It seems to me that any regiment of Nootropics also requires an adequete intake of various vitamins, minerals, and anti-oxidants. I think that one of the problems and side effects with Nootropics can often be traced back to the very foundation for sound mental health: nutrition.
Firstly, I have found in my personal experience that just taking certain Nootropics (i.e. Piracetam, Aniracetam, Galantamine, Huperzine A, (et al) often isn't sufficient to achieve the kind of mental awareness that I would personally like to attain. So, I did some research on the effects of various vitamins and particularly Omega-3 fatty acids, and found that these can have a significant impact on emotional well-being and mental acuity overall. For example, the B-vitamin Pyridoxine (B-6) has been largely implicated in the incidence of emotional stress and states of anxiety (Cancer Treat Rev 2000 May; 54(5):803-807). Also, the B-vitamin Cobalamin (B-12) has been related to levels of psychological distress, the study reports: "Cobalamin level was inversely related to self-reported overall distress level and specifically to depression, anxiety, and confusion subscale scores, as well as to clinically rated depressed and anxious mood" (J Psychosom Res 2000 Feb 1; 48(2):177-185).
There was a study conducted by the University College Swansea in the UK relating Vitamin supplementation for 1 year with improved mood, in which "One hundred and twenty-nine young healthy adults took either 10 times the recommended daily dose of 9 vitamins, or a placebo, under a double-blind procedure, for a year [...] Males taking the vitamins differed from those taking the placebo in that they reported themselves as feeling more 'agreeable' after 12 months. After 12 months the mood of females taking the vitamin supplement was significantly improved in that they felt more 'agreeable', more composed and reported better mental health. (Neuropsychobiology, 1995, 32:2, 98-105).
Secondly, I think it is of great importance to maintain a positive antioxidant status while on any regiment of Nootropics, because their effect on the body has not been fully elucidated. When you consume any drug or nutrient, it is usually transported to the liver via portal circulation, in which first-pass metabolism occurs. When you have large amounts of any particular drugs running through your liver every day, certain liver enzymes are raised to compensate for the incoming foreign substance. This can result in certain instances in the lowering of the cellular antioxidant glutathione, which protects the liver from oxidative stress. As glutathione levels lower, liver function becomes increasingly taxing on your body, and toxins begin to build eventually resulting in liver scarring. Gone untreated, this dysfunction of the liver can result in cirrhosis, which can cause permanent liver damage. Likewise, after your body has used these substances, their metabolic breakdown products are usually excreted in the urine, via the kidneys (for example, the breakdown product of 5-Hydoxytryptamine or serotonin is 5-HIAA or 5-hydroxyindoleacetic acid). The kidneys maintain a proper sodium/potassium balance in the body, and detoxify various chemicals excreted in the urine. A large amount of stress on the kidneys can result in decreased function (and therefore toxin outflow), resulting in greater time for bodily retention of toxic substances.
This is not to say that all Nootropics will cause your bodily organs to fail, rather, it is a suggestion as to the possibility of the potential chemical stress exerted on your body via the ingestion of large amounts of Nootropics. This is why I believe it is important to take anti-oxidants which protect the liver and kidneys from oxidative stress, such as Milk Thistle, which contains various flavonolignans such as silymarin and silybin. The latter have a particular protective effect on cells of the liver caused by various chemical and environmental toxins, via the enhanced production of cellular glutathione (Pharmacol Toxicol. 2000 Jun;86(6):250-6, Clin Ter. 1977 May 31;81(4):333-62., Z Arztl Fortbild Qualitatssich. 1999 Jun;93(4):VI-XI, et al.)
Conclusively, my point is that before venturing into the Nootropical realm of treatment, first see if your problem stems from a nutritional deficiency. If you already are involved in Nootropics, and find they don't work very well, the base of your problem to begin with could have been nutritional, in which Nootropics would be of little help. The best course, in my opinion, is to blend Nootropics with various nutrients, multi-faceted to the emotional/cognitive enhancement goal. Secondarily, a word of caution should be noted with the every day use of any type of Nootropic, in consideration for your body's capacity for chemically induced stress. Overall, the concomitant use of vitamins, minerals, anti-oxidants and Nootropics yields the most probable success and safety of any "Smart Drug" regiment.