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Piracetam Side Effects & Adverse Reactions (List)

Piracetam is a drug that was synthesized in 1964 by Corneliu E. Giurgea et al. at the pharmaceutical company “UCB” headquartered in Belgium.  Chemically, it is identified as 2-oxo-1-pyrrolidine acetamide, shares the same base structure with pyroglutamic acid, and as a result of its pyrrolidone nucleus, is classified as a “racetam” compound.  Following the synthesis of piracetam, scientists tested its effects in humans, noting that it significantly enhanced cognitive performance without toxicity concerns.

Its ability to bolster cognition in healthy adults without major safety risks prompted lead scientist Corneliu E. Giurgea to label it a “nootropic.”  Piracetam would eventually hit the market in the 1970s and was sold under the brand name “Nootropil,” a cyclic derivative of GABA that functions as a positive allosteric modulator of AMPA (a subtype of glutamate receptors).  Positive allosteric modulation of AMPA receptors alters glutamatergic transmission in such a way that functionality of learning and memory processes are enhanced.

It may also elicit a host of other pharmacologic effects including: ion channel modulation (sodium, potassium, etc.), mitochondrial modulation, upregulation of membrane fluidity, increases in acetylcholine, and heightened cerebral oxygenation.  Though not FDA approved for the treatment of any medical condition, piracetam is commonly purchased online by biohackers, self-experimenters, and others endeavoring to enhance cognitive function with minimal risk.  Unfortunately, certain piracetam users may experience unexpected side effects and adverse reactions, some of which may be intolerable.

Piracetam Side Effects & Adverse Reactions (List)

Despite the fact that piracetam is regarded as a relatively safe nootropic, some users will experience side effects and adverse reactions.  Understand that the severity and number of side effects experienced from piracetam is subject to significant individual variation.  One user may not perceive any side effects, while another may notice severe adverse reactions.  Of all piracetam side effects, the most common include: nervousness, increased body movements (hyperkinesia), and weight gain.

Agitation: A subset of piracetam users report becoming extremely agitated, or internally aroused.  This agitation may be associated with an uptick in anxiety, nervousness, irritability, and restlessness – all of which may facilitate poorer cognitive function.  If you feel increasingly agitated after taking piracetam, know that you’re not alone.  There are a multitude of possible reasons for this piracetam-induced agitation, one of which may be a result of an increase in acetylcholine.

Anxiety: Many individuals report feeling increases in anxiety after taking piracetam.  Since piracetam is thought to exhibit anxiolytic properties and increase alpha brain waves (thereby increasing interhemispheric connectivity), perhaps some users experience a relaxation-induced form of anxiety in which they feel physically relaxed, but mentally anxious.  Others may experience anxiety as a result of an acetylcholine spike and/or altered monoamine levels and/or monoaminergic turnover in brain regions.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/6535371

Brain fog: Although many individuals surmise that piracetam may eradicate brain fog, a cornucopia of anecdotal reports have surfaced from former users noting that piracetam exacerbated their clouding of cognition (brain fog, cog fog, etc.).  If you notice that your thinking becomes foggy or clouded after taking piracetam, it’s likely more than just a coincidence.  There are numerous potential neurophysiologic mechanisms that may contribute to your brain fog.

Piracetam is thought to upregulate alpha waves throughout the cortex, thereby connecting more brain regions.  Though you may suspect that an upregulation in slower brain waves is beneficial, clearly it isn’t in all cases.  Individuals with ADHD often exhibit deficiencies in fast-paced beta waves and an overabundance of slow waves (e.g. alpha / theta).  For this reason, it should be speculated that this brain fog may be caused by a neuroelectrical modification as a result of

Additionally, piracetam-induced foggy thinking may be spurred via oxidative stress.  Some research notes that piracetam administration in animals increased “MDA,” a biomarker for oxidative stress within the cerebral cortex, hippocampus, hypothalamus, and striatum.  Therefore, it is possible that piracetam, especially at high doses, is pro-oxidative, resulting in increased levels of reactive oxygen species (ROS), which in turn may yield brain fog.

It is also necessary to consider that piracetam-induced modulation of: monoamines, glutamate, acetylcholine, and ions (sodium, potassium, etc.) may interfere with healthy neurotransmission in certain users.  Altered densities of neurotransmitters in certain regions of the brain, turnover rates, etc. – may contribute to foggy thinking.  Furthermore, from a holistic perspective, the combined effect of: neuroelectrial alterations, oxidative stress, and/or modified neurotransmission – may cause brain fog.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/21448596
  • Source: http://www.ncbi.nlm.nih.gov/pubmed/6535371

Cognitive impairment: Most individuals supplementing with piracetam are doing so to attain some sort of cognitive advantage.  While piracetam may enhance cognitive processes in certain individuals, others may notice no change in cognition.  Another subset of users has reported mild, moderate, (and in some cases) severe cognitive impairment as a side effect.

If you notice that piracetam interferes with your ability to learn new information, organize your thoughts, and/or perform cognitively-demanding tasks – there’s a chance that it may be a suboptimal fit for your neurochemistry.  Impaired cognition may be facilitated by the same aforementioned causative mechanisms of piracetam-induced brain fog, namely: neuroelectrical changes, altered monoaminergic transmission, and increased oxidative stress.

Common examples of cognitive impairment associated with piracetam include: difficulty reading, increases in spelling and/or grammatical errors, poor verbal retrieval, and speech abnormalities (e.g. mumbling).  Obviously if you were to take piracetam and notice cognitive impairment, the next logical step to take is to discontinue supplementation.  That said, it may be possible to experience a temporary form of cognitive impairment during an adjustment phase in which the brain is reorganizing to accommodate piracetam’s modifications.

Depression: Piracetam, as well as other cholinergic nootropics may blunt affect and/or subdue mood, usually to a mild extent.  If you feel increasingly depressed and/or melancholic after administration of piracetam, it may be helpful to realize that this is a common side effect.  The exact cause of depression from piracetam isn’t understood, but it may be related to altered monoamine levels in particular regions of the brain (e.g. 5-HT, DA, NA).

It is also necessary to consider that depression may stem from acetylcholine alterations as induced by piracetam.  Many speculate that piracetam uses up reserves of acetylcholine in the cortex, thereby depleting them at a quicker rate than they’re replenished through a standard diet.  To avoid the depressive symptoms associated with low acetylcholine levels, it may be beneficial to concomitantly ingest a choline supplement.

Fatigue: Some individuals notice after taking piracetam that they become fatigued, both mentally and physically.  It may feel like a chore to physically exercise and you may feel like a total couch potato.  In addition, you may have a tough time summoning the motivation to engage in any sort of cognitively-challenging task while taking piracetam due to the lethargy you’re experiencing.

Since somnolence and drowsiness are commonly reported effects of piracetam, it makes sense that some users become fatigued.  Keep in mind that in some cases, the fatigue may be more prominent after the effect of piracetam has “worn off” due to low acetylcholine levels.  One possible way to reduce likelihood of fatigue is to ensure that your choline stores are sufficient.

Hemocrit/Hemoglobin levels: A small percentage of users may exhibit elevations in HCT (hemocrit) and HGB (hemoglobin) levels.  Essentially, HCT is a biomarker indicative of red blood cell concentration vs. plasma in the blood.  Individuals with abnormally high HCT/HGB levels may have a condition known as Polycythemia which may lead to a host of other problems.

Though most piracetam users aren’t reporting changes in HCT and HGB, it is plausible to consider that piracetam may alter hemocrit and hemoglobin levels in certain individuals.  In rodent studies, piracetam has been noted to proliferate red blood cells via erythropoiesis.  Assuming piracetam induces erythropoiesis, it may increase risk of mortality.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/8203283

Headaches: A common side effect experienced among those taking piracetam is headaches.  Headaches experienced from piracetam are thought range from mild to moderate intensity, but may be more severe in some cases.  There is some debate in regards to the cause of these headaches, but many users speculate that they are spurred by abnormally high levels of acetylcholine, leading to vasoconstriction.

If the headaches are experienced after piracetam is out of circulation and/or a user has inadequate acetylcholine levels, piracetam-related headaches may stem from excess vasodilation.  There are numerous other theories as to what may contribute to headaches from piracetam including: a downregulation of acetylcholine receptor sites and/or relocation of acetylcholine reserves to specific parts of the cortex (e.g. prefrontal cortex).  That said, the specific mechanisms by which piracetam causes headaches may differ depending on the user.

In some cases, rather than experiencing headaches or migraines, users may report a feeling of “pressure” in specific regions of their brain.  This pressure may be rooted in vasodilation/vasoconstriction as a result of acetylcholine modification.  Optimizing your acetylcholine levels may help curb both the headaches, and the general “cerebral pressure” that is experienced from piracetam.

Hyperkinesia: If after taking piracetam you experience uncontrollable movements, excessive movements, and/or restlessness – this is known as “hyperkinesia.”  There is evidence to suggest that piracetam is likely to increase bodily movement and restlessness as a side effect.  In fact, one study documented that piracetam administration normalized hypokinesia (decreased bodily movement) as often exhibited in neurodegenerative diseases (e.g. Parkinson’s).

It is believed that piracetam may promote hyperkinesia via mediating phospholipid metabolism within brain tissue.  Some also speculate that increases and/or decreases in acetylcholine in certain regions of the brain as a result of piracetam administration may also induce hyperkinesia.  If you have the urge to move and or find your body moving uncontrollably, realize that piracetam can have this effect.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/8974583

Insomnia: While some individuals may sleep better and/or experience increased somnolence from piracetam, others report insomnia or inability to fall asleep.  Insomnia may also manifest itself as an inability to stay asleep throughout the night and/or waking before a desired time with a failure to reinitiate sleep.  This insomnia is likely induced via piracetam’s modulation of neurotransmitter levels and turnover in various regions of the brain.

Some believe that insomnia may be a result of rapid-thinking and/or an inability to slow heightened cortical activity.  If you’re experiencing insomnia after taking piracetam, it may be beneficial to take it at a different time of day (e.g. morning) and/or utilize concomitant agents to offset the effect of insomnia.  In rat studies, piracetam was shown to increase firing of noradrenergic neurons, which in turn increases vigilance – a possible mechanism by which piracetam could induce insomnia.

  • Source: http://www.ncbi.nlm.nih.gov/pubmed/7175517

Irritability: If you suddenly feel irritable, every little thing is getting on your nerves, and you feel and/or you feel the anger mounting – it may be from your piracetam.  Irritability can be triggered by nearly any agent that modifies neurotransmission and neurological processes.  Some speculate that the irritability induced from piracetam may be a byproduct of an acetylcholine surge and/or reorganization of acetylcholine stores.

Feeling irritable on piracetam may also be related to altered transmission of monoamines (e.g. serotonin, norepinephrine, and dopamine).  Additionally, if you experience brain fog and/or any form of cognitive impairment from piracetam, it is possible that these effects in themselves may result in frustration, stress, and irritability.  To offset this irritability, it may be beneficial to discontinue piracetam and engage in relaxation exercises to decrease your stress level.

Libido increase: Another reaction that has been noted among individuals taking “racetams” is an increase in libido or sex-drive, sometimes to the extent of hypersexuality.  If you notice that after taking piracetam your libido skyrockets, know that this is a potential side effect.  Some individuals may perceive this as a favorable side effect, especially those with preexisting forms of sexual dysfunction.

However, in other cases, heightened libidinal urges may be unwanted and/or interfere with cognitive performance.  Since various drugs that increase acetylcholine levels are thought to improve cases of psychogenic erectile dysfunction, one mechanism by which piracetam may increase libido is via its effect on acetylcholine.

Lightheadedness: Many individuals report feeling lightheaded when they first begin taking piracetam.  This lightheadedness may occur as a result of a preliminary adaptation phase in which the brain is adjusting to piracetam, but could also be related to the dosage ingested.  A high initial dose may result in feelings of wooziness, slight dizziness, and the aforementioned lightheaded feeling.

The lightheaded feeling may be related to changes in vasoconstriction and/or vasodilation stemming from acetylcholine modulation.  Concomitant supplements such as choline sources may also influence the degree to which a piracetam user experiences lightheadedness.  In some cases, the lightheaded feeling may be transient, eventually subsiding after several days of continued piracetam usage.

Muscle spasms: Don’t be surprised if after taking piracetam, you notice that your muscles spasm or twitch uncontrollably.  Should you notice any spasms or twitching, realize that they’re likely a result of the piracetam.  Piracetam is thought to use up acetylcholine stores, possibly reorganizing cholinergic systems throughout the brain and body.

There have been reports of ongoing muscle twitching and spasms that remained long after piracetam discontinuation.  While in most cases, optimizing acetylcholine levels after cessation of piracetam should mitigate spasms, acetylcholine may not be the only mechanism by which these spasms are caused.  It is possible that phospholipid metabolism modulation within brain tissue as a result of piracetam may elicit both hyperkinesia and spasms.

Nausea: The cholinergic properties of piracetam may increase the likelihood of nausea (and in more extreme cases, vomiting) in certain users.  Some hypothesize that administration of piracetam (especially with a choline source) may overtax the cholinergic system, leading to feelings of nausea and related effects.  It is possible that nausea may be triggered by an abnormally high dose of piracetam, a high dose of concomitant choline, and/or perhaps via modification of acetylcholine transmission in highly specific brain regions.

Nervousness: Some users find that piracetam reduces anxiety and elicits an anxiolytic effect, whereas others report increased nervousness.  If you feel more nervous as usual while taking piracetam, it could be due several mechanisms.  Two likely mechanisms by which piracetam may induce subjective feelings of nervousness include via: acetylcholine increases and norepinephrine increases.

Restlessness: Many individuals notice that after taking piracetam, they feel internally restless and/or are unable to sit still.  If you’re feeling restless after taking piracetam, it may be a result of spikes in the neurotransmission of acetylcholine.  High acetylcholine levels can promote involuntary muscle movement, as well as an inability to remain still.  Restlessness may also be caused by other changes in monoaminergic transmission after taking piracetam (e.g. 5-HT, DA, NA increases or decreases in certain regions).

Shakiness: Another side effect that some piracetam users report is shakiness or tremors.  If you notice that your entire body feels shaky and/or certain parts of your body are shaking uncontrollably, you may want to scale back on your piracetam dose.  Though this side effect could be transient, it’s likely a result of an inability of your neurophysiology to handle the array of modifications induced by piracetam.

Most would agree that like the unwanted muscle spasms and restlessness associated with piracetam, shakiness is a byproduct of heightened acetylcholine.  Should you deplete your acetylcholine stores with continued use, it is possible that the shakes may subside.  That said, it is also possible that they may worsen in some cases, especially among those taking high doses piracetam and acetylcholine.

Sleep disturbances: Many piracetam users note that their sleep is compromised as a side effect.  Piracetam affects a broad spectrum of neurophysiologic processes, not all of which are understood.  As a result of its ability to change neurotransmission, neuroactivation, etc. – some piracetam users report an increase in somnolence, while others may feel more energized.

Altered arousal throughout the day stemming from piracetam can lead to changes in sleep quality at night.  If you notice that you’re unable to sleep steadily throughout the night, wake up more frequently than usual, and/or have difficulty staying asleep – the piracetam is a likely culprit.  Keep in mind that the time of day that you take piracetam may influence its propensity to alter your circadian rhythm, and ultimately disturb your sleep.

Taking it earlier in the day (e.g. morning) is usually considered optimal compared to later in the day (e.g. afternoon / night).  If no matter what time you end up taking piracetam, you still experience sleep disturbances, you may want to consider possible interactions, concomitant choline dosages, etc.  Perceived cognitive benefits from any substance, including piracetam, are likely to be offset if sleep quality is compromised; sleep is critical for optimal cognition.

One theory regarding how piracetam may alter sleep is via its effect on aldosterone / mineralcorticoid receptors, each of which are activated by aldosterone and cortisol (respectively).  When these receptors exhibit abnormally high activation, they can increase a stress response, which in turn may interfere with sleep.  Keep in mind that this specific mechanism is unlikely to be the sole cause of piracetam-induced sleep abnormalities.

Speech impairment: Though you may not be an outgoing, gregarious extrovert, you may notice that your communication skills actually decline while taking piracetam.  Many users have reported that piracetam impairs various aspects of verbal speech including: word retrieval, recall, and fluency.  If before taking piracetam you had no problem thinking of words to say during small-talk conversation, but now you find it difficult to think of acceptable words and/or are obsessing over the words you use in a conversation, it may be a problem.

Impaired speech as a result of piracetam can be a big deal, and is usually related to the side effect of brain fog.  When your thinking is clouded and/or foggy, it’s difficult to converse with others because you’re unable to think of the proper or ideal words to use in a conversation.  This may lead to further anxiety, which in turn worsens your speech impairment.  If verbal conversation all-of-a-sudden becomes an overwhelming chore, discontinuation of piracetam may reverse these deficits.

Somnolence: In clinical trials of piracetam, a moderately reported side effect was somnolence or an increase in sleepiness.  If after taking piracetam you notice an increase in drowsiness and become sleepy, it’s likely more than just a coincidence.  Though this somnolence may be related to disturbed sleep (also as a result of the piracetam), it is more likely related to neurophysiologic changes as induced by piracetam.

Between 1 out of 10-100 are thought to experience drowsiness or sleepiness from piracetam.  Keep in mind that this drowsiness may be a direct result of the dosage taken and/or concomitantly administered agents (or lack of choline).  If you feel relaxed to the extent that you feel like napping, cessation of piracetam is likely a smart option.

That said, some individuals may notice an increase in somnolence for the first week or two of administration, but may find that it subsides thereafter as the neurochemistry “adjusts” to piracetam’s effect.  If you experience somnolence after piracetam, your ability to operate a motor vehicle and/or heavy machinery may be compromised; therefore, avoid these activities until you know how piracetam affects your arousal.

Sweating: Taking piracetam may lead to excess sweating throughout the day and/or at night (e.g. night sweats).  If you notice that piracetam is increasing your perspiration, there are multiple mechanisms by which it may be doing so.  Its ability to affect acetylcholine could be the principal cause of sweating increase due to the fact that it interacts with sweat glands.

However, it is possible that piracetam disrupts normative hypothalamic function, leading to dysregulation.  Dysregulated hypothalamic function could also be another reason that piracetam is making you sweat.  Furthermore, the combination of both acetylcholine, hypothalamic alterations, and other undocumented effects may lead to increased sweating.

Visual changes: A side effect that has been reported by some piracetam users is vision changes.  Changes in visual perception as a result of piracetam ingestion may be induced by altered activity within the visual cortex.  Specifically, if you notice that colors become more vivid, it may be a result of heightened activity within the occipital region of the brain.

However, many users report unwanted visual changes such as blurred vision and/or a thin, hazy film over their visual field.  If your vision has worsened after taking piracetam, its unlikely to be affecting your actual eyes, but it could be altering processes within regions such as the occipital lobe, thereby altering your visual perception.  Discontinuation of piracetam for awhile should restore homeostatic function to the affected regions, leading you to regain your “normal” vision again.

Weakness: A relatively common side effect reported in piracetam clinical trials was “asthenia” or physical weakness.  If you notice that your body feels week, you have a tough time getting out of bed, or walking from “Point A” to “Point B” without feeling tired – this side effect could be a problem.  The exact cause of piracetam-induced asthenia is unclear, but it is believed to affect between 1 and 100 users.

Like most of piracetam’s side effects, the likely mechanism for inducing asthenia is altered acetylcholine transmission.  It should be considered that among long-term and/or high dose piracetam users, weakness may occur as a result of acetylcholine depletion (especially if choline stores aren’t replenished).  Simply adding a bit of extra choline to account for deficits could offset weakness for certain users.

Weight gain: There is modest evidence to suggest that piracetam may affect a user’s body weight.  Specifically, clinical trials indicated that users taking piracetam exhibited slight weight gain compared to those taking a placebo.  If you gain a modest amount of weight while taking piracetam, it could be due an array of reasons including: decreased energy and/or motivation (resulting in sedentarism), altered neurotransmission (resulting in arousal changes, metabolic changes, food cravings, etc.).

It is unclear as to whether dosage plays a role in piracetam-induce weight gain, but usually the greater the dosage, the more significant the weight gain (from any drug).  This is due to the fact that at higher dosages, piracetam elicits greater influence on neurophysiologic processes that may increase one’s weight.  That said, for most piracetam users, weight gain isn’t of major significance nor concern.

Note: Most users won’t experience all of the aforestated side effects, the above is simply a compilation of possible adverse effects and reactions.  If you took piracetam and experienced a side effect that wasn’t mentioned, feel free to share it in the comments section below.

Factors that may influence Piracetam side effects

It is necessary to consider that various factors may influence whether you experience side effects on piracetam, the number of side effects you experience, as well as their respective severities.  When contemplating why you’re experiencing side effects and someone else isn’t, consider factors such as: dosage, concomitantly ingested agents, term of administration, and specific sourcing of your piracetam.

  1. Dosage (High vs. Low)

The higher the dosage of piracetam you take on a daily basis, the greater the neurophysiologic response you can expect.  In other words, high amounts of an exogenous substance are going to alter basic physiologic and neurologic processes to a more significant extent than lesser amounts.  If you’re taking an abnormally high dose of piracetam (e.g. up to 10 grams), you’re setting yourself up to experience a greater number of side effects than lower dose users.

Individuals taking microdoses of piracetam (e.g. under 1 gram) may experience little or no noticeable side effects, simply because there isn’t enough of the drug within their system to evoke a consciously noticeable unwanted neurophysiologic response.  High doses are more likely to deplete acetylcholine stores, yield additional oxidative stress, exert greater manipulation of monoaminergic processes, etc.

For this reason, it is usually recommended to start low and work your way up to a minimal effective dose.  Although some experts actually suggest starting with a moderate-high dose, this methodology is relatively irresponsible, especially considering that a significant adverse effects may be endured as a result.  Remember that high dose users, especially over a longer-term, are more likely to experience side effects than those taking smaller doses.

  1. Co-ingested supplements (or drugs)

These days everyone wants to engineer the utopian smart drug stack, yet most don’t have a clue how their entire stack interacts.  Someone taking a stack of 10 supplements may fail to consider that each supplement could interact with each other, possibly in multiple ways, making it very difficult to determine the specific cause of side effects.  Furthermore, since the mechanisms of action associated with every drug aren’t well-understood, it makes it difficult to know the root pharmacological causes of the side effects.

If you experience side effects from piracetam, it is firstly necessary to consider that the side effects may be from an interaction.  They could also be directly from the other supplements and have nothing to do with the piracetam itself.  For this reason, it may be best to take piracetam as a standalone supplement to determine whether it truly is the culprit for your adverse reactions – or whether another supplement may be to blame.

That said, a lack of co-ingested choline with piracetam could also cause side effects.  If you’re taking high doses of piracetam on a regular basis without adequate dietary (or supplemental) choline, you may deplete choline stores, leading to deficient acetylcholine.  Acetylcholine deficiency is associated with a host of unwanted side effects.  Some users recommend taking dosage ratios of 4/3/2/1:1 (piracetam to choline); whether these ratios are optimal isn’t understood.

  1. Term of administration

The duration over which you’ve been taking piracetam may dictate whether you experience side effects.  Those using piracetam for a short-term may be more likely to experience side effects as the neurophysiology adjusts to regular ingestion of piracetam.  On the other hand, some short-term users may be less likely to experience side effects because, over the short-term, they were taking such a low dose that it didn’t alter their neurophysiology enough to trigger an unwanted reaction.

Over the long-term, there’s a chance that some piracetam users may not experience any side effects (or a minimal number) because they’ve adapted to its effects.  In other words, their body and brain have learned to accommodate regular piracetam administration via adjustments.  That said, some long-term users may be more prone to side effects as a result of taking a high dose, acetylcholine depletion (especially without concomitant choline ingestion), etc.

Another subset of users may experience side effects when they initially begin taking piracetam and find that they linger throughout their entire term of administration.  In this case, term of administration doesn’t affect number/severity of side effects.  That said, many users may want to reflect on whether they’ve been taking piracetam for a short or long-term and consider how the cumulative term of administration may affect side effects.

  1. Piracetam Source (Quality)

The specific source of your piracetam may dictate its quality.  Since piracetam is considered an unregulated substance in the United States, many individuals purchase it online from an array of sources.  Some of these sources manufacture a quality piracetam product, while others may be selling a piracetam product of questionable quality.

It is possible that certain piracetam products are of suboptimal purity and/or laden with contaminants.  In other words, what you’re actually taking may be piracetam laced with other chemicals and/or mixtures.  In some cases, it may be that what you believe to be piracetam is a closely-related and/or entirely different pharmacological agent.

Be extremely careful as to avoid manufacturers selling piracetam of suboptimal quality and/or that may contain a blend of other unwanted exogenous ingredients.  If you aren’t taking a pure piracetam product, not only could you be inducing neurophysiologic damage, but you may be unable to tolerate the various chemical additives included within the formulation.  It’s usually worth paying a bit of extra money to attain pure piracetam from a reputable vendor, rather than risk adverse effects from a contaminated product.

Piracetam: Do the benefits outweigh the side effects?

Whenever taking piracetam, it is necessary to ask yourself whether the perceived therapeutic benefits outweigh the unwanted side effects.  If you’re taking piracetam and you’re reaping major cognitive benefits without any adverse effects, obviously you’ll have a natural inclination to continue taking it.  That said, one should always proceed with caution knowing that there’s usually no such thing as a biological free lunch; if you’re getting major benefits now, there may be some future physiologic toll to be paid.

If you’re taking piracetam and are experiencing a blend of benefits and side effects, you’ll need to decide whether the benefits are more prominent than the side effects.  For example, if your cognitive performance improves moderately, but you’re also experiencing uncontrollable muscle spasms, you’ll need to assess whether you can put up with those spasms for the desired benefits.  If the spasms are incessant and disconcerting to the extent that they provoke anxiety, you may be better off ceasing piracetam altogether.

On the other hand, if the spasms are mild and intermittent, you may be able to justify continued piracetam usage.  If since starting piracetam, you haven’t noticed any significant therapeutic and/or cognitive benefit, it’s not even worth taking.  Many people have convinced themselves that they should be taking piracetam simply because it is popularly regarded as a “nootropic,” but in reality, they don’t need it and it may not provide any benefit.

Another set of users may experience nothing but side effects since starting piracetam and no obvious benefits.  In this case, it is relatively easy to justify discontinuing piracetam administration.  Obviously if piracetam is making you feel worse, and costs money (its not free), taking it regularly is a lose-lose situation.

To help track your piracetam experience, I recommend utilizing quantified cognitive testing as well as a journal to document side effects.  Ultimately it is up to you to determine whether piracetam is worth continuing as a supplement.  If you have further questions or concerns about the side effects that you’ve endured while taking piracetam, consult a medical professional.

Possible ways to reduce Piracetam side effects

If you’ve been taking piracetam and are experiencing unwanted side effects, you may want to know of some possible mitigation strategies to consider implementing.  Commonsense methods to reduce piracetam side effects include: dosage reduction, co-supplementation (choline, antioxidants, etc.), continued supplementation, and/or discontinuation.  If none of these strategies provide benefit in regards to side effect mitigation, cessation of piracetam is likely a smart option.

    1. Dosage reduction: If you started taking piracetam at a high dose, side effects are to be expected.  If your initial dose of piracetam is 5 grams per day, you may want to cut back to less than 1 gram per day (e.g. 500 mg) and determine whether side effects persist.  Once you’ve reduced your dose to a quantity that doesn’t prompt unwanted side effects, you can gradually increase it until you’ve found an amount that enhances cognitive function without significant side effects.
    2. Choline supplementation: In some cases, taking piracetam as a standalone supplement may provide cognitive benefit without any adverse effects.  However, it is necessary to consider that over time, cholinergic transmission may be modified as a result of piracetam ingestion.  Piracetam may reorganize choline storage within the brain, and with continued usage, may deplete endogenous choline. Low choline is a problem for many piracetam users who fail to concomitantly ingest a high-quality choline source.  Certain side effects and/or adverse reactions may be triggered solely as a result of insufficient cholinergic transmission.  For this reason, supplementation may be necessary at a 5/4/3/2:1 ratio (piracetam to choline) depending on the specific user (and their dietary choline intake) as well as the potency of the choline ingested.
    3. Antioxidant intake: Animal studies have shown that piracetam administration increases biomarkers indicative of oxidative stress, particularly in regions such as the hypothalamus.  Although choline supplementation may effectively offset side effects stemming from piracetam-induced choline depletion, it may not combat oxidative stress stemming from piracetam.  Oxidative stress may be the direct (or indirect) cause of various side effects such as: brain fog, cognitive impairment, speech difficulties, and irritability. Though choline supplementation can offset some degree of oxidative stress, other antioxidants may be necessary.  Be sure to ramp up both dietary and supplemental intake of antioxidants, particularly alpha-lipoic acid.  Alpha lipoic acid is a neuroprotective agent that should decrease reactive oxygen species (ROS), especially within the hippocampus. (Source: http://www.ncbi.nlm.nih.gov/pubmed/25193852)
    4. Decrease supplement intake: If you’re ingesting a “stack” of supplements and/or pharmaceutical drugs with piracetam, it is possible that they may facilitate an unwanted interaction.  The pharmacodynamics of piracetam aren’t fully known, nor are the pharmacokinetics, meaning there are likely many unknown contraindications.  If you take piracetam with other substances (besides choline), you may want to decrease the number of concomitantly ingested supplements. Many people automatically assume that piracetam is problematic rather than considering it may interact with the 5-10 other supplements that they’re shoveling down the hatch.  To avoid interaction-based effects, it may be best to take piracetam as a standalone substance (with choline).  If the side effects miraculously diminish or subside when you eliminate other agents within a large “stack,” an interaction may have been reason for your side effects.
    5. Continue using: Assuming you’ve optimized your piracetam dosage, configured choline intake, ramped up antioxidant intake, and eliminated unnecessary supplements from your stack (that may have caused interactions) – you may want to continue using piracetam for a week or so to determine whether side effects improve.  Some individuals experience unwanted side effects when they initially start taking drugs, only to find that these side effects subside after a few weeks of consistent administration.  If side effects subside and/or diminish after several weeks, it may be likely that your neurochemistry simply needed a bit of time for piracetam adaptation.
    6. Discontinuation: If no matter what adjustments you make, piracetam’s side effects remain unbearable, a logical option would be to discontinue usage.  Realize that not everyone tolerates piracetam to the same extent; a drug yielding no side effects in one user may be disastrous (or harmful) for another. Persistent unwanted side effects should be considered a communication signal from your body that piracetam isn’t a good fit for your physiology.  Ignoring the physiologic feedback presented as side effects is a fool’s game.  Unfortunately, many people “put up with” side effects for a long period (e.g. brain fog, shakes, etc.) because they’ve heard from many sources and convinced themselves that piracetam must be healthy.  In summary, if the response you’re getting from piracetam isn’t good – cease usage sooner than later.

Have you experienced Piracetam side effects?

If you’ve taken piracetam, feel free to mention whether you experienced side effects in the comments section below.  Discuss when you first noticed piracetam side effects, which side effects were most debilitating, and make note of how severe each was (on a scale of 1 to 10).  If you had success with any particular mitigation strategies to combat or offset the side effects of piracetam, document them within your comment.

To help others better understand your situation, include some additional information such as: source of piracetam (brand), dosage taken, term of administration, and whether you ingested other agents concomitantly (e.g. pharmaceuticals, supplements, etc.).  Realize that while piracetam is often regarded as being completely risk-free by many on the internet, it is certainly not devoid of risk.  (For more information, you may want to read the article, “Potential Dangers of Nootropics.”)

Though piracetam may be lower risk than many pharmaceuticals, we don’t really know how it fully works and whether it is likely to work for everyone.  The intention of this article isn’t to discourage piracetam usage, especially among those deriving significant therapeutic benefit, rather, it is to highlight the fact that side effects and adverse reactions can occur – some of which may seem counterintuitive (e.g. cognitive deficits).  Always listen to your body and be cognizant of potentially deleterious side effects that may have been induced by piracetam.

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