▴ Nefiracetam (DM 9384) is a pyrrolidone derivative with potential for use in patients with dementia secondary to cerebrovascular disorders or Alzheimer's disease.▴ It is thought to act by normalising dysfunctional acetylcholine,&ggr;-aminobutyric acid (GABA) and possibly monoamine neurotransmitter systems, but it may also facilitate N/L-type calcium channel opening.▴ Nefiracetam for 2 to 12 months improved cognitive function and psychiatric symptoms in patients with dementia due to cerebrovascular disorders.▴ Nefiracetam was at least as effective as idebenone and was superior to placebo in patients with cerebrovascular dementia in large double-blind 8-week trials.▴ Adverse events as reported in clinical trials are infrequent and are mainly gastrointestinal in nature.