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Pramiracetam, otherwise known by its branded title Pramistar®, is a nootropic supplement of the racetam family, a group of synthetic medicines designed for cognitive enhancement and improved memory retention, attentiveness, and motivation . It is considered to be one of the most potent and effective of the racetams .
Pramiracetam vs. Piracetam
Pramiracetam is one of the most recent nootropic substances derived from piracetam, the original “brain booster” synthesized in the 1970s . The molecule that conceives pramiracetam was originally isolated from piracetam during laboratory studies, in which researchers found that it had significant anti-amnesiac activity in rats .
Unlike piracetam, pramiracetam doesn’t directly impact GABA (gamma-aminobutyric acid) receptors in the human brain. Instead it acts on the neurotransmitters acetylcholine and glutamate, both of which support learning and memory retention. Further, laboratory research indicates that pramiracetam is effective in treating patients suffering from Alzheimer’s dementia as well as otherwise healthy individuals who experience attention issues (such as ADHD, or Attention Deficit Hyperactivity Disorder) and anxiety-induced cognitive difficulties .
Pramiracetam has been shown to act quickly and has a fairly long duration of effectiveness, with a half-life of approximately four-to-six hours . It is also highly fat-soluble, which means it can diffuse easily across lipids and cell membranes . A comparative study conducted in 2004 indicated that pramiracetam may be five to ten times more potent than the original piracetam .
Benefits and Effects
Research indicates that pramiracetam can have a number of benefits, including:
Improved Memory Retention and Amnesia Reduction
Several clinical studies have validated pramiracetam’s capabilities in long-term memory improvement and even amnesia reversal in both healthy individuals and patients with cognitive deficits or injuries. A 1996 study with thirty-five healthy older men (with a mean age of 65 years) revealed that those supplemented with pramiracetam demonstrated greater memory improvement than their control counterparts, who received either memory training alone or nothing at all .
A 1991 study found that 400 mg of pramiracetam was effective in treating memory retention issues in young men with traumatic brain injuries. Further, the improvement continued during the month-long follow-up period after supplementation was discontinued .
Pramiracetam has been demonstrated to be effective against medication-induced amnesia. A 1994 study examined the nootropic’s anti-amnesiac abilities in twenty-four males treated with scopolamine, a post-operative anti-nausea medication that can cause lethargy and memory loss. Pramiracetam was shown to reduce amnesiac effects in both young and elderly subjects .
Increased Concentration and Focus
Many individuals supplemented with pramiracetam have anecdotally reported increased focus, motivation, and concentration . However, clinical research has not yet verified pramiracetam’s specific action in terms of focus .
Reduction in Anxiety (Social and/or Generalized)
While pramiracetam has not been clinically validated to ameliorate anxiety when taken alone, many testimonials have reported that taking pramiracetam alongside other nootropics like aniracetam, oxiracetam, and/or piracetam helps alleviate social and/or generalized anxiety  . Anexdotally, some individuals taking pramiracetam have cited increased social fluency as a surprising benefit of the nootropic. Alternatively, others have described emotional deadening as a negative side effect, inducing a slightly “robotic” state that dissuades them from wanting to engage socially .
Though some users have described amelioration in anxiety-related and depressive symptoms when taking the supplement as a supplementary treatment, pramiracetam should never be taken in substitution to prescribed anti-anxiety or antidepressant medications .
Elevated Mental Alertness
An early 1985 study with laboratory rats compared pramiracetam to piracetam in terms of cognitive arousal. Results indicated that pramiracetam acted much more powerfully in speeding up EEG waves in the rats’ frontal cerebral cortexes and dorsal hippocampuses . Similar laboratory studies have validated that pramiracetam yields significant elevation in cortical and hippocampal stimulation and arousal .
Heightened Sensory Perception
The neurotransmitter acetylcholine plays a significant role in stimulating function in the sensory cortex . As ACh decreases, both cognition and sensory processes decline . Pramiracetam supports production and activity of ACh, which accounts for its ability to enhance sensory processing .
How Pramiracetam works
Pramiracetam functions as a cognitive enhancer, or a “smart drug.” One of its primary mechanisms of action involves a process called high affinity choline uptake, which supports the conversion of choline into acetylcholine and the subsequent neuronal synthesis of ACh . The cholinergic system plays an integral role in sensory stimulation, learning, memory, and overall cognition . Pramiracetam also increases the production and synthesis of nitric oxide in the brain, which has been demonstrated to alleviate age-related memory loss in clinical research .
Pramiracetam is unique in that it is able to impact the transmission and synthesis of neurotransmitters while acting outside of the brain . Instead, the nootropic affects cognitive function via the adrenal cortex, which is heavily involved in modulating the body’s response to stressful stimuli . This may contribute to the anti-anxiety and mood-modulating effects many users of pramiracetam have reported, though this remains to be validated in placebo-controlled clinical trials.
In addition to its cognitive enhancement capabilities, pramiracetam may have a mild anti-diabetic effect. A 2012 study of the nootropics noopept, piracetam, and pramiracetam and their effects on diabetic rats indicated that each supplement had an inhibitory action against platelet hyperactivity and chronic hyperglycemia .
Pramiracetam is reputed to be safe and effective at a daily dosage of 1,200 mg at 400 mg thrice or 600 mg twice per day . Some clinical evidence suggests that a 1,600 – 2,000 mg dosage is fit for daily consumption as well . Like all nootropics, pramiracetam is tolerated well even at high dosages, but laboratory research into its tolerability is somewhat limited. Further, pramiracetam is much stronger than many of its other nootropic counterparts, so remaining at or under a maximum dosage of 1,200 mg total daily is advisable .
Pramiracetam can be ingested in a powdered or capsule form. In terms of how to take pramiracetam powder, users often mix a powder dosage of 200-400 mg with milk, olive oil, or a number of other beverages. However, many individuals have reported a highly unpleasant taste and a slight burning sensation in the throat from pramiracetam powder .
Since it is both fat-soluble and cholinergenic, pramiracetam should be consumed with food and a source of choline . Choline can be taken as a supplement, but it can also be found in egg yolks, liver, fish, mushrooms, broccoli, brussel sprouts, peanuts and peanut butter, and legumes .
Reported side effects of pramiracetam are extremely limited . Like virtually all nootropics, pramiracetam is non-toxic and non-addictive, but there is the possibility of escalating tolerance and reduced effect with increased use. Users can preserve pramirecitam’s long-term efficacy by cycling and taking regular periods off from supplementation .
The majority of clinical research studies have reported a lack of side effects in patients administered the nootropic . However, anecdotal evidence indicates that users may experience anxiety, fatigue, irritability, and/or abdominal discomfort when taking pramiracetam. Further, some individuals have stated that pramiracetam caused them to experience anxiety after stopping supplementation . Users have also described emotional dullness as an inconvenient effect of the nootropic .
Pramiracetam and Choline/Alpha-GPC
The best way to take pramiracetam is alongside a beneficial source of choline, either via supplements or choline-rich foods . Since this nootropic is highly cholinergenic, sometimes individuals choose to supplement with Alpha Glycerol Phosphoryl Choline, or Alpha-GPC, which is often used to treat memory issues resulting from dementia or stroke .
Pramiracetam and Eugeroics
Pramiracetam is well-tolerated alongside other nootropics. Many individuals advocate for adrafinil, modafinil, and armodafinil alongside pramiracetam. These three drugs are classified as eugeroics, which promote alertness and are sometimes used in the treatment of sleeping disorders such as narcolepsy . However, both modafinil and armodafinil require prescriptions, and all three medications have higher risks of negative side effects, such as anxiety, skin irritation, and gastrointestinal issues, than other nootropic types .
Pramiracetam and Aniracetam/Oxiracetam
Pramiracetam and aniracetam are both fat-soluble nootropics and generally stack well together. Since aniracetam positively impacts mood, some individuals stack these two together in order to achieve improved cognition as well as a reduction in anxiety-related or depressive symptoms .
Oxiracetam’s mental enhancement capabilities coupled with its property as a mild neural stimulant make it a popular stack with pramiracetam as well. This stack is believed to elevate cognitive vitality and alertness .
Reported effects of nootropic stacks include abdominal upset, headache, and sleep disruption .
Pramiracetam and Phenylpiracetam
Phenylpiracetam is a phenyl-substituted, water-soluble variant of pramiracetam . It yields many of the same benefits as pramiracetam, but is believed to be more efficient in terms of mood enhancement and stress reduction. Many users choose to stack phenylpiracetam with pramiracetam for elevated anxiolytic effects and overall cognitive performance. However, phenylpiracetam is reported to have a higher propensity for causing headaches and/or gastrointestinal issues than pramiracetam alone .
Pramiracetam and Huperzine-A
Huperzine-A is an alkaloid supplement and an acetylcholinesterase inhibitor extracted from Huperzia serrata, a toothed club moss endemic to China . At a 200 mg daily dosage, Huperzine-A is known to be an effective cognitive enhancer with potential for reversing severe memory impairments in patients with Alzheimer’s dementia. It also increases NGF, or Nerve Growth Factor, meaning it supports the formation of new neurons. Given its functional similarities to pramiracetam, some users will stack Huperzine-A with pramiracetam for improved memory and mental clarity .
Huperzine-A is believed to be safe to ingest for a duration of less than three months. Its reported side effects include gastrointestinal upset, profuse salivation or sweating, blurry vision, muscle twitching and contraction, increased fluid secretion in the organs (congestion), and slow heart rate. Individuals with lung, heart, intestinal, or urinary tract complications should be particularly careful using this supplement .
“Top quality product. My focus and motivation is the highest [they have] ever been because of pramiracetam.” – Dean S.
“Yes, pramiracetam definitely has the Spock factor going on. I’m surprised that it’s not used more for studying or solving complex engineering problems.” – Maxwell V.
“Time almost seems to pass at a slower rate on pramiracetam, it is almost as if I am able to think at a higher speed within a shorter period of time. I have experienced higher productivity at work, both in terms of being able to more quickly deal with tedious tasks and to produce higher quality material in more mentally intensive projects. Now for the bad/weird: 1) Pramiracetam tastes absolutely horrible, 2) It tears up my stomach if I don’t consume food with it, 3) I have a greater propensity to employ words on the frontiers of my mastered vocabulary, which can occasionally lead me to either misuse a word or sound [pretentious] for using ‘big words’ regardless of the context, 4) I often find myself attempting to create new words on pramiracetam. The most common manifestation of this is my tendency on pram of converting words into a non-standard English adverb form in both text and speech, 5) I feel incredibly robotic and logical, which can often be a bad thing in social situations.” – Anonymous
“Being new to nootropics, I decided to start with pramiracetam and choline together (800 mg of pramiracetam and 1600 mg of choline). By taking choline with the pramiracetam I did not experience any side effects such as headaches, albeit I have only been taking this around a month. Others have recommended taking 1200 mg a day, but I am [observing] good effects at 800 mg so I am happy with that. Brain function has been a huge improvement, in terms of taking in information in and remembering [it]. Past memories are also clearer, and quicker to recall.” – George L.
“I’ve been a user of piracetam for a year or so, and just got some pramiracetam and decided to try it instead and to me, it definitely feels cleaner than piracetam. Both increase alertness, but pramiracetam seems to be more eccentric and electric. I’m on day 2 now and pramiracetam seems to bring even more alertness in a more centered, peaceful, and calm way.” – Anonymous