A novel CaV2.2 channel inhibition by piracetam in peripheral and central neurons

The mechanistic role of piracetam in the management of vascular dementia

Piracetam is a cyclic derivative of gamma aminobutyric acid, has a neuroprotective effect against neurodegenerative disease by inhibiting neuroinflammation. Piracetam augments the effect of acetylcholine on the muscarinic receptors thereby improving learning and memory. In addition, piracetam through modulation of ion channels increases the activity of different neurotransmitters involved in cognitive function. Excitingly, piracetam improves blood flow by increasing erythrocyte deformability and reducing adhesion of erythrocytes to the vascular endothelium by inhibiting fibrinogen; thus, it improves microcirculation and can be used in the management of vascular dementia (VaD). Also, piracetam improves cognitive function in VaD by reducing mitochondrial dysfunction and oxidative stress. Hence, piracetam has a neuroprotective effect against VaD. However, the exact neuroprotective mechanism of piracetam against the development and progression of VaD was not fully clarified. Consequently, this review attempts to discuss the potential effect of piracetam in VaD.

Prevention of Alzheimer's disease by treating mild cognitive impairment with combinations chosen from eight available drugs

Several hundred clinical trials of initially promising drugs have failed to produce meaningful clinical improvement of Alzheimer's disease (AD), which is probably because there are at least 25 biochemical pathways known to be aberrant that underpin the disease, and unless there is a single drug that addresses all or most of them, even promising drugs if given alone are unlikely to succeed. Because so many pathways are potentially at fault, it is quite possible that no treatment might succeed. However, because amnestic mild cognitive impairment (aMCI) often precedes AD and, assuming that those with aMCI who progress to AD commence with insufficient risk factors for AD but accrue them later, then it is likely that fewer pathways need addressing in aMCI than in AD to either prevent progression of aMCI to AD or effect its reversion. Published reports show that eight drugs, that is, dantrolene, erythropoietin, lithium, memantine, minocycline, piracetam, riluzole, and silymarin, address many of the pathways underlying MCI and AD. Among those eight drugs, combinations between either two or three of them have combined nonoverlapping actions that benefit enough of the approximately 25 pathways at fault so that their convergent efficacy has the potential to prevent aMCI from progressing to AD. The combinations should be subjected to a clinical trial in persons with aMCI to establish their safety and efficacy.