Pramiracetam is a racetam molecule that was initially synthesized from piracetam due to its modifications having more anti-amnesiac potential in rats. Relative to the other racetams, pramiracetam is not that well researched but does appear to have some human evidence.
When looking at the animal evidence, otherwise healthy young and old rats seem to experience benefits to long-term memory formation with supplementation of pramiracetam. It appears to be effective when taken acutely (1-2 hours) before cognitive testing, and studies looking at working memory do not note much effects. Human studies support this, but they are limited in statistical power and currently there are no human studies in otherwise healthy youth for the purpose of cognitive enhancement.
The mechanisms of pramiracetam are not well known, but it appears to alter EEG activity in all tested rats (young and old) and may be able to enhance high-affinity choline uptake. It is similar to piracetam and other racetams in the sense that its mechanisms seem dependent on the adrenal glands and some peripheral effects, but beyond that the mechanisms have not been further elucidated.