Abstract In a double-blind, randomized, controlled study, we investigated the effects of piracetam, a nootropic compound, on cognitive disturbances and the potency of antiepileptic drugs in 60 epileptic patients and 15 age-matched control subjects. Each subject was given the following tests at the time of entry and 3 and 5 weeks after the start of treatment: memory for design test, Wechsler Intelligence Scale for Children/Wechsler Adult Intelligence Scale subtests, electroencephalography, and a neurologic examination. Our findings suggest that piracetam has a positive influence on cognitive measures in epileptic patients. In addition, piracetam does not diminish the antiepileptic effects of anticonvulsant drugs. Instead, it improved seizure protection in patients receiving carbamazepine.