Effects
Several meta-reviews of literature on Piracetam indicate that Piracetam increases performance on a variety of cognitive tasks among dyslexic children, though this may reflect its enhancement of cross-hemispheric communication and of cognitive function in general, rather than a specific improvement in whatever causes dyslexia. Piracetam also seems to inhibit brain damage caused by a variety of factors including hypoxia and excessive alcohol consumption.
Piracetam has been studied in an extensive number of clinical experiments, mostly focusing on dyslexic children, and some believe that understanding the mechanism it works through can teach us about the role of inter-hemispheric communication in the brain.
Mechanisms of action
The mechanisms of action of Piracetam are quite broad. Piracetam is understood to work by stimulating the cerebral cortex as well as by increasing the rate of metabolism and the energy levels of neurons. It possibly facilitates movement of information between the brain's two hemispheres via the corpus callosum, and improves the function of the neurotransmitter acetylcholine via muscarinic cholinergic (ACh) receptors which are implicated in memory processes. Furthermore, Piracetam may have an effect on NMDA glutamate receptors which are involved with learning and memory processes. Finally, Piracetam may exert its global effect on brain neurotransmission via modulation of ion channels (ie. Ca2+, K+).
Dosage
Piracetam is usually supplied in 800 mg tablets or capsules. The recommended dosage varies based on the indication, usually ranging from 1.6-9.6 grams daily (2-12 pills daily). Some people report faster results when taking 1-2 pills every hour for 4-6 hours or taking 4-8 pills at once for the first few days to notice an effect.
It has been studied up to 45 grams daily without major side effects.
It has no known LD-50 in humans when taken orally.
In the US, and possibly other countries in which Piracetam is unregulated, it is often sold in bulk as a powder. It is up to the user to decide how they want to ingest said powder; orange juice is frequently cited as a good mixer to mask the taste.
Contraindications
Piracetam is contra-indicated in patients with severe renal impairment (renal creatinine clearance of less than 20 ml per minute), hepatic impairment and to those under 16 years of age. It is also contraindicated in patients with cerebral haemorrhage and in those with hypersensitivity to piracetam, other pyrrolidone derivatives or any of the excipients .
Special warnings and precautions for use
Due to the effect of piracetam on platelet aggregation, caution is recommended in patients with underlying disorders of haemostasis, major surgery or severe haemorrhage.
Abrupt discontinuation of treatment should be avoided as this may induce myoclonic or generalised seizures in some myoclonic patients.
As piracetam is almost exclusively excreted by the kidneys caution should be exercised in treating patients with known renal impairment. In renally impaired and elderly patients, an increase in terminal half-life is directly related to renal function as measured by creatinine clearance. Dosage adjustment is therefore required in those with mild to moderate renal impairment and elderly patients with diminished renal function.
Undesirable effects
The following adverse experiences (very rare usually occurring in 1 out of 1,000 people) were reported for piracetam with a statistically significantly higher incidence than placebo. Incidences are given for piracetam versus placebo treated patients.
Central and peripheral nervous system disorders: hyperkinesia (1.72 versus 0.42 %)
Metabolic and nutritional disorders: weight gain (1.29 versus 0.39 %)
Psychiatric disorders: nervousness (1.13 versus 0.25 %), somnolence (0.96 versus 0.25 %), depression (0.83 versus 0.21 %)
Body as a whole - general disorders: asthenia (0.23 versus 0.00 %)
Post-marketing experiences have reported the following undesirable effects:
Ear and labyrinth (inner ear) disorders: vertigo
Gastrointestinal disorders: abdominal pain, upper abdominal pain, diarrhoea, nausea, vomiting
Immune system disorders: anaphylactoid reaction, hypersensitivity, multiple chemical sensitivity
Nervous system disorders: ataxia, impaired balance, aggravated epilepsy, headache, insomnia, somnolence
Psychiatric disorders: agitation, anxiety, confusion, hallucination
Skin and subcutaneous tissue disorders: angioneurotic oedema, dermatitis, pruritus, urticaria, rash
