Nootropil (piracetam) is a GABA analogue and nootropic medication. In some areas---notably Europe and Asia---it is used to help treat myoclonus (a condition in which involuntary twitching or jerking movements are present). Off-label it may be used to help treat dementia, depression, anxiety, vertigo, dyslexia and other conditions.

Like other nootropics, Nootropil is also sometimes used as a cognitive enhancer, particularly among college students. This use is also off-label and, though frowned upon by authorities in most locations, it is usually not technically illegal.

How It works

Nootropil is associated with improving reasoning, memory, learning, and alertness centers in the brain. It may also have some vasodilator properties, with potential as a treatment for victims of stroke.

The medication is thought to work by improving blood flow and oxygen to the brain, as well as increasing oxygen consumption by the brain. It is also thought to influence the brain's supply of neurochemicals and the function and synthesis of certain receptors. This is all speculative; the exact mechanism of action has not been determined.

Though its mechanism of action and effectiveness may be debatable, Nootropil is widely regarded as very safe. It is not a stimulant or a sedative, and addiction is practically unheard of. Side effects are typically few and mild, and do not persist after treatment ends.

Controversies

To be frank, not much is understood about this medication. Studies are currently ongoing, and existing studies produced mixed results, with some showing improvements in brain function or reduction in myoclonus symptoms, while others show no difference between Nootropil and placebo. The reason for these differences are unclear.

Nootropil is approved for use in treating myoclonus in much of the EU, Australia, Asia, and South America. In these areas a doctor may also prescribe it for off-label use as well. As a medication or health supplement a prescription or pharmacist approval is required to purchase Nootropil.

In the USA and Canada the drug is not approved and it cannot legally be sold as a medication or health supplement, but it can be sold without making any health claims. It is legal to use and it can be imported if desired. Note that, though unlikely, more local state or city laws may apply regarding legality; patients concerned about this may want to look into local regulations.

Taking Nootropil

Nootropil comes in capsules or tablets of 800 mg. These are best swallowed whole; capsules can be opened or tablets crushed, but it will be extremely bitter. Each dose should be taken with a glass of fluid; food is optional.

Patients who have difficulty swallowing whole tablets or capsules may be able to acquire an oral solution from a pharmacist. This solution will also have a very bitter taste, which can be alleviated to some extent by following it with a flavored drink.

Treatment varies widely with the medication's intended use.

To treat myoclonus in otherwise healthy adults:

• Start with 7.2 grams each day (9 capsules), divided into two or three smaller doses taken throughout the day.
• Dosage may be gradually increased if needed.

Ultimately treatment will be individualized for a specific patient. Other medications are usually given along with Nootropil, which can influence dosage.

Other, off-label uses are difficult to summarize, as there's no widely-accepted treatment guidelines. There is an abundance of information about various Nootropil uses on the internet, however; patients interested in using this product for off-label purposes should do research and find an organization or doctor familiar with using Nootropil for a given purpose.

Treatment can continue as long as it provided benefit and no adverse reactions develop.

Potential Complications

As mentioned above, Nootropil is widely regarded as safe, with side effects being rare. Rare, however, doesn't mean nonexistent; side effects can and do happen, and certain populations may be at increased risk of experiencing them.

Do not use Nootropil without first discussing risks and potential complications with a doctor when patients:

• Are under 16 or over 65 years old
• Are pregnant or breastfeeding
• Have moderate to severe kidney or liver impairment
• Have, or are at risk of, any bleeding disorder
• Are taking medications that influence bleeding
• Have a history of stroke
• Have Huntington's disease

Individuals undergoing any sort of medical or dental procedure should be sure the doctors involved are aware that Nootropil is being taken; treatment may need to stop for a while.

Note that Nootropil capsules, tablets, and oral solution all contain sodium. This may be a concern for individuals on sodium-restricted diets.

Though rare and usually mild, possible side effects include:

• Weight gain
• Nervousness
• Sleepiness
• Feeling weak

Very rare symptoms that may or may not be related to Nootropil use include:

• Agitation
• Increased anxiety
• Hyperkinesia
• Severe vertigo
• Insomnia
• Moderate to severe headache

If any of the above become severe enough to be disruptive a doctor should be consulted.