Piracetam, a synthetic drug licensed in parts of Europe and sold unofficially for sharper thinking, has thin, inconsistent evidence for preserving memory with age. Clearest benefits are narrow: fewer involuntary muscle jerks from certain brain disorders and fewer breath-holding episodes in toddlers. In older adults with memory problems, measured memory did not improve. Side effects are usually mild; it slightly reduces blood clotting and builds up when kidney function declines. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Creatinine clearance (estimated from serum creatinine) | >80 mL/min for the usual dose | Sets dose; stops use below 20 mL/min |
| Platelet count | 150–450 × 10⁹/L | Safety check; low count stops use |
| INR (only if taking vitamin K antagonists) | 0.8–1.2 (standard reference range); individual therapeutic target on vitamin K antagonists | Safety check; a rise changes use |
| Body weight | No established target; track change from own baseline | Safety check; unexplained gain changes use |
| Cognitive test score (e.g., MoCA) | No established target; track change from own baseline | Marker the intervention is expected to change |
Cadence: Baseline kidney function, platelet count, cognitive test score and body weight, plus INR for anyone taking anticoagulants; kidney function and weight at 4 weeks, then every 6–12 months; INR within 1–2 weeks of starting alongside a vitamin K antagonist, then per the anticoagulation schedule; the same cognitive test at 8–12 weeks