reptides / pramiracetam

pramiracetam

Pramiracetam has small human studies in brain injury, age-related memory complaints and drug-induced amnesia, plus regulated medical use in Romania. Results range from selected positive memory scores to a failed Alzheimer replication. No controlled trial establishes a dependable cognitive boost in healthy rested adults.

Small-molecule racetam

  • The best-known brain-injury crossover enrolled four men; its 18-month continuation was open-label.
  • A 60-person blinded older-adult trial reported psychometric improvement, but the abstract omits between-group effect sizes and had six placebo withdrawals.
  • In a 10-person Alzheimer study, only two of eight apparent initial responders reproduced a response.
  • A 24-man healthy-volunteer study tested protection from scopolamine-induced amnesia, not ordinary unchallenged enhancement.
  • Two healthy-volunteer PK studies found a variable plasma half-life measured in hours.
  • Romanian product information summarizes safety across 1,110 treated subjects and reports lower clearance with impaired kidney function.
Identity and formulation Brain injury Dementia and impairment Mechanism Animal PK Healthy volunteers Regional clinical reports Healthy cognition and longevity Human pharmacokinetics Safety and regulation

What is pramiracetam, and does the salt matter?

Pramiracetam, also called CI-879 or Pramistar, is a racetam. The Romanian medicine uses pramiracetam sulfate expressed as an equivalent amount of the parent drug. A study of that regulated formulation does not verify the identity or exposure of an online powder.

PubChem: pramiracetam chemical identity

Government chemical identity database

National Library of Medicine. PubChem CID 51712.

C14H27N3O2; molecular weight 269.38 g/mol.

Participants / model
Chemical record
Follow-up
Living database
Study design
Curated structure record

Formula and molecular weight establish the recorded structure, not the contents of a retail product or an effective dose.

Read the original source
Official Pramistar label and 1,110-subject safety summary

Official medicine label

Romanian National Agency for Medicines and Medical Devices. Pramistar summary of product characteristics. 2019.

The label summarizes adverse reactions across 1,110 treated subjects, contraindications, renal clearance and formulation details.

Participants / model
Clinical safety population summarized by the regulator; 1,110 treated subjects
Follow-up
Varied exposure in the underlying clinical program
Study design
Regulatory synthesis of clinical and product data

Common reactions include agitation, insomnia, dizziness, nausea and upper-abdominal pain. Part of the interaction rationale is extrapolated from piracetam.

Read the original source
2024 Romanian regulatory review

Official regulatory assessment

Romanian National Agency for Medicines and Medical Devices. Pramiracetamum evaluation. 2024.

The authority records a licensed indication for degenerative or vascular memory and concentration problems, particularly in older adults.

Participants / model
Romanian regulatory context
Follow-up
Current at the 2024 report date
Study design
Health-technology and reimbursement assessment

This establishes regulated local medical use, not a new placebo-controlled efficacy result or US approval.

Read the original source

What did the four-person brain-injury study find?

Four young men with memory problems after head injury or oxygen deprivation completed a 12-week double-blind placebo crossover. Delayed recall and other memory measures improved during pramiracetam exposure. Four people are too few to estimate a stable average effect or uncommon harms.

The authors reported that improvement continued through an 18-month open extension and one month after treatment stopped. Everyone received treatment during the extension, so it cannot supply an 18-month placebo comparison. The cited report does not provide full numerical tables or washout details.

Four-man brain-injury crossover and open extension

Primary human study

McLean A et al. Brain Injury. 1991. PMID 1786500. DOI 10.3109/02699059109008110.

Delayed recall and other memory measures improved during the controlled phase; improvement was reported through an open extension and one month after cessation.

Participants / model
Four young men with cognitive impairment after head injury or anoxia
Follow-up
12-week controlled phase; 18-month open extension
Study design
12-week double-blind placebo crossover followed by open treatment

NARIC supplies the sample and crossover details missing from the abstract. The cited records do not report full tables, washout details, or adverse-event counts.

Read the original source
Brain-injury study cohort and design

Government bibliographic study record

National Rehabilitation Information Center. REHABDATA record J28403; McLean and colleagues, 1991.

The indexed study involved four men in a 12-week blinded crossover, followed by an 18-month open extension.

Participants / model
Four young men with cognitive impairment after brain injury or anoxia
Follow-up
12-week controlled phase
Study design
Bibliographic abstract describing randomized treatment order

This index record supplies the sample size and controlled-phase duration. Its journal issue and page fields differ from PubMed, and secondary summaries disagree about dose frequency. The exact regimen remains unresolved.

Read the original source

What happened in Alzheimer disease and older-adult studies?

The controlled studies do not point in one direction. A 10-person Alzheimer enrichment study failed to reproduce most apparent initial responses. A separate 60-person blinded older-adult study reported psychometric improvement, but the abstract does not give a direct effect estimate.

Controlled and uncontrolled memory studies
StudyResultWhat limits it
Alzheimer disease: 10Eight appeared to have a best dose initially; only two reproduced a similar responseResponder selection and tiny sample; authors judged tested doses unlikely to give symptomatic benefit
Older adults with memory impairment: 60 randomized 30/30Psychometric scores improved in the active arm; six placebo participants and no active participants withdrewThe abstract does not report a between-arm effect size, variance, dropout analysis, or multiplicity handling
Memory complaints: 35Objective memory improved in the drug-only and drug-plus-training groupsOpen four-group study; drug-only group 8 and control group 7
Probable vascular impairment: 104Scores improved during three months of treatmentOpen, noncomparative study; complete numerical tables not reported in the cited record
10-person Alzheimer trial with failed response replication

Primary placebo-controlled human study

Claus JJ et al. 1991. PMID 2011259.

Eight patients appeared to have an initial best dose; only two reproduced a similar response in the replication stage.

Participants / model
10 people with probable Alzheimer disease
Study design
Two-stage placebo-controlled dose-enrichment and replication study

The authors concluded that the tested exposures were unlikely to provide symptomatic benefit. The sample was too small for a precise effect estimate.

Read the original source
60-person blinded older-adult memory trial

Primary randomized double-blind placebo-controlled study

Marini G et al. Advances in Therapy. 1992;9(3):136-146.

The abstract reports psychometric improvement in the active arm and no significant placebo change; six placebo participants and no active participants withdrew.

Participants / model
60 older adults, mean age 74.6; 30 randomized to each arm
Follow-up
12 weeks after a two-week placebo washout
Study design
Randomized double-blind placebo-controlled study after a placebo washout

The abstract omits between-arm effects, variance, dropout handling, and multiplicity correction.

Read the original source
35-person open memory-training pilot

Primary exploratory human study

De Vreese LP et al. Archives of Gerontology and Geriatrics. 1996. PMID 18653001. DOI 10.1016/0167-4943(96)86906-8.

Objective memory gains favored the drug groups; subjective memory results were less clear.

Participants / model
35 older adults with memory complaints and without dementia or depression
Follow-up
Not reported in the abstract
Study design
Open random allocation to training, drug, both or control

Group sizes were 10, 8, 10 and 7. There was no blinding or placebo, and the abstract lacks detailed effects and safety counts.

Read the original source
104-person open vascular-impairment study

Primary open human study

Scarpazza P, Guffanti EE, Marchi E, Corsonello F, Vozza A, Spezie I. Multicenter evaluation of pramiracetam for the treatment of memory impairment of probable vascular origin. Advances in Therapy. 1993;10(5):217-225.

The indexed abstract reports improved cognitive-test scores during treatment.

Participants / model
104 older patients with probable vascular cognitive impairment
Follow-up
Three months
Study design
Open, noncomparative multicenter study

Without a concurrent comparator, practice effects, recovery, and changes in care remain possible. The report does not provide full tables or adverse-event denominators.

Read the original source

Does the choline mechanism prove a stack or a cognitive effect?

Rat experiments found increased hippocampal high-affinity choline uptake at selected exposures. Higher and lower exposures were ineffective. This does not show that people need supplemental choline or that a pramiracetam and choline combination improves cognition.

Selected animal findings
ExperimentPositive resultNull or boundary
Normal-rat object recognitionOne of three exposures improved 24-hour recognitionNonmonotonic response; no human result
Radial-arm mazeReference memory improved after pretreatmentWorking memory did not improve
Nitric-oxide synthaseHigher exposure increased cortical activity about 20%No hippocampal increase or mRNA change; lower exposure ineffective
Developing-rat hypoxiaFirst afterdischarge shortened in 18-day-old animalsNo effect in 12-day-old pups or on repeated afterdischarges
Rat hippocampal choline-uptake study

Preclinical primary study

Shih YH, Pugsley TA. Life Sciences. 1985. PMID 2987637. DOI 10.1016/0024-3205(85)90311-X.

Intermediate pramiracetam exposures increased sodium-dependent high-affinity choline uptake; higher and lower exposures were ineffective.

Participants / model
Rats and isolated hippocampal nerve-terminal preparations
Follow-up
Acute experiments
Study design
Controlled neuropharmacology experiments

This finding does not establish a human cognitive effect or a need for a choline supplement.

Read the original source
Normal-rat object-recognition experiment

Preclinical primary study

Ennaceur A et al. 1989. PMID 2765166.

One of three exposures improved 24-hour object recognition without changing total exploration.

Participants / model
Normal rats
Follow-up
Acute treatment with 24-hour memory test
Study design
Controlled object-recognition experiment

The response was not monotonic and does not provide a human effect estimate.

Read the original source
Rat reference-memory positive and working-memory null

Preclinical primary study

Radial-arm maze learning study. 1986. PMID 3088666.

Reference memory improved at both tested exposures; working memory did not improve significantly.

Participants / model
Rats
Follow-up
Seven weeks of pretreatment
Study design
Controlled radial-arm maze experiment

The domain-specific null prevents describing the result as broad memory enhancement.

Read the original source
Rat cortical NOS experiment

Preclinical primary study

Nitric-oxide synthase study. 1995. PMID 8557218.

A higher exposure increased cortical NOS activity about 20%; lower exposure was ineffective.

Participants / model
Rats
Follow-up
Acute experimental period
Study design
Controlled biochemical experiment

No hippocampal increase or significant NOS mRNA change was found. Lithium interaction was animal-only.

Read the original source
Age-dependent hypoxia experiment

Preclinical primary study

Hypobaric hypoxia study. PMID 9200217.

The first afterdischarge shortened in 18-day-old animals.

Participants / model
Developing rats
Follow-up
Acute experimental period
Study design
Controlled hypobaric-hypoxia experiment

No effect occurred in 12-day-old pups or on repeated afterdischarges. This does not establish adult human neuroprotection.

Read the original source

What did the Chinese pharmacokinetic study measure?

The Chinese study measured pramiracetam in dogs and rats. Dog plasma half-life was 2.3 to 3.9 hours; rats had highest measured tissue concentrations in kidney, with brain exposure detected. These values cannot replace the human formulation studies.

Measured protein binding was about 20% to 22% in the tested animal system. The separately indexed Chinese journal record may describe the same program and is not counted as independent human evidence.

Chinese dog and rat pharmacokinetics

Preclinical primary pharmacokinetic study

Fang Z, Liu X, Xiao Y. Pramiracetam pharmacokinetics in animals. PMID 11387954.

Dog plasma half-life was 2.3 to 3.9 hours; rat distribution was highest in kidney with brain exposure detected.

Participants / model
Dogs and rats
Follow-up
Acute pharmacokinetic sampling
Study design
HPLC pharmacokinetic and tissue-distribution experiments

These species-specific measurements do not define human clearance. A separate Chinese journal record may describe the same program.

Read the original source

Does the healthy-volunteer study show everyday enhancement?

Twenty-four healthy men received pramiracetam or placebo for 10 days before a scopolamine challenge. Pramiracetam partially reduced the induced amnesia. Scopolamine still impaired episodic memory and selective attention, and the abstract does not show a useful improvement at unchallenged baseline.

A separate Russian-language report followed 20 neurologically healthy older adults, mean age 62, for 20 days. Memory, attention, subjective health and selected EEG or Doppler measures improved from baseline; anxiety and most vascular measures did not. With no placebo group, practice effects and time remain possible explanations.

24-man scopolamine challenge

Randomized placebo-controlled human challenge study

Mauri M et al. Archives of Gerontology and Geriatrics. 1994. PMID 15374306. DOI 10.1016/0167-4943(94)00542-7.

Pramiracetam partially reduced scopolamine-induced amnesia; other challenged domains remained impaired or unaffected.

Participants / model
24 healthy men in younger and older age strata
Follow-up
10 treatment days before a single challenge
Study design
Placebo-controlled treatment followed by scopolamine challenge

The abstract does not show a useful unchallenged-baseline effect or a reusable treatment effect size.

Read the original source
20-person uncontrolled older-adult study

Primary uncontrolled human study

Korsunskaya LL. Crimean Therapeutic Journal. 2007;2(2):119-123.

Memory, attention, subjective health and selected EEG or Doppler measures improved; anxiety and most vascular measures did not.

Participants / model
20 neurologically healthy older adults, mean age 62; mild hypertension permitted
Follow-up
20 days
Study design
Uncontrolled before-and-after study

All participants completed and no adverse effects were reported. With no comparator, the changes cannot establish prevention or a causal treatment effect.

Read the original source

What do the regional brain-injury reports add?

Regional reports describe improvement during pramiracetam-containing care, but do not isolate a clean drug effect. A 65-person mild-traumatic-brain-injury comparison omits group sizes, randomization, masking and numerical effects. A later 108-patient report used extensive co-treatment and may overlap with the earlier series.

Regional clinical evidence
ReportFindingMissing information
Mild brain injury: 65Orientation, well-being and amnesia favored pramiracetam-containing care over piracetam-containing careArm sizes, randomization, masking and effect estimates
Acute concussion: 108Abstract emphasizes improvement in asthenic symptomsQuantitative treatment contrast; cohort independence from the earlier report
Chronic cerebrovascular insufficiency or stroke sequelaeAbstract reports changes across several symptomsSample size, allocation, comparator, duration and effect estimates
65-patient mild-brain-injury comparison

Primary human clinical report

Tkachev AV. Russian-language clinical report. 2007. PMID 18418926.

Orientation, subjective well-being and amnesia measures favored pramiracetam-containing care over piracetam-containing care.

Participants / model
65 patients with mild traumatic brain injury
Follow-up
Assessments on days 1, 10 and 30
Study design
Comparison within complex clinical care; allocation and masking not reported in the abstract

Both groups received other treatment. Arm sizes and numerical between-group effects are absent from the abstract.

Read the original source
108-patient concussion co-treatment report

Primary human clinical report

Tkachev AV. Russian-language clinical report. 2008. PMID 19145827.

The abstract reports improvement in asthenic symptoms during pramiracetam-containing care.

Participants / model
108 patients: 37 received piracetam and 71 Pramistar; 30 healthy controls
Follow-up
Assessments on days 1, 10 and 30
Study design
Clinical comparison with analgesics, tranquilizers, B vitamins, magnesium sulfate and diuretics

No quantitative treatment contrast is supplied. Investigator and schedule match an earlier series, so cohort overlap is possible.

Read the original source
Cerebrovascular clinical report with missing design details

Primary human clinical report

Russian-language cerebrovascular clinical report. 2004. PMID 14965012.

The abstract reports changes in several cognitive and neurologic symptoms.

Participants / model
People with chronic cerebrovascular insufficiency or stroke sequelae
Follow-up
Not specified in the abstract
Study design
Design, allocation and comparator not specified in the abstract

The abstract omits sample size, allocation, comparator, duration and effect estimates.

Read the original source

Does pramiracetam improve cognition or prevent decline in healthy people?

The cited blinded trials did not test ordinary cognitive enhancement in healthy rested adults without a drug challenge. The uncontrolled 20-person older-adult report is too weak to show prevention. The cited human trials did not measure dementia incidence, stroke prevention, lifespan, or healthspan.

Normal-animal memory results and disease-model biomarkers can support a research hypothesis. They do not establish a human anti-aging outcome.

20-person uncontrolled older-adult study

Primary uncontrolled human study

Korsunskaya LL. Crimean Therapeutic Journal. 2007;2(2):119-123.

Memory, attention, subjective health and selected EEG or Doppler measures improved; anxiety and most vascular measures did not.

Participants / model
20 neurologically healthy older adults, mean age 62; mild hypertension permitted
Follow-up
20 days
Study design
Uncontrolled before-and-after study

All participants completed and no adverse effects were reported. With no comparator, the changes cannot establish prevention or a causal treatment effect.

Read the original source
Normal-rat object-recognition experiment

Preclinical primary study

Ennaceur A et al. 1989. PMID 2765166.

One of three exposures improved 24-hour object recognition without changing total exploration.

Participants / model
Normal rats
Follow-up
Acute treatment with 24-hour memory test
Study design
Controlled object-recognition experiment

The response was not monotonic and does not provide a human effect estimate.

Read the original source
Rat reference-memory positive and working-memory null

Preclinical primary study

Radial-arm maze learning study. 1986. PMID 3088666.

Reference memory improved at both tested exposures; working memory did not improve significantly.

Participants / model
Rats
Follow-up
Seven weeks of pretreatment
Study design
Controlled radial-arm maze experiment

The domain-specific null prevents describing the result as broad memory enhancement.

Read the original source
2026 Parkinson-model combination study

Preclinical primary study

Ukraine and Kyrgyzstan-affiliated animal study. Wiadomosci Lekarskie. 2026.

The Pramistar combination row lacked significance marks for the reported HIF, HSP70 and c-Fos endpoints, and the abstract did not list it among favored combinations.

Participants / model
90 rats described across nine groups
Study design
Combination-treatment Parkinson-model experiment

Group denominators and several table symbols conflict. The experiment cannot establish pramiracetam monotherapy, Parkinson treatment efficacy or healthy cognition.

Read the original source

What has been measured in people?

In 12 fasting healthy men, single oral exposure produced peak plasma concentrations after two to three hours and half-lives of 4.5 to 6.5 hours. An 11-person formulation study found mean half-lives of 4.7 plus or minus 2.4 hours for solution and 4.3 plus or minus 2.2 hours for tablets, with an overall two-to-eight-hour range.

Solution was absorbed faster than tablets. Plasma PK does not establish brain exposure, how long a cognitive effect lasts or a schedule for self-treatment.

12-man fasting single-dose pharmacokinetics

Primary human pharmacokinetic study

Chang T et al. Journal of Clinical Pharmacology. 1985. PMID 4008675. DOI 10.1002/j.1552-4604.1985.tb02841.x.

Peak plasma concentrations occurred at two to three hours; half-lives ranged from 4.5 to 6.5 hours.

Participants / model
12 healthy men in two groups of six
Follow-up
Single-dose sessions
Study design
Randomized blinded alternating placebo and fasting single oral exposures

No significant adverse effects were reported in this tiny acute study. It does not define repeated-use safety or cognitive-effect duration.

Read the original source
11-person solution-versus-tablet pharmacokinetics

Primary human pharmacokinetic study

Pramiracetam formulation pharmacokinetic study. 1992. PMID 1473879.

Mean half-lives were 4.7 plus or minus 2.4 hours for solution and 4.3 plus or minus 2.2 hours for tablets; solution absorption was faster.

Participants / model
11 fasting volunteers
Follow-up
Single-exposure pharmacokinetic sampling
Study design
Oral solution and tablet formulation comparison

Individual half-lives ranged from two to eight hours. The study did not measure cognition.

Read the original source

What risks are documented?

Romanian product information draws on 1,110 treated subjects. It lists agitation, insomnia, dizziness, nausea and upper-abdominal pain as common, with confusion and tremor less frequent. It contraindicates severe kidney impairment, liver impairment, pregnancy and breastfeeding, and reports lower clearance as kidney function declines.

The label cautions about anticoagulant or antiplatelet treatment and thyroid extract, while noting that part of this interaction rationale comes from piracetam rather than direct pramiracetam trials. Rat platelet experiments show exact-compound biological activity but do not provide a human bleeding rate.

A 2024 Romanian authority report confirms a licensed use for degenerative or vascular memory and concentration problems, especially in older adults. That status does not establish healthy enhancement or US approval.

Official Pramistar label and 1,110-subject safety summary

Official medicine label

Romanian National Agency for Medicines and Medical Devices. Pramistar summary of product characteristics. 2019.

The label summarizes adverse reactions across 1,110 treated subjects, contraindications, renal clearance and formulation details.

Participants / model
Clinical safety population summarized by the regulator; 1,110 treated subjects
Follow-up
Varied exposure in the underlying clinical program
Study design
Regulatory synthesis of clinical and product data

Common reactions include agitation, insomnia, dizziness, nausea and upper-abdominal pain. Part of the interaction rationale is extrapolated from piracetam.

Read the original source
2024 Romanian regulatory review

Official regulatory assessment

Romanian National Agency for Medicines and Medical Devices. Pramiracetamum evaluation. 2024.

The authority records a licensed indication for degenerative or vascular memory and concentration problems, particularly in older adults.

Participants / model
Romanian regulatory context
Follow-up
Current at the 2024 report date
Study design
Health-technology and reimbursement assessment

This establishes regulated local medical use, not a new placebo-controlled efficacy result or US approval.

Read the original source
Rat platelet experiment

Preclinical primary study

Russian-language platelet study. 2012. PMID 22702111.

Pramiracetam showed antiaggregatory activity in an alloxan-hyperglycemia model.

Participants / model
Rats with experimental hyperglycemia
Follow-up
Experimental treatment period
Study design
Controlled platelet-function experiment

Exact-compound biological activity does not establish a human bleeding rate.

Read the original source
Rat platelet-mechanism follow-up

Preclinical primary study

Platelet mechanism study. 2014. PMID 24824701.

Pramiracetam-associated antiaggregation was linked to thromboxane-A2 metabolism in this model.

Participants / model
Rats with chronic experimental hyperglycemia
Follow-up
Experimental treatment period
Study design
Controlled platelet-mechanism experiment

Related work from the same research line is not independent human confirmation.

Read the original source

Studies and sources

Four-man brain-injury crossover and open extension

Primary human study

McLean A et al. Brain Injury. 1991. PMID 1786500. DOI 10.3109/02699059109008110.

Delayed recall and other memory measures improved during the controlled phase; improvement was reported through an open extension and one month after cessation.

Participants / model
Four young men with cognitive impairment after head injury or anoxia
Follow-up
12-week controlled phase; 18-month open extension
Study design
12-week double-blind placebo crossover followed by open treatment

NARIC supplies the sample and crossover details missing from the abstract. The cited records do not report full tables, washout details, or adverse-event counts.

Read the original source
PubChem: pramiracetam chemical identity

Government chemical identity database

National Library of Medicine. PubChem CID 51712.

C14H27N3O2; molecular weight 269.38 g/mol.

Participants / model
Chemical record
Follow-up
Living database
Study design
Curated structure record

Formula and molecular weight establish the recorded structure, not the contents of a retail product or an effective dose.

Read the original source
Chinese dog and rat pharmacokinetics

Preclinical primary pharmacokinetic study

Fang Z, Liu X, Xiao Y. Pramiracetam pharmacokinetics in animals. PMID 11387954.

Dog plasma half-life was 2.3 to 3.9 hours; rat distribution was highest in kidney with brain exposure detected.

Participants / model
Dogs and rats
Follow-up
Acute pharmacokinetic sampling
Study design
HPLC pharmacokinetic and tissue-distribution experiments

These species-specific measurements do not define human clearance. A separate Chinese journal record may describe the same program.

Read the original source
24-man scopolamine challenge

Randomized placebo-controlled human challenge study

Mauri M et al. Archives of Gerontology and Geriatrics. 1994. PMID 15374306. DOI 10.1016/0167-4943(94)00542-7.

Pramiracetam partially reduced scopolamine-induced amnesia; other challenged domains remained impaired or unaffected.

Participants / model
24 healthy men in younger and older age strata
Follow-up
10 treatment days before a single challenge
Study design
Placebo-controlled treatment followed by scopolamine challenge

The abstract does not show a useful unchallenged-baseline effect or a reusable treatment effect size.

Read the original source
Rat hippocampal choline-uptake study

Preclinical primary study

Shih YH, Pugsley TA. Life Sciences. 1985. PMID 2987637. DOI 10.1016/0024-3205(85)90311-X.

Intermediate pramiracetam exposures increased sodium-dependent high-affinity choline uptake; higher and lower exposures were ineffective.

Participants / model
Rats and isolated hippocampal nerve-terminal preparations
Follow-up
Acute experiments
Study design
Controlled neuropharmacology experiments

This finding does not establish a human cognitive effect or a need for a choline supplement.

Read the original source
Brain-injury study cohort and design

Government bibliographic study record

National Rehabilitation Information Center. REHABDATA record J28403; McLean and colleagues, 1991.

The indexed study involved four men in a 12-week blinded crossover, followed by an 18-month open extension.

Participants / model
Four young men with cognitive impairment after brain injury or anoxia
Follow-up
12-week controlled phase
Study design
Bibliographic abstract describing randomized treatment order

This index record supplies the sample size and controlled-phase duration. Its journal issue and page fields differ from PubMed, and secondary summaries disagree about dose frequency. The exact regimen remains unresolved.

Read the original source
65-patient mild-brain-injury comparison

Primary human clinical report

Tkachev AV. Russian-language clinical report. 2007. PMID 18418926.

Orientation, subjective well-being and amnesia measures favored pramiracetam-containing care over piracetam-containing care.

Participants / model
65 patients with mild traumatic brain injury
Follow-up
Assessments on days 1, 10 and 30
Study design
Comparison within complex clinical care; allocation and masking not reported in the abstract

Both groups received other treatment. Arm sizes and numerical between-group effects are absent from the abstract.

Read the original source
12-man fasting single-dose pharmacokinetics

Primary human pharmacokinetic study

Chang T et al. Journal of Clinical Pharmacology. 1985. PMID 4008675. DOI 10.1002/j.1552-4604.1985.tb02841.x.

Peak plasma concentrations occurred at two to three hours; half-lives ranged from 4.5 to 6.5 hours.

Participants / model
12 healthy men in two groups of six
Follow-up
Single-dose sessions
Study design
Randomized blinded alternating placebo and fasting single oral exposures

No significant adverse effects were reported in this tiny acute study. It does not define repeated-use safety or cognitive-effect duration.

Read the original source
35-person open memory-training pilot

Primary exploratory human study

De Vreese LP et al. Archives of Gerontology and Geriatrics. 1996. PMID 18653001. DOI 10.1016/0167-4943(96)86906-8.

Objective memory gains favored the drug groups; subjective memory results were less clear.

Participants / model
35 older adults with memory complaints and without dementia or depression
Follow-up
Not reported in the abstract
Study design
Open random allocation to training, drug, both or control

Group sizes were 10, 8, 10 and 7. There was no blinding or placebo, and the abstract lacks detailed effects and safety counts.

Read the original source
10-person Alzheimer trial with failed response replication

Primary placebo-controlled human study

Claus JJ et al. 1991. PMID 2011259.

Eight patients appeared to have an initial best dose; only two reproduced a similar response in the replication stage.

Participants / model
10 people with probable Alzheimer disease
Study design
Two-stage placebo-controlled dose-enrichment and replication study

The authors concluded that the tested exposures were unlikely to provide symptomatic benefit. The sample was too small for a precise effect estimate.

Read the original source
60-person blinded older-adult memory trial

Primary randomized double-blind placebo-controlled study

Marini G et al. Advances in Therapy. 1992;9(3):136-146.

The abstract reports psychometric improvement in the active arm and no significant placebo change; six placebo participants and no active participants withdrew.

Participants / model
60 older adults, mean age 74.6; 30 randomized to each arm
Follow-up
12 weeks after a two-week placebo washout
Study design
Randomized double-blind placebo-controlled study after a placebo washout

The abstract omits between-arm effects, variance, dropout handling, and multiplicity correction.

Read the original source
104-person open vascular-impairment study

Primary open human study

Scarpazza P, Guffanti EE, Marchi E, Corsonello F, Vozza A, Spezie I. Multicenter evaluation of pramiracetam for the treatment of memory impairment of probable vascular origin. Advances in Therapy. 1993;10(5):217-225.

The indexed abstract reports improved cognitive-test scores during treatment.

Participants / model
104 older patients with probable vascular cognitive impairment
Follow-up
Three months
Study design
Open, noncomparative multicenter study

Without a concurrent comparator, practice effects, recovery, and changes in care remain possible. The report does not provide full tables or adverse-event denominators.

Read the original source
20-person uncontrolled older-adult study

Primary uncontrolled human study

Korsunskaya LL. Crimean Therapeutic Journal. 2007;2(2):119-123.

Memory, attention, subjective health and selected EEG or Doppler measures improved; anxiety and most vascular measures did not.

Participants / model
20 neurologically healthy older adults, mean age 62; mild hypertension permitted
Follow-up
20 days
Study design
Uncontrolled before-and-after study

All participants completed and no adverse effects were reported. With no comparator, the changes cannot establish prevention or a causal treatment effect.

Read the original source
108-patient concussion co-treatment report

Primary human clinical report

Tkachev AV. Russian-language clinical report. 2008. PMID 19145827.

The abstract reports improvement in asthenic symptoms during pramiracetam-containing care.

Participants / model
108 patients: 37 received piracetam and 71 Pramistar; 30 healthy controls
Follow-up
Assessments on days 1, 10 and 30
Study design
Clinical comparison with analgesics, tranquilizers, B vitamins, magnesium sulfate and diuretics

No quantitative treatment contrast is supplied. Investigator and schedule match an earlier series, so cohort overlap is possible.

Read the original source
Cerebrovascular clinical report with missing design details

Primary human clinical report

Russian-language cerebrovascular clinical report. 2004. PMID 14965012.

The abstract reports changes in several cognitive and neurologic symptoms.

Participants / model
People with chronic cerebrovascular insufficiency or stroke sequelae
Follow-up
Not specified in the abstract
Study design
Design, allocation and comparator not specified in the abstract

The abstract omits sample size, allocation, comparator, duration and effect estimates.

Read the original source
11-person solution-versus-tablet pharmacokinetics

Primary human pharmacokinetic study

Pramiracetam formulation pharmacokinetic study. 1992. PMID 1473879.

Mean half-lives were 4.7 plus or minus 2.4 hours for solution and 4.3 plus or minus 2.2 hours for tablets; solution absorption was faster.

Participants / model
11 fasting volunteers
Follow-up
Single-exposure pharmacokinetic sampling
Study design
Oral solution and tablet formulation comparison

Individual half-lives ranged from two to eight hours. The study did not measure cognition.

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Official Pramistar label and 1,110-subject safety summary

Official medicine label

Romanian National Agency for Medicines and Medical Devices. Pramistar summary of product characteristics. 2019.

The label summarizes adverse reactions across 1,110 treated subjects, contraindications, renal clearance and formulation details.

Participants / model
Clinical safety population summarized by the regulator; 1,110 treated subjects
Follow-up
Varied exposure in the underlying clinical program
Study design
Regulatory synthesis of clinical and product data

Common reactions include agitation, insomnia, dizziness, nausea and upper-abdominal pain. Part of the interaction rationale is extrapolated from piracetam.

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2024 Romanian regulatory review

Official regulatory assessment

Romanian National Agency for Medicines and Medical Devices. Pramiracetamum evaluation. 2024.

The authority records a licensed indication for degenerative or vascular memory and concentration problems, particularly in older adults.

Participants / model
Romanian regulatory context
Follow-up
Current at the 2024 report date
Study design
Health-technology and reimbursement assessment

This establishes regulated local medical use, not a new placebo-controlled efficacy result or US approval.

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Normal-rat object-recognition experiment

Preclinical primary study

Ennaceur A et al. 1989. PMID 2765166.

One of three exposures improved 24-hour object recognition without changing total exploration.

Participants / model
Normal rats
Follow-up
Acute treatment with 24-hour memory test
Study design
Controlled object-recognition experiment

The response was not monotonic and does not provide a human effect estimate.

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Rat reference-memory positive and working-memory null

Preclinical primary study

Radial-arm maze learning study. 1986. PMID 3088666.

Reference memory improved at both tested exposures; working memory did not improve significantly.

Participants / model
Rats
Follow-up
Seven weeks of pretreatment
Study design
Controlled radial-arm maze experiment

The domain-specific null prevents describing the result as broad memory enhancement.

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Rat cortical NOS experiment

Preclinical primary study

Nitric-oxide synthase study. 1995. PMID 8557218.

A higher exposure increased cortical NOS activity about 20%; lower exposure was ineffective.

Participants / model
Rats
Follow-up
Acute experimental period
Study design
Controlled biochemical experiment

No hippocampal increase or significant NOS mRNA change was found. Lithium interaction was animal-only.

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Age-dependent hypoxia experiment

Preclinical primary study

Hypobaric hypoxia study. PMID 9200217.

The first afterdischarge shortened in 18-day-old animals.

Participants / model
Developing rats
Follow-up
Acute experimental period
Study design
Controlled hypobaric-hypoxia experiment

No effect occurred in 12-day-old pups or on repeated afterdischarges. This does not establish adult human neuroprotection.

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Rat platelet experiment

Preclinical primary study

Russian-language platelet study. 2012. PMID 22702111.

Pramiracetam showed antiaggregatory activity in an alloxan-hyperglycemia model.

Participants / model
Rats with experimental hyperglycemia
Follow-up
Experimental treatment period
Study design
Controlled platelet-function experiment

Exact-compound biological activity does not establish a human bleeding rate.

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Rat platelet-mechanism follow-up

Preclinical primary study

Platelet mechanism study. 2014. PMID 24824701.

Pramiracetam-associated antiaggregation was linked to thromboxane-A2 metabolism in this model.

Participants / model
Rats with chronic experimental hyperglycemia
Follow-up
Experimental treatment period
Study design
Controlled platelet-mechanism experiment

Related work from the same research line is not independent human confirmation.

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2026 Parkinson-model combination study

Preclinical primary study

Ukraine and Kyrgyzstan-affiliated animal study. Wiadomosci Lekarskie. 2026.

The Pramistar combination row lacked significance marks for the reported HIF, HSP70 and c-Fos endpoints, and the abstract did not list it among favored combinations.

Participants / model
90 rats described across nine groups
Study design
Combination-treatment Parkinson-model experiment

Group denominators and several table symbols conflict. The experiment cannot establish pramiracetam monotherapy, Parkinson treatment efficacy or healthy cognition.

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Why is pramiracetam in C tier?

C reflects small human studies reporting selected memory benefits in impaired or challenged populations. A negative Alzheimer replication, tiny groups, incomplete reporting, open designs and co-treatment leave the average effect uncertain. Healthy cognition and long-term safety remain unestablished.

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