Picamilon, which joins the B vitamin niacin to the brain's main calming messenger, is a Russian prescription medication for reduced brain blood flow and anxiety, sold unlawfully in United States supplements. A manufacturer-funded Russian trial adding it to ginkgo found slightly better thinking scores in brain blood-vessel disease; healthy adults remain untested. Reported side effects are generally mild and long-term safety is unstudied; product quality is the largest practical hazard. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Estimated glomerular filtration rate | ≥90 mL/min/1.73 m² | Kidneys clear the drug |
| Serum creatinine | 0.7–1.0 mg/dL (men), 0.6–0.9 mg/dL (women) | Feeds the kidney estimate |
| Urine albumin-to-creatinine ratio | <10 mg/g | Early kidney damage |
| Seated and standing blood pressure | 110–120 / 70–80 mmHg; standing drop <20 mmHg systolic | Detects excess vessel widening |
| MoCA score | 26–30 points | Tracks thinking benefit |
| Pittsburgh Sleep Quality Index | ≤5 points | Tracks sleep effect |
Cadence: Baseline before starting; home blood pressure daily during the first 2 weeks, then weekly; symptom review at 2 and 4 weeks; MoCA and sleep questionnaire at the end of each 1–2-month course and 6 weeks after stopping; kidney tests every 6–12 months when repeating courses