Picamilon (nicotinoyl-GABA)

For cognitive impairment, picamilon is used in Russian practice as a nootropic. Independent international RCTs with MMSE, MoCA, or ADAS-Cog endpoints do not exist. AAN and Alzheimer's Association guidelines do not list the drug. In 2015 the FDA issued an official warning about illegal picamilon sales in the US as a dietary supplement.

Picamilon (nicotinoyl-GABA) is a Soviet-era drug marketed in Russia as a mild tranquilizer with a vascular component for stress, anxiety, and reduced productivity. It is not included in any international clinical guidelines; the FDA, EMA, and AEMPS have not approved picamilon, and the FDA banned its sale as a dietary supplement in the US in 2015 because it is an unregistered drug. There are no independent clinical studies in humans with endpoints on validated anxiety or stress scales. For persistent stress or anxiety, it is more useful to see a clinician for a diagnostic workup (generalized anxiety disorder, depression, sleep disorders), where evidence-based treatments are available. If picamilon was prescribed for stress, consider seeking a second opinion.