«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half-life of 2.5–3 hours,[19,20] but its pharmacokinetic profiles in humans are unpublished.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 trauma (33 people) and glioma
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 trauma. The
differences noted favoured phenylpiracetam over
piracetam because of faster alleviation of headache 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 multivitamin
and physiotherapy.[90] It is unclear whether any
particular patient(s) was unresponsive to or relapsed after therapy»