act like a stimulant||Either acutely or chronically. Tolerance may form after chronic dosing.||100 mg to 200 mg|
|Memantine||Chronically - Needs to build up. Initial effects may be negative.||20 mg a day|
|Ginseng||Modulation of dopamine and noradrenaline||Chronically - Research uses chronic dosing||1000 mg twice a day|
|Iron||Chronically - Iron needs time to build up in the system||N/A - Consult your doctor for proper dosing|
|Meditation||Changes in brain structure||Chronically||N/A|
A drug used to treat narcolepsy, modafinil increases dopamine in the brain with almost the same potency as methylphenidate in humans. Several clinical trials have been performed to test the efficacy of modafinil in children, adolescents, and adults with ADHD. In all these studies, it was shown to significantly reduce symptoms and was well-tolerated. In comparison to adderall, a study found no withdrawal effects upon discontinuation of modafinil following 2 weeks of treatment in children and adolescents with ADHD.
Interestingly, there were no rebound ADHD symptoms suggesting it may have a long-term benefit. Moreover, a study found modafinil to be equivalent to dextroamphetamine in reducing the symptoms of ADHD – Adderall is a mixture of amphetamine salts that’s 75% dextroamphetamine and 25% levoamphetamine. Regarding dosing, one study found once a day administration to be superior to divided doses.
A nootropic drug of the racetam family, fasoracetam is unique in that it doesn’t act a stimulant. In contrast to typical stimulants, it doesn’t seem to increase dopamine and noradrenaline levels. Instead, it acts via glutamate. Some ADHD patients have abnormal genes for the glutamate receptors which is thought to cause their symptoms. In a study, adolescents with ADHD and an abnormal glutamate gene were started at 50 mg twice a day and had their dose increased weekly up to a maximum of 500 mg 2x per day.
With each passing week the benefits increased. Side effects were not nearly as harsh compared to adderall. They mainly consisted of headache and fatigue. Plus, since it acts via a different mechanism it can be combined with other nootropics for ADHD, like modafinil. This will result in a synergistic effect.
Also known as ladasten. A very unique compound, bromantane is thought to work by upregulating dopamine production. Tyrosine hydroxylase (TH) is the rate-limiting enzyme that controls L-DOPA production. Aromatic L-amino acid decarboxylase (AAAD), also known as DOPA decarboxylase, is the rate-limiting enzyme that converts L-DOPA to dopamine. The more tyrosine hydroxylase is expressed, the more L-DOPA is produced. Likewise, the more AAAD is expressed, the more dopamine is produced.
Bromantane was shown to remarkably enhance the expression of both tyrosine hydroxylase and AAAD in rats, and the effects were rapid and long-lasting.  Moreover, it seems bromantane also increases dopamine release in the striatum of rats and it has been noted to last up to 8 hours.
As few studies have been on humans, caution should be taken for those already sensitive to dopaminergics. It is not yet known if the effects of bromantane are permanent or semi-permanent. In rats, it definitely seems to last a long time.
Commonly known as Deprenyl or EMSAM, selegiline is a classic nootropic that has been shown to possess remarkable benefits. It enhances memory and learning, mood, libido, motivation, focus, and may even extend lifespan in humans. It was already shown to extend the lifespan of rats.
Selegiline works by binding to an enzyme known as MAO-B, short for monoamine oxidase type B. This is one of the main enzymes to breakdown or metabolize dopamine and phenethylamine (PEA). PEA is an endogenous compound that releases dopamine and noradrenaline. In fact, amphetamines like adderall are derived from PEA. The brain continuously produces PEA, but because of MAO-B it has a very short half-life of just 10 minutes. When MAO-B is eliminated, however, the half-life becomes much longer.
So not only does selegiline increased dopamine levels, but it also increases PEA levels which in turn increases dopamine release. Several studies have shown selegiline to improve ADHD symptoms on its own, and with one study finding it comparable to methylphenidate, but with much fewer side effects.
Though, a study found it ineffective in treating impulsivity, but nonetheless found it effective for the inattentive type of ADHD.
Also known as phenotropil. A nootropic of the racetam family, phenylpiracetam has been shown to upregulate several dopamine receptors involved in ADHD and focus. In addition, it seems to have a stimulant-like effect with many anecdotes supporting this notion. Phenylpiracetam is unique in this list in that it has both acute and chronic effects, the acute being the stimulant-like effect and the chronic being the upregulation of the dopamine receptors. However, not much research has been done on this nootropic and many users find its effects begin to wane the longer they take it. Indeed, there is some Russian research to support this claim where after 4-8 weeks of treatment, the effects of phenotropil were decreased as compared to the first few weeks.
Though not designed to treat ADHD, memantine has found a new use within the ADHD and nootropic community. In light of its ability to prevent opiate tolerance, some users have speculated that it may also prevent stimulant tolerance. Moreover, it also appears to enhance some of the positive effects of stimulants; in a study on humans, memantine administered for 7-10 days prior to cocaine consumption was able to enhance cocaine’s subjective high feelings and overall positive effects. Regardless, not many studies have been done to assess its effects on stimulant tolerance.
However, memantine alone has been found to be effective for ADHD. In one study, 34 adults aged 18-55 were titrated on a dose of 10 mg twice a day. After 6 weeks, there were significant improvements in attention, working memory, and other executive domains. In another study, children aged 6-12 years were given memantine for 8 weeks and improvements in ADHD symptoms were noted. However, those receiving 20 mg had larger improvements and were more likely to complete the trial than those receiving 10 mg.
Compared to stimulants for ADHD, memantine was found to be less effective than methylphenidate in reducing ADHD symptoms in children and adolescents. On the other hand, a small study found that memantine and extended-release methylphenidate combined well to produce a synergistic effect.
Ginseng seems to be a wonder herb that miraculously offers many health benefits, but a lot of these claims have yet to be confirmed by research. Luckily, one of them has been, and that is ginseng’s effect on ADHD. It has long been touted that ginseng can improve focus, energy, and improve overall cognitive function, and recent research backs these claims up.
In one study, children aged 5-16 years old received either ginseng or placebo twice a day. At the 8 week mark there were significant improvements in inattention and hyperactivity with the authors concluding that ginseng may be a viable treatment option for ADHD. Another study also found improvements in hyperactivity, inattention, and immaturity in 3 teenagers aged 14-17. Finally, one case study involving a 7 year old boy found 1800 mg of ginseng a day for 8 weeks improved his symptoms of ADHD and several ADHD rating scales.
The mechanism of Ginseng is not yet fully known, but it’s believed to increase dopamine and noradrenaline activity. However, at the same time it may also modulate it. What this means is that ginseng on its own can normalize levels of dopamine and noradrenaline in the brain. But, combining ginseng with other substances that increase dopamine, like adderall, will antagonize or blunt their effects. There are lots of studies in animals where ginseng inhibited dopamine release caused by stimulants such as cocaine, nicotine and even methamphetamine.
Iron is well-known to be essential for a variety of different functions in the body. Iron deficiency results in low energy, general weakness, but also a condition known as restless leg syndrome (RLS). This syndrome is directly linked to dopamine dysfunction. In other words, low iron results in low dopamine. Indeed, when we look at the production steps of dopamine we can see that iron is required for converting Phenylalanine into Tyrosine and Tyrosine into L-DOPA. However, iron goes beyond this and is very important in maintaining normal dopamine receptor function.
In fact, there are many studies in which iron was found to be effective at treating ADHD symptoms, particularly in those with low ferritin levels. Ferritin is a protein that binds to iron and transports it in the bloodstream or serum. There appears to be an inverse relationship between serum ferritin levels and ADHD symptoms, i.e. the lower the iron levels are the more severe the ADHD symptoms and vice-versa.
One study utilizing 14 boys aged 7-11 years old found iron supplementation to raise serum ferritin levels and subsequently decrease ADHD scores from 17.6 ± 4.5 to 12.7 ± 5.4. Another study involving children aged 5-8 years old with serum ferritin levels less than 30 ng/mL found a progressive decrease in ADHD scores during the 12 weeks of treatment. The authors of this study also concluded that iron supplementation was as effective as stimulants in treating ADHD.
Warning: Iron supplementation can be dangerous as the body has no way to discard or remove excess iron. Prolonged supplementation, especially with high doses, should be done under a doctor’s supervision with regular bloodwork done to assess iron levels in the body.
While not something you can ingest, more and more evidence has come forth revealing the beneficial effects of meditation on the brain. Meditation changes the brain structure and improves many cognitive factors including attention. There are many ways to meditate and one method that’s widely used in research is called mindfulness meditation. In essence, this technique is simply focusing on being in the present, i.e. being aware of where we are, what we’re doing, and to ignore what’s going on around us. Of course, being able to do this requires tremendous effort. However, you have to think of it as a game and you’re starting at level 1. At first it will feel impossible, but the more you do it, the easier it becomes.
Now, on to the science. In a study involving 24 adults and 8 adolescents with ADHD, 8 weeks of mindfulness meditation resulted in self-reported improvements in not only their ADHD symptoms, but also anxiety and depression. A similar 8-week study with 11 adults with ADHD also found improvements in both self-reported ADHD symptoms and clinician ratings of ADHD.
Mindfulness is not the only method that offers benefits to those with ADHD. Transcendental Meditation (TM) was also found to significantly reduce the symptoms of ADHD in 2 separate studies, with one of the studies finding that TM also resulted in increased verbal fluency.
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