Piracetam and cognition

Piracetam

  • Vitamins & Supplements
  • Updated August 24, 2018

Piracetam is a nootropic (i.e., cognitive enhancing) drug, though the FDA has not approved it for any medical use. Several clinical studies found that piracetam may benefit cognitive functions in older people, though the evidence is mixed and many of these studies were of low quality. No benefits have been observed in dementia patients. In preclinical studies, piracetam enhances the fluidity of cell plasma membranes and mitochondrial function, which could benefit cognition and help prevent dementia. Piracetam is generally regarded as safe, though it does have some drug interactions.

Evidence

There have been numerous clinical trials of piracetam, though many are dated and of poor quality. Our search identified:

  • 8 meta-analyses in various patient populations
  • 8 randomized controlled clinical trials
  • 1 brain imaging study in dementia patients
  • Numerous preclinical studies on possible mechanisms of action

Potential Benefit

Several studies have shown that piracetam improves cognitive functions in older people, though many of the studies are dated and used subjective measures of cognitive functions.

In healthy, older people, one controlled clinical trial reported improvement in visual perception, attention, function, and acuity [1], while a larger controlled trial failed to show significant improvement in 10 different cognitive tests when compared to placebo [2]. In cognitively impaired older adults, piracetam treatment was associated with clinical improvement based on a meta-analysis of numerous randomized controlled trials [3]. However, in most studies the measurements used were crude and did not test specific cognitive functions. In a controlled clinical trial of psychiatric patients with mild cerebral impairment, piracetam treatment improved overall functioning, particularly alertness, socialization, and cooperation, relative to the control group [4]. In a meta-analysis of randomized controlled trials in post-stroke patients, piracetam treatment did not improve overall severity of aphasia, but the treatment was associated with improvement in written language [5].

In preclinical studies, piracetam enhances the fluidity of plasma membranes and membranes of brain mitochondria. Several studies have shown that piracetam enhances mitochondrial function and energy production while reducing cell death [6][7]. Piracetam can also protect against oxidative stress and the harmful effects of beta-amyloid in model systems [8][9]. Theoretically, this could protect neurons from damage, reducing cognitive impairment and dementia risk.

For Dementia Patients

In two double-blind randomized controlled trial of Alzheimer's patients, piracetam treatment did not result in improvement in cognitive functions [10][11]. A double-blind randomized controlled trial of 20 people with Parkinson's dementia also reported that piracetam treatment failed to improve cognitive or neurological measures [12].

Safety

Side effects with piracetam are uncommon and include dizziness, drowsiness, and diarrhea [13][14][15]. The evidence also suggests that piracetam treatment is generally safe and does not result in toxicity [1][11]. Piracetam may interact with thyroid extract, thyroxine, aspirin, and anticoagulants (e.g., warfarin or acenocoumarol) [16]. You should not take piracetam if you have experienced serious kidney problems, brain hemorrhage, or Huntington's disease. Piracetam is excreted in human breast milk and should not be taken by breastfeeding mothers [17].

NOTE: This is not a comprehensive safety evaluation or complete list of potentially harmful drug interactions. It is important to discuss safety issues with your physician before taking any new supplement or medication.

How to Use

Piracetam is not approved by the FDA for any medical use and is not permitted to be sold as a dietary supplement. In Europe, piracetam is sold under various trade names including Nootropil® and Lucetam®. Most clinical trials have used doses of 4.8 g/day (ranging from 2.4-9.6 g/day) [3][5][18][19][20].

Learn More

Information on possible side effects, warnings, and precautions from Drugs.com

References

  1. Mindus P, Cronholm B, Levander SE et al. (1976) Piracetam-induced improvement of mental performance. A controlled study on normally aging individuals. Acta Psychiatry Scand 54, 150-160.
  2. Abuzzahab FS, Sr., Merwin GE, Zimmermann RL et al. (1977) A double blind investigation of piracetam (Nootropil) vs placebo in geriatric memory. Pharmakopsychiatr Neuropsychopharmakol 10, 49-56.
  3. Waegemans T, Wilsher CR, Danniau A et al. (2002) Clinical efficacy of piracetam in cognitive impairment: a meta-analysis. Dement Geriatr Cogn Disord 13, 217-224.
  4. Chouinard G, Annable L, Ross-Chouinard A et al. (1983) Piracetam in elderly psychiatric patients with mild diffuse cerebral impairment. Psychopharmacology (Berl) 81, 100-106.
  5. Zhang J, Wei R, Chen Z et al. (2016) Piracetam for Aphasia in Post-stroke Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials. CNS Drugs 30, 575-587.
  6. Leuner K, Kurz C, Guidetti G et al. (2010) Improved mitochondrial function in brain aging and Alzheimer disease - the new mechanism of action of the old metabolic enhancer piracetam. Front Neurosci 4.
  7. Stockburger C, Miano D, Pallas T et al. (2016) Enhanced Neuroplasticity by the Metabolic Enhancer Piracetam Associated with Improved Mitochondrial Dynamics and Altered Permeability Transition Pore Function. Neural Plast 2016, 8075903.
  8. Verma DK, Joshi N, Raju KS et al. (2015) Metabolic enhancer piracetam attenuates rotenone induced oxidative stress: a study in different rat brain regions. Acta Neurobiol Exp (Wars) 75, 399-411.
  9. Mingeot-Leclercq MP, Lins L, Bensliman M et al. (2003) Piracetam inhibits the lipid-destabilising effect of the amyloid peptide Abeta C-terminal fragment. Biochim Biophys Acta 1609, 28-38.
  10. Croisile B, Trillet M, Fondarai J et al. (1993) Long-term and high-dose piracetam treatment of Alzheimer's disease. Neurology 43, 301-305.
  11. Growdon JH, Corkin S, Huff FJ et al. (1986) Piracetam combined with lecithin in the treatment of Alzheimer's disease. Neurobiol Aging 7, 269-276.
  12. Sano M, Stern Y, Marder K et al. (1990) A controlled trial of piracetam in intellectually impaired patients with Parkinson's disease. Mov Disord 5, 230-234.
  13. Al Hajeri A, Fedorowicz Z (2016) Piracetam for reducing the incidence of painful sickle cell disease crises. Cochrane Database Syst Rev 2, CD006111.
  14. Ricci S, Celani MG, Cantisani TA et al. (2012) Piracetam for acute ischemic stroke. Cochrane Database Syst Rev, CD000419.
  15. De Reuck J, Van Vleymen B (1999) The clinical safety of high-dose piracetam--its use in the treatment of acute stroke. Pharmacopsychiatry 32 Suppl 1, 33-37.
  16. Piracetam. Drugs.com.
  17. Piracetam. PubChem.
  18. Flicker L, Grimley Evans G (2001) Piracetam for dementia or cognitive impairment. Cochrane Database Syst Rev, CD001011.
  19. Herrmann WM, Stephan K (1992) Moving from the question of efficacy to the question of therapeutic relevance: an exploratory reanalysis of a controlled clinical study of 130 inpatients with dementia syndrome taking piracetam. Int Psychogeriatr 4, 25-44.
  20. Samorajski T, Vroulis GA, Smith RC (1985) Piracetam plus lecithin trials in senile dementia of the Alzheimer type. Ann N Y Acad Sci 444, 478-481.