Piracetam (Cerebryl, Nootrop, Nootropil) is a nootropic supplement/drug. Nootropic drugs have the effect of improving a range of cognitive functions. Piracetam has various possible mechanisms of action on ME/CFS patients including lowering blood viscosity and decreasing platelet aggregation. It may benefit some ME/CFS patients by reducing cognitive impairment and increasing circulation.
ME/CFS Relevant Studies
This Boiko et al. study (http://www.ncbi.nlm.nih.gov/pubmed/17294097) administered patients ‘Fezam’ which is a combination of Piracetam and Cinarrizine (Cinarrizine is an anti-histamine.) The patients studied had a range of identified and heterogeneous etiologies causing their chronic fatigue including MS and CFS. The Fezam “significantly” decreased the severity of the patients’ physical chronic fatigue. 12% of patients experienced mild side effects which mainly consisted of sleep disturbances. This study was focused on patients with focal brain lesions. It should be noted that many ME/CFS patients have focal brain lesions. Dr. Komaroff found that almost 80 percent of ME/CFS patients contained within the Incline Village outbreak had brain lesions.
Moriau et al. (http://www.ncbi.nlm.nih.gov/pubmed/8328997) examined the efficacy of Piracetam as a treatment for both primary and secondary Raynaud ’s phenomenon. This study determined that 4 grams of Piracetam daily in synergy with 600mg of Buflomedil was the most effective treatment for Raynaud’s phenomenon out of the set of treatments generally considered effective for Raynaud’s phenonmenon. In order from most effective to least effective, the remainder of treatments were: Piracetam (8 grams per day), Buflomedil (600mg per day), Piracetam (4 grams per day) plus acetylsalicylic acid (100mg per day), pentoxifylline 1200mg per day, calcium antagonists and ketanserin (120mg per day.) This study was performed on patients with severe Raynaud’s phenomenon. The study stipulates that the effective 8g per day dose of Piracetam was reached in three smaller doses administered at 8 hour intervals. Raynaud’s phenomenon is a condition in which blood vessel spasms impair blood flow to bodily extremities. It is thought to be a symptom that affects between 30-50% of ME/CFS patients.
Glas-schottl (http://www.ncbi.nlm.nih.gov/pubmed/2656442) performed a study that analysed the effects that Piracetam had on patients suffering from soft tissue rheumatism. This study involved both intravenous and oral Piracetam being administered to the test subjects. Piracetam was found to be “significantly superior” to the placebo in terms of all parameters studied.
In the studies examined, patients rarely experienced side effects while on Piracetam. The Glas-schottl study noted one patient in the placebo group experiencing side effects while no patients taking Piracetam reporting side effects. Boiko et al. found that 12% of patients taking Piracetam experienced sleep disturbances.
If headaches occur, some patients report choline to be a beneficial tandem treatment to reduce this side effect. Some ME/CFS patients have indicated online that they can only tolerate small doses (in the 100mg range.) Anecdotal reports from ME/CFS patients taking Piracetam suggest that starting at the recommended dosage may leave some patients feeling ‘wired.’
Different countries have varying classifications of Piracetam. It is labelled as an over the counter supplement in some countries while a prescription drug in other countries. There is plentiful information online as to which countries have which corresponding medicinal status relating to Piracetam.
Piracetam is traditionally used to treat myoclonus in doses of up to 20 grams daily however ME/CFS patients require much smaller amounts. The dosage range for ME/CFS patients generally covers the spectrum from 0.8 grams to 4.8 grams. This dosage total is normally achieved by consuming the Piracetam 3 times per day (at 1/3rd of the daily dose on each occasion) at 8 hour intervals. Some ME/CFS patients have reported that anything in excess of 0.1 grams is too much for them. As Piracetam dosage for ME/CFS patients seems to be a highly individualised thing, it may be worth starting Piracetam conservatively at a lower dose and increasing the dosage to the recommended range accordingly.