Piracetam

Structural formula
General
Non-proprietary name	Piracetam
other names	2-oxopyrrolidine-1-acetamide ( IUPAC ) PIRACETAM ( INCI )
Molecular formula	C 6 H 10 N 2 O 2
External identifiers / databases
CAS number 7491-74-9 EC number 231-312-7 ECHA InfoCard 100.028.466 PubChem 4843 ChemSpider 4677 DrugBank DB09210 Wikidata Q410069
Drug information
ATC code	N06 BX03
Drug class	Anti-dementia
properties
Molar mass	142.16 g · mol -1
Physical state	firmly
Melting point	151.5-152.5 ° C
safety instructions
Please note the exemption from the labeling requirement for drugs, medical devices, cosmetics, food and animal feed GHS labeling of hazardous substances no GHS pictograms H and P phrases H: no H-phrases P: no P-phrases
Toxicological data	2000 mg kg −1 ( LD 50 ,  mouse ,  oral ) 9200 mg kg −1 ( LD 50 ,  mouse ,  iv )
As far as possible and customary, SI units are used. Unless otherwise noted, the data given apply to standard conditions .

Piracetam is a cyclic derivative ( γ-lactam ) of γ-aminobutyric acid (GABA) and a drug from the group of anti-dementia drugs ( nootropics ).

It stimulates the cellular sugar metabolism and the utilization of oxygen in the brain and is used for the symptomatic treatment of performance disorders caused by chronic brain organism ( dementia ).

As part of an overall therapeutic concept, Piracetam can improve the symptoms of memory, concentration and thinking disorders, lack of drive and motivation, and fatigue in people with dementia. At a symposium organized by the manufacturing company UCB, researchers presented numerous studies five years after the market launch that suggested a "general improvement in the cerebral aging process" or were intended to demonstrate "a clinically relevant improvement in memory function". Seniors in need of care improved their daily activities and were less in need of help.

However, the Drugs Commission of the German Medical Association found in 2004 that many of the older studies with Piracetam had methodological weaknesses. Reference is made there to a literature analysis by the Cochrane Collaboration, according to which piracetam improves the overall clinical impression in dementia , but not the brain performance.

The German Society for Neurology lists Piracetam in its guideline dementia published in 2016 under “other active ingredients”. She calls the evidence for Alzheimer's dementia "insufficient" and judges: "Treatment is not recommended."

Piracetam is also sometimes prescribed for systemic treatment of sudden hearing loss to promote blood flow.

Chemically related active substances ( analogues ) are u. a. Aniracetam , Oxiracetam, and Pramiracetam .

Manufacturing

The synthesis starts from 2-pyrrolidone , which is reacted with ethyl chloroacetate after deprotonation using sodium hydride . In the next step, the target compound is obtained by converting the ester to the amide using ammonia . A one-step synthesis is possible through the use of chloroacetamide .

Side effects

While taking or using Piracetam, the following side effects may occasionally occur:
agitation, increased drive, nervousness, restlessness, irritability, aggressiveness, tremors, depression , anxiety disorders , insomnia, tiredness and drowsiness, nausea, nausea, abdominal pain, diarrhea , weight gain.

Rarely rare side effects include:
dizziness, weakness, lowering of blood pressure, increased blood pressure, increased desire ( libido ).

Very rare and therefore sporadic side effects can be the following:
headache, movement disorders, balance disorders, states of confusion, delusions, allergic reactions such as anaphylactic shock , hives , reddened skin, sensation of heat, itching, sweating.

Trade names

Monopreparations

Cerebryl (A), Cerepar (D), Nootrop (D), Nootropil (A, CH), Normabrain (D), Pirabene (A), various generics (D)

Individual evidence

1. ↑ Entry on PIRACETAM in the CosIng database of the EU Commission, accessed on July 6, 2020.
2. ^ The Merck Index. An Encyclopaedia of Chemicals, Drugs and Biologicals. 14th edition, 2006, p. 1290, ISBN 978-0-911910-00-1 .
3. ↑ ^{a b c} Data sheet Piracetam from Sigma-Aldrich , accessed on June 16, 2011 ( PDF ).
4. ^ ^{A b c} Axel Kleemann , Jürgen Engel, Bernd Kutscher and Dietmar Reichert: Pharmaceutical Substances, 4th edition (2000), 2 volumes published by Thieme-Verlag Stuttgart, ISBN 978-1-58890-031-9 ; online since 2003 with biannual additions and updates.
5. ↑ Symposium Piracetam in brain disorders
6. ↑ Drug Ordinance in Practice: Dementia ( Memento from March 18, 2015 in the Internet Archive )
7. ^ German Society for Neurology: Guideline Dementia
8. ↑ medikamio.com: Nootropil
9. ↑ ^{a b c} Onmeda: Piracetam: Side Effects

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !