Pyrrolidinones (Racetams) | l-Deprenyl (Eldepryl,
While piracetam increases nerve cell membrane fluidity and
normalizes hyperactive platelet aggregation, its effects are considerably
potentiated by CDP-choline, idebenone, vinpocetine, and selegiline.
Piracetam enhances the antihypoxic effect of CPH by protecting cell
membranes from phospholipid peroxidation. Oxiracetam, aniracetam,
and pramiracetam have shown greater benefits than piracetam. Human
studies using racetams to augment the effects of CDP-choline and
other cholinesterase inhibitors are needed. Large double-blind,
placebo-controlled studies support racetam benefits in poststroke
aphasia and dyslexia. (For reviews, see Table 39–8 and Brown et al. 2009.) Piracetam given within 7 hours of stroke, combined
with speech therapy, enhanced language recovery (De Deyn et al. 1997). In postconcussion syndrome, piracetam reduced
symptoms (especially vertigo and headache) and accelerated recovery
(Hakkarainen and Hakamies 1978). PET scans demonstrated
improved task-related blood flow in the left hemisphere speech area
in poststroke patients given piracetam (Kessler et al. 2000).
In practice, ginkgo and piracetam can synergistically augment language
retraining for dyslexia and aphasia: gingko improves attention and
perception; piracetam improves learning. In a DBRPC of 98 patients
with ischemic stroke following coronary artery bypass surgery, those
treated with piracetam had significant improvement in cognitive
function versus placebo (Szalma et al. 2006).