Piracetam and Down Syndrome
Piracetam and Dyslexia
- Wilsher CR et al. Piracetam and dyslexia: effects on reading
tests. J Clin Psychopharm 7(4): 230-237, 1987. 225 dyslexic
children between 7 and 12 years old, all with normal IQs, enrolled in
double-blinded, placebo controlled study. Authors report significant improvement
in reading and comprehension.
- Volavka J et al. Effect of piracetam on EEG spectra of
boys with learning disorders. Psychopharm 72: 185-188, 1981.
Studied EEG changes by piracetam on 30 children with learning disorders.
Changes in delta waves, no change between left and right hemispheres. Same
effect as seen with amphetamines. (Note: learning disorders are associated
with EEG slowing, and the effect of piracetam is similar to that of ritalin
per these authors.)
- Ackerman PT et al. A trial of piracetam in
two subgroups of students with dyslexia. J Learning
Disab 24(9): 542-549, 1991. 53 children with dyslexia, categorized as dysphonetic
(could not associate sounds with phonic representations) or phonetic (could
associate). Piracetam helped phonetic group improve word recognition; no
other differences noted. Both groups given tutoring with the piracetam.
- Di Ianni M et al. The effects of piracetam
on children with dyslexia. J. Clin. Psychopharm 5:272-278, 1985.
Piracetam improved verbal meaning and increased reading speed.
- Levinson HN Dramatic favorable responses of children
with learning disabilities or dyslexia and attention deficit disorder to
antimotion sickness medications: Four case reports. Percep Motor Skill 73:723-738,
1991. (The title explains the gist of the article.)
Piracetam and Senile Dementia
- Stegink AJ The clinical use of piracetam, a new
nootropic drug. Arzneim.-Forsch. 22:975-979, 1972. (German)
Double-blinded with placebo study on patients in nursing home. Attention
improved, no other effects seen.
- Faleni J Pharmacol 5(30), 1974 80% of senile dementia patients
showed improvement after piracetam treatment for 11 weeks.
- Friedman E et al. Clincal Response to choline plus
piracetam in senile dementia: relation to red-cell choline levels. New
Eng J Med 1981 Jun 11; 304(24): 1490-1. This is actually
a "letter" rather than a full paper, and consisted giving 10 patients with
presenile dementia piracetam and choline for 7 days in a non-controlled study.
3 of the 10 had "marked improvement" cognitively, but no description
of the cognitive tests or whether the testing was blinded is mentioned.
The 3 who responded had higher choline red blood cell levels than the
7 who didn't respond.
- Chouinard G et al. Piracetam in elderly
psychiatric patients. Psychopharm 81:100-106,1983. Piracetam
improved scores in various memory tests in patients with "mild diffuse cerebral
impairment." 12 week treatment.
- Growdon JH et al. Piracetam combined with lecithin
in the treatment of Alzheimer's disease. Neurobiol of Aging
7:269-276, 1986. Piracetam was administered alone or with lecithin
(phosphatidylcholine) in a double-blinded test. No effect was seen,
with or without lecithin, on cognition or memory test scores.
- Corona GL et al. Clinical and biochemical responses
to therapy in Alzheimer's disease and multi-infarct dementia. Eur.
Arch. Psychiatr. Neurol. Sci. 239:79-86, 1989. Patients with either
AD or multi-infarct dementia were given either piracetam or piracetam with
choline. This was not paired with placebos. Despite biochemical changes,
there was no change in memory performance.
- Nicholson CD Pharmacology of nootropics and
metabolically active compounds in relation to their use in dementia.
Psychopharm 101:147-159, 1990. Review of literature to
date on this topic. "Despite [piracetam's] interesting animal pharmacology,
convincing evidence that piracetam is an effective agent against the cognitive
symptoms of primary dementia is still awaited....In general, the trials have
not been performed in well-defined patient collectives, but rather in patients
with ill-defined psycho-organic brain syndromes." (A very good article.)
- Heiss W-D et al. Abnormalities of energy metabolism
in Alzheimer's disease studied with Positron Emission Tomography.
Ann NY Acad Sci, 1991. Using piracetam created an increase in glucose
metabolism by brain cells in patients with A.D., but
not in normal patients.
- Croisile B et al. Long-term and high-dose
piracetam treatment of Alzheimer's disease. Neurology 43:
301-305, 1993. 1 year, double-blinded with placebo study of 30 A.D.
patients treated with piracetam. No improvement in dementia noted, but there
was a significant slowing of deterioration.
- Weinstock M The pharmacology of Alzheimer's Disease
based on the cholinergic hypothesis: an update. Neurodegen 4:
349-356, 1995. A "where we are now" review of the literature, briefly
touching upon piracetam as increasing alertness but without effect
on memory or improving cognition.
- Zs.-Nagy, I On the possible role of nootropica in
geriatric prevention and therapy. Annals NY Acad Sci
444-452, 1996. Has an interesting section on the history of nootropica;
reviews briefly all the nootropic drugs' uses in senile dementia.
Piracetam and Myoclonus
and other paroxysmal disorders
(Note: myoclonus refers to the spasm or twitching of a muscle or group of
muscles, and is not associated with a loss of consciousness. It can
be a part of many neurologic diseases and can be cortical (epileptic) or
subcortical. This appears to be the current main focus of attention
of piracetam by UCB Pharma. "Paroxysmal" disorders are those with a
sudden onset of a symptom, such as a seizure.)
- Kunneke PS. A controlled clinical trial on the
effect of piracetam in epileptic children. Br J Clin Practice
33(9): 266-271, 1979. 16 children with epilepsy and learning disorders
given piracetam or placebo for 6 weeks. No effect on severity or frequency
of seizures noted. Researchers report a positive effect on visual
perception and on memory as tested by digit spans.
- Brown, P et al. Effectiveness of piracetam in cortical
myoclonus. Movement Disorders 8(1): 63-68, 1993. 21 patients
with cortical myoclonus were evaluated in a double-blind, controlled study
with placebo. Piracetam markedly helped myoclonus. No interaction
seen between piracetam and anticonvulsants. Note: sudden withdrawal
of piracetam caused worsening of myoclonus and seizures.
- Ikeda A et al Clinical trial of piracetam
in patients with myoclonus: Nationwide multiinstitution study in
Japan. Movement Disorders 11(6): 691-700, 1996. 60
adults studied, with good results.
- Van Vleymen V and Van Zandijke M Piracetam in the
treatment of myoclonus: an overview. Acta Neurol Belg 96: 270-280,
1996. This paper summarizes all trials and case reports known to the
authors to date. It showed efficacy in several types of myoclonus,
there was no obvious interaction with anticonvulsants, and adverse effects
- Guerrini R et al. Cortical myoclonus in Angelman
syndrome. Ann Neurol Jul;40(1):39-48, 1996. 11 patients
with Angelman syndrome, ages 3 to 28 years. All had myoclonus with
abnormal EEG activity. 5 were given piracetam, with good results for
all five patients.
- Dulac O et al. Myoclonus and epilepsy in childhood:
1996 Royaumont meeting. Epilepsy Research 30:91-106, 1998.
This paper is a terrific resource for the description and etiology
of all types of myoclonus. However, the portion dealing with treatment
takes up only 2 full pages. Piracetam gets a brief mention: "In various
types of cortical myoclonus including progressive myoclonic epilepsy and
post anoxic myoclonus, it has marked effect on over one third of the cases...but
is poorly effective against thalamocortical and subcortical myoclonus."
- Donma MM. Clinical efficacy of piracetam in treatment
of breath-holding spells. Ped Neuro 18(1): 41-45, 1998. 39
children ages 6 to 36 months of age were given piracetam for 2 months, and
showed piracetam to be successful in stopping breath-holding spells from
causing a loss of consciousness.
Piracetam and Aphasia/Stroke
- Huber, W et al. Piracetam as an adjuvant to language
therapy for aphasia: a randomized double-blind placebo-controlled pilot study.
Arch Phys Med Rehabil 78: 245-250, 1997. 24 adults with stroke
or brain injury resulting in moderate to severe aphasia were given piracetam
along with speech therapy for 6 weeks. Piracetam had a significant
effect on written language but not on spoken language. Total mean scores
on an aphasia scale were higher with the group on piracetam.
- De Deyn PP et al. Treatment of acute ischemic stroke
with piracetam. Members of the Piracetam in Acute Stroke Study (PASS)
Group. Stroke 28(12):2347-52, 1997. A multicenter, randomized, double-blind trial to
test whether piracetam conferred benefit when given within 12 hours of the
onset of acute ischemic stroke to a large group of patients. Piracetam
did not influence outcome when given within 12 hours of the onset of acute
ischemic stroke. Another study is underway decreasing the time interval to 7
Studies on Mechanism of Action and Other Rat Studies
- Mondadori C Do piracetam-like compounds act centrally
via peripheral mechanisms?Brain Res 435: 310-314, 1987.
Removing the adrenal glands inactivates any effect of piracetam;
therefore, adrenal steroids moderate piracetam's actions somehow.
- Ennaceur A et al. A new one-trial test for
neurobiological studies of memory in rats: effects of piracetam and pramiracetam.
Behav Brain Res 33: 197-207, 1989. Giving piracetamto rats gives
significant amount of retention of recognition of previously
introduced objects at 24 hour intervals ("promnesic" effect). Piracetam
conjectured to have no effect on working memory but may improve reference
- Mondadori C et al. Blockade of the nootropic action of
piracetam-like nootropics by adrenalectomy. Behav Brain Res
34: 155-158, 1989. Adrenalectomized rats do not respond to piracetam
at any dosage. Confirms earlier theory of adrenal steroids.
- Laszy J and Sarkadi A Hypoxia-induced sleep disturbance
in rats. Sleep 13(3): 205-217, 1990. Rats were placed
in chambers with low oxygen amounts (hypoxia) which caused a disturbance
in the sleep cycle. Piracetam almost fully restored the cycle, even with
the oxygen still low. Hypoxic sleep disturbance is a model of hypoxic brain
damage, so piracetam may reverse brain damage caused by hypoxia.
- Mondadori C Involvement of a steroidal component
in the mechanism of action of piracetam-like nootropics. Brain
Res 506: 101-108, 1990. Piracetam's mechanism of action may be due
to intervention in steroid-sensitive gene transcription/protein synthesis.
- Mondadori C Aldosterone receptors are involved in
the mediation of the memory-enhancing effects of piracetam. Brain
Res 524: 203-207, 1990. Expands further on the same topic.
- de Angelis L Memory storage and effect of repeated
treatment with rubidium chloride. J Intern'l Med Res 19:
395-402, 1991. Piracetam improved memory of rats in this study,
but not as well as strychnine or rubidium chloride.
- Paula-Barbosa MM et al. The effects of piracetam
on lipofuscin of the rat cerebellar and hippocampal neurons after long-term
alcohol treatment and withdrawal. Alcohol Clin Exp Res 15(5):
834-838, 1991. Large amounts of lipofuscin (granules
of lipid residuals from metabolism in individual cells) in nerve cells is
a characteristic of nervous system aging. It can also be seen early on in
chronic alcohol consumption. Piracetam treatment in rats reduces lipofuscin
accumulation by improving enzymatic activity in cell digestive processes.
- Chleide E et al. Enhanced resistance effect of piracetam
upon hypoxia-induced impaired retention of fixed-interval responding in rats.
Pharmacol Biochem. Behav 40: 1-6, 1991. Hypoxic
rats given tasks, then repeated with either piracetam or saline. Pir-treated
rats performed tasks better than saline-treated rats. (Note: this paper has
a nice discussion on the mechanism of action of piracetam on memory; authors
concluded piracetam facilitates memory retrieval. --LL)
- Stancheva SL et al. Age-related changes of the effects
of a group of nootropic drugs on the content of rat brain biogenic monoamines.
Gen Pharmac 22(5): 873-877, 1991. Age-related decrease
in the content and turnover rate of biogenic amines (precursors to
neurotransmitter chemicals) are examined in senile rats. (Note: don't ask
me how they knew the rats were senile.) Piracetam increased the level
of amines, and facilitated learning and memory.
- Nalini K et al. Effects of piracetam on retention
and biogenic amine turnover in albino rats. Pharmacol
Biochem Behav 42: 859-864, 1992. Piracetam caused a decrease
in all neurogenic amines and metabolites in these rats, but there was an
overall decreased turnover of brain amines. Increased memory retention noted.
- Nicoletti, F et al. Excitatory amino acids and neuronal
plasticity. Funct Neurol 7: 413-422, 1995. In cultured neurons,
piracetam enhanced the stimulation of the influx of calcium ions.
- Cohen SA and Muller WE. Effects of piracetam
on NMDA receptor properties in the aged mouse brain. Pharmacol 47:
217-222, 1993. Piracetam increased the number of specific
N-Methyl-D-Aspartate receptors in senile rat brains. The receptors involved
appear to be part of the memory process.
- Rose S Cell-adhesion molecules, glucocorticoids
and long-term-memory formation. Trends Neurosci 18(11): 502-506,
1995. Chicks were used to show that the transition of short-term
to long term memory may involve the enhanced synthesis of glycoprotein
cell-adhesion molecules (CAMs). Steroids enhance this synthesis. The author
proposes (but does not test the theory) that nootropics such as piracetam
may work by influencing this steroid-enhanced mechanism.
- Jordaan B et al. Cerebral blood flow effects of
piracetam...in the baboon model compared with... acetazolamide.
Arzneim-Forsch/Drug Res 46(II): 844-847, 1996. Using SPECT
imaging of the brain, piracetam is shown to cause increased blood flow to
the occipital area and the left side of the brain.
- Verbnyi, YI et al. Piracetam-induced changes in
the functional activity of neurons as a possible mechanism for the effects
of nootropic agents. Neurosci Behav Physiol 26(6): 507-515,
1996. Piracetam had significant effects on electrical activity of neurons
of pond snails, which was mediated by an increase in intracellular calcium.
(A lot of research on piracetam has been done in Russia; this is a rare paper
from Russia in that it made it into an English translation.)
- Muller WE et al. Effects of piracetam on membrane
fluidity in the aged mouse, rat and human brain. Biochem Pharmacol
53: 135-140, 1997. Reduced fluidity of brain cell membranes has been
postulated to be responsible for impaired cognitive functions. This
paper shows piracetam can increase membrane fluidity in aged rats given piracetam
orally for several weeks, and was associated with improved avoidance-learning
in those rats. (Human brain cells were taken from autopsy cases and
soaked in piracetam in a tube for this study, and showed increased fluidity
of membranes also.)
- Verbnyi Y et al. Piracetam-induced changes in the
functional activity of neurons as a possible mechanism for the effects of
Piracetam and Blood Disorders
- Grekas D et al. Piracetam as a potent inhibitor
of plasma thromboxane B2 during hemodialysis. Nephron 52: 372-373,
1989. Dialysis causes unwanted blood clotting by the unintentional
creation of thromboxanes, which stimulate platelet cells to clump together
and clot the blood. Piracetam inhibits the production of thromboxane
B2, and therefore may be useful in dialysis.
- Grekas D A pilot study of piracetam in cuprophan
hemodialysis. Artificial Organs 13(5):422-426, 1989.
Piracetam has an antiplatelet effect during blood-membrane interaction.
(Note: this paper also references others I was unable to find that state
piracetam also has an antiplatelet effect in strokes and during transplants
of kidneys and removal of spleens. --LL)
- Murayama M Decompression-inducible platelet aggregation
and hemostasis. Thrombosis Research 54: 493-498, 1989.
Texas Green frogs were used to study decompression effects on
blood clotting. Frogs were exposed to the barometric pressure equivalent
to the summit of Mt. Everest. Piracetam was found to block the platelet clumping
normally produced by this type of decompression. (Note: this is my favorite
study. Not only do they specify that this is the Texas green frog, but the
best quote of all these papers is here: "Now it is generally known that there
are great similarities between frog and man." The only problem is, I don't
know what a Texas green frog would be doing at the top of Mt. Everest.)
- Murayama M Decompression-induced hemostasis in mice.
Thrombosis Research 57: 813-816, 1990. Piracetam inhibited
decompression-induced hemostasis in mice.
- Moriau M et al. Treatment of the Raynaud's phenomenon
with piracetam. Arzneimittelforschung 43(5):526-35, 1993.
A very nice paper in which piracetam was shown to be helpful in relieving
the symptoms of Raynaud's syndrome, probably through inhibition of platelet
function and increasing red blood cell membrane deformability. Piracetam
was well tolerated.
- El-Hazmi MAF et al. Piracetam is useful in the treatment
of children with sickle cell disease. Acta Haematol 96: 22-226, 1996. A well-done
controlled, double-blinded test showing improvement of children with sickle
cell anemia while taking piracetam. Of note is that the children were on
the drug for 1 year with no toxic side effects.
Piracetam: Review Articles
- Gouliaev AH and Senning A Piracetam and other
structurally related nootropics. Brain Res Rev, 1994; 19: 180-222.
(This is an excellent review article. The section on piracetam
by itself is only 6 pages, though. --LL)
- Vernon MW and Sorkin EM Piracetam: An overview of
its pharmacological properties and a review of its therapeutic use in senile
cognitive disorders. Drugs and Aging 1(1): 17-35, 1991.
(Another excellent review article, and goes greatly into detail about
its actions in the body as well as what is known about its use in presenile
- Pranzatelli MR and Nadi S Mechanism of action of
antiepileptic and antimyoclonic drugs. In "Negative Motor
Phenomena," ed. Fahn S et al, Advances in Neurology Vol 67, 329-360
Lippincott-Raven, 1995. This article contains a couple of pages
on piracetam, summarizing what's known about it's mechanism of action.
- Mondadori C Nootropics: Preclinical results in the
light of clinical effects; Comparison with tacrine. Critical Reviews
in Neurobiol 10: 357-370, 1996. A review of clinical effects of nootropics
in memory enhancement, and compared
to tacrine, a cholinesterase inhibitor and the only drug registered to date
in the US for Alzheimer's disease. Mondadori, who has several studies published
on piracetam, concludes: "Given the observed overall positive effects of
the nootropics and their occasionally quite distinct effects in individual
patients, this category of compounds would appear useful. The results
available so far give no indication that tacrine is superior to the nootropics,
- Tacconi MT and Wurtman RJ Piracetam: Physiologic
disposition and mechanism of action. In Advances in
Neurology Vol 43, 675-685, Raven Press, NY 1986. At the time,
a very nice review of the literature to date.