Informational only. Not medical advice.INFORMATIONAL PLATFORM ONLY — NOT MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT
Head-to-head comparison of Fasoracetam and NSI-189 — mechanism, side effects, legal status, and pricing.
Fasoracetam (NS-105, NFC-1) is a non-peptide racetam-class small molecule characterized as a metabotropic glutamate receptor (mGluR) activator that also modulates acetylcholine release and GABA-B signaling. A single Phase 1 trial in 30 adolescents with ADHD and mGluR-network gene variants showed clinical improvement on CGI scales, but broader development was discontinued and fasoracetam has never been approved in any jurisdiction. It is sold only as an unregulated research chemical/nootropic.
NSI-189 (INN: amdiglurax; developmental code ALTO-100) is a non-peptide small-molecule benzylpiperazine-aminopyridine derivative investigated as a neurogenic/neuroplasticity-modulating agent for major depressive disorder. It stimulates hippocampal neural progenitor proliferation and differentiation in vitro and neurogenesis in vivo (mouse), acting independently of monoamine reuptake pathways. NSI-189 has never been FDA-approved; Phase 2 monotherapy trials in MDD (220 patients, 2020) and a Phase 2b trial under Alto Neuroscience (~300 patients, 2024) both failed to meet primary MADRS endpoints, and it remains investigational only.
Fasoracetam
NSI-189
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Fasoracetam
NSI-189
No pricing data yet.
Check NSI-189 prices →COA corpus from Disclosed Labs — independently tested batches only.
Fasoracetam
1
COAs
99.7%
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1
Labs
NSI-189
No COA data yet.
Submit testing data →Human data exist but the compound is not approved anywhere. The best-sourced human study is a completed Phase 1 open-label single-dose PK/single-blind placebo-controlled dose-escalation trial of NFC-1 (fasoracetam) in 30 adolescents (age 12–17) with ADHD carrying mGluR-network gene variants (NCT02286817; Elia et al. 2018, Nature Communications). CGI-I improved from 3.79 to 2.33 and CGI-S from 4.83 to 3.86 from baseline to week 5 (both P<0.001) in this small, largely uncontrolled sample. In rats (Wistar), fasoracetam reversed memory disruption across scopolamine-, NBM-lesion-, AF64A-, cerebral-ischemia-, baclofen-, and ECS-induced amnesia models, increased cortical acetylcholine release, and enhanced high-affinity choline uptake in cortex and hippocampus (Shirayama et al., 1999).
Human data exist from three registered trials: a Phase 1 single-dose PK study in healthy volunteers (NCT01310881), a Phase 1B multiple-dose-escalation study in 24 MDD patients (28-day inpatient dosing at 40 mg once/twice/thrice daily; half-life ~17.4–20.5 hours; no serious adverse events; no significant hippocampal volume change at day 28 or 84), and a Phase 2 double-blind, placebo-controlled trial in 220 MDD outpatients (12 weeks at 40 mg or 80 mg daily) that missed its primary MADRS endpoint at both doses (p=0.22 and p=0.34, respectively), with some significant secondary/patient-reported benefits at 40 mg. A Phase 2b trial under the ALTO-100 designation (~300 adults, 34 US sites, 6-week double-blind) also failed to meet its primary MADRS endpoint (topline October 2024). Preclinical findings include improved motor/neurological deficits sustained to 24 weeks in a rat stroke model (oral dosing starting 6 hours post-MCAO; increased hippocampal/cortical MAP2 neurite outgrowth; in vitro OGD/R assays showed reduced cell death and upregulated BDNF/SCF), reversal of motor and cognitive impairments in an Angelman syndrome mouse model (with mild performance enhancement in wild-type mice), improved Barnes maze memory retention in a 5xFAD Alzheimer's mouse model (conference abstract), and prevention of peripheral neuropathy indices with increased hippocampal neurogenesis/synaptic markers/volume and protected long-term memory in mouse and rat models of type 1 and type 2 diabetes, alongside enhanced mitochondrial function in a type 2 diabetic rat model.
Fasoracetam and NSI-189 are both in the Cognitive category and may have overlapping mechanisms. Researchers should review both profiles carefully, understand the mechanisms of action, and monitor the relevant biomarkers when combining compounds in the same class. As always, consult a licensed healthcare provider before making any decisions about combining research compounds.
This platform provides informational tools only, not medical advice. This comparison is for educational purposes only. Consult a licensed provider.
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