article on Aniracetam and brain injury rehabilitation
 

I found this article/study and thought I would share it here.

Study on Aniracetam for treatment after traumatic brain injury:

Journal of Neurotrauma
Delayed, Post-Injury Treatment with Aniracetam Improves Cognitive Performance after Traumatic Brain Injury in Rats
To cite this paper:
Anna I. Baranova, Mark D. Whiting, Robert J. Hamm. Journal of Neurotrauma. August 1, 2006, 23(8): 1233-1240. doi:10.1089/neu.2006.23.1233.

Anna I. Baranova
Department of Psychology, Virginia Commonwealth University, Richmond, Virginia.
Mark D. Whiting
Department of Psychology, Virginia Commonwealth University, Richmond, Virginia.
Robert J. Hamm, Ph.D.
Department of Psychology, Virginia Commonwealth University, Richmond, Virginia.

Chronic cognitive impairment is an enduring aspect of traumatic brain injury (TBI) in both humans and animals. Treating cognitive impairment in the post-traumatic stages of injury often involves the delivery of pharmacologic agents aimed at specific neurotransmitter systems. The current investigation examined the effects of the nootropoic drug aniracetam on cognitive recovery following TBI in rats. Three experiments were performed to determine (1) the optimal dose of aniracetam for treating cognitive impairment, (2) the effect of delaying drug treatment for a period of days following TBI, and (3) the effect of terminating drug treatment before cognitive assessment. In experiment 1, rats were administered moderate fluid percussion injury and treated with vehicle, 25, or 50 mg/kg aniracetam for 15 days. Both doses of aniracetam effectively reduced injury-induced deficits in the Morris water maze (MWM) as measured on postinjury days 11–15. In experiment 2, injured rats were treated with 50 mg/kg aniracetam or vehicle beginning on day 11 postinjury and continuing for 15 days. MWM performance, assessed on days 26–30, indicates that aniracetam-treated animals performed as well as sham-injured controls. In experiment 3, animals were injured and treated with aniracetam for 15 days. Drug treatment was terminated during MWM testing on postinjury days 16–20. In this experiment, aniracetam-treated rats did not perform better than vehicle-treated rats. The results of these experiments indicate that aniracetam is an effective treatment for cognitive impairment induced by TBI, even when treatment is delayed for a period of days following injury.

I saw this study some time ago. I have not found any follow up studies. I would be interested to see what the research shows long term. Are the effects long term or is there a need to maintain the drug regimen?

I found that aniracetam can cause severe head ache and pain from acetycholine depletion. It is suggested that a acetylcholine precursor such as 1-alpha glycerylphosphorylcholine (Alpha GPC) be co-administered in a ratio of 4 parts aniracetam to 3 parts Alpha GCP.

There is a lack of thorough human studies except to note that the maximum beneficial daily does it 1000mgs. The FDA has not approved it. It is sold as a smart drug and to body builders.

I would be interested in more human studies, whether US or foreign. It appears to have been studied in humans in japan.

*edit*

Mark,

There have been hundreds of human studies done on it since the 1970's in Europe and Asia. All have shown benefit from its use for head injured patients.

A google search shows a very limited amount of research on aniracetam. The patent was originated by Hoffman Roche in 1993. I have seen it referenced as far back as 1983 but only in rat studies or in the senile elderly.

Many of the references are copies of the same report or article.

I find it interesting that it is a prescription drug in Europe but sold over the counter as a food supplement in the USA.

Can you point me to some of the hundreds of human studies?

The 'racetams have been around since the 1970's. I was generally referring to the 'racetams when I made my statement. They are all just derivatives os Piracetam, so, essentially, they are the same compound. So, generally speaking, there have been hundreds of 'racetam studies done on humans since the 1970's. But that really is just splitting hairs.

It is only a prescription drug in two European countries.

The FDA won't approve any drug that is marketed as a cognitive enhancer, regardless of the research that has been done on it. Don't know why this is, it just is. Also, because of patent issues, no drug company wants to push this through for FDA clearance. But, the FDA is certainly not the end-all-be-all of the prescription drug manufacturing world. Just look up how ritallin was cleared and you'll know what I'm talking about.

It is recommended to take a choline supplement while taking any 'racetam.
It does deplete your brain of choline, which I have experienced first hand. Makes you very tired and groggy, but as soon as you take a choline pill, you're right as rain again.

The research has proven that it can improve any brain injured persons condition. The degree of improvement varies, but some research has stated seeing a 65% improvement in subjects studied. Not saying that it is a cure-all, but most brain injured people would agree that even a 10% improvement can be pretty dramatic.

It is pretty costly to get right now as there aren't any manufactures who make it in bulk anymore, except for Piracetam. A months supply will cost around $40. However, most co-pays on prescription drugs now cost around that as well.

Overall, I would say that it is definitely worth giving a try for a month. If it doesn't work, you're only out $40 bucks and at least you tried it.

Well, actually, it is not too expensive.

About $20 per month combined with Alpha GPC at 1000mg Aniracetam /600 mgs Alpha GCP

These links take you to the best prices I found. I found it to cost much more $40 per month in the prescription countries, not including the A GPC.

http://allnutri.com/pid40935/aniracetam.aspx
http://allnutri.com/search.aspx?query=alpha+gpc

Aniractem is more concentrated and targeted that piracetam and the other racetams although piracetam appears to have a better following of users.

I was informed that Alpha GPC has been found to increase the beta-amyloid plaque formation in Alzheimer's patients.

Its use should be considered very cautiously.

There is a different choline supplement used by many to restore choline levels. It is CDC Choline. It is also sold a Citicoline. It is an ingredient in 5 Hour Energy Drink. It is a bit more expensive the Alpha GCP.

Here is a really good article on choline, and which foods provide it well.

http://www.whfoods.com/genpage.php?t...trient&dbid=50

This nutrient is really neglected today. Since people have the cholesterol phobia thanks to the media, eggs are often not eaten anymore. Egg yolks are very high in choline.

This article is interesting too:
http://findarticles.com/p/articles/m...9/ai_72613111/

It has been thought for a while now that some children are low in choline intake. Sensory integration disorder is sometimes treated with choline supplements.
http://www.sciencedirect.com/science...a4aa00efa7c653

In fact some children's vitamins now have choline added.

Mark,

Can you provide a link to your finding on Alpha GPC and beta-amyloid plaque formation? I performed a google search and couldn't find anything on it. I actually found 3 sites that mentioned using Alpha GPC to prevent beta-amyloid formation in AD.

im gonna give this a shot! I ordered ALPHA GPC and aniracetam about 5 mins ago, should be in my hands in im assuming 10 business days.. ill be sure to post results :)

That's great to hear. FYI, aniracetam is fat soluble, so make sure you take it with food and preferably with some sort of good fat. Also, if aniracetam doesn't work for you, then you should try oxiracetam. From what I have read, people either respond to one or the other. However, the research also stated that almost every head injured patient responds to it because we are all deficient in the area(s) the medication works on. It also has a half life of a couple of hours, so make sure to take it twice a day.

I begin my aniracetam/alpha gpc trial on Monday. It will be interesting to compare notes. Good Luck!

what do they say as far as taking it for a long term? Is it something you can take until your body is able to sustain that level or is it something you'd almost expect to need to take for a long time

I haven't actually found any articles on long term use. Most of the studies I read had their participants on the 'racetams for 6 months, but there were not follow up studies done. One guy, who posts on another forum, has been using it for 5 years, and he says that he hasn't built up a tolerance to it. I would imagine that you'll have to be on it indefinitely to get he maximum benefits from it. However, I did find a wholesale supplier out of China who sells 1 kg of it for $150 (all of this stuff is made in China right now). I haven't done the math, but my guess is that this would last at least 6 months. So, if you find you like it, let me know and I'll pm you their information. Also, while I'm on the topic of long term use, some people recommend to cycle this stuff. Not sure what that cycle entails, but just make sure you cycle off of it once in a while.

ya im not much of a pill popper, I mean if it helps great im all for it as long as its clean, but the last thing I want is to become reliant on it.. I get annoyed taking pills.. even the travacor.balanced thing gets irritating lol, maybe im just lazy!

well the nice thing about it is that is has shown to demonstrate neuroprotection against dementia. So, taking it long term may not be such a bad thing.

mike
 

mike aniracetam is an effective treatment for cognitive impairment induced by TBI, even when treatment is delayed for a period of days following injury. like the new stroke drugs these drugs only limit the after burn effect of brain injury, so please take care with self medicating , supplements, are fine but I draw the line at advising anything stronger

TC

*edit* information about the beta amyloid plaque formation. *edit* You may be able to find this information by googling aniracetam and alzheimer's. I found it on an Alzheimer's forum.

The FDA is working hard to stop the flow of Aniracetam into this country. The importers are claiming it is a nutritional supplement but it is a in reality a synthesized drug.

It is definitely contra-indicated for anybody with a family history of Alzheimer's. It can cause beta-amyloid plaque to build up faster for those with the Alzheimer's plaque problem.

I have looked into it extensively and was considering buying some, but then learned about the plaque problem.

As for the Alpha GPC, I have found that Choline CDC is considered a better choline supplement. The Alpha GPC has a storied history. The Choline CDC does not and has been studied for much longer.

just a note

links to articles/published work/news reports with a "snip" or abstract are fine to be placed on the forums

However, frequently THEIR copyright regulations prohibit us from allowing members to copy and paste the entire article. We sometimes get authors/publications etc contact us when *their* copyright is infringed that way. If we do not abide by and respect copyright, we could face legal issues. that is why we ask members rather to just post a few lines, with title and citation and then link to the article for others to read more if they are interested

if in doubt look at the bottom of the article...if it says "all rights reserved" or some other copyright statement, then it should be linked here and not copied

thank you

Mark,

Can you provide evidence of this? I ran a google search and found nothing. I actually found a myriad of studies that used aniracetam to prevent the worsening of symptoms from alzheimers. Why would scientists use a drug to combat alzheimers if it has been shown to induce the very thing that causes alzheimers? No offense, but it doesn't seem like sound logic to me.

Also, can you please provide evidence that CDC Choline is superior to Alpha GPC? I have always read on forums that Alpha GPC is far superior to CDC Choline. Alpha GPC is even more expensive to buy than CDC Choline. Simple economics would suggest that the superior product would be more expensive. But please, if you have solid evidence, please provide it so I can start buying the cheaper one.

I also found nothing on the FDA trying to ban the importation of aniracetam. Please provide evidence to this as well. I did find one person who stated primaracetam is getting harder to find and they speculated that this could be due to the FDA, but I would hardly consider this person a valid source.

I have tried to get the actual text of the reports I found referenced. Unfortunately, I do not have subscriptions to the text that allow copy and paste. The Abstracts do not say much worth repeating.

One reference says that a study was conducted in Japan in 2000-2001 and due to negative results, the study was not completed. Another comment says that due to an article with a negative result the drug (trade name Draganon) was delisted. It may be referring to the Japan study.

Keep in mind that there are many different kinds of studies. In one abstract of a review of the published literature, it commented that there were myriads of both pro and con reports about Aniracetam and Piracetam.

It did not include a review of most of the reports because the methodology was not scientific due to open label, lack of adequate pre and post trial testing (neuropsych) or other statistical problems. A common problem was combining too many different types of dementia. In one report reviewed, the cohort was 150 patients. Upon thorough review of the patient histories, only 19 were properly qualified for the study as it was designed.

It was the Alpha GPC that was problematic to AD plaque formation, not the Aniracetam. The same was true of the CDC Choline (Citocholine). The AD brain already has an excess of acetylcholine.

As brain injury has been found to relate to a 4 to 10 fold increase in the prevalence of Alzheimer's Disease, it is easy to combine the two and see the long term risk.

There is a common problem with brain injury/dementia studies. It is all but impossible to get enough volunteers to participate in a long term double blind study because many of the patients are not willing to delay what ever other treatments may be available. A properly designed study needs to isolate the subjects from other treatments and therapies.

The studies of subjects with Alzheimer's were usually cut short unless positive results were documented early in the study.

I can not get the required written authorizations for the other information from another forum so that I can post it.

Either way, After my preliminary research, I discussed it with my wife and I was about to order some Aniracetam and CDC Choline to try but now will not take the risk.

I may have horrible memory problems and slowed thinking but my intelligence is still intact. I can not imagine losing any more mental abilities. I know what it is like to lose mental skills step by step over the last 40 years. This last step of lost skills was devastating. I cannot afford another step down in brain function.

By the way, in reviewing some past posts, it appears I never answered an important question. Why did the neurologist and neurofeedback therapist suggest neurofeedback was not recommended for my case? He could tell from the level of damage shown in my 22 lead QEEG that I have serious damage beyond the level that would be recoverable due to neuroplasticity.

He believed that my multiple concussions (13) had just finally overwhelmed my brain's ability to rewire. He based some of his prognosis on my reports of my prior successful brain retraining. He was actually shocked at my high level of functioning considering the damage shown in my QEEG waveforms. He did not know how bad my function was a year earlier. I had learned many work-arounds and accommodations to hide my dysfunctions.

This neuropsychiatrist had a full time clinic that kept busy and profitable doing neurofeedback. He used a QEEG targeted system, not a take home shotgun approach. At the time, I had the money to spend. His QEEG tech had recovered from a brain tumor and two-lobe-ectomy and used brain retraining to go on to earn a master's degree.

I had had very good recoveries from most of my concussions until a concussion in 1996. I worked hard at brain retraining and got intellectual functions and memory back to a high level but never regained tolerance for visual or auditory stimuli.

I was assaulted from behind with a blow the the head in 1999 and has even more struggle to recover. A new injury in Jan 2001 was the end to my ability to recover.

Upon starting serious research into brain injuries, I was able to define the functions I had been losing step by step after each concussion. It was like at each concussion, I took three steps back and recovered with two steps forward. Finally, it was three steps back and one step forward then no steps forward.

When I started devoting my energies to learning work-arounds and accommodations, my ability to function at a high level returned, not 100% nor 24/7 but enough that I could rest up for an event where I needed maximum function.

Mark what kind of brain retraining did you do?

I did a variety of things to retrain my brain. My most common training in the past was doing mental math. Anytime I had a need to do arithmetic or such, I would always try to do it in my head first. I would try to challenge the cash register at the store by trying to add up the prices and figure the sales tax in my head. Before the prevalence of scanners, I could do this regularly. Now, it is not possible. I would get to a point where I could often be very close if not right on.

An example of this retraining is my high school years. I was a year ahead of my grade level in math. My freshman year, I challenged freshman Algebra and took sophomore Geometry instead. I suffered a decompensation early in my sophomore year from a concussion from heading the ball at soccer. After straight A's as a freshman, I struggled to get B's as a sophomore, even in the junior math class that was my strongest subject.

It took more than a year to recover from the decomp. I did not take any math my junior or senior year. (The only teacher was my neighbor and he was a jerk). I took the SAT early in my junior year and scored 640 on the math. I continued to challenge my mind with math, even though I was not taking any math classes. A year later, I took the SAT again and scored a 710 on the math portion. It had been almost two years since I had a math class.

This recovery is what taught me that I could retrain my brain. Back in 1971, brain retraining was never suggested by my neuro.

I suffered another decomp in college and almost flunked out. Again, I focused on mental math and spacial relations puzzles. I regained most of my functions.

I have always been an inventor or fixer. I would see a problem and go through all kinds of mental gymnastics to solve it. I still try to do this but now I often need to rely on a pencil and paper. My visualization skills are too haphazard.

More recently, I would play computer games. Freecell is a Windows solitaire game that requires planning multiple moves before you start the move. Minesweeper requires visual patterning to be successful. There were other games I would play that challenged visual perception and multiple step functions. These were great brain exercises.

Now, I get overwhelmed and exhausted by the visual challenges. I also struggle to sequence the multiple steps of games like Freecell. I have tried to retrain with the same games and techniques but get mentally exhausted to quickly. It is like a fog drops in front of my eyes.

I tried less strenuous tasks like sorting screws and nuts. This was a great help at visual perception and hand to eye coordination.

I still do some of these exercises by researching to learn about and understand a variety of issues. When someone mentions a new therapy or report, I research it to understand it. The thought process of learning new information is a great brain exercise. Sometimes, I will have to stop and walk away because i get overwhelmed.

If I return later with a fresh brain, I can try again. The internet is a fabulous brain training tool. There is a very interesting aspect to information. Truthfully presented information makes sense. You can find a logical system of discovery.

If you learn to ask yourself questions about things that you don't understand, then go looking for the answers, you will embark on a vigorous exercise for your brain. The information may have no importance to you, but the task of learning is a great exercise for your brain.
I believe that 75% of high school and college classes are just exercises in how to learn and understand new information. Very few jobs use the skills you were taught in school (except hard sciences). But they rely on your college successes as an indicator of your ability to persevere and learn.

This same system can be used to retrain your brain.

Oddly, I can do mental exercises about things that have no value to me but strengthen my brain, but I have a hard time doing physical exercise just for the sake of the exercise to strengthen my body.

There are more directed brain training systems available now. Brain Age makes programs for the Nintendo DS.

There are some more expensive systems such as http://www.positscience.com/products/
http://www.mindsparke.com/brain_fitness_pro.php
http://www.braintrain.com/
http://www.getrealresults.com/
and a residential program at http://www.arrowsmithschool.org/

These may be worthwhile for some but many of us can just choose to be inquisitive and work our brains. There are a few free online challenges. I like to do Numbrix puzzles at http://www.parade.com/askmarilyn/num...-20090617.html
Sudoku can also be a great exercise. Memorizing anything (math tables, poems, scripture, lyrics) can be helpful.

There is a concept called delight directed studies. It refers to how the brain will put extra effort into study and problem solving in areas of interest.

Now, go find something to challenge your brain.

btw, I have much more success with objective tasks and information. I struggle to process abstract ideas and information. This is a common problem with cognitive impairment. Puzzle pieces that fit are easier to work with than a hodgepodge of abstract tidbits.

Mark,

I found the alzhiemers forum that you belong to and read some of Jab's response to your question. Admitidely, it was so long and cumbersome that I didn't feel like reading all of it. However, I would like to comment on a couple of points that I consider important.

First, all of the information he gave pertains to the alhzeimer's population and not to the head injured population. I understand your concern about developing dementia due to your head injuries but please know that researchers have not found a direct linkage between head injuries and dementia. In one study I read about (I can't find the link anymore, my apologies) half of the subjects who had incurred a head injury got dementia later in life and the other half who had incurred the same level of head injury did not.

Second, I would be interested to find out what the credentials of JAB, who posted that information, are. I try not to make it a habit of taking the advice one person's perspective on a subject, especially someone who is not medically or scientifically trained. I found a link to another forum that discusses the same research article he refers to, but from a different point of view. I thought you might be interested to read it. http://www.imminst.org/forum/index.php?showtopic=562
. So, it seems that the same information can be interpreted differently, which is very common in science.

Third, alpha gpc is only used to restore the depleted acytalcholine levels in the brain that the 'nootropics cause, and not to raise the level. So, theoretically, your acetylcholine levels are never being raised because the nootropic is depleting them, and thus, an equilibrium occurs.

Fourth, *edit*. My intention is not to persuade but rather, merely to inform. With that in mind, you could also look into oxiracetam, which has been used more extensively for brain injuries. There is also cerebrolysin you could research. However, cerebrolysin is a bit more cumbersome because you have to inject it into your system.

JAB is highly respected for her research skills. She has been researching brain issues for years. In some situations she tends to be overly conservative, but her logic is usually very sound.

As I said, the studies that reviewed the published literature about aniracetam and other racetams determined that most of the published studies were poorly done. They looked at more than just Alzheimer's in the studies.

I just think it is important to note that most of the articles on Aniracetam are based on anecdotal or studies with weak study methodology.

If you compare the claims, you will find a circle of information. A repeats B who repeats C who repeats D who repeats A. It is hard to find any original studies except the rat studies. They have extrapolated on the rats studies and added anecdotal information.


An important concern I have is the ability of Aniracetam and Alpha GPC to cross the blood brain barrier without restriction.

This same problems shows up with 5-HTP when it is taken rather than L-Tryptophan. L-Tryptophan get metabolized by the body into 5-HTP in a regulated system.

There have been not long term studies with Aniracetam. Rats don't live long enough and the human anecdotal or poor methodology studies do not track the subjects long enough.

As good as it sounds, I am not willing to risk it. As I said, I was about to buy some.

It is not an issue of Big Pharma trying to block Aniracetam as is the case with many alternative treatments. The science is just weak.

I have a whole list of other articles I found but will not post due to copy/paste guidelines. Get creative with your Google search terms. Aniracetam, FDA, dementia, long term, etc. You will most likely find the same mix of conflicting studies. Notice the supporting studies often repeat much of the same information from an old study.

Regarding brain injury and Alzheimer's. They have not found a causal link but do notice a statistical connection between brain injury and a higher incident of Alzheimer's. I think this may be tied to an Alzheimer's diagnostic criteria that does not adequately exclude brain injury dementia but the studies don't make this claim.

Interested In China Source for Aniracetam
 

I would be interested in your source from China... Please email me back that information. Thanks much...

The website is alibaba. You can also run a google search: aniracetam, china suppliers. If you live in the States, may be tricky to import because they sell it in bulk and you are only allowed to import a 3 month supply legally.

Might you be able to post the links that Alpha GPC
increases plaque formation in Alzheimer's ?


On Alpha GPC. I have long wanted to give it, as an alternative
to CDP Choline, and ALCAR, benfotiamine, etc, to my vascular
demented father, but have been prevented by institutionalization
in a nursing home as well as by my elder brother, who has never
heard of life extension, let alone smart drugs and nutrients, and
trusts only doctors.


Since I am not allowed to post links yet due to forum restrictions on
new users, I will just post the Medline reference numbers, which could
be keyed into the search window :


19185780 - ALA, ALCAR, GPC, DHA and PS improves cognitive performance.

8477148 - Alpha GPC outperforms ALCAR in Alzheimer's.

1916007 - Alpha GPC outperforms citicholine in vascular dementia.