My best friend is 19 y/o male and he's had upwards of 10 concussions his last one was 16 months ago and he has serious migraines mood issues and light sensitivity. Do you guys know of any nootropics that could help?
Yes Piracetam and CDP-Choline have been clinically studied in various types of head injuries.
Piracetam
Eksp Klin Farmakol. 2003 Jul-Aug;66(4):6-8.
Effect of Piracetam on the color discriminative function of retina in patients with craniocerebral trauma.
The chronic administration of piracetam over a period of four weeks in patients after heavy craniocerebral traumas significantly improves the color discrimination of retina with respect to all four colors studied. It is suggested that the improved functioning is related to the nootrope effect upon the GABAergic processes both in the retina and in the related cerebral structures.
Neurol Neurochir Pol 1998 Sep-Oct;32(5):1189-97
Piracetam in severe cranio-cerebral injuries
A group of 100 patients treated immediately following a cranio-cerebral injury was analyzed. The patients, administered piracetam either in an intravenous infusion (GCS 3-8) or orally (GCS above 9), were divided into groups depending on the dose and clinical status. Piracetam participates in the activity of the majority of neurotransmitters, increases glucose and oxygen consumption in the ischaemic nervous tissue and increases blood flow through cerebral terminal vessels. In cranio-cerebral injuries, piracetam is employed to achieve cytoprotection and improve cerebral blood flow. In patients with neurological deterioration following the administration of 6-10 mg/day, no good results were obtained. A dose of 24-30 mg/day had a significant positive effect on therapeutic results providing certain conditions were met, such as ensuring proper partial oxygen pressure (oxygen therapy) and proper blood glucose levels.
The use of piracetam is justified immediately after an injury; after the discharge oral piracetam therapy is recommended.
Przegl Lek 1999;56(2):119-20
Clinical observations concerning piracetam treatment of patients after craniocerebral injury
Piracetam (Nootropil) is a cytoprotective to brain tissue and improving cerebral blood flow medicine. In the Department of Neurotraumatology
we investigated results of piracetam treatment in a group of 100 succeeding patients admitted between 1995-96 due to craniocerebral injury. High doses (24-30 g per day) of this medicine have a positive effect on final result of treatment, when treatment is initiated immediately after the injury and described conditions are abided. We also showed usefulness of piracetam treatment in posthospital management.
Zh Nevropatol Psikhiatr Im S S Korsakova 1988;88(5):42-8
Effect of piracetam on the functional activity of the brain in patients with craniocerebral injuries
Repetitive EEG spectral analysis in 32 patients after severe of mild head trauma revealed two types of responses to Piracetam evidencing the ambiguity of its effect on unspecific activating brain structures. Besides the brain cortex, the hypothalamo-thalamic system was found to participate in the response.
With epileptoid signs present in the EEG, the drug could reduce the seizure threshold.
Eur Neurol 1978;17(1):50-5
Piracetam in the treatment of post-concussional syndrome. A double-blind study.
The effect of piracetam, a cyclical derivative of GABA, was compared with that of a placebo in a double-blind study of 60 patients with post-concussional syndrome of 2-12 months' duration. The daily dose of piracetam was 4,800 mg. After 8 weeks of treatment piracetam significantly reduced the occurrence and severity of the following symptoms: vertigo, headache, tiredness, decreased alertness, increased sweating and neurasthenic symptoms. No significant effect was observed on the following symptoms: tremor, orthostatic symptoms, and memory disorders. Side effect were reported by 64% of the patients under piracetam and by 32% under placebo.
In the author's opinion, piracetam seems to be a promising new drug for the treatment of post-concussional syndrome.
Acta Anaesthesiol Belg 1975 Apr;26(1):51-60
Clinical trial of piracetam in disorders of consciousness due to head injury.
The authors first remind some toxicological and some pharmacological properties of piracetam (Nootropil), then present the results of a test giving evidence of the presence of this drug in the cerebrospinal fluid after intravenous administration to man. In a double blind study, the activity of piracetam is tested on 31 patients suffering from coma after head injury. Only 27 patients without intracranial space occupying lesions are taken into account. Methods and results are described.
Piracetam, although showing no activity on mortality, improves the level of consciousness.
CDP-Choline
Methods Find Exp Clin Pharmacol 1995 Oct;17 Suppl B:1-54
CDP-choline: pharmacological and clinical review.
Cytidine 5'-diphosphocholine, CDP-choline or citicoline, is an essential intermediate in the biosynthetic pathway of the structural phospholipids of cell membranes, especially in that of phosphatidylcholine. Upon oral or parenteral administration, CDP-choline releases its two principle components, cytidine and choline. When administered orally, it is absorbed almost completely, and its bioavailability is approximately the same as when administered intravenously. Once absorbed, the cytidine and choline disperse widely throughout the organism, cross the blood-brain barrier and reach the central nervous system (CNS), where they are incorporated into the phospholipid fraction of the membrane and microsomes. CDP-choline activates the biosynthesis of structural phospholipids in the neuronal membranes, increases cerebral metabolism and acts on the levels of various neurotransmitters. Thus, it has been experimentally proven that CDP-choline increases noradrenaline and dopamine levels in the CNS. Due to these pharmacological activities, CDP-choline has a neuroprotective effect in situations of hypoxia and ischemia, as well as improved learning and memory performance in animal models of brain aging. Furthermore, it has been demonstrated that CDP-choline restores the activity of mitochondrial ATPase and of membranal Na+/K+ ATPase, inhibits the activation of phospholipase A2 and accelerates the reabsorption of cerebral edema in various experimental models. CDP-choline is a safe drug, as toxicological tests have shown; it has no serious effects on the cholinergic system and it is perfectly tolerated. These pharmacological characteristics, combined with CDP-choline's mechanisms of action, suggest that this drug may be suitable for the treatment of cerebral vascular disease,
head trauma of varying severity and cognitive disorders of diverse etiology. In studies carried out on the treatment of patients with head trauma, CDP-choline accelerated the recovery from post-traumatic coma and the recuperation of walking ability, achieved a better final functional result and reduced the hospital stay of these patients,
in addition to improving the cognitive and memory disturbances which are observed after a head trauma of lesser severity and which constitute the disorder known as postconcussion syndrome. In the treatment of patients with acute cerebral vascular disease of the ischemic type, CDP-choline accelerated the recovery of consciousness and motor deficit, attaining a better final result and facilitating the rehabilitation of these patients. The other important use for CDP-choline is in the treatment of senile cognitive impairment, which is secondary to degenerative diseases (e.g., Alzheimer's disease) and to chronic cerebral vascular disease. In patients with chronic cerebral ischemia, CDP-choline improves scores on cognitive evaluation scales, while in patients with senile dementia of the Alzheimer's type, it slows the disease's evolution. Beneficial neuroendocrine, neuroimmunomodulatory and neurophysiological effects have been described. CDP-choline has also been shown to be effective as co-therapy for Parkinson's disease. No serious side effects have been found in any of the groups of patients treated with CDP-choline, which demonstrates the safety of the treatment.
Life Sci 1995;56(9):637-60
Metabolism and actions of CDP-choline as an endogenous compound and administered exogenously as citicoline.
Weiss GB. M. Hurley & Associates, Inc., Murray Hill, New Jersey 07974-1584.
CDP-choline, supplied exogenously as citicoline, has beneficial physiological actions on cellular function that have been extensively studied and characterized in numerous model systems. As the product of the rate-limiting step in the synthesis of phosphatidylcholine from choline, CDP-choline and its hydrolysis products (cytidine and choline) play important roles in generation of phospholipids involved in membrane formation and repair. They also contribute to such critical metabolic functions as formation of nucleic acids, proteins, and acetylcholine. Orally-administered citicoline is hydrolyzed in the intestine, absorbed rapidly as choline and cytidine, resynthesized in liver and other tissues, and subsequently mobilized in CDP-choline synthetic pathways. Citicoline is efficiently utilized in brain cells for membrane lipid synthesis where it not only increases phospholipid synthesis but also inhibits phospholipid degradation. Exogenously administered citicoline prevents, reduces, or reverses effects of ischemia and/or hypoxia in most animal and cellular models studied, and
acts in head trauma models to decrease and limit nerve cell membrane damage, restore intracellular regulatory enzyme sensitivity and function, and limit edema. Thus, considerable accumulated evidence supports use of citicoline to enhance membrane maintenance, membrane repair, and neuronal function in conditions such as ischemic and traumatic injuries. Beneficial effects of exogenous citicoline also have been postulated and/or reported in experimental models for dyskinesia, Parkinson's disease, cardiovascular disease, aging, Alzheimer's disease, learning and memory, and cholinergic stimulation.