FasoracetamvsPhenylpiracetam

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.

Phenylpiracetam modulates AMPA and NMDA glutamate receptors like other racetams through positive allosteric modulation. The phenyl group confers additional affinity for dopamine (DAT) and norepinephrine (NET) transporters, acting as a weak reuptake inhibitor and increasing synaptic catecholamine availability — providing stimulatory and motivational effects. It binds to α4β2 and α7 nicotinic acetylcholine receptors as a positive allosteric modulator, enhancing cholinergic transmission in the prefrontal cortex and hippocampus. The phenyl moiety improves blood-brain barrier penetration via increased lipophilicity and potentially P-glycoprotein substrate properties. Downstream effects include enhanced CREB phosphorylation and BDNF expression. The combination of glutamatergic, dopaminergic, noradrenergic, and cholinergic modulation produces synergistic cognitive enhancement.