Piracetam

What is it?

Piracetam is sold in Europe and other countries as a medication to improve cognition. It is also known by brand names such as Nootrpil, Lucetam and Breinox. It has been studied for over a decade for its use in stroke patients. However, it is used in a wide variety of neurological conditions, from schizophrenia to alcoholism. Its efficacy in stroke still remains unestablished, and more research is necessary to make a recommendation.

How does it work?

The mechanism of action with drugs like piracetam is not well understood. It does not have a depressive nor stimulant effect on the brain, yet it does increase brain activity. Some have hypothesized that this increase in activity helps to increase blood flow to all areas of the brain. With increased blood flow, the parts of the brain injured by the stroke are able to get oxygen and may not become as damaged. In addition, it increases activity in general, possibly opening up new channels around stroke damaged brain tissue.

What is it used for?

Piracetam is used for many conditions related to cognition. It is often used to reverse the effects of age-related memory loss and as a cognitive booster for students looking to enhance their memory. It is used in Alzheimer’s, depression, autism, alcoholism, and schizophrenia. Its use in stroke victims is only one of these many uses. Proponents say it improves post-stroke cognition and helps with aphasia, although these contentions remain highly speculative with limited scientific research to support it.

Research and Evidence

A study published in Stroke in 1997 measure the efficacy of this medication on acute ischemic stroke patients. It showed no benefit when given within 12 hours of a stroke, although the research does hint to the fact that it may be helpful if started within 7 hours for moderate to severe ischemic stroke. However, more research would be needed to bear that out.

Another article published in Stroke in 2006 examined piracetam’s use in acute ischemic stroke by reviewing all available clinical trials. Once again, it found no benefit in preventing death either in the early or the late stages. An alarming trend was actually found that those who take the medication may be more likely to experience early death. This could be the result of the relative severity of the strokes between the groups and would require further investigation for recommendation.

 

References

Stroke; Treatment of Acute Ischemic Stroke With Piracetam; Peter Paul De Deyn, et. al.; 1997

http://stroke.ahajournals.org/content/28/12/2347.full

Stroke; Piracetam for Acute Ischemic Stroke; Graeme J. Hankey, MD, FRCP, et. al.; 2006

http://stroke.ahajournals.org/content/37/8/2191.full