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PIRACETAM FAQ
Maintained by Erowid
Version 0.7
Jul 2004




Table of Contents


  1. Preliminary
      2. 1.1 Revision history
      1.2 Copyright notice
      1.3 Disclaimer notes
  2. Introduction
      2.1 What is piracetam? 2.2 What are the reported benefits of piracetam?
  3. Research
      3.1 What have medical studies found? 3.2 How does piracetam work? 3.3 Are there side effects to piracetam use?
    4 Usage Guidelines
      4.1 What is a typical dose?
      4.2 Does piracetam interact with other drugs?
    5 Availability
      5.1 What is the legal status of piracetam?
      5.2 Where can I find more information?
        5.2.1 Web resources
        6 References


1. Prelminary

1.1 Revision history

1.2 Copyright notice

Permission is granted to re-publish this document in its entirety as long as a link is included back to the current central repository location (http://www.erowid.org/smarts/piracetam/piracetam_faq.shtml) to allow for updates to propagate. This copyright notice must also be included. HTML and formatting may be changed. This copyright is consistent with the Creative Commons Attribution-NoDerivs 1.0 license.

1.3 Disclaimer

This FAQ is not intended to provide medical advice nor should any decisions be based solely on information from this document. Talk to your doctor before making any decisions about medications.

2. Introduction

2.1 What is piracetam?

 Piracetam

Piracetam is a member of the class of drugs known as nootropics or 'smart drugs'. Nootropics are known commonly as cognitive enhancers. Piracetam is similar in molecular structure to the amino acid pyroglutamate. Piracetam and pyroglutamate have the same base chemical structure, the 2-oxo-pyrrolidine, but they differ by a side chain. Pyroglutamate is 2-oxo-pyrrolidine carboxylic acid, and piracetam is 2-oxo-pyrrolidine acetamide.

Piracetam was created about 30 years ago by UCB laboratories. Other trade names include: Avigilen, Cerebroforte, Cerebrospan, Cetam, Dinagen, Encefalux, Encetrop, Euvifor, Gabacet, Genogris, Memo-Puren, Nootron, Nootrop, Nootropil, Nootropyl, Normabrain, Norzetam, Pirroxil, Psycotron, Stimucortex, and UCB-6215.

Similar drugs

A number of drugs are related to piracetam. These include oxiracetam, pramiracetam, etiracetam, nefiracetam, aniracetam and rolziracetam. These have additional structural analogues that behave in a similar manner.[4] Unless otherwise indicated, the information contained in this FAQ is about piracetam itself.

2.2 What are the reported benefits of piracetam?



Considered a "smart drug" or nootropic, piracetam is reported to enhance cognitive functions of the brain such as memory, attention, intelligence, etc. There is very little empirical evidence to support this claim in healthy individuals. Piracetam is believed to increase blood flow between the two hemispheres of the brain. It's also been reported to protect brain tissue from various physical and chemical abrasions such as alcohol damage.

One study described the benefits of piracetam in this way: "In animal models and in healthy volunteers, the drug improves the efficiency of the higher telencephalic functions of the brain involved in cognitive processes such as learning and memory. The pharmacology of piracetam is unusual because it protects against various physical and chemical insults applied to the brain. It facilitates learning and memory in healthy animals and in animals whose brain function has been compromised, and it enhances interhemispheric transfer of information via callosal transmission. At the same time, even in relatively high dosages it is devoid of any sedative, analeptic or autonomic activities." [7]

3. Research and studies

3.1 What have medical studies found?



 Alzheimer's disease

Abstract: Preclinical research suggests that piracetam (a nootropic drug) may improve cognitive functions, but previous studies have failed to demonstrate a clear benefit for the treatment of Alzheimer's disease (AD). We report a 1-year, double-blind, placebo-controlled, parallel-group study with a high dose of piracetam (8 g/d per os) in 33 ambulant patients with early probable AD. Thirty subjects completed the 1-year study. No improvement occurred in either group, but our results support the hypothesis that long-term administration of high doses of piracetam might slow the progression of cognitive deterioration in patients with AD. The most significant differences concerned the recall of pictures series and recent incident and remote memory. The drug was well-tolerated.[6]

 Elderly drivers

Abstract: 101 elderly motorists with reduced reaction capacity were examined under real traffic conditions with regard to their driving ability. They were given a daily dose of 4.8 g piracetam or placebo over a six-week period in a randomized double-blind study. The percentage of correctly solved sign-observance items, which reflects orientation and perception in real traffic conditions, increased in the placebo-treated test-group from 79.86% in the pretest to 80.07% in the retest, whereas the test subjects of the piracetam-treated group improved their performance from 77.08% to 84.16%. After being treated with piracetam for 6 weeks, the drivers showed a significantly better performance than the placebo-group. Of particular interest is the finding that the test-subjects who had scored less than 80% in the pretest improved without exception in the retest after treatment with piracetam.[1]

 Children with dyslexia

Abstract: Sixty children with dyslexia (41 boys, 19 girls; ages 9 to 13) were enrolled in a 10-week summer tutoring program that emphasized word-building skills. They were randomly and blindly assigned to receive either placebo or piracetam, a purportedly memory-enhancing drug that has been reported to facilitate reading skill acquisition. The children were subtyped as "dysphonetic" or "phonetic" on the basis of scores from tests of phonological sensitivity and phoneme-grapheme correspondence skills. Of the 53 children who completed the program, 37 were classified as dysphonetic and 16 as phonetic. The phonetic group improved significantly more in word-recognition ability than the dysphonetic group. Overall, the children on medication did not improve more than the nonmedicated ones in any aspect of reading.

The phonetic subgroup on piracetam gained more in word recognition than any subgroup but did not improve significantly more than the phonetic subgroup on placebo. Results are discussed in relation to findings from previous studies of piracetam in children with dyslexia.[3]

 Parkinson's disease

Abstract: Twenty patients with Parkinson's disease and marked intellectual impairment or dementia participated in a double-blind placebo controlled trial of the nootropic, piracetam. A standardized neurological examination, a neuropsychological test battery, and a functional scale, The Sickness Impact Profile, were completed for all patients. They were then assigned by blind randomization to drug or placebo conditions receiving 3.2 g of piracetam or an identical amount of placebo for 12 weeks. The dose was increased to 4.8 g for an additional 12 weeks. Neurological, psychological, and functional measures were rated as improved, unchanged, or worsened in comparison to baseline performance. Twenty-five percent of the patients did not complete the trial for reasons unrelated to the medication. Although there was a significant improvement on one subtest of the functional scale, no significant effects were demonstrated in cognitive or neurological measures.[12]

3.2 How does piracetam work?



 Theories

This continues to be somewhat of a mystery. No definitive mechanism of action has been found. A study conducted in 1994 reviewed previously published literature from 1965-1992 (407 references). An excerpt:

"We believe that the effect of the racetams [[piracetam and others mentioned in 1.1]] is due to a potentiation of already present neurotransmission and that much evidence points in the direction of a modulated ion flux by, e.g., potentiated calcium influx through non-L-type voltage-dependent calcium channels, potentiated sodium influx through alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor gated channels or voltage-dependent channels or decreases in potassium efflux. Effects on carrier mediated ion transport are also possible."[4]


"How piracetam exerts its effects on memory disorders is still under investigation, although among other proposed mechanisms of action it is thought to facilitate central nervous system efficiency of cholinergic neurotransmission. Results from trials involving elderly patients with senile cognitive disorders have been equivocal, as have the results obtained when piracetam has been combined with acetylcholine precursors." [7]

How it doesn't work

It has been determined the piracetam does not work through many common metabolic pathways.

"No affinity for the alpha 1-, alpha 2-, beta-, muscarinic, 5-hydroxytryptamine-, dopamine, adenosine-A1-, mu-opiate, gamma-aminobutyric acid (GABA) (except for nefiracetam (GABAA)), benzodiazepine and glutamate receptors has been found."[4]

3.3 Are there side effects?



No significant side effects of been observed. Piracetam is remarkably well tolerated in humans through a wide range of doses. [7] Women who are breast feeding or pregnant should not use this drug. Piracetam may cause stomach upset as well. The effects of this drug are largely subjective. Some of the effects may be undesirable.

4. Usage Guidelines

4.1 What is a typical dose?



Dosages form 400mg to 4800mg are considered safe. Some literature recommend an 'attack dose' in the range of 1600mg to 2400mg for the first few days to initiate a response in people seeking cognitive enhancing effects. Start with a normal dose like 800mg. It is likely that you will feel the effects at this level. Then try and attack dose if you feel it necessary.

Some individuals report that they could feel strong effects at 800mg on the first day. On subsequent days at the same dosage the effects were not as noticeable. It is unclear whether maximum benefits are obtained from daily use over time or if occasional use has benefits. If possible work with your doctor.

4.2 Does piracetam interact with other drugs?



Piracetam is said to increase the effects of alcohol and amphetamines. No other drug interactions have been noted. It is recommended that alcohol be avoided as one of the reported effects of piracetam is increased flow of blood to the brain, which would increase damage and intoxication.

5. Availability

5.1 What is the legal status of piracetam?



This will vary from country to country. It is generally available through mail order. Legal issues exist. This section is organized by country.

United States

Piracetam has not been approved by the FDA for use in the United States. This does not mean that it is illegal. It is legal to use, possess, and import piracetam on a 'personal use' basis. Overseas distributors have reported that they have very little trouble shipping to the U.S., and over the past few years piracetam has become available from a number of U.S. companies. What follows is a large excerpt taken from a text on the FDA web site http://www.fda.gov/ circa 2003, covering various elements of legality like 'serious conditions' and 'personal use'.

"For many years FDA has permitted individuals to bring into the country small "personal-use" quantities of drugs sold abroad but not approved in the U.S. -- provided that the drugs do not pose unreasonable or significant safety risks, that their use will not be commercialized, and that they are for a serious condition for which there is no satisfactory treatment available in this country. The policy was designed to allow people to import through their personal baggage small quantities of medicines they may have been treated with while traveling abroad, and to allow individuals with serious conditions the ability to import through the mail personal-use quantities of unapproved drugs that they feel might be helpful in treating their conditions."

"Personal-use quantities are generally considered to be amounts for a patient's treatment for three months or less. Imports involving larger quantities may not be permitted as they lend themselves to commercialization."

"In recent years this policy has gained greater attention because of the plight of people with AIDS who have sought to import unapproved therapies from abroad. These include importations brought into the country though personal baggage carried back from a trip to another country or through mail shipments."

"Persons with additional questions about importation of drugs for personal use should consult with the local FDA district office or the Imports Operations Branch in Rockville, MD at (301) 443-6553."

United Kingdom

If you have information regarding the availability or piracetam in the UK please send a message to submissions@erowid.org

Mexico

Piracetam is a prescription medication in Mexico.

5.2 Where can I find more information?





Internet resources

rec.drugs.smart

6. References

1. 
Abbreviated Journal Title: Pharmacopsychiatry
Date Of Publication: 1991 Jul
Journal Volume: 24
Page Numbers: 121 through 126 
Country of Publication: GERMANY
Language of Article: Eng
Issue/Part/Supplement: 4
ISSN: 0176-3679
3.
Abbreviated Journal Title: J Learn Disabil
Date Of Publication: 1991 Nov
Journal Volume: 24
Page Numbers: 542 through 549 
Country of Publication: UNITED STATES
Language of Article: Eng
Special Journal List: 
Issue/Part/Supplement: 9
ISSN: 0022-2194
4.
Abbreviated Journal Title: Brain Res Brain Res Rev
Date Of Publication: 1994 May
Journal Volume: 19
Page Numbers: 180 through 222 
Number of References: 422
Country of Publication: NETHERLANDS
Language of Article: Eng
Issue/Part/Supplement: 2
ISSN: 0165-0173
6.
Abbreviated Journal Title: Neurology
Date Of Publication: 1993 Feb
Journal Volume: 43
Page Numbers: 301 through 305 
Country of Publication: UNITED STATES
Language of Article: Eng
Issue/Part/Supplement: 2
ISSN: 0028-3878
7.
Abbreviated Journal Title: Drugs Aging
Date Of Publication: 1991 Jan
Journal Volume: 1
Page Numbers: 17 through 35 
Number of References: 102
Country of Publication: NEW ZEALAND
Language of Article: Eng
Issue/Part/Supplement: 1
ISSN: 1170-229X
12.
Abbreviated Journal Title: Mov Disord
Date Of Publication: 1990
Journal Volume: 5
Page Numbers: 230 through 234 
Country of Publication: UNITED STATES
Language of Article: Eng
Issue/Part/Supplement: 3
ISSN: 0855-3185


Last Modified - Sat, Mar 18, 2006 Used by Erowid with permission of author
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