FasoracetamvsOxiracetam

Fasoracetam upregulates GABA-B receptor (GABA-B1/GABA-B2 heterodimer) expression and function, which is unique among racetams — this receptor upregulation is potentially beneficial for restoring GABAergic sensitivity after prolonged benzodiazepine or phenibut use. It enhances group II metabotropic glutamate receptor (mGluR2/mGluR3) signaling, which modulates presynaptic glutamate release and reduces excitotoxicity. Fasoracetam increases acetylcholine release in the cerebral cortex via modulation of choline acetyltransferase activity and vesicular acetylcholine transporter function. It may also modulate the glutamatergic system through mGluR5. The combination of GABAergic (GABA-B-mediated inhibition), glutamatergic (mGluR modulation), and cholinergic enhancement provides anxiolytic effects alongside cognitive enhancement. Clinical trials focus on ADHD patients with GRM (glutamate receptor) gene variants.

Oxiracetam enhances glutamatergic neurotransmission through positive allosteric modulation of AMPA receptors, increasing the amplitude and duration of excitatory postsynaptic potentials. It increases the release of excitatory neurotransmitters glutamate and D-aspartic acid from hippocampal presynaptic terminals, acting as a glutamate analog. Oxiracetam stimulates protein kinase C (PKC) isoforms, particularly PKC-α and PKC-γ, which phosphorylate substrates involved in memory consolidation, long-term potentiation (LTP), and synaptic plasticity. PKC activation enhances NMDA receptor function and AMPA receptor trafficking to the synapse. Its mild stimulatory effect derives from cholinergic system enhancement via increased acetylcholine release and nicotinic α7 receptor potentiation in the cortex.