Prohibited drug found in dietary supplements

Posted 11 December 2019

Piracetam has been touted as a brain-enhancing substance despite poor evidence of its efficacy. Although it is not approved as a drug and is prohibited as a dietary supplement ingredient in the United States, U. S.-based researchers were able to purchase two samples of each of 12 brands of piracetam products online from sellers they identified through a Google search.

Reference: Cohen P and others. Presence of piracetam in cognitive enhancement dietary supplements. JAMA Internal Medicine. doi:, Nov 25, 2019

Five of those brands were labeled as dietary supplements. Chemical analysis revealed that the piracetam content ranged from 85% to 188% of the labeled dosage. The researchers noted that (a) known adverse effects of piracetam include anxiety, insomnia, agitation, depression, drowsiness, and weight gain, and (b) the effects of the doses found, particularly in elderly consumers with poor kidney function are unknown. They concluded:

Our findings demonstrate that even after the FDA rejected an application to market piracetam as a new supplement ingredient, the drug was nevertheless introduced into the marketplace. Despite FDA warning letters, the products remain on the market. Until the law governing supplements is reformed such that products adulterated with drugs can be effectively removed from the market, clinicians should advise patients that supplements marketed as cognitive enhancers may contain prohibited drugs at supratherapeutic doses. 

Source: Consumer Health Digest #19-48 December 8 2019

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