From the data reported in the literature , it emerges that nootropics may be an effective alternative for strengthening and enhancing cognitive performance in patients with a range of pathologies .
Although nootropics , and specifically the cholinergic precursors , already have a long history behind them , according to recent renewal of interest , they still seem to have a significant therapeutic role .
Drugs with regulatory indications for symptomatic treatment of Alzheimer 's disease , such as cholinesterase inhibitors and memantine , often have transient effects in dementia disorders .
Nootropics represent probably the first " smart drugs " used for the treatment of cognitive deficits .
The aim of this paper is to verify , by a systematic analysis of the literature , the effectiveness of nootropics in this indication .
The analysis was limited to nootropics with cholinergic activity , in view of the role played by acetylcholine in learning and memory .
Acetylcholine was the first neurotransmitter identified in the history of neuroscience and is the main neurotransmitter of the peripheral , autonomic , and enteric nervous systems .
Piracetam prevents cognitive decline in coronary artery bypass: a randomized trial versus placebo.
BACKGROUND Coronary artery bypass grafting ( CABG ) can be associated with postoperative cognitive impairment and ischemic stroke . No effective treatment is currently available . The aim of this study was to evaluate the effectiveness of piracetam to treat the cognitive impairment  after CABG in an investigator-initiated , double-blind , placebo-controlled , r and omized clinical trial . METHODS Patients undergoing CABG ( n = 98 ) were r and omized to placebo  ( n = 48 ) or  piracetam  ( n = 50 ) . Study drugs were administered intravenously ( 150 mg/kg daily ; 300 mg/kg on the day of surgery ) from the day before surgery to 6 days after surgery , then orally ( 12 g/day ) up to 6 weeks after surgery . Cognitive function was assessed before surgery ( baseline ) and 6 weeks after surgery ( outcome ) by using a battery of 12 neuropsychologic tests . The Spielberger Anxiety Inventory and the Beck Depression Inventory were also administered . The combined score derived from the st and ardized neuropsychologic assessment s was analyzed by using an analysis of covariance with baseline and education as covariates . RESULTS Six weeks after surgery , the combined score indicated a statistically significant treatment effect in the per protocol population ( 1.848 , p = 0.041 ) and a tendency towards statistical significance in the intent-to-treat population ( 1.624 , p = 0.064 ) in the group treated with piracetam , but no statistically significant treatment effect was seen in the placebo . The state of anxiety measured by the Spielberger Anxiety Inventory was decreased in both groups ( -9.27 and -6.37 in the placebo and piracetam groups , respectively ) . CONCLUSIONS Six weeks after CABG , cognition was significantly improved in patients treated with piracetam .  Additional trials are required to confirm these effects
From the data reported in the literature , it emerges that nootropics may be an effective alternative for strengthening and enhancing cognitive performance in patients with a range of pathologies .
Although nootropics , and specifically the cholinergic precursors , already have a long history behind them , according to recent renewal of interest , they still seem to have a significant therapeutic role .
Drugs with regulatory indications for symptomatic treatment of Alzheimer 's disease , such as cholinesterase inhibitors and memantine , often have transient effects in dementia disorders .
Nootropics represent probably the first " smart drugs " used for the treatment of cognitive deficits .
The aim of this paper is to verify , by a systematic analysis of the literature , the effectiveness of nootropics in this indication .
The analysis was limited to nootropics with cholinergic activity , in view of the role played by acetylcholine in learning and memory .
Acetylcholine was the first neurotransmitter identified in the history of neuroscience and is the main neurotransmitter of the peripheral , autonomic , and enteric nervous systems .