Nootrop - Piracetam

In the face of the failure of rational approaches in the treatment of AzD it is perhaps not surprising that there have been many less rational ones. These include the use of vasodilators and nootropics. The former, such as hydergine, a mixture of ergot alkaloids, are intended to increase cerebral blood flow and neuronal metabolism despite some reduction in blood pressure, while the latter, like piracetam, are metabolic stimulants that increase cerebral metabolism and ATP production. Neither are of proven value in AzD. 

Gouliaev All and Senning A (1994). Piracetam and other structurally related nootropics. Brain... 

Nootropics. The nootropic medications (of which piracetam is the best known) are believed to enhance nerve cell activity by improving circulation in the tiniest of blood vessels (capillaries) that provide oxygen-rich blood to the nerve cells. In addition to enhancing nerve cell metabolism, these medications should theoretically protect nerve cells in the same manner as the anticoagulants. Although theoretically sound, the nootropics have not shown any significant benefit for demented patients. Therefore, we cannot recommend their use. 

Few results are available from experiments in healthy volunteers involving the use of the older nootropic drugs, such as co-dergocrine mesylate, piracetam or... 

Nootropic agents, antihypoxic agents E.g. piracetam, amiracetam, pramiracetam, oxiracetam No evidence for efficacy in AD... 

Note There is no evidence that nootropics (e.g. piracetam, nimodepine) are beneficial but some (e.g. co-dergocrine) may cause a minor improvement in neuropsychological and behavioural parameters. 

Piracetam is a so-called nootropic drug, one of a class of drugs that affect mental function (1). In healthy volunteers it improves the higher functions of the brain involved in cognitive processes, such as learning and memory. Its mechanisms of action are not known but may include increased cholinergic neurotransmission. 

These drugs, knot3 FE5 fl lSf 0 yrrolidone derivatives, are the most important family of nootropics Smart drug enthusiasts say they cause remarkable enhancement of memory. No one knows how they w Ork, hut they may affect nerve pathways in the brain that use acetylcholine as a neurotransmitter. Acetylcholine declines with age, possibly accounting for slowed mental function in the elderly. Users say piracetam is a central nervous system stimulant that wakes up the brain. They claim that it has no toxicity or addictive properties. Piracetam is not sold in the U.S, hut can he ordered by mail or jiurchased over-the-counter at Mexican pharmacies. 

L-dopa, a precursor of the neurotransmitters norepinephrine and dopamine, was introduced into HE therapy by J.D. Parkes et al. in 1970. The results were good. As yet, there is still no accepted opinion on the use of this substance. Piracetam, as a nootropic substance, led to a clear improvement in typical electrical brain activities in animals displaying hepatic damage and symptoms of encephalopathy. Similarly, a double-blind randomized cross-over study with the nootropic agent centropheno-xine partly showed positive effects in psychometric testing. Bromocriptine, an agonist of the dopamine receptor, was also used in 1980 for chronic hepatic encephalopathy. (146,163) Application of L-carnitine (6 g/day orally, divided into two doses, for 4 weeks) leads to a marked reduction of hyperammonaemia and a clear improvement in clinical symptoms of HE in cirrhotic patients. (119) (s. p.49)... 

C. Altomare, S. Cellamare, A. Carotti, G. Casini, M. Ferappi, E. Gavuzzo, F. Mazza, P.-A. Carrupt, P. Gaillard, and B. Testa, /. Med. Chem., 38,170 (1995). X-ray Crystal Structure, Partitioning Behavior, and Molecular Modeling Study of Piracetam-type Nootropics Insights into the Pharmacophore. 

Five-membered ring lactams also named y-lactams or 2-oxopyrrolidines are present in biologically active naturally occurring products and also found in approved drugs. Compoxmds of the same class derived from N-substituted-y-lactams are known as nootropic drugs such as piracetam 36 or related compoxmds, oxiracetan 37, or pramiracetam 38 (Figure 10). 

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