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Reflections from a Med Student


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#151 fenra

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Posted 03 May 2013 - 05:23 AM

I for one would not mind having that bittersweet smell around me at all times... but I'm quite weird like that.

#152 NoopMed

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Posted 04 May 2013 - 03:53 PM

Just a couple clarifications I wanted to make about my current stack, due to one error in my last post and a lack of detail regarding a few other points. This resulted from trying to finish my post to quickly so I could return to studying: Basically in copying stuff from my logs, I failed to proofread and left in CDP-Choline which I don't use, forgot to change some of the dosage values for the CILTEP I use and left one component, didn't elaborate on the type of Magnesium I use, and left out a few other things-- including cannabis. My apologies, my time has been stretched lately.

So here's a more accurate current stack:

--Daily--

**Breakfast**

Core:
-120mg Ginkgo biloba

-1200mg Piracetam
-1 Scoop of Spark (500mg L-tyrosine, 500mg Choline bitartrate/citrate, 120mg caffeine, B vitamins, and other useful stuff.)
-1400mg Fish Oil (Containing 647 mg EPA, and 253mg DHA)
-1200mg Soy Lecithin
-10mg Loratadine

CILTEP: (Note: I weigh and fill my own capsules with the following ingredients. You may not be able to find premade capsules of these weights.)
-250mg Quercetin
-12mg Forskolin (20% purified extract from powder, total weight is greater)
-250mg L-Phenylalanine

(A special thanks to Abelard Linsday for efforts in researching CILTEP)

**Every 4.5 Hours After Breakfast**
(For me, this appears the be ideal time to re-dose Ginkgo and Piracetam and reinforce choline so that I have no reduction in performance.)
-800-1200mg Piracetam
-60mg Ginkgo biloba
-__X__ Choline Source (I've actually found the lecithin to be the most balanced, but I don't take it all the time due to high omega-6 fatty acid content, and my desire to keep a high omega-3 : omega-6 ratio for cardiovascular health. I find Alpha-GPC to be a bit strong for me, with some refractory dullness when it begins to wear off. Choline bitartrate is the mostly poorly absorbed, and while I find it to make a significant difference, it merely seems to maintain the baseline. Therefore I rotate, depending on the potency of choline precursor I need at the time. I'll switch between 300mg Alpha-GPC, 1200mg lecithin, and 500mg pure choline bitartrate-- these are listed in decreasing order of perceived effectiveness.)

--------------------------------------
Additional Components:

Analyze your diet. Use something like FitDay (http://www.fitday.com/) or Choose My Plate (http://www.choosemyplate.gov) to educate yourself on a balanced, healthy nutrition. I've considered myself a health-conscious eater most of my life, and I've had dozens of classes on nutrition even recently in medical school, but I was surprised to find significant gaps and excesses when I plugged in a week of meals into one of these calculators. The meal calculator on FitDay was useful for me to pinpoint specific vitamin gaps in my diet, like Calcium, Potassium, and Magnesium. Many vitamins are critical for neurotransmission, and deficiency can lead to sub optimal performance and even unwanted side effects as you push your brain with these stacks. For things like Calcium, Potassium, Sodium, Magnesium, and other water soluble vitamins (most OTHER THAN D, E, A, and K) some of the daily recommended values should probably be higher if you drink a lot of coffee, as high caffeine intake [a diuretic] can wash out some of these water soluble vitamins.

**Rare Use**
Stimulant-- (Used sparingly to amplify the above stack.)
-150mg Armodafinil (Taken early in the morning on a power-study day. Not taken on consecutive days.


Approximately 2-6 times per Month (Use sparingly during relaxation, not while actively studying.):
-100mg Cannabis (vaporized) (This is a much broader topic, perhaps some day I'll have time to discuss neuroplasticity, synaptic pruning, and LTD. Basically this acts as a potential counter balanced to CILTEP, I suppose you could consider it CILTED...)


Approximately Once Per Month, taken over two days.
1500mg ALCAR

-------------------------------------------

Edited by NoopMed, 04 May 2013 - 03:57 PM.

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#153 NoopMed

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Posted 04 May 2013 - 07:25 PM

Also, another addition to this in regard to Armodafinil:

It should be noted that Modafinil has been shown to interfere with the benefits of Forskolin CILTEP. This is probably similar for the purified enantiomer armodafinil, but has not been specifically studied.
Abelard discusses this a bit here: http://www.longecity...sm/#entry548197

From anecdotal view, I notice that when I take Armodafinil and take practice exams my rote memory recall is enhanced, but my problem solving ability is often a bit reduced. In the on words, on some questions I feel that I recognize certain answers with greater certainty than I'm normally capable of, while on other questions, I mistakenly latch onto the wrong point of recognition (generally a red herring-- a trick question) and follow the incorrect logical route to select the incorrect answer. In many traditional college exams this is fine because they ask pointed, first-level questions. I.e. "Disease X presents with which of the following symptoms? A, B, C, or D?" These kind of questions are almost never present on board exams, as tertiary level questions are preferred. For example, "Patient presents with symptom X, Y, and Z. He is treated with a drug, and returns a week later. His original condition is improved, but he now has symptoms A, B, and C. You find out he has a history of ____ Disease. Through what mechanism is this patient's new medication interacting with another medication he is likely being treated with but forgot to mention?" These kind of questions require multiple instances of rote recall, which to my understanding is hippocampus driven, however; they also obviously require a great deal of executive thought and problem solving to successfully integrate the right data into a solution.

Learning and successful exam performance are a balance of many neural activities. Armodafinil presents a double edged sword in this case, and this is one of the reasons why I don't include it regularly in my stack. Some days you simply need to reset your circadian rhythm and power through a lot of information that simply needs to be memorized. Days like that probably benefit from modafinil, but on days where you're learning to integrate and execute information for top exam performance it should probably be avoided.

Edited by NoopMed, 04 May 2013 - 07:29 PM.


#154 deh707

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Posted 04 May 2013 - 08:47 PM

Also, another addition to this in regard to Armodafinil:

It should be noted that Modafinil has been shown to interfere with the benefits of Forskolin CILTEP. This is probably similar for the purified enantiomer armodafinil, but has not been specifically studied.
Abelard discusses this a bit here: http://www.longecity...sm/#entry548197

From anecdotal view, I notice that when I take Armodafinil and take practice exams my rote memory recall is enhanced, but my problem solving ability is often a bit reduced. In the on words, on some questions I feel that I recognize certain answers with greater certainty than I'm normally capable of, while on other questions, I mistakenly latch onto the wrong point of recognition (generally a red herring-- a trick question) and follow the incorrect logical route to select the incorrect answer. In many traditional college exams this is fine because they ask pointed, first-level questions. I.e. "Disease X presents with which of the following symptoms? A, B, C, or D?" These kind of questions are almost never present on board exams, as tertiary level questions are preferred. For example, "Patient presents with symptom X, Y, and Z. He is treated with a drug, and returns a week later. His original condition is improved, but he now has symptoms A, B, and C. You find out he has a history of ____ Disease. Through what mechanism is this patient's new medication interacting with another medication he is likely being treated with but forgot to mention?" These kind of questions require multiple instances of rote recall, which to my understanding is hippocampus driven, however; they also obviously require a great deal of executive thought and problem solving to successfully integrate the right data into a solution.

Learning and successful exam performance are a balance of many neural activities. Armodafinil presents a double edged sword in this case, and this is one of the reasons why I don't include it regularly in my stack. Some days you simply need to reset your circadian rhythm and power through a lot of information that simply needs to be memorized. Days like that probably benefit from modafinil, but on days where you're learning to integrate and execute information for top exam performance it should probably be avoided.



Your explanation on Modafinil (Armodafinil, in your case) is spot on, in my opinion.

Whether it's 50mg, 100mg, 150mg, or 200mg Modafinil, there is always that "dull but awake, robotic" feeling. It's no wonder they call it the "grunting/grinding drug". It's marvelous in assisting with doing long, repetitive tasks that do not require too much creativity or thinking outside the box. More like a "doing what I'm programmed/know how to do already".

However, at 50mg, that side effect is nowhere near as severe as 100mg-200mg is. It seems to be the perfect dose universally. I wonder how 25mg would do.

Also, I find that piracetam helps with the creativity-dullness induced by Modafinil. For me, at least.

As for my Armodafinil experience. To put it simply, nothing happens until the 2 hour mark. By this time, it feels like a first-time caffeine rush, lasting an hour or two, then fades into a pretty irritating crash. This is not for me.

Just my 2 cents.

Edited by deh707, 04 May 2013 - 08:49 PM.


#155 NoopMed

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Posted 20 May 2013 - 03:00 PM

--Update--

After trying CILTEP for about a month in total now, I've decided to drop it from my current stack. For the first week and half it was an excellent addition, providing remarkably improved stamina and enhancement of my core stack, but it gradually resulted in a decreased attention span and what actually felt like impaired memory encoding. My ability to sustain study focus and perform well on practice exams throughout the day was markedly diminished after about 1.5 weeks-- and what first made me suspicious of CILTEP as the culprit was the fact that I would begin to regain focus in the evenings, presumably as the CILTEP component began to wear off. In my normal stack, my focus would diminish gradually and predictably throughout the day-- what would normally be expected in a circadian rhythm. I tried switching from Quercetin to Artichoke extract for luteolin PDE4 inhibition. I also tried substituting mesembrenone for this purpose. These changes resulted in an even greater decrease in focus and motivation, likely attributable to the removal of Quercetin's caffeine-like effect on adenosine receptors. I also tried using Sunifiram and Phenylpiracetam (separately) in addition Piracetam, as these have reportedly enhanced CILTEP, anecdotally. None of these modifications ameliorated the lack of focus and I was experiencing. I also began to experience apathy, agitation, and depression. (This was relieved by St. John's Wort, which leads me to believe some sort of serotonin depletion was at work, but that wasn't a prudent solution for sustained cognitive performance.) After a solid try with CILTEP, I removed it, and returned to my old self after about 2-3 days using only the elements of my core stack. It's possible that there are conflicts with CILTEP and other elements of my stack, but I don't have the time right now to extensively research and sort out the issue as board exams are imminent. It might simply be the modality of learning/testing/cognition I'm focused on improving, which is heavily dependent on rote memorization of facts and rapid deductive reasoning-- i.e. less "right brain," creative cognition, and conditioned motor/skill learning-- and TONS of raw, declarative memorization, recall, pattern recognition, and cold deductive reasoning. (To this regard, I did note improved musical creativity and performance accuracy throughout my use of CILTEP. This diminished on cessation of CILTEP, which was disappointing, but for now I need to function much more akin to Sherlock & Kasparov than to Miles Davis and Van Gogh...) It may also simply be that my own neurochemistry is incompatible. Regardless, this is what I'm working with now. Note that I have reduced my Ginkgo dosage temporarily, as it has been my past experience that cycling off or at least switching to a lower dosage yields higher performance when the dosage is increased acutely-- ie. days immediately before an exam. This probably has something to do with tolerance to the proposed ability of Ginkgo to enhance norepinephrine transmission. I've also added in a conservative amount of Pramiracetam, Noopept, L-glutamine, and Armodafinil for a bit of kick in these last few weeks of intense studying. Noopept has classically diminished my focus mildly, likely through its GABAergic activity in the hippocampus. Some anecdotes report this effect diminishing with habitual use. Either way, the small amount of L-glutamine and armodafinil seem to negate this adverse effect.

**Breakfast**

-60mg Ginkgo biloba
-37.5mg Armodafinil
-1200mg Piracetam
-200mg Pramiracetam
-10mg Noopept
-1 Scoop of Spark (500mg L-tyrosine, 500mg Choline bitartrate/citrate, 120mg caffeine, B vitamins, and other useful stuff.)
~300mg L-glutamine
-1400mg Fish Oil (Containing 647 mg EPA, and 253mg DHA)
-1200mg Soy Lecithin
-10mg Loratadine


**Every 4.5 Hours After Breakfast**
-800-1200mg Piracetam
-10mg Noopept
-200mg Pramiracetam (Only once maintence dose, as the half life is longer than other racetams)\
-30mg Ginkgo biloba
-500mg Choline bitartrate
~300mg L-glutamine

----------------------------------------

--Also of significant note--
I've been trying out a new bed time stack with the goal of upregulating the population of specific neurotransmitters while I sleep... and also to aid with sleep after a long day of noots, of course.

-13.5mg Diphenhydramine (benedryl) (BBB soluble H1 Histamine and M1-3 Acetylcholine antagonist)
-16mg Magnesium from 222mg Magnesium Threonate (NDMA Glutamate antagonist)
-1mg Melatonin (Mild sleep aid)
-50 mg L-Theanine (Probable GABA agonist, among other effects.)

The use of the above acetylcholine and glutamate receptor antagonists should in theory aid in upregulating the population of these receptors. Several studies show this occurring dramatically with scopolamine. The doses here are very small, so this desired effect is also probably very small, but I don't want lingering antagonism in the morning. I sleep very well with this addition, and after a few days seem to experience an increased sensitivity to racetams, along with increased cholinergic side effects--thus needing less choline probably. (This is possibly placebo, or possibly just due to a very deep sleep-- though I only sleep for about 6-7 hours. Either way, I can't complain.) You may scoff at the absolutely tiny dose of Mg-Threonate I'm using, but I seem to experience a very potent effect with this supplement that has negative consequences if I'm not careful. The bottle from Jarrow recommends taking 3 666mg pills for a total of 2g Mg Threonate containing 144mg of Mg that should theoretically be delivered quite efficiently into the CSF. Perhaps it's just incredibly soluble through my particular BBB, but when I took that recommended dose I experienced profound relaxation and an absolute inability to study or test. I felt supremely sedated. I'm convinced it just shut down all my NMDA channels! Even one pill at night left me a bit foggy in the morning. I've taken these pills and divided them into thirds, divided the benedryl into halves, crushed up some melatonin, divided the L-theanine in half, mixed thoroughly and loaded into capsules.

---------------------------------------

That's all for now. Happy neuron hacking!

Edited by NoopMed, 20 May 2013 - 03:03 PM.

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#156 leftside

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Posted 21 May 2013 - 11:57 PM

I'm glad I'm not the only one who also gets similar effects from Magnesium. Like you, just one of those pills at night would leave me feeling foggy the next day. I've tried multiple different brands/combos. I tried it for a month with just one pill, but always felt foggy the next day. As soon as I stopped taking it I was ok again.

#157 stablemind

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Posted 22 May 2013 - 12:08 AM

Just a couple clarifications I wanted to make about my current stack, due to one error in my last post and a lack of detail regarding a few other points. This resulted from trying to finish my post to quickly so I could return to studying: Basically in copying stuff from my logs, I failed to proofread and left in CDP-Choline which I don't use, forgot to change some of the dosage values for the CILTEP I use and left one component, didn't elaborate on the type of Magnesium I use, and left out a few other things-- including cannabis. My apologies, my time has been stretched lately.

So here's a more accurate current stack:

--Daily--

**Breakfast**

Core:
-120mg Ginkgo biloba

-1200mg Piracetam
-1 Scoop of Spark (500mg L-tyrosine, 500mg Choline bitartrate/citrate, 120mg caffeine, B vitamins, and other useful stuff.)
-1400mg Fish Oil (Containing 647 mg EPA, and 253mg DHA)
-1200mg Soy Lecithin
-10mg Loratadine

CILTEP: (Note: I weigh and fill my own capsules with the following ingredients. You may not be able to find premade capsules of these weights.)
-250mg Quercetin
-12mg Forskolin (20% purified extract from powder, total weight is greater)
-250mg L-Phenylalanine

(A special thanks to Abelard Linsday for efforts in researching CILTEP)

**Every 4.5 Hours After Breakfast**
(For me, this appears the be ideal time to re-dose Ginkgo and Piracetam and reinforce choline so that I have no reduction in performance.)
-800-1200mg Piracetam
-60mg Ginkgo biloba
-__X__ Choline Source (I've actually found the lecithin to be the most balanced, but I don't take it all the time due to high omega-6 fatty acid content, and my desire to keep a high omega-3 : omega-6 ratio for cardiovascular health. I find Alpha-GPC to be a bit strong for me, with some refractory dullness when it begins to wear off. Choline bitartrate is the mostly poorly absorbed, and while I find it to make a significant difference, it merely seems to maintain the baseline. Therefore I rotate, depending on the potency of choline precursor I need at the time. I'll switch between 300mg Alpha-GPC, 1200mg lecithin, and 500mg pure choline bitartrate-- these are listed in decreasing order of perceived effectiveness.)

--------------------------------------
Additional Components:

Analyze your diet. Use something like FitDay (http://www.fitday.com/) or Choose My Plate (http://www.choosemyplate.gov) to educate yourself on a balanced, healthy nutrition. I've considered myself a health-conscious eater most of my life, and I've had dozens of classes on nutrition even recently in medical school, but I was surprised to find significant gaps and excesses when I plugged in a week of meals into one of these calculators. The meal calculator on FitDay was useful for me to pinpoint specific vitamin gaps in my diet, like Calcium, Potassium, and Magnesium. Many vitamins are critical for neurotransmission, and deficiency can lead to sub optimal performance and even unwanted side effects as you push your brain with these stacks. For things like Calcium, Potassium, Sodium, Magnesium, and other water soluble vitamins (most OTHER THAN D, E, A, and K) some of the daily recommended values should probably be higher if you drink a lot of coffee, as high caffeine intake [a diuretic] can wash out some of these water soluble vitamins.

**Rare Use**
Stimulant-- (Used sparingly to amplify the above stack.)
-150mg Armodafinil (Taken early in the morning on a power-study day. Not taken on consecutive days.


Approximately 2-6 times per Month (Use sparingly during relaxation, not while actively studying.):
-100mg Cannabis (vaporized) (This is a much broader topic, perhaps some day I'll have time to discuss neuroplasticity, synaptic pruning, and LTD. Basically this acts as a potential counter balanced to CILTEP, I suppose you could consider it CILTED...)


Approximately Once Per Month, taken over two days.
1500mg ALCAR

-------------------------------------------


Why do you only use ALCAR once per month?

#158 chung_pao

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Posted 22 May 2013 - 01:24 PM

Why do you only use ALCAR once per month?


He explained this earlier in the thread, with reference to a "carnitine pool" that seldom needs to be replenished.

To Noopmed:
Thanks for keeping such an informative log here on Longecity. It really helps those of us with similar goals.
I'm 23 and working hard to get admitted to medschool in Sweden right now.
The latest explanation on the addition of magnesium, theanine and melatonin before bed was really useful.

Since, I've also implemented my own version of a receptor recovery-stack before sleep, built around magnesium, theanine and gaba.
Instead of melatonin I do cold baths though. It really contributes to the quality of my sleep, along with hormonal and miscellaneous benefits.

This really seems to help with resensitizing the receptors for the following day.

Your stack is really effective, and I've copied most of it a few times.
But there's just one thing missing in your log: an explanation on the addition of pramiracetam.
You first wrote it made you too "speedy", and you were adverse to it because of the NO-induced neurotoxicity.
What made you implement it after all?
Also, what effects have you felt from it? How has it contributed?

Edited by chung_pao, 22 May 2013 - 01:32 PM.

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#159 NoopMed

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Posted 22 May 2013 - 03:21 PM

Why do you only use ALCAR once per month?


He explained this earlier in the thread, with reference to a "carnitine pool" that seldom needs to be replenished.

To Noopmed:
Thanks for keeping such an informative log here on Longecity. It really helps those of us with similar goals.
I'm 23 and working hard to get admitted to medschool in Sweden right now.
The latest explanation on the addition of magnesium, theanine and melatonin before bed was really useful.

Since, I've also implemented my own version of a receptor recovery-stack before sleep, built around magnesium, theanine and gaba.
Instead of melatonin I do cold baths though. It really contributes to the quality of my sleep, along with hormonal and miscellaneous benefits.

This really seems to help with resensitizing the receptors for the following day.

Your stack is really effective, and I've copied most of it a few times.
But there's just one thing missing in your log: an explanation on the addition of pramiracetam.
You first wrote it made you too "speedy", and you were adverse to it because of the NO-induced neurotoxicity.
What made you implement it after all?
Also, what effects have you felt from it? How has it contributed?



Cold bath is actually a very legitimate strategy to aid in sleep. One of my professors suggested this in his lecture on sleep medicine. Colder environmental temperature may correlate with an endogenous release of melatonin-- specifically he mentioned that the transition from hot to cold may be the key, and even added that a hot shower, with a few minutes of switching to very cold water at the end might have the best effect. In addition, a cool room temperature with significant air circulation provide the best environment for a healthy sleep cycle-- as long as the air circulation isn't so much as to dry out your mucous membranes excessively while you sleep.

In regard to pramiracetam & phenylpiraracetam. I do still find these too speedy for daily use, but the longer half life of pram. and possible cross reactivity with adrenergic receptors in phenyl. are a nice short term boost as I cruise into the final weeks of studying for the big test. In regard to the NO upregulation and neurotoxicity... After reading up on the matter, I don't think the elevation in nNOS is going to be significant enough to cause any damage, especially with the doses I'm taking. I'm not even really sure it could elevate high enough at exceptionally high doses in vivo. From what I recall, that study was done in vitro with an extremely high concentrations. There's a whole thread on here discussing this concern, and that seemed to be the consensus.

In regard to ALCAR-- thanks for reiterating there. That's correct, I just try to maintain my carnitine pool, though if you read below I've actually found out a little more about it. In general, once per month is not a hard and fast rule, I've just found sporadic usage to be more beneficial than chronic usage. I note that when I don't take any for a few weeks, and then proceed to take 500-1000mg, I get a significant boost in some cognitive elements-- such as rote recall and memory integration that seems to last for a while, but after if I take it chronically, I tend to have a decrease in cognition usually in the form of some increased difficulty naming objects or people for example-- even though I "know" on some level exactly what I'm trying to say. A study I read recently indicates that ALCAR acts to upregulate a subtype of NMDA glutamate channel in the cortex, specifically-- but not in the hippocampus or other areas of the brain. I can see this being beneficial for cognition, but also pose the risk of a decreased "signal to noise ratio" in neurotransmission. I don't have a thorough explanation beyond that, but I just know it's what seems to work best for me. In fact, instead of saying, "once per month," a more accurate statement would be that I'm attuned enough to my cognition because of constant exams to know how my stack is performing for me, and when I begin to notice a decline in performance a day or two of ALCAR supplementation seems to put me back on track.

Finally, in regard to Magnesium threonate. I re-read some of the original publication from MIT (from the creator of this compound) and wasn't too surprised to find that they found acute high dosage to actually cause no change or even decrease performance in their rats. It was only after chronic high dosage that a benefit was noted, and that benefit looked pretty significant. This makes sense as Magnesium is acting as an "antagonist" to NMDA glutamate channels-- it's a little more complicated than antagonism because it's actually performing a natural "ball-valve" type function in these channels that assures they stay closed until the membrane depolarizes enough to eject the magnesium molecule-- I'm assuming it's something like: too much Mg--> too much ball in the valve--> higher voltage threshold for release--> less chance of firing--> NMDA receptor density becomes upregulated over time. Ball valve probably is the most accurate analogy, but you get the idea... it's basically keeping the receptor inactive until enough glutamate AMPA receptor stimulation has depolarized the neuron membrane to the point where the net charge is positive enough to release the Mg molecule and allow the NMDA receptor to become sensitive to glutamate. Due to my current short term goals, inhibition from MgThr is not going to play a significant part for me, and I may even remove the small amount I take at night. I definitely experience dramatic cognitive inhibition when I take this supplement, but I've only taken it in the recommended doses for a day or two at a time. However, once I have a week or two to relax and the pressure of exams is behind me, perhaps I'll give it a decent shot and power through the fog to the gains it may provide with chronic administration. If anyone has experience with long term, high dose (aka the recommended dose on the bottle of about 2000mg MgThr (144mg elemental magnesium)) please let me know what you think.
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#160 nuc

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Posted 23 May 2013 - 08:01 PM

I'm afraid you will always be able to benefit from cannabis while on noots, but you will never be able to benefit from noots if you continue taking cannabis. Take my word on this one, you are wasting your money on noots as long as you keep using cannabis.
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#161 NoopMed

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Posted 23 May 2013 - 08:23 PM

I'm afraid you will always be able to benefit from cannabis while on noots, but you will never be able to benefit from noots if you continue taking cannabis. Take my word on this one, you are wasting your money on noots as long as you keep using cannabis.


Got anything to add to that?


(Unfortunately, I accidentally upvoted this post while trying to click downvote on my smartphone and cannot remove the +1... Must have been all the cannabis.)

Edited by NoopMed, 23 May 2013 - 08:26 PM.


#162 nuc

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Posted 24 May 2013 - 06:12 PM

lol
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#163 Sholrak

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Posted 24 May 2013 - 07:19 PM

I'm afraid you will always be able to benefit from cannabis while on noots, but you will never be able to benefit from noots if you continue taking cannabis. Take my word on this one, you are wasting your money on noots as long as you keep using cannabis.


I agree. Doesn't mean it makes them not work, but with time, you'll realize that all nootropics have a sinergy with cannabis (as mostly all hard and not hard drugs) and it will let you gain the benefits, but with time all the benefits will get "encapsuled" in a limit that is the cannabis. I haven't tried any nootropics without being in pot, and that will change for a time, I'm sure the will be more benefitial and in some time I could start less frequently to smoke. Realize, cannabis stays in the organism 14 DAYS. That's a huge amount of time, probably it's mechanism is unique.

Always had the sensation that marijuana is an edge drug and literally it carries you to other world, emotional, sensorial, of thinking... But sometimes is needed a stop. If you smoke cannabis every day, no matter what you take to counter that, you'll be high and missing things in life every day.



Anyone has done DMT here? I'm curious in trying this some day, when I feel I'm ready, to see if it can bring memories from the deep of my mind lost much much time ago, and others that never remembered and I don't know. Can have nootropic effect or not?
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#164 NoopMed

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Posted 24 May 2013 - 08:50 PM

I'm afraid you will always be able to benefit from cannabis while on noots, but you will never be able to benefit from noots if you continue taking cannabis. Take my word on this one, you are wasting your money on noots as long as you keep using cannabis.


I agree. Doesn't mean it makes them not work, but with time, you'll realize that all nootropics have a sinergy with cannabis (as mostly all hard and not hard drugs) and it will let you gain the benefits, but with time all the benefits will get "encapsuled" in a limit that is the cannabis. I haven't tried any nootropics without being in pot, and that will change for a time, I'm sure the will be more benefitial and in some time I could start less frequently to smoke. Realize, cannabis stays in the organism 14 DAYS. That's a huge amount of time, probably it's mechanism is unique.

Always had the sensation that marijuana is an edge drug and literally it carries you to other world, emotional, sensorial, of thinking... But sometimes is needed a stop. If you smoke cannabis every day, no matter what you take to counter that, you'll be high and missing things in life every day.



Anyone has done DMT here? I'm curious in trying this some day, when I feel I'm ready, to see if it can bring memories from the deep of my mind lost much much time ago, and others that never remembered and I don't know. Can have nootropic effect or not?



It's true that if you smoke cannabis all day, every day you will experience significant inhibition of learning and cognitive performance-- along with risk of mood disorder and serious amotivation. I would never recommend high dose, daily, diurnal usage outside the serious, medically therapeutic settings such as the role of cannabis as a chemotherapy antiemetic or HIV orexogenic. Nootropic drug use, in my experience, has never been intended to counter adverse effects of cannabis. Rather, I have found that very conservative cannabis use can augment peak potential and provide sustained efficacy for the other elements of my stack. The only things that encapsulate Nootropic "potential", what I'm assuming you mean as drug efficacy, are the pharmacologic properties of the particular nootropic drug in question and the neurologic potential of the individual in using them.

Secondly, the metabolism and receptor interactivity of THC is variable and progressively adaptive. Metabolism and elimination from the body can vary from about 2-60 days depending on factors like body fat percentage, liver and kidney function, and diet. The mechanism cannabinoid receptor activity and the activation of CB/CB2 receptors in response to blood THC concentration is somewhat unique and still being explored, but the pharmacoketic properties and mode of elimination are not a mystery. You can read about them extensively on Wiki and PubMed.

Seems that we're drifting from the original intent of this thread a bit... but DMT is a psychedelic hallucinogen, not a nootropic. I've never tried it, nor do I plan to. There's a realm of thought concerning philosophies of cognitive experience and the enhancement of the "the human experience" involving psychedelics, but that is beyond the scope of my intents in this thread. While the neuropharmacologic properties of psychedelics are interesting to discuss, I'd rather stick to nootropics here.

Please try to offer constructive discussion, ideally of the clinical or biomedical, evidenced-based science variety. I get the feeling this thread may be starting to slip into a tone that I'm no longer interested in being a part of. Bound to happen eventually, I suppose.
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#165 PTShapeShifter

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Posted 25 May 2013 - 05:19 AM

I have personally found that 50mg Picamillon, a known GABAergic precursor, seems to help me mitigate the mild 'hangover' mood disorder symptoms associated with occasional cannabis use.

Recent studies cited in PubMed, see below, seem to bear this out citing the success of GABApentin in reducing withdrawal symptoms of chronic cannabis users seeking to reduce their consumption. Also "

Gabapentin was also associated with significantly greater improvement in overall performance on tests of executive function (p=0.029). This POC pilot study provides preliminary support for the safety and efficacy of gabapentin for treatment of

cannabis

dependence." cite:

http://www.ncbi.nlm.nih.gov/pubmed/22373942
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#166 NoopMed

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Posted 25 May 2013 - 12:21 PM

I have personally found that 50mg Picamillon, a known GABAergic precursor, seems to help me mitigate the mild 'hangover' mood disorder symptoms associated with occasional cannabis use.

Recent studies cited in PubMed, see below, seem to bear this out citing the success of GABApentin in reducing withdrawal symptoms of chronic cannabis users seeking to reduce their consumption. Also "

Gabapentin was also associated with significantly greater improvement in overall performance on tests of executive function (p=0.029). This POC pilot study provides preliminary support for the safety and efficacy of gabapentin for treatment of

cannabis

dependence." cite:

http://www.ncbi.nlm....pubmed/22373942



Interesting stuff. Any experience with Phenibut? Gabapentin and Baclofen are derivatives of GABA, and both are widely used in clinical neurology-- generally in the setting of treating neuropathic pain and neuromuscular disorders. Should be similar in concept I would think, as phenibut is a similar derivative. Picamilon is a chimera of niacin and GABA that helps deliver GABA to the brain.
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#167 Gnibja

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Posted 25 May 2013 - 12:52 PM

This isn't bluelight or drugsforum; lets keep the subject beneficial so Noop can continue to provide us the quality knowledge we've come to expect from this thread.
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#168 NoopMed

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Posted 25 May 2013 - 11:27 PM

1st Full Practice USMLE Step One Exam Complete!
(4 blocks from paid NBME practice database, plus 3 additional blocks of UWorld QBank to simulate full 322 question, 8 hour length.)

Breakfast:
-Oatmeal with Blueberries and 2g Lecethin
-1 Scoop Spark (http://www.advocare....tive/A2094.aspx)
~60mg additional caffeine anhydrous
-Small glass of Grapefruit juice (p450 inhibitor, slows caffeine metabolism, hopefully counters some of modafinil p450 induction)
-2.4g Piracetam
-60mg Ginkgo biloba
-200mg Modafinil

-1 hour of shower and prep... (feeling really jacked... probably too much caffeine for the grapefruit juice.)

**Exam Blocks 1-3** (1 block of UWorld and first 2 blocks of USMLE-- 3 hours)

Break 1 (10 minutes total for food/drink/maintenance dose/bio-break):
-1 Scoop Spark
-1.2g Piracetam
-30mg Ginkgo biloba
-Zone brand Protein Bar 40/30/30% carbs/protein/fat
-Handful of Almonds

**Blocks 4&5** (Both from NBME exam)

Break 2 (15 minutes)
-1 Scoop Spark
-800mg Piracetam
-30mg Ginkgo
-1 Double-stack peanut butter and jelly sandwiche (3 pieces of bread, Jif creamy, and raspberry preserves...mmm)

**Blocks 6&7** (Both from UWorld. Felt like it was losing focus a lot here, but still scored higher than my first UWorld. Definitely getting tired/frustrated/bored.)

DONE!


Results:
-USMLE 4-Block Practice Test: 630, translating to Step Score of 252.
-UWorld QBanks Scores 85/87/91%, probably translating to a similar score, but no way to tell really.


In summary, a very successful day! If I can score 240+ on the real deal, my choice of specialty will be very open.
For reference: the highest Step One USMLE score average for a specialty on the most recent, easily accessible report(2011) was in Plastic Surgery, with an average of 250.

With these long exams, one thing I note is a gradual decrease in my "dedication/sureness" to an answer coinciding with a gradual increase in my scores throughout the day. I experienced this on a half-length simulation, and in QBank while studying daily. Probably correlates with an increasing awareness of variables and alternative answers to questions throughout the day...aka higher levels of integration and broader differential formation. Uncertain at this point if this is simply a product of "warming up," or if I should be taking my breakfast stack a longer time before the start of the exam. Practice makes perfect.

Edited by NoopMed, 25 May 2013 - 11:28 PM.

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#169 MasterHerb

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Posted 27 May 2013 - 02:06 AM

Why did you replace Armodafinil with Modafinil?

#170 NoopMed

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Posted 28 May 2013 - 06:00 PM

Why did you replace Armodafinil with Modafinil?



I have both and wanted to give each one a try in my full length practice runs. Armodafinil is likely the better choice and seemed to work better for me on past exams. The effects seem much more refined and steady throughout the therapeutic window. Traditional modafinil seems to provide more of a stimulant-type effect for me, but also seems to aggravate my allergies more. I will likely use Armodafinil in my next run through, but just wanted to be thorough and give regular modafinil a shot, since I hadn't used it on a full length exam before.
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#171 nuc

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Posted 28 May 2013 - 10:31 PM

Let me ask you something. Before i ask, i will clarify that i'm not asking if you enjoy reading, or if reading is enjoyable compared to other things, but rather if you were to read a book would you be able to enjoy reading it in a sense that your mind pleasantly draws out the picture?
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#172 NoopMed

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Posted 28 May 2013 - 11:03 PM

Let me ask you something. Before i ask, i will clarify that i'm not asking if you enjoy reading, or if reading is enjoyable compared to other things, but rather if you were to read a book would you be able to enjoy reading it in a sense that your mind pleasantly draws out the picture?


I'll let the prolific Levar Burton answer that query for me:



I predominately read science fiction and fantasy.

#173 chung_pao

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Posted 29 May 2013 - 01:14 AM

Wanna give some examples of good scifi or fantasy reading? I find It helps me wind down and divert the mind from main goals, such as work or study.
Good reads would be of much help.

#174 nuc

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Posted 29 May 2013 - 06:10 AM

Let me ask you something. Before i ask, i will clarify that i'm not asking if you enjoy reading, or if reading is enjoyable compared to other things, but rather if you were to read a book would you be able to enjoy reading it in a sense that your mind pleasantly draws out the picture?


I'll let the prolific Levar Burton answer that query for me:
http://youtu.be/-FD1K8OvVCs


I predominately read science fiction and fantasy.


In that case, may i suggest you lower your cannabis dosage to 65-75mg, and if you plan on vaporizing, do it 1 hour before you sleep while allowing yourself to watch 2 anime episodes of anime. Then in the morning when you are back on your nootropic stack, your mind should have far less tension and would make learning much easier as you have managed to make a break in reality for the past couple of hours without using as much energy as you usually would when reading a book.
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#175 NoopMed

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Posted 30 May 2013 - 04:03 AM

I recently really enjoyed reading Hyperion by Dan Simmons, as well as the sequel Fall of Hyperion. Perdido Street Station and the sequel The Scar by China Mieville are also excellent reads if you're looking to really delve into some of the most descriptive fantasy/adventure writing I've encounter recently... to '"'pleasantly' or perhaps 'unpleasantly' draw out a remarkable and somewhat terrifying picture..."

As far as my mind using more or less energy-- I prefer it to use as much as possible, all the time. If you think reading a book expends too much energy at night, you might want to consider what REM sleep is doing. In general I try to treat my mind like a small city. The neurons are homes, factories, offices, etc...Cheezy, I know... But, you use them or you lose them. If you don't maintain them constantly, they fall into disrepair-- nobody wants to use them, nobody remembers what they were for. Build them, reinforce them, and supply them with the raw materials to become more intricate and more robust, and give your neuron city an unrelenting sense of purpose-- do this, and your city will likely outshine and outlast not only your expectations, but the expectations of those around you. Maybe I'm crazy, but my mind has never been happier, wittier, more precise nor more creative than when it has been working hard(pushed to learn, study, read, and critically think under pressure) for many days while getting a reasonable amount of rest(sleep), oxygen(exercise), and nutrition(diet). Overutilization is not my concern, nor do I think it's possible... I only dread the day when I grow old, become soft, and the inevitable grasp of Entropy finally takes hold of the biologic elements of mind and body; elements like genetic stability in the absence of malignant, cancerous proliferation, which science has yet to fully understand and reinforce. Entropy will eventual grasp, tighter and tighter to any organized, endergonic creation of this universe, and the more diligently we work against that, the longer order and function can be maintained-- the mind is not excluded from this. Now, I've gone and delved into metaphysics... which can likely be explained by the following:

I got some Picamilon today! It was very pleasant with the stack. I FELT much more relaxed and focused than usual, however this didn't seem to translate into better exam scores. I scored roughly equivalent. I did feel more motivated in general, more creative, and less stressed out. I was making connections and happening upon observations about life and my daily activities that I'm not normally aware of. It's difficult to describe, but I felt more "functional," logical, and practical in general. I would describe it as a pretty significant and positive alteration in my mood and general disposition. However, I also noticed myself failing to make some of the subtle (perhaps hidden) connections in exam questions regarding knowledge I definitely knew (upon reviewing the correct answers). These were the sort of connections that are easy to miss when moving quickly, and I was moving at a good clip; feeling a subjective sense of reading material more easily and completing questions more quickly (as per the timer). I would say Picamilon effectively blurred some of the small details I normally catch while simultaneously clarifying the "big picture." Greater understanding at the expense of accuracy? Macrocognition > Microcognition? That's probably how I would describe today's experience. It seemed to help with certain types of problems involving active visualization of a system-- ie. anatomy, neurology, cardiology, pulmonolgy-- but hurt things like genetics, biochemistry, pharmacology-- things I find to be highly detail and rote-memory oriented. I'll try some soon with the full stack (armodafinil included) for a full length practice exam. More to come soon.
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#176 MasterHerb

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Posted 30 May 2013 - 09:55 PM

Hey NoopMed I am a prospective med student, who is applying now actually, and I am wondering if you could look at my stack and give me tips? Thank you so much for this thread it has been very helpful.

My thread:

http://www.longecity...627#entry590627

#177 PTShapeShifter

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Posted 31 May 2013 - 07:16 PM

I am curious if youu, NoopMed, or anyone here has tied to enhance your nootropic effect of piracetam by adding 50mg to 100mg of Phenylpiracetam -- reported to be a significantly stronger racetam?

In order to test combos and dosage, I took 25mg phenylpiracetam with 475mg piracetam and 200mg caffeine. Wow, the world really sharpened up! I noticed colors were brighter (piracetam), but my focus was enhanced (phenylpiracetam). As strange as this sounds, I also noticed a time lengthering effect. Time seemed to move slower after taking it. Similarly, after biking from home to school I found the bike ride which would normally have taken at least 15m took 8m instead! I suspect these effects are the result of my mind and body becoming more efficient and less cluttered with distraction and fatigue. I seemed to be able to do more in less time. I also noticed a decrease in appetite, and my reaction time to things was faster.



Two days later, in the morning I took 25mg of phenylpiracetam with 200mg caffeine -- no piracetam. This got me moving and out the door. I visited a friend and helped her study for her test, and the concepts were easily clear to me. I could read the practice questions with relative ease. After that, I ran errands easily.

The appetite decrease returned, so it is likely due to phenylpiracetam since that's the only thing I took.


After my errands were done I went home and took 25mg again and relaxed. But I quickly discovered that relaxing is not an easy feat on phenylpiracetam. If I took a walk to relax, I thought about all the other things I could be doing and wasn't. I had a costume party that evening, but I was going crazy with boredom that I wasn't doing anything

at that moment

! Surfing the net and watching TV were as enjoyable as ever though.



Next day I took 25mg of phenylpiracetam with 200mg caffeine 250mg PEA (L-phenylalanine) since I had noticed a synergistic effect between LPA and piracetam. However, the synergy did not occur; I felt as though I hadn't taken the PEA at all! I slogged through a 4 hour study session, and then at 1pm I took 600 mg piracetam with 25mg phenylpiracetam. This sharpened things up and I kept going for the rest of the day. I have ascertained that it has a relatively constant effect across a variety of conditions, enough to prove it effective for me.



I noticed the visual brightness, accelerated reaction time, and appetite-reducing effects again.




My Preliminary Conclusion:

For me, phenylpiracetam seems to have the following effects:

  • positive mood
  • anti-fatigue
  • vision brightness enhancement
  • increased auditory awareness
  • increased mental focus
  • faster reaction time
  • appetite reduction
  • slower time event sequencing


#178 NoopMed

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Posted 31 May 2013 - 07:48 PM

I have tried Phenylpiracetam. Very potent stuff indeed. I had taken it in the 100-200mg dose range because that was the amount I saw used in some of the studies-- it was probably too much. I felt the effects you described, but to a greater extent where my heart rate became too high for comfort. My blood pressure was fine, always seems to be steady as a rock around 116/76, but it got me worried enough to check. Maybe I'll try it again at a lower dose. One thing I did have trouble with was it seemed to reduce my ability to "visualize with my minds eye." I was having a lot of trouble conceptualizing certain things, and for the first time EVER actually became too distracted by my music to study with my normal playlist going. Almost like I couldn't process the music and my case studies simultaneously. The racetams that are used as anti-seizure medications, the most popular being Levetiracetam (FDA Approved and one of the fastest growing anti-epileptics) reduce corpus collosum activity-- slowing down communication between the hemispheres-- thereby slowing and ideally stopping the spread of a seizure. At least in theory. Piracetam has been shown to elevate this activity. The way that I responded to Phenylpiracetam had me worried it was acting more like Levetiracetam in that I was having a lot of trouble integrating traditional right and left brain activities to my normal ability. Just a theory though.

In another thread, IrishMD commented that it may have adrenergic potential:
http://www.longecity...henylpiracetam/

This substance needs more research, the phenyl group to this racetam causes a very dramatic effect, the phenyl group must be doing something, there must be a better reason for why tolerance occurs i'm thinking.


Phenylpiracetam contains the phenylethylamine pharmacophore and likely directly interacts with adrenergic receptors. It probably also undergoes en vivo hydrolysis into some interesting species with likely intrinsic receptor interactions: 4-phenyl-2-pyrrolidinone, 1-ethyl-4-phenylpyrrolidin-2-one, 1-methyl-4-phenylpyrrolidin-2-one.


This would explain some of the stimulant activity you mention.


BTW: Here's a good summary of Phenylpiracetam from a meta-review on the Racetam family that I often reference:

4.1.5 Phenylpiracetam
A phenyl derivative of piracetam, phenotropil
or phenotropyl is absorbed fast and exhibits high
oral bioavailability (Phenotropil, product insert).
Studies on rodents (100 mg/kg, intramuscular,
oral) showed absorption time of <1 hour and
half-life of 2.5–3 hours,[19,20] but its pharmacokinetic
profiles in humans are unpublished. It
demonstrates multitherapeutic potential, some in
common with subgroup 2 AEDs.
Memory, Cognition, Attention, Depression
Phenylpiracetam is reportedly beneficial to
people who develop cognitive deficits and/or depression
after encephalopathy and brain injures
(table V). It increased quality of life in patients
with encephalopathy after acute lesions (30 people),
brain traumas (33 people) and gliomas
surgery (36 people). The average minimental
state examination (MMSE) scores (a standard
30-point questionnaire used to assess cognition)
from baseline improved in all groups. In the end,
anxiety improved and depression declined substantially,
and that resulted in less discomfort and
better ability to execute everyday activities.[85]
Recovery of memory, attention and sensomotor
disturbances were indistinguishable for similar
treatments in mild cranial brain traumas. The
differences noted favoured phenylpiracetam over
piracetam because of faster alleviation of headaches
and a general fatigue after 7 and 14 days.[86]
Phenylpiracetam was favoured in the treatment
of chronic vascular encephalopathy as it improved
the cognitive performance in all tests,
whereas only two of the eight test scores increased
in the piracetam arm.[87] It also improved both
asthenia and depression scores, albeit to a lesser
extent in MS patients.[88]
In a comparative trial, asthenia and chronic
fatigue syndrome (CFS) patients were treated
with phenylpiracetam (68 people), piracetam
(65 people) and placebo (47 people). The scores
of the ten-word memory test and attention
switching tests for the phenylpiracetam improved
relative to those of piracetam and placebo.
Overall, 83%of asthenic and 87%of CFS patients
responded well to phenylpiracetam versus 48%
and 55%, respectively, to piracetam.[89] In agreement
with this, phenylpiracetam markedly increased
the problem-solving skills of adolescents
with asthenia who were A-players, B-players and
C-players (i.e. the number of individuals able to
respond to the memory and attention tests after
the first, second and third attempts) from 11%,
15%, 73% before to 23%, 40%, 37% after treatment,
respectively. It was superior to piracetam
(400 mg/day) in combination with multivitamins
and physiotherapy.[90] It is unclear whether any
particular patient(s) was unresponsive to or relapsed
after therapy.
Convulsion/Epilepsy, Seizure
Phenylpiracetam exhibited an antiepileptic
action in rodents. Its effective dose (300 mg/kg)
decreased the metrazol (a drug used as a circulatory
and respiratory stimulant)-induced seizure
by 50%.[106] Phenylpiracetam was administered
to patients in addition to one standard AED
(including valproyl amide, carbamazepine, lamotrigine,
topiramate or a barbiturate, or structured
polytherapy with more than one of these
drugs). It substantially mitigated the number and
frequency of seizures of patients receiving AED
only and the number of individuals with a desynchronous
EEG profile decreased from eight
to three, while the number of individuals with
seizure remissions increased modestly.[91] Consistent
with this, cognitive functions in epileptic
patients based on an MMSE test improved to
only a small extent.[92] These trials favoured
phenylpiracetam as add-on medication for epilepsy
(table V).
Cerebral Stroke/Ischaemia
Because the immune system has a crucial role
in the pathogenesis of ischaemia-stroke, titres of
antibodies against the main myelin protein and
phospholipids were measured in patients with
acute cerebral stroke treated with phenylpiracetam.
The titres of both antibodies decreased,
suggesting possible reduction of ongoing demyelination[
93] (table V). In a two-arm parallel trial
with patients receiving one tablet (80 people) and
two tablets (40 people) a day, both MMSE and
severity of stroke scores improved significantly,
while only showing a trend toward improvement
in daily living activities (Barthel test).[94] A post
hoc analysis for a subset of these data might be
useful, but overall the therapy appears modestly
beneficial (table V).
Vision/Glaucoma
The cause of blindness in glaucoma is optical
neuropathy and ganglia cell apoptosis. Use of a
neuroprotective agent in delaying or preventing
ganglial cell death was the rationale of a recent
trial. Phenylpiracetam was given to patients with
unstable open-angle glaucomas after the eye
pressures were normalized using ocular hypotensive
therapy and laser trabeculoplasty. The
average number of blind spots or islands of loss
or impairment of visual acuity decreased, and
glaucoma stabilized in 80% of patients at
6-month follow-up[95] (table V). It is premature to
conclude whether the trial favours phenylpiracetam
because of the lack of a prospective
placebo control and possible variables such as
patient heterogeneity at the trial entry point.

Edited by NoopMed, 31 May 2013 - 07:54 PM.

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#179 NoopMed

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Posted 31 May 2013 - 07:54 PM

Piracetam and Derivatives
Last Updated Sep 10 2012 01:22 AM


This is a great meta review of Racetams btw...
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#180 PTShapeShifter

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Posted 31 May 2013 - 10:42 PM

Thank you NoopMed, for your comments & Racetam refs & links.

To date, I have not added Provigil / Modafinil to my stack, preferring instead to rely on my personal success with a low, 25 mg Phenylpiracetam in early AM as a boost to my 800 mg - 1600 mg Piracetam also taken in the AM. Then, at 1 PM I've been adding 1,600 mg of Piracetam which keeps me focussed on textbooks as I am concerned about the risk of sleep loss with Modafinil... that's my idea of a more personally conservative approach. As I am older, sleep quality has become super important.
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