Piracetam is a substance derived from the gamma-aminobutyric acid (GABA), a type of amino acid and brain chemical. Often referred to as a “smart drug,” piracetam is available over-the-counter in a number of countries (including the United Kingdom).
Although piracetam is also available for sale in the United States, the U.S. Food & Drug Administration has stated that piracetam cannot be marketed as a dietary supplement due to the fact that it cannot be classified as a vitamin, mineral, amino acid, botanical, or dietary substance.
Uses for Piracetam
Piracetam is said to act as a nootropic, a class of drugs designed to enhance memory and boost cognitive function. In alternative medicine, it’s thought that piracetam can help increase brain function by promoting communication between the left and right hemispheres of the brain.
In addition, piracetam is purported to treat or prevent the following health problems:
- Alzheimer’s disease
- Central nervous system disorders (such as epilepsy)
- Deep vein thrombosis
Piracetam is also said to slow up the aging process and promote recovery from alcoholism.
Benefits of Piracetam
So far, scientific support for the benefits of piracetam is limited. Here’s a look at several study findings on the potential benefits:
For a report published in the Cochrane Database of Systematic Reviews in 2012, investigators analyzed the available research on the use of piracetam among stroke patients.
The study’s authors note that piracetam can help protect against the formation of blood clots and shield nerve cells from injury or breakdown, which could benefit stroke patients.
However, looking at data from three clinical trials (involving a total of 1,002 patients), the report’s authors found no evidence that piracetam can help improve functioning or reduce mortality in people who have experienced a stroke.
2) Cognitive Impairment
Piracetam may benefit elderly people suffering from dementia or cognitive impairment, according to a 2002 report published in Dementia & Geriatric Cognitive Disorders. Analyzing the results of 19 previously published studies, the report’s authors found that piracetam was superior to placebo in the treatment of older adults with cognitive impairment.
3) Central Nervous System Disorders
A report published in the journal Drugs in 2010 suggests that piracetam shows promise in the treatment of central nervous system disorders. Sizing up the available research on piracetam for central nervous system disorders, the report’s authors determined that piracetam may aid in the treatment of depression, anxiety, myoclonus epilepsy, and tardive dyskinesia (a type of neurological disorder).
Piracetam may trigger a number of side effects, such as sleep disruption, dry mouth, weight gain, and anxiety.
It’s important to keep in mind that supplements haven’t been tested for safety and dietary supplements are largely unregulated. In some cases, the product may deliver doses that differ from the specified amount for each herb. In other cases, the product may be contaminated with other substances such as metals. Also, the safety of supplements in pregnant women, nursing mothers, children, and those with medical conditions or who are taking medications has not been established.
Alternatives to Piracetam
If you’re seeking an alternative to piracetam, a number of natural remedies may help improve your brain health. For instance, fish oil, a source of omega-3 fatty acids, have been found to enhance cognitive function, preserve memory, and protect against depression and Alzheimer’s disease. Found naturally oily fish (including salmon, sardines, tuna, mackerel, and herring), fish oil is also sold in supplement form.
Possible Mechanisms of Side Effects
1) NMDA receptor
Piracetam activates AMPA receptors (allosteric) and increases the number of NMDA receptors. These receptors are also important for learning and plasticity.
However, activation of NMDA receptors can potentially cause anxiety, restlessness, irritability, insomnia, OCD, brain fog and a host of psychiatric disorders that are involved in NMDA receptor over-activation.
2) AMPA receptor
Faramptor is a molecule that activates AMPA receptors (allosteric) in a low impact way, just like the racetams, and can cause a headache, sleepiness, and nausea.
Piracetam is an anticholinergic, which is why people also supplement with choline. For example, piracetam reduces acetylcholine in the hippocampus of rats.
I suspect that the people getting headaches and muscle spasms weren’t taking enough choline or if they were then they were taking too much. Acetylcholine also interacts with sweat glands, possibly contributing to this side effect.
4) Oxidative Stress
In rodents, piracetam increased oxidative stress in the hypothalamus with an equivalent human dosage of around 3.25g (for a 68kg person).
Oxidative stress in the hypothalamus likely plays in causing brain fog (IMO), which is a side effect of racetams.
People who are healthy are less likely to notice these effects if they are sleeping well, but this doesn’t imply that nothing is happening under the hood.
Here’s a review that sums it up: “If I take too much, with or without an alpha-gpc choline source, I get a bit tired, or tense, or foggy – especially if I’m not well rested and well fed when I go higher into my ‘personal’ dosing range.”
Some of the piracetam’s memory enhancing effects are mediated by aldosterone/mineralocorticoid receptors .
Increased activation of this receptor may help explain the side effects of sweating, irritability and sleep issues from piracetam.
Very little is known about ampakines; the only example to reach human clinical trials as of 2014 is Cortex Pharmaceuticals’ CX-717, which was evaluated in Phase I for the treatment of Alzheimer’s disease. However, tissue damage was seen in animal studies and the FDA denied the application and the approval stopped (Cortex claimed this was not caused by the drug). None of the other ampakines is known to currently be in human trials, so little can be proven about their efficacy or safety in healthy individuals.
Racetams increase brain plasticity, but that’s not always good. Brain plasticity in the areas of the brain that affect emotional and mood functions could potentially lead to poor emotional regulation and impulsivity if plasticity is excessive and unregulated.
Side Effects Reported in Forums
Based on case reports, the main side effects of piracetam and other racetams are:
- Brain fog
- Sleep issues
- Muscle twitching
- Cognitive problems (issues with reading, spelling and verbal retrieval)