Pramiracetam

Considered one of the more potent racetams for focused cognitive work. Limited but positive evidence in amnesic patients and traumatic brain injury.

A rough internal score reflecting quantity, quality, and consistency of human evidence. Not a clinical recommendation.

Small trials show memory improvement in scopolamine-induced amnesia and traumatic brain injury. Italian studies in elderly with cognitive decline showed improvement. HACU stimulation mechanism differentiates it from piracetam. Low emotional or anxiolytic effect — considered a pure cognitive enhancer.

• High oral bioavailability and longer duration than piracetam
• Stimulates HACU for increased acetylcholine synthesis
• Positive results in amnesia and TBI trials

400–1200 mg/day in divided doses. Take with fat-containing meals.

• Headache (especially without choline supplementation)
• GI upset
• Irritability

Fat-soluble — take with dietary fat. Taste is extremely bitter. May cause headaches if choline intake is insufficient.

Trial data is limited to small, older studies. Perceived as potent in the nootropic community but evidence is thinner than for piracetam.

• Focus50
• Memory45