Pm9.0

Piracetam Research

38 peer-reviewed studies · Evidence score: 9/10

Augmentation with glutamatergic modulators for schizophrenia: A network meta-analysis

Liang CW et al. • Progress in neuro-psychopharmacology & biological psychiatry (2025)

Notably, memantine, N-acetylcysteine, and sarcosine exhibited efficacy across multiple outcome domains.

Notably, memantine, N-acetylcysteine, and sarcosine exhibited efficacy across multiple outcome domains.
The effects of some novel agents within specific dose ranges on cognitive function improvement were also observed.

Meta-Analysisn=12,339

DOI

Pharmacological interventions to diminish cognitive side effects of electroconvulsive therapy: A systematic review and meta-analysis

Verdijk JPAJ et al. • Acta psychiatrica Scandinavica (2022)

Memantine and liothyronine are promising for further research and future application.

Low-quality evidence of efficacy was established for memantine (large effect size) and liothyronine (medium effect size).
Memantine and liothyronine are promising for further research and future application.
Quality of evidence was low because of differences in ECT techniques, study populations and cognitive measurements.

Meta-Analysisn=1,387

DOI

The treatment of cognitive dysfunction in dementia: a multiple treatments meta-analysis

Perng CH et al. • Psychopharmacology (2018)

The most effective intervention for dementia available is symptomatic treatment for vascular dementia.

The pooled standardized mean difference of the treatment effects on cognitive dysfunction was 0.439 (95% confidence interval 0.374, 0.504).
The most effective intervention for dementia available is symptomatic treatment for vascular dementia.
Antipsychotic treatment for dementia alleviates cognitive dysfunction less effectively than does symptomatic treatment.

Meta-Analysisn=44,854

DOI

Piracetam for acute ischaemic stroke

Ricci S et al. • The Cochrane database of systematic reviews (2012)

There is some suggestion (but no statistically significant result) of an unfavourable effect of piracetam on early death, but this may have been caused by baseline differences in stroke severity in the trials.

We included three trials involving 1002 patients, with one trial contributing 93% of the data.
Piracetam was associated with a statistically non-significant increase in death at one month (approximately 31% increase, 95% confidence interval 81% increase to 5% reduction).
There is some suggestion (but no statistically significant result) of an unfavourable effect of piracetam on early death, but this may have been caused by baseline differences in stroke severity in the trials.

Meta-Analysisn=1,002

DOI

Efficacy of piracetam in children with breath-holding spells: a systematic review and meta-analysis

Sharawat IK et al. • European journal of pediatrics (2024)

The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Number of participants with complete response or total cessation of attacks was more in the piracetam group compared to placebo (RR: 5.7 (95% CI-1.4-23.2), I2 = 88%, p = 0.01).
Change in the average number of BHS was significantly more in the piracetam group, as compared to the placebo group (mean difference-4.9 (95% CI-0.7-9.0), I2 = 99%, p = 0.02).
Number of participants with treatment-emergent adverse effects were comparable in both piracetam and placebo groups (RR: 1.9 (95% CI-0.5-7.6), I2 = 0%, p = 0.33).

Meta-Analysisn=437

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Treatment Efficacy of Pharmacotherapies for Frontotemporal Dementia: A Network Meta-Analysis of Randomized Controlled Trials

Huang MH et al. • The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry (2023)

This study provides the first NMA for clinical recommendation to support the use of high-dose oxytocin and caution regarding the use of piracetam for neuropsychiatric symptoms in patients with FTD.

Compared with placebo, high-dose oxytocin (72 international units) was associated with the greatest improvement in patients' neuropsychiatric symptoms (SMD = -1.17, 95% CIs = -2.25 to -0.08, z = -2.10, p = 0.035).
Piracetam significantly worsened neuropsychiatric symptoms (SMD = 3.48, 95% CIs = 1.58 to 5.37, z = 3.60, p < 0.001) and caregiver stress (SMD = 2.40, 95% CIs = 0.80-4.01, z = 2.94, p = 0.003).
Trazodone had significantly higher rates of adverse events (OR = 9.53, 95% CIs = 1.85-49.20, z = 2.69, p = 0.007).

Meta-Analysisn=243

DOI

A meta-analysis of the effect of different neuroprotective drugs in management of patients with traumatic brain injury

El Sayed I et al. • Neurosurgical review (2018)

Further research with high validity is needed to reach a solid conclusion about the use of neuroprotective drugs in cases of brain injury.

Patients treated with cerebrolysin (n = 112) had favorable GOS three times more than controls (OR 3.019; 95 % CI 1.76 to 5.16; p = 0.003*).
The odds of cognition improvement in the treatment group was 3.4 times more than controls (OR 3.4; 95 % CI 1.82 to 5.21; p < 0.001*).
Survival of cerebrolysin-treated patients did not differ from controls (103 patients; OR = 2.81; 95 % CI 0.905 to 8.76).

Meta-Analysisn=103

DOI

Piracetam for reducing the incidence of painful sickle cell disease crises

Al Hajeri A et al. • The Cochrane database of systematic reviews (2016)

The small number of included trials and their poor methodological quality provided insufficient reliable evidence to support the routine use of this medication for preventing the incidence of painful sickle cell disease crises.We will continue to run searches to identify any potentially relevant trials; however, we do not plan to update other sections of the review until new trials are published.

Although there was no significant difference between the piracetam and placebo periods for the number of days of hospitalisation (P = 0.87) in one trial, inconsistencies in the criteria necessary for hospitalisation during sickle crises did not permit accurate conclusions to be drawn.
Further research warranted to confirm findings

Meta-Analysisn=169

DOI

An update on the efficacy of anti-inflammatory agents for patients with schizophrenia: a meta-analysis

Çakici N et al. • Psychological medicine (2019)

Some, but not all agents with anti-inflammatory properties showed efficacy.

The results of aspirin [mean weighted effect size (ES): 0.30; n = 270; 95% CI (CI) 0.06-0.54], estrogens (ES: 0.78; n = 723; CI 0.36-1.19), minocycline (ES: 0.40; n = 946; CI 0.11-0.68), and NAC (ES: 1.00; n = 442; CI 0.60-1.41) were significant in meta-analysis of at least two studies.
Some, but not all agents with anti-inflammatory properties showed efficacy.
Effective agents were aspirin, estrogens, minocycline, and NAC.

Meta-Analysisn=270

DOI

Piracetam for Aphasia in Post-stroke Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Zhang J et al. • CNS drugs (2016)

Piracetam plays a limited role in the rehabilitation of overall language impairment and only benefits written language ability at the end of trials.

Piracetam plays a limited role in the rehabilitation of overall language impairment and only benefits written language ability at the end of trials.
Its effect on overall linguistic level and written language tends to emerge within a short period and declines thereafter.
Further research warranted to confirm findings

Meta-Analysisn=261

DOI

Piracetam for fetal distress in labour

Hofmeyr GJ et al. • The Cochrane database of systematic reviews (2012)

There is not enough evidence to evaluate the use of piracetam for fetal distress in labour.

Piracetam compared with placebo was associated with a trend to reduced need for caesarean section (risk ratio 0.57, 95% confidence interval 0.32 to 1.03).
There were no statistically significant differences between the piracetam and placebo group for neonatal morbidity (measured by neonatal respiratory distress) or Apgar score.
There is not enough evidence to evaluate the use of piracetam for fetal distress in labour.

Systematic Reviewn=96

DOI

Reconsideration of the Benefits of Pharmacological Interventions for the Attenuation of the Cognitive Adverse Effects of Electroconvulsive Therapy

Andrade C • The Journal of clinical psychiatry (2022)

A risk is that whatever attenuates ECT-induced cognitive AEs may also attenuate ECT-related therapeutic benefits.©

Regrettably, none of the RCTs examined clinically meaningful outcomes such as subjective cognitive impairment, impairments in daily life, and persistent autobiographical memory deficits.
Future research should study such clinically meaningful outcomes (rather than laboratory tests), using pharmacologic interventions, perhaps in combination, for ECT procedures that are associated with higher cognitive AE burden.
A risk is that whatever attenuates ECT-induced cognitive AEs may also attenuate ECT-related therapeutic benefits.©

Meta-Analysisn=26

DOI

Effects of Central Nervous System Drugs on Recovery After Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Yeo SH et al. • Clinical drug investigation (2017)

Administration of SSRIs may improve gross motor function, reduce disability and enhance QOL for patients recovering from stroke.

Administration of SSRIs may improve gross motor function, reduce disability and enhance QOL for patients recovering from stroke.
Further research warranted to confirm findings

Meta-Analysisn=44

DOI

A Systematic Review of Neuroprotective Strategies during Hypovolemia and Hemorrhagic Shock

Nistor M et al. • International journal of molecular sciences (2017)

This important topic therefore requires more in-depth research.

We identified three subsets of results: (1) hypothermia; (2) fluid therapy and/or vasopressors; and (3) other neuroprotective strategies (piracetam, NHE1-inhibition, aprotinin, human mesenchymal stem cells, remote ischemic preconditioning and sevoflurane).
Overall, risk of bias according to SYRCLE's tool was medium; generally, animal experimental models require more rigorous adherence to the reporting of bias-free study design (randomization, etc.).
While the individual study results are promising, the retrieved neuroprotective strategies have to be evaluated within the current scientific context-by doing so, it becomes clear that specific promising neuroprotective strategies during states of haemorrhagic shock remain sparse.

Systematic Review

DOI

Pharmacologic treatment of pediatric headaches: a meta-analysis

El-Chammas K et al. • JAMA pediatrics (2013)

More research is needed.

Drugs more effective than placebo for episodic migraines (<15 headaches per month) included topiramate (difference in headaches per month, -0.71; 95% CI, -1.19 to -0.24) and trazodone (-0.60; 95% CI, -1.09 to -0.11).
Patients given placebo experienced a significant (P = .03) decline in headaches, from 5.6 (95% CI, 4.52-6.77; Q = 8.14 [Cochran Q is a measure of the heterogeneity of the included studies]) to 2.9 headaches per month (95% CI, 1.66-4.08; Q = 4.72).
Among the 10 active comparator trials, flunarizine was more effective than piracetam (difference in headaches per month, -2.20; 95% CI, -3.93 to -0.47) but no better than aspirin, dihydroergotamine, or propranolol.

Meta-Analysisn=21

DOI

The Diagnosis and Treatment of Reading and/or Spelling Disorders in Children and Adolescents

Galuschka K et al. • Deutsches Arzteblatt international (2016)

Evidence- and consensus-based guidelines for the diagnosis and treatment of reading and/or spelling disorders in children and adolescents are now available for the first time.

Evidence- and consensus-based guidelines for the diagnosis and treatment of reading and/or spelling disorders in children and adolescents are now available for the first time.
Reading and spelling abilities should be systematically and comprehensively reinforced, and potential comorbid disorders should be sought and treated appropriately.
The efficacy of many treatments now in use has not been documented; if they are to be used in the future, they must be tested in randomized, controlled trials.

Meta-Analysis

DOI

Pharmacological Management of Lewy Body Dementia: A Systematic Review and Meta-Analysis

Stinton C et al. • The American journal of psychiatry (2015)

High-level evidence related to pharmacological strategies for managing Lewy body dementia is rare.

High-level evidence related to pharmacological strategies for managing Lewy body dementia is rare.
Strategies for important areas of need in Lewy body dementia, such as autonomic symptoms and caregiver burden, have not been investigated, nor have the views of patients and caregivers about pharmacological strategies.
Further research warranted to confirm findings

Meta-Analysis

DOI

Systematic review of interventions for fatigue after traumatic brain injury: a NIDRR traumatic brain injury model systems study

Cantor JB et al. • The Journal of head trauma rehabilitation (2014)

Despite areas of promise, there is insufficient evidence to recommend or contraindicate any treatments of PTBIF.

Despite areas of promise, there is insufficient evidence to recommend or contraindicate any treatments of PTBIF.
Modafinil is not likely to be effective for PTBIF.
Piracetam may reduce it, as may bright blue light.

Systematic Review

DOI

Pharmacological perioperative brain neuroprotection: a qualitative review of randomized clinical trials

Bilotta F et al. • British journal of anaesthesia (2013)

Of importance from this review is the need for shared methodological approach when clinical studies on pharmacological neuroprotection are designed.

The POCD did not differ between treated patients and control group for other tested drugs (thiopental, propofol, nimodipine, GM1 ganglioside, lexipafant, glutamate/aspartate, xenon, erythropoietin, remacemide, piracetam, rivastigmine, pegorgotein, and 17β-estradiol).
None of the tested drugs was associated with a reduction in mortality rate.
Drugs with various mechanisms of action have been tested over time; current evidence suggests that pharmacological brain neuroprotection might reduce the incidence of new postoperative neurological deficits and POCD, while no benefits on perioperative mortality are described.

Meta-Analysisn=25

DOI

Piracetam in elderly cognitive impairment: meta-analysis

Waegemans T et al. • Dementia and Geriatric Cognitive Disorders (2002)

Piracetam showed significant improvement in cognition across multiple domains in elderly patients.

Significant cognitive improvement
Benefits across multiple domains
Well-tolerated

Meta-Analysisn=1,482

DOI

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