Piracetam: oldest and most researched drug of the racetam family!
Piracetam’s mechanism of action isn’t entirely clear, the most prominent current view is that piracetam enhances neuronal function first through increasing membrane fluidity, which is usually disturbed in aged brains, then subsequently increasing mitochondrial function. If this hypothesis is true then young people will likely benefit the least from piracetam. Though some evidence still suggests that piracetam may increase memory in non-elderly populations. In one longitudinal study piracetam use was actually found to be associated with increased cognitive decline over 20 years, though the authors caution drawing conclusions given the small sample size in the piracetam group.
Folk wisdom usually suggests consuming some form of choline source with piracetam, to either increase the effects or mitigate “racetam headaches”, a phenomenon a minority of users report. While choline is generally a pro-cognitive compound, especially for the elderly there likely isn’t a special requirement here. Most people can take piracetam with or without choline. But choline may have beneficial effects of its own.