This page shows what was measured, who it was measured in, and what that does not settle.
What Piracetam does in the body
A rare jerking movement disorder, or unapproved use as a thinking supplement.
Piracetam is a small cyclic molecule, a ring version of the neurotransmitter GABA, though it does not act on GABA receptors. Sixty years after its synthesis nobody has identified what it binds. The leading account is that it inserts itself into cell membranes and changes their physical properties, which alters how membrane proteins move and how neurons signal — a mechanism that is unusual precisely because it is physical rather than a lock-and-key fit. Whatever the mechanism, in cortical myoclonus it does something that placebo does not: in the trial that established it, half the patients could not tolerate the placebo phase and had to be taken off it.
What happened in people
In 21 people with severe jerking, ten needed rescue without it and none needed rescue while taking it.
✓ Reviewed first-read answer
Where this came from
A person wrote this and a reviewer approved it against this exact record. It carries no effect size.
A reviewer approved this against this record. The reviewed-claim record carrying the exact population and effect size does not exist yet.
No source is stored against this line.
The limit that matters most
Dementia studies improved general impressions but not any specific thinking ability, and no molecular target is confirmed.
Where it acts
Cortical neuronal membranes; the sensorimotor cortex in myoclonus
Kind of result
The kind of result is not recorded
Supervision
RNAWiki has not recorded a supervision or regulatory status for this substance.
What the registries record it as
The substance registry classes this as chemical.
FDA substance registry · ZH516LNZ10 · read 2026-08-29
The supplement label database classes it as other, under the name Piracetam.
Its recorded molecular formula is C6H10N2O2, weighing 142.16.
PubChem record · 4843 · read 2026-08-29
Where each sentence above came from
No recorded sentence describes the change this makes in a way that stands on its own. The page opens with what it is taken for instead, and the recorded explanation follows below.
Shown as the opening line on this page.
The limit a reviewer approved as the one that matters most here.
The four opening statements run to 140 words.
Words this page uses
Four words worth knowing first
Chosen from what this page shows, with each one explained before the word it depends on.
Randomisation
Randomisation means chance decides who gets which treatment.
A picture of it, and where the picture fails
It is like a coin toss deciding the groups.
Where that stops being true. A coin toss is fair once. Fairness here comes from doing it for everyone.
What people get wrong. It is thought to make groups identical. It makes them similar on average, including on things nobody measured.
Allocation of participants to arms by a chance process, so that unmeasured factors are balanced in expectation.
Confidence interval
A confidence interval is the range the true answer is likely to sit in.
A picture of it, and where the picture fails
It is like a weather forecast giving a range rather than one number.
Where that stops being true. A forecast range covers tomorrow. This one covers what the study could resolve.
What people get wrong. The middle number is read as the answer. A range crossing zero means no change is still possible.
An interval estimate that would contain the true parameter in a stated proportion of repeated studies.
Receptor
A receptor is a part of a cell that a signal fits into.
A picture of it, and where the picture fails
A receptor is like a lock waiting for one key.
Where that stops being true. A lock either opens or does not. A receptor can be half-triggered, or worn out.
What people get wrong. Fitting a receptor is read as causing a benefit. It causes a step, and nothing more.
A protein that binds a specific ligand and converts that binding into a cellular response.
Pathway
A pathway is a chain of steps inside a cell, each one setting off the next.
A picture of it, and where the picture fails
A pathway is like a row of dominoes.
Where that stops being true. Dominoes fall one way. Pathways loop back and can switch themselves off.
What people get wrong. Changing one step is read as changing the outcome. Other steps often absorb it.
An ordered series of molecular interactions producing a defined cellular change.
What happened in people◇Read from sources, not yet reviewed
What happened in people
Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.
Stimulus sensitivity, motor, writing, functional disability, global assessment and visual analogue scales
✓ The study showed what it set out to show
Who was studied
Brown 1993 double-blind crossover trial in cortical myoclonus
How many people
21
Study design
Randomised double-blind placebo-controlled crossover, 14 days per phase
Compared against
A dummy treatment
Kind of result
What a body can do day to day
What was found
Significant improvement on motor, writing, functional disability, global assessment and visual analogue scores; total rating score improved by a median of 22%. 10 of 21 patients required rescue from the placebo phase and 0 from the piracetam phase
Repeated elsewhere
Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Nineteen of 21 patients were taking other antimyoclonic drugs concurrently, so the result is an add-on effect rather than a monotherapy effect.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet or oral solution, 800 mg and 1200 mg strengths; licensed myoclonus doses in grams per day
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
Global impression of change, cognition and other clinical measures
✗ The study did not show it
Who was studied
Flicker 2001 Cochrane review: piracetam for dementia or cognitive impairment
How many people
0
Study design
Systematic review and meta-analysis of randomised trials
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
Global impression of change odds ratio 3.55 (95% CI 2.45-5.16) fixed effects, 3.47 (95% CI 1.29-9.30) random effects, with significant heterogeneity (chi-square 20.8, df 5). Effects on cognition and other measures inconclusive
Repeated elsewhere
Failed to Replicate
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. Many included studies were crossover designs whose first-phase data were unavailable or could not be extracted, which is a systematic limitation on the whole pooled estimate.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet or oral solution, 800 mg and 1200 mg strengths; licensed myoclonus doses in grams per day
Interval reported. 95% CI 2
Written into the record, not signed off as a reviewed claim.
Death at one month, with functional outcome and dependence
✗ The study did not show it
Who was studied
Ricci 2012 Cochrane review: piracetam for acute ischaemic stroke
How many people
1002
Study design
Systematic review of three randomised trials, treatment within three days of onset
Compared against
Not recorded for this study
Kind of result
Living longer, or avoiding a major event
What was found
Approximately 31% increase in death at one month, 95% CI from 81% increase to 5% reduction — not statistically significant. No difference in functional outcome or dependence
Repeated elsewhere
Unreplicated
What this does not prove. A study that did not show an effect does not show that no effect exists anywhere.
The limits of this study, and where it came from
Main limit. Adverse effects were not reported in the included trials. One trial contributed 93% of the data, and the mortality trend disappeared after correction for stroke severity imbalance.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet or oral solution, 800 mg and 1200 mg strengths; licensed myoclonus doses in grams per day
Interval reported. 95% CI from 81% increase to 5% reduction — not statistically significant
Written into the record, not signed off as a reviewed claim.
Identity and quantity of unapproved drugs in supplements labelled as containing omberacetam, aniracetam, phenylpiracetam or oxiracetam
✓ The study showed what it set out to show
Who was studied
Cohen 2021 analysis of racetam-containing supplements
How many people
10
Study design
Analytical survey of products purchased online
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
Five unapproved drugs detected across ten products; up to 40.6 mg omberacetam against a 10 mg typical dose; 9 of 12 declared quantities inaccurate; up to four unapproved drugs in a single product
Repeated elsewhere
Unreplicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. No limitation is recorded for this study.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet or oral solution, 800 mg and 1200 mg strengths; licensed myoclonus doses in grams per day
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
RNAWiki holds 4 written-up human studies for this substance, each with the question it asked.
How we know it
Each card names the study, the number of people and what the study set out to measure.
What this does not prove
These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters
A study that failed is as informative as one that worked, and both are here.
What we still do not know
No reviewed claim exists, so no exact population, effect size or interval is published yet.
What happened in people◇Read from sources, not yet reviewed
How close this is to real life
The top step is something a person would feel or care about. The bottom is a guess from software. Filled steps are where evidence exists for this substance.
□Living longer, or avoiding a major eventNo evidence recorded. Death, a heart attack, a stroke, a hospital stay.0 registered measures of this kind. 1 written-up study measured this and did not show a benefit.
□What a body can do day to dayNo evidence recorded. Walking, dressing, breathing, recovering.No registered study measures this.
□Measured performanceNo evidence recorded. How much was lifted, how far was run, how fast.No registered study measures this.
□Symptoms and quality of lifeNo evidence recorded. Pain, tiredness, mood, sleep, as the person rated it.No registered study measures this.
□A number that stands in for healthNo evidence recorded. Cholesterol, blood sugar, bone density. A stand-in, not the thing itself.No registered study measures this.
■A step measured inside a personEvidence recorded. Something measured in human tissue or human cells.A human record sits on the stored organism ladder.
■AnimalsEvidence recorded. Mice, rats, dogs. Useful for ideas, not proof about people.Stored records in Mouse, Rat. A result in animals says what to test next. It does not say what happens in people.
■Cells in a dishEvidence recorded. Cells or chemistry on a bench, far from a whole body.Stored mechanism abstracts describe steps measured in cells or tissue.
□A guess from softwareNo evidence recorded. Nobody measured it. RNAWiki never publishes one as a finding.RNAWiki stores no prediction for this record. Software can suggest a link. RNAWiki does not publish one as a finding.
Higher on these steps means closer to something a person would feel. It does not mean better done.
What it changes in the body◇Read from sources, not yet reviewed
The path through the body
From what a person takes to what changes. A solid line is a step measured in people. A dashed line is a step nobody has measured that way.
Start
Piracetam
What a person takes: Oral tablet or oral solution, 800 mg and 1200 mg strengths; licensed myoclonus doses in grams per day.
The measurement behind this step
Film-coated tablets and an oral solution. Because there is no high-affinity target, the effective dose is measured in grams: the myoclonus literature describes 7 to 24 g daily with wide individual variation and dose-related response, and up to 45 g daily in progressive myoclonus epilepsy added to existing treatment. Supplement servings sold in the United States are set by vendors and bear no relation to the licensed regimen.
Getting in
Taken by mouth in gram quantities
The licensed doses are grams per day, not milligrams — several orders of magnitude above a typical drug dose.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Highly water-soluble with essentially complete oral absorption. Licensed myoclonus doses run from 7 to 24 g daily with individual variation, and case series describe up to 45 g daily added to existing antiepileptic treatment. The gram-scale dosing is a direct consequence of having no high-affinity target.
It crosses into the brain and then leaves the body unchanged in urine, without being broken down.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Crosses the blood-brain barrier and distributes into cerebrospinal fluid. Piracetam undergoes essentially no metabolism and is cleared unchanged by renal excretion, which is why dose reduction is required in renal impairment and why it has almost no drug-drug interaction profile.
There is no lock this key fits. The leading account is that it changes the physical behaviour of the cell membrane itself.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
The dominant hypothesis is an interaction with the polar head groups of membrane phospholipids that restores fluidity in aged or damaged membranes, altering the mobility and function of membrane-embedded proteins. A second hypothesis is positive allosteric modulation at AMPA receptors. Neither is established, and the absence of a target is why the effective dose is measured in grams.
In the condition it is licensed for, the abnormal cortical discharges that produce the jerks are reduced.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
In cortical myoclonus the measurable effect is reduced stimulus sensitivity and reduced jerk severity, dose-related across a wide individual range. The electrophysiological correlates — giant somatosensory evoked potentials and jerk-locked back-averaged cortical discharges — are what confirm the cortical origin of the myoclonus being treated.
Real in myoclonus, not supported in dementia, unclear in stroke
It works for the rare movement disorder it is licensed for. The Cochrane reviews do not support it for dementia and raise a question in acute stroke.
──Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.
The measurement behind this step
Myoclonus: 10 of 21 patients rescued from placebo and none from drug, with a median 22% improvement in total rating score. Dementia: odds ratio 3.55 for global impression of change and no benefit on any specific measure, with reviewers concluding against use. Acute stroke: a non-significant 31% increase in one-month death, possibly attributable to baseline severity imbalance.
No suggested links are held for this record, so nothing is hidden from this path.
What we know
The record describes 5 steps from taking it to an effect in a person.
How we know it
Each step names the study behind it in the technical detail beside it.
What this does not prove
A change inside the body is a reason to look. It is not a result in a person.
Why it matters
A reader can see exactly where the chain stops being measured in people.
What we still do not know
No reviewed claim binds any of these steps to a named population.
What is missing or unclear◇Read from sources, not yet reviewed
Were people like you studied?
RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.
Who was studied
People similar to this profile were included.
On prescription: patients with cortical myoclonus, usually alongside clonazepam, valproate or levetiracetam. Off prescription: people taking it as an over-the-counter cognitive supplement, which in the United States means taking an unapproved drug.
Who is missing from the studies
Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
Where the result stopped carrying
The Cochrane review of piracetam for dementia and cognitive impairment concluded that the published literature does not support its use
The Cochrane review of piracetam in acute stroke found a possible unfavourable early mortality signal and insufficient evidence on dependence
The Cochrane review of piracetam for painful sickle cell crises found the trials too few and too poor to support routine use
This is a scope explorer, not a diagnosis engine.
It shows who was studied so you can see whether people similar to you were included.
RNAWiki cannot tell whether a study fits you. It can show who was in it.
What it would be like to take◇Read from sources, not yet reviewed
Why it might seem to do nothing
A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.
It was studied for a different goal
The studies measured something else entirely.
On this record: Some registered studies measured things that match no goal on this page.
It was studied in different people
The people in the studies were not much like the reader.
On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
The evidence may simply be wrong
Small early studies often do not hold up.
On this record: RNAWiki has not yet published a reviewed conclusion for this use.
The product may not be what it says
Contents of a sold product are not always what the label states.
On this record: This is sold as a supplement, so no agency checked what is in a given tub before it was sold.
Other reasons RNAWiki checked and found nothing for (9)
A different form was studied
The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct
Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too
In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel
A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it
Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet
The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied
Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time
Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
No recorded reason
RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.
None of these is a reason to take more. Taking more is not a step this page ever suggests.
What it would be like to take◇Read from sources, not yet reviewed
What taking it involves
The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.
How it is supplied
Prescription only
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Read from the recorded approval status.
No source is stored against this line.
Form and route
Oral tablet or oral solution, 800 mg and 1200 mg strengths; licensed myoclonus doses in grams per day
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form and route recorded on this substance.
No source is stored against this line.
Who oversees it
RNAWiki has not recorded a supervision or regulatory status for this substance.
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
No register row and no identity class settled the question.
No source is stored against this line.
What is in the pack
Film-coated tablets and an oral solution.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on how this is sold. The rest of the recorded wording: Because there is no high-affinity target, the effective dose is measured in grams: the myoclonus literature describes 7 to 24 g daily with wide individual variation and dose-related response, and up to 45 g daily in progressive myoclonus epilepsy added to existing treatment. Supplement servings sold in the United States are set by vendors and bear no relation to the licensed regimen.
No source is stored against this line.
Where it is registered
Regulatory records are listed in the technical disclosure at the foot of this page.
# Counted from records
Where this came from
A count of rows RNAWiki holds. It describes our records, not your body.
Register entries are stored per jurisdiction and shown with their dates.
No source is stored against this line.
Why people stop
Not recorded.
∅ Nothing recorded
Where this came from
RNAWiki holds nothing here and says so rather than guessing.
No record of why people stopped taking it is stored for this substance.
No source is stored against this line.
What it would be like to take◇Read from sources, not yet reviewed
What can go wrong
Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.
·Worth asking a clinician aboutWritten into the record from the studies named on this page
Tolerability at high doses over long periods is described in the myoclonus literature as very good, without toxicity or serious adverse effects, with side effects occasional, mild and transient. Because piracetam is cleared unchanged by the kidney, dose reduction is required in renal impairment. The acute stroke review found a non-significant increase in one-month death that may have been a severity-imbalance artefact, and did not report adverse effects. The specific risk in the supplement market is not piracetam itself but the undeclared companion drugs found alongside it.
Nobody counted how many people took this and were fine, so this cannot be turned into a rate.
These are reports people sent to a regulator. They do not show the medicine caused the reaction.
Nobody counted how many people took the medicine and reported nothing.
The same event can be reported more than once, and many reports are incomplete.
News coverage, lawsuits and new warnings change how often people report.
A count is not a rate and not a risk.
Piracetam appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 89 reaction mentions were counted. One report can name several reactions.
The recorded terms (10)
pyrexia — 13 reaction mentions
agitation — 11 reaction mentions
suicide attempt — 10 reaction mentions
confusional state — 9 reaction mentions
drug interaction — 9 reaction mentions
bradycardia — 8 reaction mentions
tremor — 8 reaction mentions
balance disorder — 7 reaction mentions
drug abuse — 7 reaction mentions
myoclonus — 7 reaction mentions
open-targets-adr · recorded 2026-06-24 · a recorded source, not a stored snapshot
Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.
Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What is missing or unclear◇Read from sources, not yet reviewed
Does the exact form matter?
Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.
The form that was studied
Oral tablet or oral solution, 800 mg and 1200 mg strengths; licensed myoclonus doses in grams per day
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form used in the studies cited on this page.
No source is stored against this line.
What is sold
A recorded note compares this form with the others that are sold. It is kept below, word for word.
§ A fixed RNAWiki sentence
Where this came from
Wording RNAWiki always uses, not a finding about this substance.
The recorded note, unchanged: Because there is no high-affinity target, the effective dose is measured in grams: the myoclonus literature describes 7 to 24 g daily with wide individual variation and dose-related response, and up to 45 g daily in progressive myoclonus epilepsy added to existing treatment. Supplement servings sold in the United States are set by vendors and bear no relation to the licensed regimen.
No source is stored against this line.
What is recorded as being sold
5 marketed supplement labels list this ingredient, classed as non-nutrient/non-botanical and other.
Those labels carry all other, no claim and structure/function claims. A claim of that kind is written by the manufacturer and is not assessed by any regulator, so its presence says nothing about whether it is true.
Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.
What it would be like to take◇Read from sources, not yet reviewed
What you could measure
This one is decided with a clinician, so this section holds questions to ask rather than a plan to run.
RNAWiki could not confidently classify this substance, so no self-experiment plan is offered.
Questions worth asking
Which of the trials of Piracetam studied people like me?
What was measured, and for how long?
Was the result a laboratory value or a health outcome?
What would we watch for, and when would we stop?
Tracking can show whether something changed for you. It cannot show what caused it.
RNAWiki records evidence. It does not say whether this substance is right for you.
What is missing or unclear◇Read from sources, not yet reviewed
Claims that go past the evidence
Things said about this substance that sound reasonable, and the exact step that is missing between the evidence and the claim.
✗Goes past the evidence
That an effect on a clinician global impression scale in dementia constitutes cognitive benefit, when the same review found nothing on specific measures
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That the myoclonus result generalises to cognition in healthy people; the myoclonus trials were add-on therapy in a rare cortical disorder at gram doses
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That either proposed mechanism — membrane fluidity or AMPA modulation — is established, when both remain hypotheses after sixty years
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That being a licensed medicine in Europe means the product bought as a supplement in the United States is that medicine
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
What is missing or unclear◇Read from sources, not yet reviewed
What nobody knows yet
Open questions, each with why it is open and what would close it.
How much did people take in the studies?
The sources RNAWiki checked hold nothing for this field.
Why it matters. A result belongs to an amount. Without the amount the result floats free.
What would answer it
A stored source that records it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
How fast does the body clear it?
The sources RNAWiki checked hold nothing for this field.
Why it matters. Without this, nothing on this page can say how long anything lasts.
What would answer it
A stored source that records it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing populations
Which groups were under-represented in the studies has not been recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing long-term data
No completed tested study window is recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
No reviewed conclusion
RNAWiki has not yet published a reviewed conclusion for this use.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing interaction studies
No interaction was found in the registers checked. Not finding one is not the same as showing there is none.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Formulation uncertainty
Several salts, forms or products of Piracetam are recorded. Results from one form may not transfer to another.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Mechanism not reviewed
No reviewed mechanism story exists for this substance.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
What happened in people◇Read from sources, not yet reviewed
Check any of this yourself
Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.
Every line above can be traced to the study named beside it. Follow the link and read it.
Half the patients had to be rescued from the placebo arm
In plain words
In a crossover trial in 21 patients with cortical myoclonus, ten had to be taken off the placebo phase because their jerking became intolerable. None had to be taken off the drug phase.
What was measured
Rescue rate from placebo versus drug phase, and total myoclonus rating score change, in a double-blind crossover trial
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Brown et al. ran a placebo-controlled double-blind crossover trial of piracetam at 2.4 to 16.8 g daily in 21 patients with cortical myoclonus, all but one with electrophysiological confirmation. Patients received 14 days of piracetam then identical placebo, or the reverse; nineteen took it in addition to routine antimyoclonic treatment and two as monotherapy. Ten of the 21 had to be rescued from the placebo phase because of severe and intolerable exacerbation of myoclonus, and none required rescue from the piracetam phase. Considered together, there was significant improvement on motor, writing, functional disability, global assessment and visual analogue scales, with the total rating score improving by a median of 22%. Genton et al. reported dose-related responses over a wide individual range of 7 to 24 g daily, and improvement maintained for up to seven years in progressive myoclonus epilepsy at doses up to 45 g daily added to existing antiepileptic treatment.
Written into the record, not signed off as a reviewed claim
Large effect on the global impression, none on anything specific
In plain words
A Cochrane review of piracetam in dementia found patients were more than three times as likely to be rated "improved" overall — and no benefit on any specific cognitive test.
What was measured
That a threefold odds ratio on a clinician global impression scale demonstrates cognitive benefit, when every specific cognitive measure in the same review was inconclusive
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Flicker and Grimley Evans reviewed piracetam for dementia or cognitive impairment. Many included studies were crossover designs whose first-phase data were unavailable or unextractable. Global Impression of Change was the only outcome with a substantial pooled evidence base, and it showed significant heterogeneity (chi-square 20.8, df 5). Using a fixed effects model the odds ratio for improvement on piracetam versus placebo was 3.55 (95% CI 2.45-5.16); with a random effects model, 3.47 (95% CI 1.29-9.30). Excluding a single-blind study gave 3.36 (95% CI 2.29-4.99) fixed and 2.89 (95% CI 1.01-8.24) random. Evidence of effects on cognition and other measures was inconclusive. The reviewers conclusion is unambiguous: the published literature does not support the use of piracetam in dementia or cognitive impairment, because although effects were found on global impression of change, no benefit was shown by any more specific measure.
Written into the record, not signed off as a reviewed claim
A possible unfavourable signal on early death in acute stroke
In plain words
A Cochrane review of piracetam in acute stroke found a non-significant increase in death at one month, which may have been an artefact of sicker patients ending up in the treatment group.
What was measured
Death at one month in piracetam versus control across three acute stroke trials totalling 1,002 patients
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
Ricci et al. reviewed randomised trials of piracetam started within three days of stroke onset, including three trials with 1,002 patients, one contributing 93% of the data. Piracetam was associated with a statistically non-significant increase in death at one month — approximately a 31% increase, 95% confidence interval from an 81% increase to a 5% reduction. The trend was no longer apparent in the large trial after correction for imbalance in stroke severity. Limited data showed no difference in functional outcome, dependence, or the proportion dead or dependent, and adverse effects were not reported. The reviewers conclude there is some suggestion but no statistically significant result of an unfavourable effect on early death, possibly caused by baseline differences in stroke severity, and not enough evidence to assess the effect on dependence. A separate Cochrane review of piracetam for reducing painful sickle cell crises found the included trials too few and too poor to support routine use.
Written into the record, not signed off as a reviewed claim
Racetam supplements contain drugs that are not on the label
In plain words
Ten cognitive-enhancement supplements were bought and analysed. They contained five unapproved drugs between them, several undeclared, and three-quarters of the stated quantities were wrong.
What was measured
Identity, quantity and label accuracy of unapproved drugs in ten cognitive enhancement supplements
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Cohen et al. searched two supplement databases for products labelled as containing omberacetam, aniracetam, phenylpiracetam or oxiracetam — four drugs not approved for human use in the United States — bought ten of them online, and analysed them by non-targeted liquid chromatography-quadrupole time-of-flight mass spectrometry. Omberacetam and aniracetam were detected along with three further unapproved drugs: phenibut, vinpocetine and picamilon. At the recommended serving sizes, consumers could be exposed to a maximum of 40.6 +/- 0.4 mg of omberacetam against a typical pharmacological dose of 10 mg, 502 +/- 0.8 mg of aniracetam, 15.4 +/- 0.3 mg of phenibut, 4.3 +/- 0.1 mg of vinpocetine and 90.1 +/- 0.7 mg of picamilon. Several detected drugs were not declared on the label and several declared drugs were not detected. Of the products stating a quantity, 75% — 9 of 12 — were inaccurate. A single product could expose a consumer to as many as four unapproved drugs at up to four times a pharmaceutical dose.
Written into the record, not signed off as a reviewed claim
Sixty years on, the mechanism is still a hypothesis
In plain words
Piracetam has no confirmed molecular target. The two leading explanations — changing membrane properties and tuning glutamate receptors — remain proposals.
What was measured
That piracetam has an established mechanism of action, when after six decades the candidates remain unresolved and largely preclinical
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Piracetam does not bind GABA receptors despite being a cyclic GABA derivative, and has no established affinity at glutamate, monoamine or benzodiazepine sites. The two mechanisms most often cited are an interaction with the polar head groups of membrane phospholipids that restores fluidity in aged or damaged membranes, and positive allosteric modulation at AMPA receptors, the latter better characterised for aniracetam than for piracetam itself. Recent work continues to propose pathways — toll-like receptor 4-mediated neuroinflammation, AMPK/SIRT-1/Nrf-2 signalling — in rodent models of vascular dementia. These are hypotheses about a drug licensed since the 1970s, and a page that presents any of them as the mechanism is describing a research programme as if it were a finding.
Written into the record, not signed off as a reviewed claim
Prescription medicine in Britain, unapproved drug in America
In plain words
Nootropil is a prescription-only medicine in the United Kingdom. In the United States piracetam has no approval at all and is not a lawful supplement ingredient.
What was measured
Regulatory status of piracetam in the United Kingdom and the United States
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Nootropil 800 mg and 1200 mg film-coated tablets are listed in the UK electronic Medicines Compendium as prescription-only medicines from ADVANZ Pharma, with a Summary of Product Characteristics. Piracetam holds national marketing authorisations across many European and other countries, granted by national regulators rather than through a central European Medicines Agency procedure, and the licensed indication in the United Kingdom is adjunctive treatment of cortical myoclonus. In the United States it appears nowhere in Drugs@FDA as an approved active ingredient. Products sold there as piracetam supplements are, in the FDA framing used for this whole class, unapproved drugs rather than dietary supplements — which is precisely the framing the analysis of racetam supplements adopted.
Source
UK electronic Medicines Compendium listings for Nootropil 800 mg and 1200 mg film-coated tablets (ADVANZ Pharma), prescription-only medicines; absence of piracetam from FDA Drugs@FDA as an approved active ingredient
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
Where else this substance is registered
FDA substance identifier (UNII)
ZH516LNZ10
CAS registry number
7491-74-9
PubChem compound
4843
ChEMBL
CHEMBL36715
WHO international nonproprietary name list entry
2687
RxNorm concept
8351
EMA substance identifier
100000091987
European Chemicals Agency number
231-312-7
DrugBank
DB09210
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What to learn next
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The older medicine-wide conclusion held in this record
Written for a clinical reader, and about the medicine as a whole rather than about one indication, population and set of trials. RNAWiki does not treat it as a programme conclusion and no reviewer has signed it off in that form. It is here word for word because it is what the record holds.
The original nootropic: in cortical myoclonus, 10 of 21 patients had to be rescued from the placebo phase of a crossover trial and none from the drug phase, while in dementia the pooled evidence shows a large effect on global impression of change and no benefit on any specific cognitive measure.
Recorded evidence blocks (12)
Q1
What did Piracetam's largest trial (676 people) and its longest (3.7 years) measure?
676 people in Piracetam's largest registered study, 3.7 years in its longest registered window, measuring Pulse, blood pressure. ClinicalTrials.gov · 2026-09-01
3 phase4, 2 na, 2 phase1, 2 phase3; NCT00567060; 2004-01; no ageing endpoint recorded. Last human test completed 2023, NCT07722000.
Interpretation These counts include studies where Piracetam was a comparison treatment, a background treatment or an exposure in an observational study, and the longest window may be a planned end date. Trial roles have not yet been classified for this record.
Show the evidence
phase4
3
na
2
phase1
2
phase3
2
Last recorded human testNCT07722000
2023-12-01
recorded 2026-09-01 · last checked 2026-09-04
Q2
From mouse to human: where has Piracetam shown lifespan?
"This study was terminated after a pre-specified interim analysis. Please see Detailed Study Description for further information."; 1 of 9 registered studies
Show the evidence
TrialNCT01883011
terminated; "This study was terminated after a pre-specified interim analysis. Please see Detailed Study Description for further information."
5 recorded sentences naming Piracetam; U-shaped, dose-response, biphasic
Show the evidence
U-shapedPMID 8272204
"U-shaped dose-dependent effects were found; they were strongest after 4.8 g piracetam."
dose-responsePMID 8821540
"This tolerance was overcome by piracetam in a significant manner but with a reversed dose-response curve; i.e. the smaller the dose of piracetam, the higher the subsequent morphine-induced PRL peak."
biphasicPMID 7901159
"Intraperitoneal injection of piracetam resulted in a biphasic response i.e.; initial excitation followed by inhibition of the aggressive behaviour."
dose-response
PMID 2658983
"Piracetam, meclofenoxate, nicergoline, naftidrofuryl, cinnarizine, and nifedipine shifted the anti-hypoxic dose-response curve of PGI2 to the left indicating synergistic interaction."
PMID 6390021
"Piracetam potentiated the effect of PGI2 shifting the anti-hypoxic dose-response curve of PGI2 to the left."
recorded 1996-02-01 · last checked 2026-09-04
Q5
Could one person measure Piracetam's effect on adverse effects?
Adverse effects: measured in Piracetam's trials.
Interpretation adverse effects is the recorded endpoint.
Show the evidence
biomarkers
adverse effects; 2026-09-01
drug use; 2026-09-01
clinical status; 2026-09-01
assessment of frequency and severity of adverse events; 2026-09-01
primary objective; 2026-09-01
mini mental state examination; 2026-09-01
human trials at or under30
3
Not recorded for this substance
a recorded half-life
smallest human trial
0; NCT00000198; PHASE1; the smallest recorded human enrolment at or below 30; the registry states no direction of its result; COMPLETED
Q6
Which of adverse effects, assessment of frequency and severity of adverse events and clinical status did Piracetam's trials measure?
adverse effects, assessment of frequency and severity of adverse events and clinical status lead 6 outcome terms across Piracetam's trials. ClinicalTrials.gov · 2026-09-01
Interpretation assessment of frequency and severity of adverse events, primary objective and mini mental state examination follow.
Show the evidence
adverse effects
1
drug use
1
clinical status
1
assessment of frequency and severity of adverse events
1
primary objective
1
mini mental state examination
1
recorded 2026-09-01 · last checked 2026-09-04
Q7
What will the one ongoing trial of Piracetam report, and when?
Evaluation of efficacy:1. Measurment of McGill Pain Scale:
Show the evidence
TrialNCT06479629
"The Effect of Piracetam on Diabetic Peripheral Neuropathy Patients"; n 60; "Evaluation of efficacy:1. Measurment of McGill Pain Scale:"; 2025-11-01
recorded 2026-09-01 · last checked 2026-09-04
Q8
Which 3 trials of Piracetam posted no result?
Posted no result
3 of 3 completed trials
Registrations
NCT00000198, NCT00567060 and NCT07722000
Completion dates
oldest 1997-10; newest 2023-12-01
Show the evidence
Trial
NCT00000198
1997-10
NCT00567060
2004-01
NCT07722000
2023-12-01
Q9
At the median, Piracetam's trials enrolled 60 people — anything larger?
Median enrolment
60
Largest enrolment
676
Registered trials counted
9
Q10
What do 89 spontaneous reports say about Piracetam — and not say?
These are reports people sent to a regulator. They do not show the medicine caused the reaction. Nobody counted how many people took the medicine and reported nothing. The same event can be reported more than once, and many reports are incomplete. News coverage, lawsuits and new warnings change how often people report. A count is not a rate and not a risk.
Piracetam appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 89 reaction mentions were counted: pyrexia 13; agitation 11; suicide attempt 10; confusional state 9. open-targets-adr · CHEMBL36715 · 2026-06-24
Show the evidence
pyrexia
13
agitation
11
suicide attempt
10
confusional state
9
drug interaction
9
bradycardia
8
4 more recorded rows
tremor
8
balance disorder
7
drug abuse
7
myoclonus
7
recorded 2026-06-24 · last checked 2026-09-04
Q11
Was Piracetam studied with fasting?
fasting is named in Piracetam's label sentences: "This study was conducted to evaluate the pharmacokinetics and bioequivalence of a newly developed generic piracetam tablet compared with the reference product (Nootropyl<sup>®</sup>) in healthy Chinese participants under fasting and fed conditions." openfda-label+europepmc · 2026-03-18
1 recorded statement; fasting
Show the evidence
fasting
This study was conducted to evaluate the pharmacokinetics and bioequivalence of a newly developed generic piracetam tablet compared with the reference product (Nootropyl<sup>®</sup>) in healthy Chinese participants under fasting and fed conditions.
recorded 2026-03-18 · last checked 2026-09-04
Q12
What is recorded about Piracetam and AMPK?
"Mechanistic studies showed that piracetam activated AMP-activated protein kinase (AMPK), which in turn upregulated sirtuin 1 (SIRT-1) and nuclear factor erythroid 2-related factor 2 (Nrf-2), leading to improved cognitive performance." — where Piracetam and AMPK appear together. Europe PMC · pathway abstract search · 2026-08-19
"Mechanistic studies showed that piracetam activated AMP-activated protein kinase (AMPK), which in turn upregulated sirtuin 1 (SIRT-1) and nuclear factor erythroid 2-related factor 2 (Nrf-2), leading to improved cognitive performance."
sirtuinPMID 41251844
"Mechanistic studies showed that piracetam activated AMP-activated protein kinase (AMPK), which in turn upregulated sirtuin 1 (SIRT-1) and nuclear factor erythroid 2-related factor 2 (Nrf-2), leading to improved cognitive performance."
AMPKPMID 41251844
"In conclusion, piracetam ameliorates cognitive impairment in CCH-induced VaD by modulating oxidative damage, neuroinflammation, and inflammatory cell death, potentially through activation of the AMPK/SIRT-1/Nrf-2 signaling pathway."
senolyticPMID 42688195
"Building on those directional findings, this short communication proposes a minimal three-arm oral regimen with unequal evidentiary weight: first, the Cheung Glutamatergic Regimen, consisting of low-dose dextromethorphan potentiated by a CYP2D6 inhibitor together with piracetam and L-glutamine, as an exploratory adjunct aimed at preserving residual functional connectivity; second, daily…"
NAD+PMID 42688195
"Building on those directional findings, this short communication proposes a minimal three-arm oral regimen with unequal evidentiary weight: first, the Cheung Glutamatergic Regimen, consisting of low-dose dextromethorphan potentiated by a CYP2D6 inhibitor together with piracetam and L-glutamine, as an exploratory adjunct aimed at preserving residual functional connectivity; second, daily…"
mTOR
PMID 38842755
"Mechanistically, Piracetam inhibited the PI3K/Akt/mTOR pathway in OGD-stimulated SH-SY5Y cells."
PMID 38842755
"Collectively, Piracetam improved oxidative stress and mitochondrial dysfunction of OGD-stimulated SH-SY5Y cells through PI3K/Akt/mTOR axis."
"We propose a fully oral, low-cost, four-component regimen designed to replicate ketamine's entire plasticity cascade: (1) dextromethorphan (DXM) supplies fast NMDA antagonism; (2) a strong CYP2D6 inhibitor (fluoxetine, paroxetine, or high-dose duloxetine) prolongs DXM exposure without relying on bupropion; (3) the AMPA positive allosteric modulator piracetam amplifies the downstream glutamate…"
NAD+PMID 4076427
"It has been established in experiments on rats that subcutaneous administration of piracetam for 6 days in a daily dose of 100 mg/kg produces in intact but not in gonadectomized animals the following alterations in the system of oxidation and energetic coupling of liver mitochondria: a decrease in the magnitude of the respiratory control according to Chance, elevation of the rate of oxidation of…"
recorded 2026-08-19 · last checked 2026-09-04
Where it is registeredIdentifiers, relations and other names
ChEMBL ATC CC BY-SA · ClinicalTrials.gov — US Government work · Europe PMC — metadata only, under the recorded legal gate · Open Targets 26.06 — CC0 · derived from this page's own recorded fields; no external licence · openFDA / DailyMed — US Government work
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