piracetam

Piracetam is a member of the racetam family of synthetic compounds, used as a general cognitive enhancer, to boost cognition and memory in conditions such as dementia and Alzheimer’s disease, and to treat myoclonus, a condition that causes brief muscle spasms and other neurological conditions. Piracetam is a smart drug, known as nootropics, a class of substances that are believed to enhance brain performance.

Piracetam is a derivative of gamma-aminobutyric acid (GABA), the principal inhibitory chemical (neurotransmitter) in the brain. It is not fully clear how exactly piracetam works. Piracetam is believed to have effects on the central nervous system and the vascular system. Piracetam may have neuroprotective and anticonvulsant properties and may improve the brain’s adaptability to form new neural connections (neuroplasticity) to compensate for injury and disease. Some of piracetam’s properties may include:

• Improving the function of acetylcholine, a neurotransmitter that plays an important role in memory processes
• Effects on NMDA glutamate receptors, protein molecules on nerve cell membranes, whose functions include learning and memory formation
• Enhancing energy metabolism and oxygen utilization in the brain
• Increasing cell membrane permeability and enhancing neurotransmission
• Facilitating the ability of red blood cells to change shape which helps their movement through blood vessels
• Reducing the adhesion of red blood cells to the blood vessel walls, reducing vasospasm and improving blood circulation in small vessels

Suggested uses of piracetam include:

• Alzheimer’s disease
• Dementia
• Memory dysfunction
• Brief, involuntary muscle twitches (myoclonus)
• Neurodegeneration from alcoholism
• Raynaud’s phenomenon, a condition with poor circulation in the extremities
• Deep vein thrombosis (DVT)
• Stroke
• Sickle cell anemia
• Cardiovascular surgery
• Tardive dyskinesia, a drug-induced movement disorder
• Dyslexia, a learning disorder
• Vertigo

In the United States, piracetam is not approved by the FDA and is classified as a new unapproved drug, because it is not generally recognized as safe and effective for the labeled uses. Piracetam failed to meet the definition as a dietary supplement and is not permitted by the FDA to be sold as a dietary supplement, nevertheless, it is available in the US in a number of supplements. In some European countries and Japan, piracetam is approved as a prescription drug for conditions such as myoclonus, dementia, and cognitive impairment.

The FDA has issued warnings to many companies that were illegally producing and selling piracetam, stating that cognitive enhancement supplements “may be ineffective, unsafe, and could prevent a person from seeking an appropriate diagnosis and treatment.” A Cochrane study conducted in 2004 concluded that piracetam may enhance memory and other intellectual functions, but published evidence does not support its use in treating dementia or cognitive impairment.

• Do not take piracetam or supplements containing piracetam in the following conditions:
  • Impaired liver function
  • Impaired kidney function
  • Pregnancy and lactation
  • Tendency to bleed or bruise easily (hemorrhagic diathesis)
• Use piracetam with caution if you:
  • Are elderly
  • Have any bleeding disorder
• Piracetam may impair physical and mental ability; avoid driving and tasks that require concentration and quick reflexes
• Avoid abrupt withdrawal of piracetam

Common side effects of piracetam include:

• Hyperactivity and muscle spasm (hyperkinesia)
• Drowsiness (somnolence)
• Sleeplessness (insomnia)
• Nervousness
• Depression
• Weakness and lack of energy (asthenia)
• Weight gain
• Diarrhea
• Abdominal pain
• Rash

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug.

Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

There is no established dose of piracetam for use in the U.S., because the drug is unapproved by the FDA. The following doses have been used in research:

Adult:
Coronary artery bypass graft (CABG) surgery

• 12 grams intravenous (IV) injection as a single dose
• 12 grams IV daily from the day before surgery to 6 days after surgery.
• 2 grams orally daily for 6 weeks, starting on day 6 after surgery

Seizure disorder

• 9.6-24 grams daily for up to 18 months

Tardive dyskinesia

• 8-24 grams IV daily
• 2.4 grams orally twice daily for 4 weeks

Vertigo

• 1-2 grams IV as a single dose.
• 800 mg three times daily for 1-8 weeks.

Pediatric:

Children younger than 16 years old

• Not recommended

The following doses have been used in research:

Breath-holding attacks

• Children 6-36 months of age: 40 mg/kg daily for 2-3 months

Dyslexia

• Children of age 7-14 years: 3.3 grams daily for at least 12 weeks

• Piracetam overdose is rare and reported symptoms include abdominal pain and diarrhea.
• Overdosage may be treated by eliminating unabsorbed drug in the stomach by induced vomiting or gastric lavage.
• There is no known antidote for piracetam. Overdose may be managed with symptomatic and supportive therapy.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Piracetam has no known severe or serious interactions with other drugs.
• Moderate interactions of piracetam include:
  • cilostazol
  • clopidogrel
  • dipyridamole
  • eptifibatide
  • prasugrel
  • ticlopidine
  • tirofiban
• Mild interactions of piracetam include:
  • levothyroxine
  • liothyronine
  • thyroid desiccated

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• Do not take piracetam if you are pregnant or breastfeeding; its efficacy and safety are not established

• There is insufficient research on piracetam’s efficacy and safety; it is not a substance generally recognized as safe (GRAS) and effective for the labeled uses; avoid use
• In the U.S., piracetam is neither approved as a drug nor as a dietary supplement, nevertheless, it is available in many dietary supplements
• Dietary supplements do not require pre-marketing approvals from the FDA; there may sometimes be discrepancy between the labeling and the actual ingredients and their amounts; exercise caution
• FDA has issued warnings to many companies that have been illegally producing and selling piracetam