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Smart Drugs & Nutrients:

How to Improve Your Memory and Increase Your Intelligence Using the Latest Discoveries In Neuroscience

VOLUME 1 in the Smart Drugs Series

by Ward Dean, M.D. & John Morgenthaler
$12.95 - 224 pages, softcover (Out of Stock)

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Section 4: Nootropics: More Doctors Recommend

Piracetam (Nootropil) | Aniracetam | Fipexide | Oxiracetam | Pramiracetam | Pyroglutamate (PCA) | Vinpocetine (Cavinton)

Piracetam (Nootropil)

This drug is reported to be an intelligence-booster with no toxicity or addictive properties. Piracetam is inexpensive (under $0.85 per day) and available by mail (see Appendix A, page 165). The subjective effect described by some people is that pir­acetam "wakes up your brain." You'll find more personal accounts of the effects of this remarkable drug in the case histories and testimonials appendix (see page 179). Its effects and safety are so impressive that piracetam prompted the creation of a new pharmaceutical category called the nootropics.

The term nootropic comes from a Greek word meaning "acting on the mind". Since the invention of piracetam by UCB Laboratories in Belgium, other pharmaceutical compa­nies have been scrambling to develop their own noo­tropics. Some of them being researched now include: vin­pocetine, aniracetam, pramiracetam, and oxiracetam. As yet, there is no nootropic compound that is FDA-approved for sale in the U.S., but there is plenty of motivation on the part of pharma­ceutical companies to get that approval. Financial analysts expect that the U.S. market for these smart drugs will soon be in excess of $1 billion per year (Pelton, 1989).

Piracetam is very similar in molecular structure to the amino acid pyroglutamate (see Pyroglutamate). Piracetam and pyroglutamate have the same "base" chemical structure, the 2‑oxo‑pyrrolidine, but they differ by the side chain. Pyro­glutamate is 2‑oxo‑pyrrolidone carboxylic acid, and pira­cetam is 2‑oxo‑pyrrolidine acetamide.

Piracetam enhances cognition under conditions of hypoxia (too little oxygen), and also enhances memory and some kinds of learning in normal humans. Outside of the U.S., piracetam is used to treat alcoholism, stroke, vertigo, senile dementia, sickle‑cell anemia, dyslexia, and numerous other health problems (Pelton, 1989).

One of the most intriguing effects of piracetam is that it promotes the flow of information between the right and left hemispheres of the brain (Buresova, 1976). We know that communication between the two sides of the brain is associa­ted with flashes of creativity. This may also be the basis for piracetam's usefulness in the treatment of dyslexia (Dilanni, 1985).

The effect of piracetam may be increased if taken with DMAE, centro­phenoxine, choline, or Hydergine. When choline and piracetam are taken together there is a synergistic effect that causes a greater improvement in memory than the sum of each when taken alone (Bartus, 1981).

We know of one person who claims she feels slightly agitated and depressed if she takes piracetam for more than a week without a choline supplement. This feeling is allevia­ted for her with a single dose of choline. It may be that the piracetam causes acetylcholine to be used up more quickly and that the choline helps to replace this important neuro­trans­mit­ter.

One fascinating study suggests that piracetam might increase the number of cholinergic receptors in the brain. Older mice were given piracetam for two weeks and then the density of muscarinic cholinergic receptors in their frontal cortexes was measured. The researchers found that these older mice had 30-40% higher density of these receptors than before. (Pilch, 1988). Piracetam, unlike many other drugs, appears to have a regenerative effect on the nervous system.

One theory of Alzheimer's disease is that the decline of intellectual functions is partly caused by a decreased activity of the cholinergic system in the brain caused by cell death and cell degeneration. The researchers in the above study specu­lated that their findings could explain how piracetam works and could also explain the finding of Bartus and his colleagues regarding the profound effect of combining choline with piracetam on memory enhancement of old rats.

As mentioned previously, the late drug researcher Arthur Cherkin related to us that he believed the combination of Hydergine and piracetam potentiate each other up to five times. This highlights the importance of adjusting the dosages when multiple substances are taken because some of these sub­stances will cause paradoxical effects when excessive amounts are taken.

Although piracetam is a derivative of GABA (Gamma Amino Butyric Acid, a neurotransmitter), there is no evidence that piracetam works through the GABAergic system. Some research even suggests GABA may inhibit memory and learning (Zhang, 1989).

Piracetam protects rats from the memory-impairment effects of hypoxia and electroconvulsive seizure (ECS). In the first part of this study, rats are administered NaCl (saline) as a control, NaCl + hypoxia, or piracetam + hypoxia. In the second part, rats are administered no treatment (control), ECS, ECS + piracetam pre‑treatment, or ECS + piracetam post‑treatment. All of the control rats (100%) had memory retention of the training task at 24 hours. The percentage of rats with memory retention is severely reduced with hypoxia and ECS, and increased by the addition of piracetam. (Re­drawn from Giurgea, 1973.)

Percentage of improvement in symptoms of senile patients (average age of 67) given placebo or 2.4 gm per day of piracetam for only eight weeks in a double‑blind study. (Redrawn from Nootropil in the Treatment of Early Symptoms of: Alzheimer's Disease, or Senile Dementia of Alzheimer Type, or Multi‑Infarct Dementia, UCB Pharma­ceutical Division.)

A double‑blind controlled study in a group of patients with cerebral arteriosclerosis. All patients were scored on 15 parameters representative of disorders due to senility. Note that the piracetam group still shows improvement for weeks after termination of treatment. (Redrawn from Nootropil in the Treatment of Early Symptoms of: Alzheimer's Dis­ease, or Senile Dementia of Alzheimer Type, or Multi‑In­farct Dementia, UCB Pharmaceutical Division.)

Precautions: Piracetam may increase the effects of certain drugs, such as amphetamines, psychotropics, and Hydergine, as stated. Adverse effects are rare but include insomnia, psychomotor agitation, nausea, gastrointestinal distress, and headaches. Piracetam has virtually no known toxicity or contraindications.

Dosage: Piracetam is supplied in 400mg or 800mg capsules or tablets. The usual dose is 2400 to 4800 mg per day in three divided doses. Some literature recommends a high "attack" dose be taken for the first two days. We have noticed that often when people first take piracetam they do not notice any effect at all until they take a high dose (approximately 4000 to 8000mg). Thereafter, they may notice that a lower dosage is sufficient. Piracetam takes effect within 30 to 60 minutes.

Sources: Piracetam is not sold in the U.S. It can be pur­chased over the counter in Mexico or by mail from the sources listed in Appendix A (see page 165). Other names include: Avigilen, Cerebroforte, Cerebrospan, Cetam, Dinagen, Encefalux, Encetrop, Euvifor, Gabacet, Genogris, Memo‑Puren, Nootron, Nootrop, Nootro­pil, Nootropyl, Normabrain, Norzetam, Novocetam, Pirroxil, Psycoton, Stimucortex, and UCB‑6215.

References:

Anderson, K., Anderson, L. Orphan Drugs. Los Angeles, CA: The Body Press, 1987, p. 169.

Bartus, R.T., Dean R.L. 3d, Sherman, K.A., Friedman, E., Beer, B. "Profound Effects of Combining Choline and Pira­cetam on Memory Enhancement and Cholin­ergic Function in Aged Rats." Neurobiology of Aging. 1981, Vol. 2, pp. 105‑11.

Buresova, O., Bures, J. "Piracetam‑Induced Facilitation of Interhemi­spher­ic Transfer of Visual Information in Rats." Psycho­phar­ma­cologia. 1976, Vol. 46, pp. 93‑102.

Bylinsky, G. "Medicine's Next Marvel: The Memory Pill." Fortune. January 20, 1986, pp. 68‑72.

Chase, C.H., Schmitt, R.L., Russel, G., Tallal, P. "A New Chemothera­peutic Investigation: Piracetam Effects on Dyslexia." Annals of Dyslexia. 1984, Vol. 34, pp. 29‑48.

Conners, C.K., Blouin, A.G., Winglee, M., Lougee, L., O'Donnell, D., Smith, A. "Piracetam and Event‑Related Potentials in Dyslexic Children." Psychopharmacology Bulle­tin. 1984, Vol. 20, pp. 667‑73.

Dimond, S.J., Browers, E.Y.M. "Increase in the Power of Human Memory in Normal Man Through the Use of Drugs." Psycho­pharmacolo­gy. 1976, Vol. 49, pp. 307‑9.

Dilanni, M., Wilsher, C.R., Blank, M.S., Conners, C.K., Chase, C.H., Funkenstein, H.H., Helfgott, E., Holmes, J.H., Lougee, L., Marletta, G.J., Milewski, J., Pirazzolo, F.J., Rudel, R.G., Tallal, P. "The Effects of Piracetam in Children with Dyslexia." Journal of Clinical Psychopharmacology. 1985, Vol. 5, pp. 272‑8.

Donaldson, T. "Therapies to Improve Memory." Anti‑Aging News. 1984, No. 4, pp. 13‑21.

Ferris, S.H., et al. "Combination of Choline/Piracetam in the Treatment of Senile Dementia." Psychopharmacology Bulletin. 1982, Vol. 18, pp. 94‑8.

Friedman, E., Sherman, K.A., Ferris, S.H., Reisberg, B., Bartus, R.T., Schneck, M.K. "Clinical Response to Choline Plus Piracetam in Senile Dementia: Relation to Red‑Cell Choline Levels." The New England Journal of Medicine. 1981, 304, No. 24, pp. 1490‑1.

Giurgea, C.E. "The `Nootropic' Approach to the Pharmacolo­gy of the Integrative Activity of the Brain." Condi­tional Reflex. 1973, Vol. 8, No. 2, pp. 108‑15.

Giurgea, C.E. "A Drug for the Mind." Chemtech. June 1980, pp. 360‑65.

Giurgea, C.E., Salama, M. "Nootropic Drugs." Progress in Neuro­psycho­pharmacology. 1977, Vol. 1, pp. 235‑47.

Kent, S. "Piracetam Increases Brain Energy." Anti‑Aging News. 1981, Vol. 2, No. 10, pp. 65‑69.

Mindus, P., Cronholm, B., Levander, S.E., Schalling, D. "Piracetam‑­Induced Improvement of Mental Perfor­mance: A Controlled Study on Normally Aging Individuals." ACTA Psychiatrica Scandinavia. 1976, Vol. 54, pp. 150‑60.

Mondadori, C., Classen, W., Borkowski, J., Ducret, T., Buerki, H., Schade, A. "Effects of Oxiracetam on Learning and Memory in Animals: Comparison with Piracetam." Clinical Neuropharma­cology. 1986, Vol. 9, Supple­ment 13. New York: Raven Press, pp. S27‑S37.

Nickerson, V.J., Wolthius, O.L. "Effect of the Acquisition‑Enhancing Drug Piracetam on Rat Cere­bral Energy Metabolism Compari­son with Naftidro­furyl and Methamphetamine." Biochemical Pharma­cology. 1976, Vol. 25, pp. 2241‑4.

Parducz, A. "Depletion of Synaptic Vesicle Lipids in Stimu­lated Cholin­er­gic Nerve Terminals." Alzheimer's Disease: Advances in Basic Research and Thera­pies. Proceedings of the Third Meeting of the Interna­tional Study Group of the Treatment of Memory Disorders Associated with Aging. Zurich, Switzerland, 1984, pp. 217‑26.

Pearson, D., Shaw, S. Durk Pearson & Sandy Shaw's Life Extension Newsletter. October 1988, Vol 1, Number 8, p. 65.

Pellegata, R., et al. "Cyclic Gaba‑Gabob Analogues." Present­ed at VI International meeting of the International Society For Neuro­chemistry, Copenhagen, August 21‑26, 1977.

Pelton, R., Pelton, T.C. Mind Food & Smart Pills. New York: Double­day, 1989.

Pepeu, G., and Spignoli, G. Neurochemical Actions of "Nootropic Drugs". Advances in Neurology. Vol. 51: Alzheimer's Disease. New York: Raven Press, Ltd., 1990.

Pilch, H., Muller, W.E. "Piracetam Elevates Muscarinic Cholinergic Receptor Density in the Frontal Cortex of Aged But Not of Young Mice." Psychopharmacology. 1988, 94, pp. 74‑8.

Poschel, B.P.H. "New Pharmacologic Perspectives on Noo­tropic Drugs." Handbook of Psychopharmacology. 1988, pp. 11‑18, pp. 24‑5.

Stegink, A.J. "The Clinical Use of Piracetam, a New Noo­tropic Drug." Arzneimittelforschung. 1972, Vol. 22, No. 6, pp. 975‑7.

U.C.B. Laboratories, Pharmaceutical Division. "Basic Scien­tific and Clinical Data of Nootropil." Brussels, Bel­gium: U.C.B. Labora­to­ries, 1977.

Wilsher, C.R. "Piracetam and Dyslexia: Effects on Reading Tests." Journal of Clinical Psychopharmacology. 1987, Vol. 7, No. 4, pp. 230‑7.

Wurtman, R.J., Magil, S.G., Reinstein, D.K. "Piracetam Diminishes Hippocampal Acetylcholine Levels in Rats." Life Science. 1981, Vol. 28, pp. 1091‑3.

Zhang, S., et al. "Effects of Cerebral GABA Level on Learn­ing and Memory." Pharmacologica Sinica. 1989 10(1): pp. 10‑2.