Piracetam therapy does not enhance cognitive functioning in children with Down syndrome

Background: Piracetam is widely used as a purported means of improving cognitive function in children with Down syndrome. Its efficacy, however, has not been rigorously assessed. Objective: To determine whether 4 months of piracetam therapy (80-100 mg/kg per day) enhances cognitive function in children with Down syndrome. Design: A randomized, double-blind, placebo-controlled crossover study. Participants and Methods: Twenty-five children with Down syndrome (aged 6.5-13 years) and their caregivers participated. After undergoing a baseline cognitive assessment, children were randomly assigned to 1 of 2 treatment groups: piracetam-placebo or placebo-piracetam. Main Outcome Measure: The difference in performance while taking piracetam vs while taking placebo on tests assessing a wide range of cognitive functions, including attention, learning, and memory. Results: Eighteen children completed the study, 4 withdrew, and 3 were excluded at baseline. Piracetam therapy did not significantly improve cognitive performance over placebo use but was associated with central nervous system stimulatory effects in 7 children: aggressiveness (n=4), agitation or irritability (n=2), sexual arousal (n=2), poor sleep (n=1), and decreased appetite (n=1). Conclusion: Piracetam therapy did not enhance cognition or behavior but was associated with adverse effects.