Piracetam

Abstract

The pyrrolidone (2-oxo-pyrrolidine) derivatives are a family of compounds that have unique properties of potential value in various neurological settings. The remarkable antimyoclonic effect of piracetam was first reported in 1978 in a case of post-anoxic myoclonus after cardiac arrest, and in the past decade the effectiveness of this drug in cortical myoclonus of various aetiologies has been confirmed. Its use in epilepsy is confined to this indication. No drug interactions have been recorded, and none indeed would be expected in view of the lack of metabolism or protein binding and its mode of elimination. Because of piracetam's extensive use as a cognitive enhancer, there is considerable experience of its clinical tolerability. Piracetam is available in 800- and 1200-mg white tablets or as a solution of 200 or 333.3 mg/mL. The drug is contraindicated in patients with creatinine clearances below 20 mL/min, and in those with severe hepatic impairment.