Request edit access
NSI-189 Survey (created Nov. 2017)
Sign in to Google to save your progress. Learn more
Collecting data on NSI-189: positive effects, side effects, dose-response relationship, dose-side effect relationship, etc., to better understand the therapeutic potential of NSI-189. A few people in the anecdotal reports collected so far have said that it was the best thing they had ever tried for their medical condition(s), including SSRIs, SNRIs, antipsychotics, and benzodiazepines. We have read reports of people saying it helped depression, anhedonia, anxiety, ptsd, depersonalization, obsessive compulsive disorder, addiction, etc. If you want to read all the reports click this link: https://goo.gl/1Sr1JX
If you have used NSI-189 in the past or are currently using it, please take the time to answer this short survey, as best as you can.
1) Did you derive any benefits from NSI-189? *
2) Do you have a mental illness (or neurological disorder), diagnosed or strongly suspected? (Your identity will remain anonymous in this survey) Please select "As a nootropic" if you don't suffer from any medical condition for which you would have been taking NSI-189 to help. If, for example, you are an anxious person but not to the point of having a diagnosis of anxiety disorder, you would pick "As a nootropic". *
3) Answer this question only if you answered yes in the previous question, otherwise please skip to question 5.  If you have a mental illness, (or neurological condition), diagnosed or strongly suspected, please specify which one(s). (Please indicate your specific symptoms in question 3.)
4) What are your main psychiatric or neurological symptom(s)? Please describe as best as you can (loss of interest, pleasure and motivation, i.e. anhedonia).
5) If you did not derive benefits from NSI-189, please skip to question 10. Did the positive effects last once you stopped taking NSI-189?
Clear selection
6) If the positive effects lasted once you stopped taking NSI-189, for how long had you been taking it? (if not applicable, skip to question 8)
7) If the positive effects lasted after you stopped taking NSI-189, for how long did they remain? (if they never went away, please say so, and state how long ago you stopped using NSI-189)
8) Please specify which positive effects you derived from NSI-189, the ones you are confident can be directly attributed to NSI-189. Feel free to choose from the list below containing all the positive effects that were mentioned in online reports to date (you can just list the numbers). Feel free to add new positive effects if they aren't in the list.
Captionless Image
9) (Skip to question 10 if you were taking NSI-189 as as nootropic). If you took NSI-189 to help a specific mental illness or neurological disorder (officially diagnosed or strongly suspected), did it help it? If so, please specificy which mental illness(es) it helped, and in what way. (You may list the positive effects that were directly helpful for your specific condition(s) next to those conditions.)
10) What form of NSI-189 did you use? *
11) Did you experience any side effects when using NSI-189? *
12) (If you did not experience any side effects, skip to question 14). Please specify your particular side effects, and the frequency of EACH of them. (see image below for a list of all reported side effects with NSI-189 to date. Some of them are VERY rare. See box in lower right corner for suggestion of frequencies.) Feel free to add any side effects that is not found in the list. Please be as precise as possible. (e.g. #1b, #10a 2 weeks, #52d average 3 times/week)
Captionless Image
13) How long after starting NSI-189 did you first notice side effects? and at what dosage (in mg) was that? (please specify what type of NSI-189 if you said you have used both in question 10)
14) Did you have to discontinue NSI-189 because of a side effect? (answer no if you didn't have any side effects) *
15) Which side effect(s) caused you to discontinue NSI-189? (if not applicable, skip to question 16)
16) At what DOSAGE did you START deriving benefits? (Please state your total dosage per day and specify the form of NSI, e.g. 30mg freebase ) (if you did not derive benefits from NSI-189 please skip to question 20)
17) How long after starting NSI-189 did you first notice POSITIVE effects?
18) At what dosage did you derive the MOST benefits (regardless of side effects)?  Please also specify the type of NSI  (e.g. 50mg phosphate) (you can always answer something like "not sure yet")
19) What was the optimal dosage per day for you to maximize benefits, and having the least amount of side effects if any? (e.g. 50mg freebase) (you can always answer something like "not sure yet")
20) How many split dosages per day did you take? (if you did not use it everyday, please specify the frequency in "other")
Clear selection
21) (If you used it once a day, skip to question 23) If you used multiple doses per day, what  was the amount per dose (in mg)? (if you used both freebase and phosphate, specify the dosages for each)
22) How many hours were there between your doses?
23) Please list any other medications you took while taking NSI-189. If nothing else, write "nothing". *
24) If you used other nootropics, medications, or substances alongside NSI-189, discuss any desirable or undesirable effects you believe resulted from the combination. (skip to next question if you wrote "nothing" in question 23)
25) How does NSI-189 compare to all the other medications, supplements, nootropics, etc., that you have tried in your life so far?
26) Did you cycle your usage?
Clear selection
27) If you cycled it, how many days did your cycle(s) last?
28) Feel free to share any other info you think could be relevant to this survey, regarding anything (positive effects, side effects, personal opinions etc., etc.)
29) Did you already post a report online on your experience with NSI-189? (e.g. on Reddit, Longecity, Facebook forums, etc.). *
30) If your answer in the previous question was no, skip to question 31. If you have already posted a report online, could you provide us a link to your report, so we can check if we have already included it in the initial analysis based on the 94 Anecdotal Reports that we collected, so we don't double-count your data and so that we can add it to our extended analysis if we haven't already? If your report was in the Nootropica or Nootropics Facebook forum prior to Nov. 1, 2017, please e-mail me at ccarriere08@gmail.com to let me know so that, again, we can see if we have already included it (we did not reveal any names in the statistical analysis). Your identity will not be revealed either in the case where you would e-mail me.
31) Lastly, please provide some kind of username, keyword, or your name initials, that you will remember, so that I have a way to know it was you specifically that answered the survey (while remaining anonymous) (for example, you may feel like re-taking the survey in the future for more accurate answers, and in that case I would have to delete your previous survey submission to avoid double-counting your data). *
Please verify if your anecdotal report has already been included in the initial statistical analysis based on 94 anecdotal reports collected online, by clicking here: https://goo.gl/LK5jeD (look for your Reddit or Longecity username for example in the list of usernames, you can use control+F to find it more quickly). If we already have your report, we will replace the results that we gathered from your report with the ones you provide us in this survey because they will probably be more precise. *
Feel free to e-mail me at ccarriere08@gmail.com, if you want me to contact you when we will have accumulated more results and updated the statistical analysis. Or if you want to discuss anything else. :)
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report