Aniracetam is a fat-soluble and supposedly more potent analog of piracetam. Anecdotally, it is claimed to facilitate associative thinking and creativity, as well as to reduce anxiety and depression. Although there are few human studies, it is currently used as a treatment for dementia and it’s being researched as a possible treatment for Alzheimer’s Disease, anxiety and depression.
Mechanism of Action
Neurotransmitters carry information between neurons. The part of the neuron that receives neurotransmitters is called a “receptor”. The glutamate receptor, as the name implies, is the receptor for the neurotransmitter glutamate. Glutamate is not only our main excitatory neurotransmitter, it is also the precursor of GABA, our main inhibitory neurotransmitter. Glutamate receptors are important for forming memories and learning. AMPA receptors are a type of glutamate receptors that are involved in memory storage. AMPA receptors are the targets of therapeutic drugs given that glutamate is believed to be involved in psychiatric and neurological disease. Aniracetam seems to reduce the rate that AMPA receptor become desensitized  to positive stimuli like glutamate. Thus, Aniracetam and other AMPA modulators are being investigated for schizophrenia and Alzheimer’s disease.  It appears that aniracetam stimulates the AMPA receptor more than other racetams.
Aniracetam seems to increase the effects of GABAergic inhibition. GABA is important for emotional wellbeing cognition, and improving GABA function could be potentially therapeutic for anxiety and cognitive disease. 
Aniracetam appears to enhance acetylcholine transmission, which plays an important role in cognitive function and the Alzheimer’s Disease.  It is theorized that the reduction of depression seen in animal studies may also be a result of Aniracetam interacting with these receptors. 
Serotonin and dopamine receptors
Animal studies indicate that Aniracetam may reduce anxiety and increase socialization by interacting with serotonin, dopamine, and acetylcholine receptors . It also seems to increase the release of serotonin and dopamine, which may work together to improve mood and judgment.  This is an interesting aspect of aniracetam; it is the only racetam that seems to be able to reduce anxiety.
In animal studies, aniracetam seems to alleviate impairment to memory and learning caused by various means, including cerebral ischemia, cholinergic antagonists, and electroconvulsive shock. Aniracetam can also protect against scopolamine-induced damage and seems more powerful than piracetam at doing so on a milligram by milligram basis. 
Conditions for which it has been used
There is some evidence that Aniracetam may improve memory and cognition in those who are cognitively impaired. Trial results involving elderly people who were cognitively impaired from either Alzheimer’s or other forms of dementia suggested that aniracetam may benefit theses conditions. Further trials are needed for confirmation of its safety and efficacy. Aniracetam was significantly more effective than placebo in tests at 4 and 6 months, and in a further 6-month trial was more effective than piracetam on certain testing parameters.
Available information from trials seems to indicate that aniracetam is well tolerated. In particular, one published overview noted that aniracetam does not appear to raise in liver enzyme levels. Preliminary evidence points towards a good tolerability profile.
Aniracetam is a fat-soluble racetam nootropic. Human studies are lacking, but it may prove to be a viable treatment for Alzheimer’s Disease or depression. Anecdotally, it is claimed to facilitate associative thinking and creativity, and animal studies have shown an anti-anxiety effect. In addition, as far as we can tell, there it does not seem to be associated with significant side effects and appears to be well tolerated.
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