Piracetam

Piracetam (sold under many brand names) is a nootropic 2 Side eects

drug in the racetams group, with chemical name 2-
oxo-1-pyrrolidine acetamide. It shares the same 2- Piracetam has been found to have very few side ef-
oxo-pyrrolidone base structure with pyroglutamic acid. fects, and those it has are typically few, mild, and
Piracetam is a cyclic derivative of GABA (gamma- transient.[13] A large-scale, 12-week trial of high-dose
Aminobutyric acid). Presently piracetam is used in many piracetam found no adverse eects occurred in the group
European countries, Asia and South America. In the taking piracetam as compared to the placebo group.[14]
United States, it is not approved by the US Food and Drug Many other studies have likewise found piracetam to be
Administration for any medical use and it is not permitted well tolerated.[13][15][16]
to be sold as a dietary supplement.[1][2] In the UK, pirac-
etam is prescribed mainly for myoclonus,[3] but is used Symptoms of general excitability, including
o-label for other conditions. Evidence to support its use anxiety, insomnia, irritability, headache, agitation,
for many conditions is unclear. nervousness, tremor, and hyperkinesia, are occasionally
reported.[10][17][18] Other reported side eects include
somnolence, weight gain, clinical depression, weakness,
increased libido, and hypersexuality.[10]

1 Medical uses
2.1 Toxicity
1.1 Dementia
The LD50 for oral consumption in humans has not been
determined;[19] however, the LD50 is 5.6 g/kg for rats and
A 2001 Cochrane review concluded that there was not 20 g/kg for mice, indicating extremely low acute toxic-
enough evidence to support piracetam for dementia or ity.[20]
cognitive problems.[4] A 2002 review and 2005 review
concluded that piracetam had some positive eects in
older patients with these problems.[5][6] In 2008, a work-
ing group of the British Academy of Medical Sciences 3 Mechanisms of action
noted that many of the trials of piracetam for dementia
were awed.[7][8] Piracetams mechanism of action, as with racetams in
general, is not fully understood. The drug inuences
neuronal and vascular functions and inuences cogni-
tive function without acting as a sedative or stimulant.[6]
1.2 Depression and anxiety Piracetam is a positive allosteric modulator of the AMPA
receptor.[21] It is hypothesized to act on ion chan-
Some sources suggest that piracetams overall eect on nels or ion [19] carriers, thus leading to increased neuron
lowering depression and anxiety is higher than on improv- excitability. GABA brain metabolism and GABA re-
[9]
ing memory. However, depression is reported to be an ceptors are not aected by piracetam [22]
occasional adverse eect of piracetam.[10] It has been found to increase blood ow and oxygen con-
sumption in parts of the brain, but this may be a side ef-
fect of increased brain activity rather than a primary ef-
fect or mechanism of action for the drug.[23]
1.3 Other Piracetam improves the function of the neurotransmitter
acetylcholine via muscarinic cholinergic (ACh) recep-
Peripheral vascular eects of piracetam have suggested tors, which are implicated in memory processes.[24] Fur-
its use potential for vertigo, dyslexia and sickle cell thermore, piracetam may have an eect on NMDA
anemia.[6] A subsequent Cochrane review of the evi- glutamate receptors, which are involved with learning and
dence did not support piracetams use in sickle cell cri- memory processes. Piracetam is thought to increase cell
sis prevention.[11] Piracetam may have potential for the membrane permeability.[24][25] Piracetam may exert its
treatment of the symptoms of childhood autism.[12] global eect on brain neurotransmission via modulation

1
2 8 NOTES

of ion channels (i.e., Na+ , K+ ).[19] It has been found to is produced by Laboratorios Farma S.A. and sold un-
increase oxygen consumption in the brain, apparently in der the brand name Breinox. In Mexico it is produced
connection to ATP metabolism, and increases the activ- by UCB de Mexico, and sold under the brand name of
ity of adenylate kinase in rat brains.[26][27] Piracetam, Nootropil. Other names include Nootropil in the United
while in the brain, appears to increase the synthesis of States, Europe, Brazil, Hong Kong, India, and Mexico;
cytochrome b5,[28] which is a part of the electron trans- Lucetam, Oikamid, Smart, Geratam, and Biotropil in
port mechanism in mitochondria. But in the brain, it also Europe and Brazil; Neurobasal in Colombia; Breinox in
increases the permeability of the mitochondria of some Ecuador and Venezuela;Stimulan in Egypt; and Nocetan
intermediaries of the Krebs cycle.[26] in Latin America.

4 History 7 See also

Aniracetam
Piracetam was rst made some time between the 1950s
and 1964.[29] There are reports of it being used for Brivaracetam an analogue of piracetam with the
epilepsy in the 1950s.[30] same additional side chain as levetiracetam and a
threecarbon chain. It exhibits greater antiepileptic
properties than levetiracetam in animal models, but
with a somewhat smaller, although still high, thera-
5 Approval peutic range.

Piracetam is primarily used in Europe, Asia, and South Hydergine

America. In the United States, it is not approved by the Levetiracetam an analogue of piracetam bear-
US Food and Drug Administration for any medical use ing an additional CH3 CH2 sidechain and bearing
and it is not permitted to be sold as a dietary supplement. antiepileptic pharmacological properties through a
Piracetam is legal to import into the United Kingdom for poorly understood mechanism probably related to its
personal use with or without prescription. Piracetam has anity for the vesicle protein SV2A.
no DIN in Canada, and thus cannot be sold but can be im-
ported for personal use in Canada.[31] It has become pop- Oxiracetam
ular as a cognitive enhancement drug among students.[32] Phenylpiracetam a phenylated analog of the drug
piracetam which was developed in 1983 in Russia
where it is available as a prescription drug.
6 Availability Pramiracetam

8 Notes
[1] Inspections, Compliance, Enforcement, and Criminal In-
vestigations
[2] Enforcement Report - Week of 20 March 2013
[3] Nootropil. NetDoctor.co.uk. 8 July 2004. Retrieved 21
September 2009.
[4] Flicker, L; Grimley Evans, G (2001). Piracetam for
dementia or cognitive impairment.. The Cochrane
database of systematic reviews (2): CD001011.
doi:10.1002/14651858.CD001011. PMID 11405971.
[5] Waegemans, T; Wilsher, CR; Danniau, A; Ferris, SH;
Piracetam 800 mg tablets Kurz, A; Winblad, B (2002). Clinical ecacy of pirac-
etam in cognitive impairment: a meta-analysis.. De-
Piracetam is sold under a wide variety of brand names mentia and geriatric cognitive disorders. 13 (4): 21724.
worldwide. Popular trade names for piracetam in Eu- doi:10.1159/000057700. PMID 12006732.
rope are Nootropil and Lucetam, among many others. [6] Winblad, B (2005). Piracetam: a review of phar-
In Argentina, it is made by GlaxoSmithKline S.A. lab- macological properties and clinical uses. CNS Drug
oratories and sold under the trade name of Noostan (800 Reviews. 11 (2): 16982. doi:10.1111/j.1527-
mg or 1200 mg). In Venezuela and Ecuador, piracetam 3458.2005.tb00268.x. PMID 16007238.
 3

[7] Horne G, et al. (May 2008). Brain science, addiction and [19] Gouliaev, AH; Senning, A (1994). Piracetam and other
drugs (PDF) (Report). Academy of Medical Sciences. p. structurally related nootropics. Brain research. Brain
145. ISBN 1-903401-18-6. research reviews. 19 (2): 180222. doi:10.1016/0165-
0173(94)90011-6. PMID 8061686.
[8] Talbot, Margaret (27 April 2009). Brain Gain: The un-
derground world of 'neuroenhancing' drugs. The New [20] Piracetam Material Safety Sheet (PDF). Spectrum.
Yorker. Retrieved 21 September 2009.
[21] Ahmed, A; Oswald, R (2010). Piracetam Denes a
[9] Malykh AG, Sadaie MR (February 2010). Piracetam New Binding Site for Allosteric Modulators of -amino-
and piracetam-like drugs: from basic science to novel clin- 3-hydroxy-5-methyl-4-isoxazole-propionic acid (AMPA)
ical applications to CNS disorders. Drugs. 70 (3): 287 receptors. Journal of Medicinal Chemistry. 53 (5):
312. doi:10.2165/11319230-000000000-00000. PMID 21972203. doi:10.1021/jm901905j. PMC 2872987 .
20166767. PMID 20163115.

[10] Nootropil. Arzneimittel-Kompendium der Schweiz. [22] Giurgea, Corneliu E. (1982-01-01). The nootropic con-
2013-09-12. Retrieved 2013-10-27. cept and its prospective implications. Drug Development
Research. 2 (5): 441446. doi:10.1002/ddr.430020505.
[11] Al Hajeri, AA; Fedorowicz, Z; Omran, A; Tad- ISSN 1098-2299.
mouri, GO (18 April 2007). Piracetam for re-
ducing the incidence of painful sickle cell disease [23] Jordaan, B; Oliver, DW; Dormehl, IC; Hugo, N (1996).
crises.. The Cochrane database of systematic reviews (2): Cerebral blood ow eects of piracetam, pentifylline,
CD006111. doi:10.1002/14651858.CD006111.pub2. and nicotinic acid in the baboon model compared with the
PMID 17443614. known eect of acetazolamide. Arzneimittel-Forschung.
46 (9): 8447. PMID 8876930.
[12] Akhondzadeh, S., et al. A double-blind placebo controlled
trial of piracetam added to risperidone in patients with [24] Winnicka, K; Tomasiak, M; Bielawska, A (2005).
autistic disorder. Child Psychiatry and Human Develop- Piracetam--an old drug with novel properties?". Acta
ment, Vol 39(3), Sep, 2008. pp. 237245. poloniae pharmaceutica. 62 (5): 4059. PMID
16459490.
[13] Koskiniemi, M; Van Vleymen, B; Hakamies, L; Lamusuo,
S; Taalas, J (1998). Piracetam relieves symptoms [25] Mller, WE; Eckert, GP; Eckert, A (1999). Piracetam:
in progressive myoclonus epilepsy: a multicentre, ran- novelty in a unique mode of action. Pharmacopsychiatry.
domised, double blind, crossover study comparing the ef- 32 Suppl 1: 29. doi:10.1055/s-2007-979230. PMID
cacy and safety of three dosages of oral piracetam with 10338102.
placebo. Journal of neurology, neurosurgery, and psychi-
atry. 64 (3): 3448. doi:10.1136/jnnp.64.3.344. PMC [26] Grau, M; Montero, JL; Balasch, J (1987). Eect of
Piracetam on electrocorticogram and local cerebral glu-
2169975 . PMID 9527146. cose utilization in the rat. General pharmacology. 18 (2):
20511. doi:10.1016/0306-3623(87)90252-7. PMID
[14] De Reuck, J; Van Vleymen, B (1999). The clinical
3569848.
safety of high-dose piracetam--its use in the treatment of
acute stroke. Pharmacopsychiatry. 32 Suppl 1: 337. [27] Nickolson, VJ; Wolthuis, OL (1976). Eect of the
doi:10.1055/s-2007-979234. PMID 10338106. acquisition-enhancing drug piracetam on rat cerebral en-
ergy metabolism. Comparison with naftidrofuryl and
[15] Fedi, M; Reutens, D; Dubeau, F; Andermann, E; methamphetamine. Biochemical pharmacology. 25 (20):
D'agostino, D; Andermann, F (2001). Long-term ef- 22414. doi:10.1016/0006-2952(76)90004-6. PMID
cacy and safety of piracetam in the treatment of pro- 985556.
gressive myoclonus epilepsy. Archives of neurology.
58 (5): 7816. doi:10.1001/archneur.58.5.781. PMID [28] Tacconi, MT; Wurtman, RJ (1986). Piracetam: physio-
11346373. logical disposition and mechanism of action. Advances
in neurology. 43: 67585. PMID 3946121.
[16] Giurgea, C.; Salama, M. (1977). Nootropic drugs.
Prog Neuropsychopharmacol. 1 (34): 235247. [29] Li, Jie Jack; Corey, E. J. (2013). Drug Discovery: Prac-
doi:10.1016/0364-7722(77)90046-7. tices, Processes, and Perspectives. John Wiley & Sons. p.
276. ISBN 9781118354469.
[17] Chouinard, G; Annable, L; Ross-Chouinard, A; Olivier,
M; Fontaine, F (1983). Piracetam in elderly psy- [30] M.D, Emeritus Profess of Neurology and Head of
chiatric patients with mild diuse cerebral impair- Epilepsy Research Group Berlin Dieter Schmidt;
ment. Psychopharmacology. 81 (2): 1006. Shorvon, Emeritus Profess of Neurology and Consultant
doi:10.1007/BF00429000. PMID 6415738. Neurologist Simon (2016). The End of Epilepsy?: A His-
tory of the Modern Era of Epilepsy Research 1860-2010.
[18] Hakkarainen, H; Hakamies, L (1978). Piracetam in Oxford University Press. p. 69. ISBN 9780198725909.
the treatment of post-concussional syndrome. A double-
blind study. European neurology. 17 (1): 505. [31] #2, Government of Canada, Health Canada, Health Prod-
doi:10.1159/000114922. PMID 342247. ucts and Food Branch, HPFB Inspectorate, Inspectorate
4 10 EXTERNAL LINKS

Ottawa, Compliance, Enforcement and Coordination Di-

vision. Guidance Document on the Import Require-
ments for Health Products under the Food and Drugs Act
and its Regulations (GUI-0084) [Health Canada, 2010]".
www.hc-sc.gc.ca. Retrieved 2016-03-06.

[32] Medew, Julia (1 October 2009). Call for testing on 'smart

drugs". Fairfax Media. Retrieved 29 May 2014.

9 References
UCB Pharma Limited (2005). Nootropil 800
mg & 1200 mg Tablets and Solution. electronic
Medicines Compendium. Datapharm Communica-
tions. Retrieved 8 December 2005.

10 External links
Piracetam (Nootropyl) by Ward Dean, M.D., and
John Morgenthaler

U.S. National Library of Medicine

 5

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