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Severe hepatitis due to pyritinol supplementation


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#1 ghamal

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Posted 26 January 2011 - 05:25 AM


I've got a bottle of this stuff lying around (400mg/pill). I was wondering if it's safe to use for studying but I did a google search and found this BMJ article from 2004 and it's scared me off. It seems to induce severe hepatitis on some people and could cause liver damage.

http://www.bmj.com/c...8/7439/572.full

Just an fyi for anyone taking or planning on taking Pyritinol.




Case reports from the article:
Case 1--A 23 year old female student complained of nausea, malaise, and jaundice one month after starting pyritinol 600 mg a day for "memory improvement." She had also been taking paracetamol with codeine sporadically for some years because of headache. Discontinuation of pyritinol led to rapid clinical improvement and to normalisation of liver function five months later.

Case 2--An 18 year old female student was prescribed nitrofurantoin 400 mg a day for cystitis and pyritinol 600 mg a day for "memory improvement." Five days later she was admitted to hospital with pruritus and jaundice of the skin and sclera. One year earlier she had been taking pyritinol at the same dose for 20 days with no known adverse effects. Improvement of her condition was observed after she stopped taking pyritinol, and liver function returned to normal five months later.

Case 3--A 27 year old woman presented at the outpatient clinic with jaundice and abnormal liver function tests. She had been taking oral contraceptives for three years and had started taking pyritinol 400 mg a day 25 days before presenting at the clinic. Liver function returned to normal more than six months after she stopped taking pyritinol.

Case 4--A 21 year old woman was admitted to hospital with malaise, vomiting, and fever of three days' duration and abnormal results for liver function tests. She had been taking pyritinol 600 mg a day for a month mad was also taking nimesulide (one or two pills a month) for dysmenorrhoea. After she stopped taking pyritinol, liver function improved but did not return to normal for nine months.

Case 5--Ten days after starting to take pyritinol 600 mg a day, a 41 year old man was admitted to hospital with nausea, vomiting, jaundice, and abnormal liver function. Complete clinical and biochemical normalisation was seen two months after he stopped taking the drug.

Case 6--A 24 year old woman had nausea, vomiting, abdominal pain, fever, and jaundice 14 days after starting to take pyritinol 400 mg a day for "memory improvement." She had also been taking erythromycin 500 mg every six hours during the previous eight days for a sore throat. Liver function returned to normal within a month. When she inadvertently took pyritinol again six months later, she developed the same symptoms and blood tests gave similar results.




Hepatitis symptoms (from Wikipedia):
  • itchiness (pruritus). Pruritus is the primary symptom of cholestasis and is thought to be due to interactions of serum bile acids with opioidergic nerves. In fact, the mixed opioid agonist/antagonist Naltrexone is used to treat pruritus due to cholestasis.
  • jaundice. Jaundice is an uncommon occurrence in intrahepatic cholestasis, but is common in obstructive cholestasis.
  • pale stool. This symptom implies obstructive cholestasis.
  • dark urine




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#2 Ichoose2live

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Posted 29 January 2011 - 07:40 PM

Another drug that doesn't fit with the definition of a Nootropic.

1. They should enhance learning and memory. - Partially fit.

Difference in learning and retention by albino-Swiss mice. Part 1. Effect of pyritinol.

A new and easy method to demonstrate different degrees of facility for learning and retention within the same strain of laboratory mice is described. According to this method, it is possible to divide the general population into given percentage of "good learners" and "poor learners". These two subpopulations react differently to the influence of several psychoactive drugs. In this study it is shown that pyritinol contributes to retention of the learned task in poor learners and has no effect on good learners.

Source

2. They should enhance the resistance of learned behaviors/memories to conditions which tend to disrupt them (e.g. electroconvulsive shock, hypoxia). - Partially fit.

pyritinol (100 mg/kg, intraperitoneally) produce a marked inhibition of the development of the retrograde amnesia only after pretreatment. Without pretreatment these drugs exert a slight or no effect.

Source

3. They should protect the brain against various physical or chemical injuries (e.g. barbiturates, scopalamine). - Could not find any study.
4. They should increase the efficacy of the tonic cortical/subcortical control mechanisms.
5. They should lack the usual pharmacology of other psychotropic drugs (e.g. sedation, motor stimulation) and possess very few side effects and extremely low toxicity. - Does not match gravely.

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#3 chrono

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Posted 31 January 2011 - 03:58 AM

Thanks for bringing this up! It's definitely a risk that's important to be aware of when deciding whether to take this, and especially if you decide to try it.

The flip side is that the BMJ paper says pyritinol has been used in 50 countries for 20 years, and by an estimated 100,000 people (who took a 3-month course) in the EU alone in the past 5 years. It's probably not much different than the odds of getting one of the "rare cases" side effects from prescription medications advertised on TV. The authors suggest that hepatitis cases may have been "significantly under-reported" due to pyritinol not being a known risk factor; possibly, but I have to imagine medications (esp. nootropics) would be the first thing considered when otherwise healthy people get sudden and acute hepatitis, and remission of symptoms takes place upon discontinuation.

Pancreatitis has also been known to occur.

Another drug that doesn't fit with the definition of a Nootropic.

Possibly, but I think that depends on how you define 'nootropic.' Here, it's used somewhat loosely to describe cognitive enhancers in general. Applying all five of those criteria will probably exclude everything we discuss here, including the substance for which the term was coined 40 years ago. Wikipedia mentions that the "very low toxicity/side effects" criterion is not employed by most researchers. Even if it was, I'm not sure 6 cases over 20 years would disqualify it.

Also note the paper showing improved reaction time in healthy volunteers, which is also the only common benefit I've seen reported anecdotally. Also neuroprotection, and resistance of learned behaviors to ethanol-induced deficits.

Edited by chrono, 31 January 2011 - 04:10 AM.


#4 canz

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Posted 11 November 2011 - 01:02 PM

I used pyritinol at 400mg everyday for about 6 months a few years ago and had no negative side effects. I will be supplementing again with it shortly because I remember it acted well synergistically with piracetam. Hopefully I will not experience any negative side effects this time around.

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#5 panhedonic

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Posted 28 October 2012 - 04:49 PM

Canz, how did that work?




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