Hello,
I'm not *extremely* experienced with nootropics, but I have a fair knowledge of them, have tried several, and have done tons of research on a few.
That said, I've never tried aniracetam or ox, or pram, but I've been using piracetam for about a year now. The first batch I got, Primaforce, was ok and only worked marginally at any dose and didn't have many of the effects I was really looking for. I even tried supplementing this with choline (mostly just lecithin, though a little DMAE also), gingko, ALA, huperzine A, and vinpocetine all with little noticable results, though 1-3 g of lecithin made the most difference of all of them. Gingko, as a nootropic...isn't. It just doesn't seem to have any noticable effects towards cognition or memory and there are plenty of studies that are very indifferent about any effects it might have. My new batch of piracetam, from Nutraplanet, is not only about 3 times as effective as the primaforce batch I got, but was also only about 2/3 the price as I paid for that from DiscountAnabolics. At about the same dose and dosing regimen, I've noticed a quick and extreme difference to word summoning, fluidity of speech and thought, synthesis of ideas into understanding a complex process, and ability to express myself in ways and to degrees I've never been able to. I've become a much more eloquent (albeit possibly more verbose ;-)) speaker and writer, I've become much better at understanding complex things quicker and finding the right questions to ask about them, and countless other things, including possibly a general mood elevation, supposing this isn't just coincidental.
From research I've done from every source I can find about piracetam, it not only doesn't downregulate receptors to anyone's knowledge of which i'm aware, but it in fact upregulates muscarinic acetylcholine receptors in certain regions of the brain, I believe the hippocampus (responsible for memory) and definitely thefrontal cortex (responsible for cognition, conscious thought). Many sources will advise a regular piracetam user to take some kind of choline supplement such as choline citrate/bitartrate, lecithin (phosphatidylcholine), alpha-GPC because piracetam increases choline neurotransmission and receptor density, and so increases choline recylcing and choline requirement for normal functioning. Regular piracetam users will often find themselves with some pretty nasty headaches if they take moderate to large doses often without choline supplementation and the piracetam can't function fully without the extra choline, so it's a waste.
A source I've seen (
http://www.ironmagazine.com/review45.html) with plenty of citations says that of the common choline supplements, the citrate and bitartrate salts are the least effective, only increasing serum concentrations of choline by about 86% and drops to baseline in about 4 hours whereas (supposedly) the same dose of phosphatidylcholine (lecithin) increases the serum concentration by 265% and drops to baseline in 12 hours! So if this is correct, not only is lecithin MUCH cheaper than the citrate and bitartrate choline supplements, but MUCH more effective in quantity and longevity. Therefore, I'd suggest lecithin and at a dose of between 1 and 5 grams per day, depending on your individual reaction and dose of piracetam. 1-2g seems enough for me, plus too high concentrations of choline can cause trimethylaminuria, a condition characterized by a person smelling "fishy."
I wish I knew more about aniracetam, but I would guess that, being that aniracetam has a virtually non-existent toxicity and is very well tolerated with few users experiencing short- or (as far as I know) long-term side effects, the dopamine agonism effect is probably not something to worry about except maybe in extreme conditions.
In general, there are few interactions of piracetam with any other drugs, but the most notable being alcohol, caffeine, and stimulants, where piracetam increases these drugs' subjective effects in most users, usually attributed to piracetam's supposed effect of increasing blood flow to the brain. Definitely take it easy at first with alcohol when using piracetam, until you know your individual reaction.
Anyway, like I said, I think gingko is placebo in terms of nootropic ability, but I doubt that it could possibly be bad. Who knows, maybe it'd work for you. Definitely don't expect any nootropics to completely change your life; they may not even do anything for you and sometimes take a week or several weeks of regular use to have an effect, but for their price and safety (piracetam is cheap and is by all definitions and to every degree non-toxic at any possible dose and the other racetams are at least similar in that degree, though not in price). Definitely start with low doses just to account for any possibility of idiosynchratic negative effects and build to a comfortable dose.
Since I've talked your ear off as it were, I'll end this here, but I'd love to help in any other way I can. I hope it all goes well for you and continue to post with your results or thoughts.
To heightening your experience and awareness!
-Jaguraguguru
