Piracetam (chemical name 2-oxo-1-pyrrolidine acetamide) is a cyclic derivative of the neurotransmitter gamma-aminobutyric acid (GABA). Although it is structurally similar to GABA, it doesn’t appear to have any GABA-like effects in animals [1]. Piracetam has a diverse range of physiological effects such as neuroprotective and anticonvulsant properties, improved neuroplasticity, improved microcirculation,… [2]. Piracetam is classified as nootropic drug in the racetam group and is commonly prescribed for cognitive impairment and dementia in several European countries.
Piracetam’s Effectivenes for Various Cognitive Disorders
Two meta-analyses have examined the effect of piracetam on individuals with age-related cognitive disorders [3,4]. Meta analysis by Waegemans and colleagues [3] evaluated 19 studies (published and unpublished studies to reduce publication bias) that lasted 6-52 weeks with doses from 2.4 to 8 grams of piracetam per day and involved about 1500 patients. This meta-analysis showed that nearly 64% of patients that received piracetam improved on Clinical Global Impression of Change (CGIC) rating scales compared with 34% of placebo-treated patients. The meta-analysis by Flicker and Grimley [4] included 6 well-controlled clinical trials of total 477 patients with various cognitive disorders. Results of this meta-analysis were consistent with findings by Waegemans and colleagues.
Significantly greater improvement compared to placebo in immediate recall was reported in 162 patients with age-associated memory impairment that were receiving 2.4 and 4,8 grams of piracetam daily for 3 months [5]. Therapy was most effective in patients whose baseline performance on memory tests was lowest. Another study in 78 patients with psychoorganic syndrome reported significant improvements with 3 x 1600 mg of piracetam daily, while no difference was reported with 3 x 800 mg of piracetam per day compared to placebo [6].
Mechanism of Action
While still under debate, it seems that piracetam exerts is beneficial effects via restoration cell membrane fluidity [2]. This effect is particularly evident when normal fluidity is compromised (e.g. during aging) [7].
Bioavailability and Absorption
Orally supplemented piracetam has excellent absorption with bioavailability close to 100% [9]. Taking piracetam with food does not seem to affect absorption but it does reduce plasma concentrations by 17% [2].
Uses for Dyslexia
Studies evaluating piracetam for treatment of dyslexia aren’t completely consistent. However, most trials show statistically significant improvements relative to placebo [10-12]. Its effects are modest at best and may take months to manifest [2].
Treatment of Alzheimer’s Disease
One well-designed and long-term (1 year) study using high dose of piracetam (8 grams per day) reported no improvement [8]. However, this research supports the hypothesis that piracetam slows the progression of Alzheimer’s disease.
Piracetam in Healthy Population
There is lack of studies in otherwise healthy population. However, there are some small and limited benefits for healthy population. A study in 16 normal volunteers who were given a total of 1200 mg (3 times 400 mg) of piracetam daily for 14 days reported no beneficial effects after 7 days but after 14 days verbal learning was significantly improved [13].
Other uses
Piracetam has also been used to treat alcoholism. It has been demonstrated to reduce neural loss following chronic alcohol consumption [14] and may also significantly reduce increased lipofuscin (an age-related waste pigment) in brain cells caused by excessive alcohol consumption [15]. Piracetam is nearly as effective as aspirin (acetylsalicylic acid) for blood clotting and better tolerated [16].
Piracetam as Bodybuilding Supplement
Piracetam, same as any other nootropic, is used to increase mental focus during workout. However, due to limited benefits in healthy population one should not expect any evident benefit from piracetam ingestion.
Side Effects
Piracetam seems to be almost completely devoid of adverse effects and is extremely well tolerated [1] even at high doses [2]. A 12-week, large-scale trial reported no side effects in the group taking piracetam [16]. Long-term studies using high dose of piracetam show that piratema is well-tolerated [8]. Piracetam does not seem to interact with any other drugs [2].
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References
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Waegemans, Tony, et al. “Clinical efficacy of piracetam in cognitive impairment: a meta-analysis.” Dementia and geriatric cognitive disorders 13.4 (2002): 217-224.
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Flicker, Leon, and John Grimley Evans. “Piracetam for dementia or cognitive impairment.” Cochrane Database Syst Rev 1 (2004).
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Levi, G., and E. Sechi. “A study of piracetam in the pharmacological treatment of learning disabilities.” Child health and development 5 (1987): 129-139.
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- Cadete-Leite, A., et al. “The GABAergic system of the dentate gyrus after withdrawal from chronic alcohol consumption: effects of intracerebral grafting and putative neuroprotective agents.” Alcohol and alcoholism 32.4 (1997): 471-484.
- Paula‐Barbosa, M. M., et al. “The Effects of Piracetam on Lipofuscin of the Rat Cerebellar and Hippocampal Neurons after Long‐Term Alcohol Treatment and Withdrawal: A Quantitative Study.” Alcoholism: Clinical and Experimental Research 15.5 (1991): 834-838.
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