Editing Nootropic (section)

===Racetams===
{{Main|Racetam}}
Racetams, such as piracetam, [[oxiracetam]], [[phenylpiracetam]], and [[aniracetam]], are often marketed as cognitive enhancers and sold [[over the counter]].<ref name="NeuroClin">{{cite journal | vauthors = Cohen PA, Avula B, Wang YH, Zakharevich I, Khan I | title = Five Unapproved Drugs Found in Cognitive Enhancement Supplements | journal = Neurology. Clinical Practice | volume = 11 | issue = 3 | pages = e303–e307 | date = June 2021 | pmid = 34484905 | pmc = 8382366 | doi = 10.1212/CPJ.0000000000000960 }}</ref><ref name="JAMAIM">{{cite journal | vauthors = Cohen PA, Zakharevich I, Gerona R | title = Presence of Piracetam in Cognitive Enhancement Dietary Supplements | journal = JAMA Internal Medicine | volume = 180 | issue = 3 | pages = 458–459 | date = March 2020 | pmid = 31764936 | pmc = 6902196 | doi = 10.1001/jamainternmed.2019.5507 }}</ref> A 2019 study found that piracetam supplements sold in the United States were inaccurately labeled.<ref name="JAMAIM"/> Racetams are often referred to as nootropics, but this property is not well established in humans, and nootropics are not consistently found in all racetams.<ref name="NHM">{{cite book |vauthors=Malenka RC, Nestler EJ, Hyman SE |veditors=Sydor A, Brown RY | title = Molecular Neuropharmacology: A Foundation for Clinical Neuroscience | year = 2009 | publisher = McGraw-Hill Medical | location = New York | isbn = 9780071481274 | page = 454 | edition = 2 }}</ref> The racetams have poorly understood [[mechanism of action|mechanisms]], although piracetam and aniracetam are known to act as [[positive allosteric modulator]]s of [[AMPA receptor]]s and appear to modulate [[acetylcholine|cholinergic]] systems.<ref>{{cite journal | vauthors = Gualtieri F, Manetti D, Romanelli MN, Ghelardini C | title = Design and study of piracetam-like nootropics, controversial members of the problematic class of cognition-enhancing drugs | journal = Current Pharmaceutical Design | volume = 8 | issue = 2 | pages = 125–138 | year = 2002 | pmid = 11812254 | doi = 10.2174/1381612023396582 }}</ref> Similar compounds, such as [[N-Phenylacetyl-L-prolylglycine ethyl ester|noopept]] and [[aloracetam]], do not meet the chemical definition for being a racetam, though they are considered "racetam-like" due to their high similarity.<ref name="WHO-INN-Stembook2018">[https://cdn.who.int/media/docs/default-source/international-nonproprietary-names-(inn)/stembook-2018.pdf The use of stems in the selection of International Nonproprietary Names (INN) for pharmaceutical substances.] Geneva: World Health Organization; 2018 (WHO/EMP/RHT/TSN/2018.1).</ref>

According to the FDA,

<blockquote>Piracetam is not a [[vitamin]], mineral, [[amino acid]], herb or other [[botanical]], or dietary substance for use by humans to supplement the diet by increasing the total dietary intake. Further, piracetam is not a concentrate, metabolite, constituent, extract or combination of any such dietary ingredient. [...] Accordingly, these products are drugs, under section 201(g)(1)(C) of the Act, 21 U.S.C. § 321(g)(1)(C), because they are not foods and they are intended to affect the structure or any function of the body. Moreover, these products are new drugs as defined by section 201(p) of the Act, 21 U.S.C. § 321(p), because they are not generally recognized as safe and effective for use under the conditions prescribed, recommended, or suggested in their labeling.<ref name="unlimited">{{cite web|url=https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2010/ucm225605.htm|archive-url=https://wayback.archive-it.org/7993/20170112004501/https://www.fda.gov/ICECI/EnforcementActions/WarningLetters/2010/ucm225605.htm|url-status=dead|archive-date=12 January 2017|title=FDA Warning Letter: Unlimited Nutrition|author=John Gridley|date=30 August 2010|publisher=Office of Compliance, Center for Food Safety and Applied Nutrition, Inspections, Compliance, Enforcement, and Criminal Investigations, US Food and Drug Administration |access-date=5 April 2016}}</ref></blockquote>