Pramiracetam: Review of Dosage, Side Effects, & Benefits
By Ali Kuoppala | Last reviewed Mon 24 September 2018
Medical Review by Dr. Stefano Pizzo, MD
What is Pramiracetam: Sold by the brand name Pramistar in Eastern Europe, Pramiracetam is a nootropic smart drug from the racetam class.
It was originally synthesized from the most basic racetam and first of its kind; Piracetam, by replacing the amide group with a dipropan-2-ylaminoethyl group.
This swap was made under the premises that it would enhance absorption and supposedly create an alternative form of Piracetam that would have a more profound effect on enhancing memory and learning.
Pramiracetam (Diisoprop-yl-(2-oxopyrrolidin-1-yl)acetamide) is synthetic and doesn’t occur naturally in plants or foods.
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How Does Pramiracetam Work
Many nootropics from the racetam class work mainly by stimulating the excitory neurotransmitters and their receptors in the brain. Pramiracetam on the other hand has no significant effect on majority of these.
Pramiracetam doesn’t significantly impact the synaptic activity of the hypothalamus either (occurrence commonly noted with other racetams).
Instead, the most notable mechanism of action behind Pramiracetams cognitive effects comes from its ability to significantly increase the high affinity choline uptake (HACU) inside the hippocampus.
In other words, Pramiracetam administration increases the amount of the neurotransmitter acetylcholine in the brain, resulting in improved verbal fluency, memory, attention, and working-memory.
Another mechanism of Pramiracetam is its effect in increasing nitric oxide (NO) levels in the cerebral cortex, resulting in increased blood flow and oxygen supply to the brain and improved overall brain plasticity (which is linked to improved synaptic signaling).
Lastly, few studies have noted that Pramiracetam can act outside of the brain to improve cognitive functions through the adrenal cortex. This was found out after Pramiracetam and Piracetam both lost their effects in rodents that had their adrenal glands surgically removed. However, the way these compounds act in the adrenals is unknown.
Pramiracetam works by significantly increasing the conversion from choline to the neurotransmitter; acetylcholine. It also increases circulation and oxygen supply to the brain and has an unknown mechanism of action via the adrenal cortex.
Pramiracetam Benefits and Research
Pramiracetam isn’t as extensively researched in humans as some of its predecessor racetams.
When Pramiracetam is administered to old rodents, their brain wave profiles improve dramatically and start to resemble those of young rats. Piracetam has similar effect, but Pramiracetam is approximately 30x more potent at this.
Pramiracetam given to young rats leads to improved brain wave (EEG) activity as well, and results in significantly improved cognitive abilities in water-mazes.
In two separate rodent studies, Pramiracetam has been found to significantly improve working-memory and object recognition memory. Again, with much higher potency than its “father compound”, Piracetam.
Further animal studies using the method of escape-learning to observe changes in memory, have noted that Pramiracetam consistently outperforms its predecessors (Piracetam, Aniracetam, Oxiracetam) in passive-avoidance and escape-learning responses.
In a pilot-study of healthy non-demented elderly humans, Pramiracetam supplementation for 3-months has been noted to improve memory recall more effectively than 90min/week of tutor-instructed memory training can (the order of effectiveness was in descending order: Pramiracetam + memory training -> Pramiracetam alone -> memory training alone -> control group).
In young men suffering from traumatic brain-injuries, Pramiracetam at 1200mg/day for 18 consecutive months – followed by 1 month pause from supplementation – resulted in noticeable and persistent cognitive improvements.
There’s also an interesting study where several human volunteers – both young and old – agreed to be injected with scopolamine hydrobromide (aCH-receptor blocker drug notorious for causing amnesia). Socopolamine significantly impaired all of the tested memory patterns. HOWEVER these effects were partially reversed in a group of subjects who had taken 1200mg/day of Pramiracetam for 10-days before the injections took place. This proving the neuroprotective effects seen before in rodents.
Pramiracetam seems to be more potent at improving learning and memory than any of the previously introduced racetam smart drugs, and its neuroprotective effects appear to be stronger as well. Overall Pramiracetam is pretty well-researched in test-tubes, animals, and humans.
Pramiracetam Dosage and How to Take
The optimal daily Pramiracetam dosage found effective in studies is 1200mg, often taken in 2-3 doses thorough the day.
Studies looking at the half-life of Pramiracetam have found slightly different results, but with the recommended dosage it can be up to 8 hours, making it more long-lasting than most of the smart drugs in the racetam family.
In their book “Smart Drugs and Nutrients“, Doctors Dean and Morgenthaler recommend using a Pramiracetam attack dose, ie. 2-5x higher dosage than the generally recommended amount on your first time taking it for the purpose of “over-stimulating” the neurons to build up the compound faster in neurons.
However, since Pramiracetam seems to enter the brain pretty quickly after ingestion and doesn’t need a build up period before it exerts it effects, I would argue that sticking to the standard dosage range is a better option.
Pramiracetam is fat-soluble and theoretically it should absorb better with a meal or with any other source of fatty-acids (this hasn’t been proven though).
Pramiracetam is very potent at increasing the production rate of acetylcholine. This means that it depletes the bodily pool of choline (a water-soluble vitamin that acts as raw material for the production of the neurotransmitter).
To combat the loss of choline, it’s highly-suggested to eat food that have plenty of choline in them when taking Pramiracetam (or any racetam for that matter).
Pramiracetam should be taken at a dosage of 1200mg/day. It has long half-life so taking it once or dividing the dose to two should be enough to note the benefits for the entire day. Being fat-soluble and cholinergic, Pramiracetam should be taken with food and preferably with a source of choline.
Pramiracetam Side Effects and Tolerance
The racetam class of smart drugs is extensively studied and found to be extremely safe even at high dosages.
Racetams are non-toxic and even with stupidly high amounts, fail to show any signs of poisoning to research animals.
Though, there are some anecdotally reported Pramiracetam side effects, such as: sleep disturbances if you take it too close to bed-time, headaches (common if you don’t co-supplement with choline), and dizziness.
But just like in the case of the previously synthesized racetams, these are rare and mostly anecdotal.
Since Pramiracetam is considered 30x more potent than Piracetam, you may want to try the less potent nootropic if you feel like Pramiracetam causes side effects to you.
Pramiracetam is non-addictive and science doesn’t seem to suggest that it has any known tolerance build up. Anecdotally some people say that if its constantly used in high dosages the effects start to diminish, so rotating racetams and keeping short breaks is advisable.
Pramiracetam is non-toxic and neuroprotective. Only anecdotal evidence of side effects is available, which in most cases should be abolished with choline co-supplementation, not taking the smart drug too late in the evening, and eating a balanced diet with proper amounts of vitamins and minerals.
Pramiracetam is similar to the other racetams, but it seems to differ a bit from the OG’s by effecting nitric oxide production and meditating its effects via the adrenal cortex.
It’s more potent than the “father” compound; Piracetam, but also has far less research behind its actual effects.
NOTE: For more info about smart drugs and nootropics, check out Chris Walker’s Smart Drug Crash Course.