Stromes Plus ( Citicoline 500 mg + Piracetam 800 mg ) is commonly prescribed to support cognitive function and neurological recovery in various conditions, including stroke, dementia (Alzheimer’s and vascular types), traumatic brain injury, and age-related memory decline.
1. Composition
Active Ingredients:
Citicoline (500 mg): A neuroprotective compound that acts as a precursor to phospholipids and acetylcholine.
Piracetam (800 mg): A nootropic agent from the racetam class, modulating neurotransmission.
Inactive Ingredients (Excipients): Typically includes binders (e.g., microcrystalline cellulose), disintegrants (e.g., croscarmellose sodium), lubricants (e.g., magnesium stearate), and coatings.
2. Uses
Cognitive Enhancement: Improves memory, focus, and learning in age-related decline or dementia (Alzheimer’s/vascular).
Stroke Recovery: Reduces neuronal damage and improves outcomes in ischemic stroke.
Traumatic Brain Injury (TBI): Supports neuronal repair.
Neurodegenerative Disorders: Used in conditions like Parkinson’s disease and cortical myoclonus (Piracetam-specific).
Evidence:
3. Dosage
Adults: 1 tablet (Citicoline 500 mg + Piracetam 800 mg) taken 1–2 times daily.
Stroke/TBI: Up to 2 tablets twice daily, administered under medical supervision.
Renal Impairment: Adjust Piracetam dose, as it is renally excreted.
4. Mechanism of Action
Citicoline
It provides choline for neurotransmitter production, aids in the formation of phosphatidylcholine for cell membrane integrity, boosts brain function, and has neuroprotective effects by preserving cardiolipin and sphingomyelin, and stimulating glutathione synthesis.
- Repairs neuronal membranes via phosphatidylcholine synthesis.
- Boosts acetylcholine and dopamine levels, enhancing neurotransmission.
- Reduces free radicals (antioxidant effect).
Piracetam
It is a GABA (gamma amino butyric acid) analogue. It works by protecting the brain and nervous system against shortness of oxygen and also affects various ion channels on nerve cell membrane.
- Enhances glutamate AMPA receptor activity, promoting synaptic plasticity.
- Improves cerebral blood flow and ATP production.
- Stabilizes erythrocyte membranes.
Synergy: Citicoline supplies membrane components, while Piracetam optimizes neuronal signaling.
5. Side Effects
Common: Headache, nausea, diarrhea, insomnia, dizziness.
Rare: Hypotension (Citicoline), anxiety, tremors (Piracetam), rash.
Severe: Bleeding risk (Citicoline in hemorrhagic stroke), seizures (Piracetam in epilepsy).
6. Precautions
Avoid in: Severe renal impairment (Piracetam), active brain hemorrhage, pregnancy (limited safety data).
Monitor: Blood pressure, renal function, bleeding time (especially when used with anticoagulants like warfarin).
Drug Interactions:
Citicoline: May potentiate acetylcholine effects; caution with anticholinergics.
Piracetam: May interact with thyroid hormones or anticoagulants.
7. Evidence & Clinical Status
Citicoline: Approved for stroke treatment in some countries (e.g., Japan, Europe); meta-analyses show modest benefits.
Piracetam: Widely used off-label for cognitive disorders but lacks FDA approval; Cochrane reviews note inconsistent efficacy.
Combination: No large-scale trials validate the synergy, but it is used empirically for neuroprotection.
🔑 Key Takeaway
The combination of Citicoline and Piracetam targets neurorepair and cognitive function enhancement. However, due to variable evidence and potential side effects, cautious use is recommended. Always consult a healthcare provider for personalized advice.