Piracetam Frequently Asked Questions
Piracetam's (2-oxo-1-pyrrolidine acetamide) earliest use in Down syndrome was in Spain and Portugal in 1974 in a comparative study, using historic case controls, of Dromia (a 5-hydroxytryptophan containing product) and Noostan (a brand of Piracetam) in 26 children from age 3 months to 12 years of age (Fialho, 1977).
Piracetam is a cyclic derivative of GABA (gamma amino butyric acid, a neurotransmitter) and enhances cognition under conditions of hypoxia (lack of oxygen), enhances memory and some kinds of learning in non-disabled persons, mitigates oxidative stress, returns fluidity to brain membranes that have undergone hardening from lipid peroxidation and allows for increased communication between the hemispheres of the brain. It is reported to be an intelligent booster and a CNS (central nervous system) stimulant with no known toxicity or addictive properties. Its effects and safety are so impressive that piracetam prompted the creation of a new pharmaceutical category called nootropics.
Piracetam is available by mail overseas or by prescription in the USA from a compounding pharmacy.
Piracetam is not FDA approved for OTC (over the counter) sale and has been granted an orphan status in the USA. As of June of 2006, piracetam is not regulated in the United States (it is neither a controlled substance nor a prescription drug).
The Piracetam NDC code for insurance purposes is 38779017725.
Piracetam and Seizures
Piracetam is an anticonvulsant. There are no know medical reports supporting the link between Piracetam and seizures. Infantile spasms are common in Down syndrome.
Piracetam and Coumadin
Piracetam can cause lack of adhesion of platelets which can affect clotting.
When a patient is on Coumadin therapy due to valve replacement, Coumadin levels will need to be adjusted if the patient is on Piracetam.
Piracetam and Surgery
Piracetam should be doubled 72 hours prior to surgery and removed 48 hours before the surgery is scheduled because of its blood thinning properties. Because Piracetam increases acetylcholine receptors, it allows the brain to handle the effects of anesthesia and cholinergic drugs better, like atropine and scopalamine, that are given as part of pre-operation medications. Resume Piracetam as soon as patient is home.
Piracetam and Flying
Piracetam has the capability of maintaining high oxygen levels in the brain even under periods of low oxygen stress such as flying. Pressurized planes have periods of low partial pressure of oxygen due to altitude. In addition, aircrafts are typically only pressurized to the equivalent of 8,000-9,000 feet altitude, i.e., there is less oxygen for a child that has a heart condition impairing oxygenation. Increase Piracetam dosage by 50% the day before and the day of flying.
Piracetam and Phosphocholine
Choline is necessary because one of the major effects of Piracetam is the stimulation of increased numbers of acetylcholine receptors. Without choline this step is inefficient and choline should be given in conjunction with Piracetam within 8 hour timespan. A dosage of 250 mg of phosphocholine for every 20 pounds of weight, up to 800 mg, in conjunction with Piracetam, is recommended for persons not on NuTriVene-D®. The dosage can be doubled for adults up to 1600 mg. Phosphocholine, also known as Phosphatidyl Choline or Lecithin, is available from most health food stores.
Piracetam and Glutamate
While glutaminergic receptors are increased in Down syndrome [Arai, Mizuguchi, & Takashima, 1996. Excessive glutamate receptor 1 immunoreactivity in adult Down syndrome brains. Pediatric Neurology, 15, 203-6] there is no evidence that Piracetam stimulates glutaminergic receptors to any great extent. Their main stimulus is on acetylcholine receptors.
Do not stop any drug that has psychotropic effects abruptly: first reduce the dose of Piracetam by half for 2 days, then drop a dose each day, until it is eliminated.