Nefiracetam

What Is Nefiracetam?

Nefiracetam is a synthetic pyrrolidone-type (“racetam”) nootropic developed as a cognition and mood agent. It is thought to act on cholinergic and GABAergic signalling and on calcium channels, and it has been marketed as a memory-enhancing compound. In practice its main published human evidence is not about healthy-user “memory enhancement” but about neuropsychiatric symptoms after stroke, where the results are genuinely mixed.

Evidence

In a double-blind trial in stroke patients with post-stroke depression, a subgroup meeting criteria for apathy (n≈70) was randomised to placebo, 600 mg/day or 900 mg/day nefiracetam; the 900 mg/day group showed significantly greater improvement in Apathy Scale scores ^{1Reference 1Robinson RG et al. · 2009RCTDouble-blind treatment of apathy in patients with poststroke depression using nefiracetam — randomised controlled trialView study →}. However, a later randomised, placebo-controlled, double-blind trial of 900 mg/day nefiracetam in non-depressed stroke patients with apathy did not find it more effective than placebo ^{2Reference 2Starkstein SE et al. · 2016RCTA Randomized, Placebo-Controlled, Double-Blind Efficacy Study of Nefiracetam to Treat Poststroke Apathy — randomised controlled trialView study →}. So the signal appears dependent on dose and on co-existing depression, and the overall picture is inconsistent. Common online claims of memory enhancement in healthy people were not supported by a citable trial in this pass.

Dosage & Safety

Doses in the cited trials were 600–900 mg/day under medical supervision ^{1,2Reference 1Robinson RG et al. · 2009RCTDouble-blind treatment of apathy in patients with poststroke depression using nefiracetam — randomised controlled trialView study →Reference 2Starkstein SE et al. · 2016RCTA Randomized, Placebo-Controlled, Double-Blind Efficacy Study of Nefiracetam to Treat Poststroke Apathy — randomised controlled trialView study →}; these are research protocols, not a personal recommendation, and there is no established over-the-counter supplement dose. Nefiracetam is not an approved dietary supplement or a generally approved medicine (it was investigated as a drug) — this entry is informational only. Toxicity is not yet characterised for general use here; interactions, pregnancy/lactation safety and long-term effects are not established.

References

1. Robinson RG, et al. (2009). Double-blind treatment of apathy in patients with poststroke depression using nefiracetam — randomised controlled trial. The Journal of Neuropsychiatry and Clinical Neurosciences. https://pubmed.ncbi.nlm.nih.gov/19622685/
2. Starkstein SE, et al. (2016). A Randomized, Placebo-Controlled, Double-Blind Efficacy Study of Nefiracetam to Treat Poststroke Apathy — randomised controlled trial. Journal of Stroke and Cerebrovascular Diseases. https://pubmed.ncbi.nlm.nih.gov/26915605/