In recent years, more and more data have emerged on the possibility of using nootropic drugs with a wide range of neurological and psychopharmacotherapeutic activity (nootrophs, neuroprotectors, nootropics). Such drugs have not only an activating effect on cognitive functions, but also anxiolytic, antiasthenic, stimulating, and thymoleptic effects. Therefore, many authors [1, 3, 4, 6] consider it advisable to include them in the treatment of somatogenies, asthenic depression, as well as for the relief and prevention of neurasthenic disorders.
The group of drugs under consideration includes the domestic drug nooclerin - deanol aceglumate, nooclerin-2-(dimethylamino)-ethanol N-acetyl-L-glutamate. In its chemical structure, it is close to natural brain metabolites and consists of two components, one of which is structurally similar to GABA and glutamic acid, and the second is a precursor to choline.
The history of deanol aceglumate in Russia is connected with the scientific activities of the All-Union Scientific Center for the Safety of Biologically Active Substances (currently OJSC All-Russian Scientific Center for the Safety of Biologically Active Substances), where in the 80s of the last century a new method for its synthesis was developed and new dosage form. A prototype was obtained in 1990, and in 1992 the industrial production of the resulting medicinal product demanol, oral solution, 100 ml bottle, manufactured by Marbiopharm (Russia)[] was launched. In 2001, the Russian pharmaceutical company began producing the drug nooclerin (deanol aceglumate).
Pharmacokinetics and pharmacodynamics
Deanol aceglumate belongs to the pharmacological group of nootropics. ATC code: N06BX Other psychostimulants and nootropic drugs.
Deanol aceglumate is a neurometabolic stimulant and has cerebroprotective, nootropic, and psychostimulating effects. It facilitates the processes of recording, consolidating and reproducing information, improves learning ability, and increases personal motivation[].
Deanol aceglumate has high bioavailability: 30-60 minutes after oral administration it is found in maximum concentration in the brain. Excreted by the kidneys. Recommended regimen: orally after meals, 1-2 g 2-3 times a day. The maximum single dose is 2 g, daily dose is 10 g.
Results of preclinical and clinical studies
The properties of deanol aceglumate have been studied both in foreign countries and in our country. Data on the first study of deanol aceglumate in the USSR were published by employees of the Institute of Pharmacology of the USSR Academy of Medical Sciences in 1986 [2]. Its action was studied simultaneously with the action of such nootropic drugs as piracetam, encephabol and cleregil. In particular, their effect on the transcallosal evoked potential (TCE) of the rabbit brain was studied. It was found that all drugs have a pronounced alleviating effect on TVP. At the same time, differences were found in their effect on the components of TVP: deanol aceglumate (cleregil) had the effect with the smallest deviation in the amplitude of all the studied components of TVP (compared to encephabol and piracetam), which is as close as possible to the picture of the study of neutral saline solution and indicates its safety .
As part of preclinical studies of deanol (dimethylaminoethanol) and deanol aceglumate in different countries, its various properties and pharmacological effects were investigated: acute and chronic toxicity [15]; pharmacokinetics of deanol derivatives in animals [14]; positive effect on neuromuscular transmission [10, 30]; influence on the lifespan of laboratory animals [9, 16, 17]; antagonism of the cardiovascular response induced by nicotine when using DMAE and analogues (experiment on guinea pigs) [28]; influence on the production of betaine, a choline metabolite, by inhibiting choline oxidase and influencing osmoregulation [23]; surface-active properties and influence on ecto-ATPase of plasma membranes [30]; stimulation of antimicrobial activity of macrophages [31]; influence on short-term memory and behavior of rats in the radial arc maze [21]; study of the psychotropic effects of nooclerin tablets.[]
As part of clinical studies of deanol aceglumate in Russia, its pharmacological effects were investigated in a variety of diseases and conditions: stimulating, activating and nootropic activity was studied in asthenic and astheno-depressive conditions of various origins, astheno-hypochondriacal disorders (dizziness, sweating, sleep and appetite disturbances); nootropic and corrective psychostimulating activity, as well as the ability to relieve side effects of neuroleptic therapy were studied in patients with schizophrenia and psychoorganic syndrome, endogenous psychoses, cyclothymia and endogenous depression; a moderately pronounced activating and nootropic effect was detected in children and adolescents with developmental delay, accompanied by severe symptoms of asthenia and psychopathic behavior, with borderline neuropsychiatric disorders of the asthenic and neurotic spectrum; influence on increasing physical performance in athletes (masters of sports in athletics); the hepatoprotective effect was studied in patients with moderate chronic viral hepatitis, as well as in patients with fatty liver and/or alcoholic hepatitis, as well as relief of alcohol withdrawal syndrome; its ability to correct functional disorders of the visual analyzer in patients with glaucoma and other pathological conditions was also studied [1, 5, 6].
In foreign clinical studies, the following pharmacological effects of deanol aceglumate were established: a mild stimulating effect in the treatment of neurasthenia and depression, the ability to correct behavior and normalize sleep with its help [8, 11-13, 18, 20, 32]; neuroleptic effect in the treatment of patients with schizophrenia, including depressive states; positive impact on the condition and behavior of mentally disabled children and children with signs of epilepsy [19, 26, 27, 29]; the possibility of use for the treatment of blepharospasm [25]; use for the prevention of skin aging and antibacterial activity of cosmetics in dermatology [15, 24, 31, 33, 36].
Results of computer methods for analyzing the biological and clinical activity of the drug
Due to the rapid development over the past decades of computer methods for drug design (Computer-Aided Drug Design), their use in practical medicine has become possible and advisable. The Research Institute of Biomedical Chemistry of the Russian Academy of Medical Sciences has created and successfully used a set of original patented computer programs for assessing the types and mechanisms of biological activity of medicinal compounds - PASS and Pharma Expert. The PASS program allows, based on the structural formula of an organic compound, to evaluate its probable spectrum of biological activity (over 6000 pharmacotherapeutic effects, mechanisms of action, interactions with enzymes of the metabolic system, transporters, etc.). The Pharma Expert program allows you to analyze the spectra of biological activity predicted by PASS, taking into account the established relationships between various types of activity, which expands the possibilities for meaningful interpretation of PASS prediction results, makes it possible to select organic compounds with the required activity profile and establish possible new indications for known drugs [7].
Using these computer programs, a detailed comparative analysis of the spectra of biological activity of nooclerin (deanol aceglumate) and pharmaceutical substances with similar properties (pyritinol, piracetam, noopept) was carried out for the first time. Pharmacological effects and mechanisms of action predicted with a high degree of probability were considered. When comparing the prediction results with established experimental data, information from the PubChem database was also used, along with published data on the pharmacological action of deanol aceglumate.
The results obtained can be grouped according to pharmacological and clinical effects applicable to therapeutic areas.
Psychiatry and neurology
: depression; alcohol withdrawal syndrome; cognitive impairment due to organic and toxic lesions; relief of side effects of neuroleptic therapy; anxiety-phobic disorders as part of complex therapy for schizophrenia; astheno-vegetative and astheno-depressive syndrome; attention deficit hyperactivity disorder (ADHD); mnestic disorders due to developmental disorders; functional asthenia of a psychogenic nature; acute stress; Parkinson's disease.
Hepatology
: acute and chronic viral and toxic (alcohol, drug) hepatitis.
Sports medicine
: increasing the endurance and performance of the body under significant physical and psycho-emotional stress.
Ophthalmology
: correction of functional disorders of the visual analyzer with increased constant exposure to it, glaucoma and anemia [].
Cosmetology and dermatology
: dermatitis; slowing down skin aging processes.
According to the analysis, the main mechanisms and pharmacological properties
, which cause the presented clinical effects: antihypoxic effect; anti-ischemic effect; antitoxic effect; cytoprotective effect; regulation of lipid metabolism; neuroprotective effect; vasodilation of cerebral and coronary vessels; vasoprotective effect; moderate antianginal effect; nootropic effect; reduction of muscle rigidity and hand tremors in Parkinson's disease; moderate immunostimulating effects and activation of complement; moderate stimulation of erythro- and leukopoiesis; inhibition of fibroblast growth factors (bFGF; FGF1; FGF2) and aldose reductase; Nerve growth factor (NGF) stimulator.
Conclusion
The results of computer, preclinical and clinical studies, as well as many years of experience in the practical use of deanol aceglumate (nooclerin) indicate that this drug demonstrates pronounced nootropic, antiasthenic, antiasthenodepressive, neuroprotective and hepatoprotective activity. In addition, deanol aceglumate has a corrective effect on various disorders of the visual analyzer, provides increased endurance and performance of the body under significant physical and psycho-emotional stress, and slows down the aging process of the skin.
Deanol aceglumate (nooclerin) is approved for use from 10 years of age. The drug is low-toxic and has virtually no side effects, including the negative properties characteristic of other nootropic drugs.
It is obvious that the potential for clinical use of the drug deanol aceglumate has not yet been fully exploited, and its use as part of complex therapy for a whole range of diseases will help achieve better clinical effects.
A computer forecast of the spectrum of biological activity indicates possible areas for expanding the indications for the use of deanol aceglumate, which can be implemented in practice with the expansion of relevant research.
[]In 1994, his registration document expired.
[]Instructions for medical use of the drug P N000447/01-300909. https://grls.rosminzdrav.ru/InstrImg.aspx?idReg=476&t=grlsView. 07/09/2013.
[] In this article, in addition to the sources indicated in the list of references, the authors used materials from reports of some Russian scientific and practical healthcare institutions for 1991-2007.
Nootropics
Nootropics (from the Greek noos - thinking, mind, tropos - direction, desire, affinity) are neurometabolic drugs that have a direct activating effect on the integrative mechanisms of the brain, optimize cognition (processes of memory, thinking, intelligence) and increase the level of wakefulness (vigilance). ), increase the brain’s resistance to harmful influences, and also improve cortico-subcortical connections.
Due to the ability of nootropics to improve mentality in healthy and sick people, they are called cognitive enhancers. Nootropics stimulate the transmission of excitation in central neurons, accelerating interneuron contacts and the exchange of neurotransmitters; activate the synthesis of protein and RNA in neurons, stabilize the membranes of nerve cells, improve energy processes, microcirculation and blood supply to the brain (without vasodilation), increase the latter’s resistance to hypoxia, have pronounced antihypoxic, neurotrophic and cerebroprotective activity, etc.
At the same time, nootropics do not affect the course of neurovegetative processes, do not have significant psychostimulating, hypnotic, sedative and analgesic effects, do not cause specific changes in the EEG, do not have significant toxicity, and do not impair blood circulation. In general, the mechanism of the therapeutic effect of nootropics has not been studied enough.
1. Piracetam. Synonyms: Lucetam, Memotropil, Nootobril, Nootropil, Noocetam, Pyrabene, Piramem, Apagon, Centilan, Euvifor, Gabazet, Norotrop, Stimubral and many others. etc. Indicated for the treatment of various psychiatric, neurological and somatic diseases.
In psychiatric practice, these are asthenic disorders of various origins, mental retardation, learning difficulties, post-stress disorders, depressive states with asthenia, apathy, adynamia, lethargy and senesto-hypochondriacal symptoms, deficiency disorders in schizophrenia with a deficit of activity, attention and communication, organic processes of various etiologies , including atrophic, traumatic, vascular and intoxication. Piracetam improves the tolerability and effectiveness of antidepressants and antipsychotics, and the severity of side effects during treatment with them. Prescribed for the treatment of abstinence, relief of exogenous-organic psychoses.
In neurology and somatic practice, it is used in the treatment of a number of organic diseases of the brain (vascular processes, comatose and subcomatose states, intoxication, trauma, inflammatory processes and their consequences, birth trauma, asphyxia, the period of convalescence after meningitis, encephalitis, etc.), heart attack myocardium, cortical myoclonus, sickle cell anemia, viral neuroinfection, etc. It is prescribed orally, intramuscularly, intravenously or by infusion. In the treatment of chronic conditions, it is usually prescribed orally, regardless of food intake, 3-4 times a day in doses of up to 2.4 g, sometimes up to 3.2 g. Treatment begins with 1.2 g / day, the dose is then increased gradually, by 0 .4 g per day. The therapeutic effect occurs after 2–3 weeks of treatment; subsequently, the dose is gradually reduced to a maintenance dose of 1.2–1.6 mg/day. For stroke, up to 12 g per day is prescribed for 2 weeks. For children, the drug is prescribed in smaller doses: under 5 years of age - 200 mg 3 times a day, from 5 to 16 years - 400 mg 3 times a day.
The course of treatment with piracetam lasts from 2–3 weeks to 2–6 months.
In acute painful conditions (coma, poisoning with morphine and barbiturates, withdrawal symptoms, pre-delirious states, acute complications during psychopharmacotherapy), piracetam is prescribed intramuscularly or intravenously. Therapy begins with the introduction of 2–4 g/day and quickly increases the dose to 4–7 g/day or more. After the condition improves, they switch to taking the drug orally.
Side effects: possible agitation, irritability, anxiety, arousal (including sexual), weakness, sleep disturbance, dyspeptic disorders, abdominal pain, tremor, dizziness, allergic reactions; Elderly patients may experience an increased frequency of attacks of coronary insufficiency. Side effects occur especially often in patients with psychiatric pathology. In such cases, the dose of the drug should be reduced or stopped taking it for a while.
Contraindications for use: hypersensitivity, acute renal failure, hemorrhagic stroke, pregnancy, breastfeeding, diabetes, age under 1 year.
Release form: capsules of 400 mg in a package of 60 pieces; tablets of 200 mg in packs of 60 and 120 pieces; 20% solution in ampoules of 5 ml (1 g of substance per ampoule) in a package of 10 pieces; piracetam granules for children in a package of 56 g (2 g piracetam, 50 g sugar and fillers) in glass jars. Combination drugs are available: Fezam - contains piracetam with cinnarizine; Procetam (Orozetam) - piracetam with orotic acid; Diapiram - piracetam with diazepam, etc.
2. Aminalonum, gamma-aminobutyric acid (GABA). Synonyms: Gammalon, Ganevrin, Apogamma, GABA, Gaballon, Mielogen, etc. It is known that GABA is the main mediator involved in the processes of central inhibition through interaction with GABAergic receptors of type A and type B. A close connection of the latter with benzodiazepine receptors has been established: benzodiazepines potentiate the effect of GABA, which, in turn, is the effect of benzodiazepines, many hypnotics and anticonvulsants. Under the influence of GABA, the energy processes of the brain are activated, the respiratory activity of tissues increases, and the brain's utilization of glucose and hemodynamics improve. The nature of the action of GABA is close to nootropics. It is used mainly in geriatric practice and in the treatment of children with mental retardation, as well as for vascular disorders of the brain. There is information about the effectiveness of the use of aminalon in the treatment of depression with asthenohypochondriacal symptoms, alcoholic encephalopathy, alcoholic polyneuritis and dementia.
It is prescribed orally before meals 3-4 times a day. Adults are prescribed up to 3.75 g/day, the average dose is 1.5–3 g/day. Children, depending on age, are prescribed from 0.5 to 3 g/day. The course of treatment is up to 2–6 months. For motion sickness, adults are prescribed 0.5 g, children - 0.25 g 3 times a day for 3-4 days.
Side effects are rare; in some cases, in the first days of treatment, dyspeptic symptoms, sleep disturbances, a feeling of heat, and blood pressure fluctuations are observed. When the dose is reduced, these effects usually disappear quickly.
Contraindications for use: hypersensitivity. Release form: tablets of 0.25 g in a package of 100 pieces.
3. Sodium oxybutyrate (Natrii oxybutiratas) . Synonyms: Sodium oxybate, Sodium salt of hydroxybutyric acid, Natrium oxybutiricum, Oxybate sodium. A nootropic with pronounced antihypoxic, sedative, general anesthetic and central muscle relaxant activity, in large doses induces sleep and a state of anesthesia. Enhances the effect of analgesics, narcotic drugs, and has an anti-shock effect. In psychiatric practice, it is used to treat neurotic and neurosis-like conditions, intoxication and brain injuries, and night sleep disorders (including narcolepsy). In somatic medicine it is used as a means of anesthesia, in the treatment of hypoxic cerebral edema, hypoxic condition of the retina, and glaucoma.
Prescribed orally, intramuscularly and intravenously. Orally for the treatment of neurotic conditions, take 0.75 g (1 tablespoon of 5% solution 2-3 times a day), insomnia - 1.5-2.25 g at night once (2-3 tablespoons of 5% solution) .
Release form: 66.7% solution in 37.5 ml bottles (before use, prepare a 5% aqueous solution by diluting the contents of the bottle in 0.5 liters of freshly boiled chilled water); 20% solution in ampoules of 10 ml in a package of 10 ampoules.
Side effects: with rapid intravenous administration, there may be motor agitation, convulsive twitching of the limbs and tongue, and in case of overdose, respiratory arrest. Upon recovery from anesthesia, motor and speech agitation sometimes occur. The antidote is bemegride. With prolonged use of the drug, hypokalemia is possible.
Contraindications for use: hypokalemia, myasthenia gravis, hypersensitivity, late toxicosis of pregnancy with arterial hypertension.
4. Phenibut - see "Antidepressants."
5. Pantogamum. Synonyms: Calcium homopantothenat, Hopaten, Hopa, etc. Nootropic with anticonvulsant, moderate and short-term hypotensive effects. Prolongs the effect of barbiturates, reduces reactions to painful stimuli. It is used to treat residual organic brain failure, decreased activity and disability, mental retardation in children, and is also effective for hyperkinesis, Jacksonian epilepsy, parkinsonism, neuroleptic syndrome, clonic stuttering in children, delayed speech development, epilepsy with petit mal and polymorphic seizures (in combination with specific antiepileptic drugs).
It is prescribed orally 15–30 minutes after meals. The daily dose for adults is 1.5-3 g, for children - 0.75-3 g in three divided doses. The course of treatment is from 1 to 4 (sometimes up to 6) months. Courses of treatment are repeated if necessary.
Release forms: tablets of 0.25 g and 0.5 g in a package of 50 pieces.
6. Picamilon (Picamilonum). Nootropic with tranquilizing and vegetotropic effects. It is prescribed orally regardless of food intake. For cerebrovascular diseases and vegetative dystonia, adults are prescribed from 0.02 to 0.05 g 2-3 times a day, the course of treatment is 1-2 months, with the course repeated after 5-6 months. In the complex of antidepressant therapy in old age, 0.04–0.2 g (in 2–3 doses) is recommended for 1.5–3 months. During the period of alcohol withdrawal, 0.1–0.15 g/day is prescribed, the course of treatment is 6–7 days, the duration of treatment can be increased to 4–5 weeks in doses of 0.04–0.06 g/day. To restore working capacity, 0.06–0.08 g/day is prescribed for 1–1.5 months.
Side effects: increased irritability, agitation, anxiety, headache, dizziness, mild nausea, itching, allergic rash.
Contraindications for use: hypersensitivity, acute and chronic kidney diseases.
Release form: tablets of 0.01 g, 0.02 g and 0.05 g in a package of 30 pieces.
7. Pyriditol (Piriditolum). Synonyms: Pyritinol, Cerebol, Enerbol, Encephabol, Biocephalin, Cogitan, Enbol, Enerbol, Pyritinol, etc. A nootropic with pronounced antidepressant activity. Enhances the effects of phenamine, the anticonvulsant effect of phenobarbital, and prolongs the effect of barbiturates. Indicated for the treatment of minor depression of various origins and neurosis-like conditions with symptoms of asthenia, apathy, adynamia, as well as residual organic conditions with a predominance of anergy phenomena, in children - mental retardation, cerebrasthenic syndrome, encephalopathy, mental retardation.
It is prescribed orally 15–30 minutes after meals 2–3 times a day (it is not recommended to take the drug in the evening). The daily dose for adults is from 0.2 to 0.6 g, for children - 0.05-0.3 g. The course of treatment is from 1 to 3 months, repeated courses - after 1-6 months.
Side effects: headache, nausea, insomnia, irritability, in children - psychomotor agitation, sleep disturbance.
Contraindications for use: psychomotor agitation, epilepsy, increased convulsive readiness, hypersensitivity.
Release forms: tablets of 0.05 g, 0.1 g and 0.2 g in a package of 60 pieces. Encephabol is available in tablets of 0.1 g and in the form of syrup of 0.1 g in 5 ml.
8. Acephenum. Synonyms: Analux, Meclofenoxate, Centrophenoxine, Cerutin, Claretil, Lucidril, Meclofenoxate hydrochloride, Ropoxil, etc. Metabolic products of acephen are free radical inhibitors, have the properties of nootropics and mild stimulants and are marketed under the name Deanol (Dinetal, Etanamin, etc.). Nootropic with a moderate stimulating effect. Indicated for the treatment of asthenia, memory loss in old and senile age, obsessions and other neurotic disorders.
It is prescribed orally at 0.1–0.3 g 3–5 times a day, the course of treatment is 1–3 months. Side effects are rare. Sometimes there is an exacerbation of psychotics, fear and anxiety. Contraindications for use: infectious diseases of the central nervous system, hypersensitivity.
Release form: tablets of 0.1 g in a package of 50 pieces.
9. Memantine. Synonym: Akatinol Memantine, Akatinol Memantin. Neuroprotective, antispastic, antiparkinsonian agent. A non-competitive antagonist of N-methyl-D-aspartate (NMDA) receptors, it inhibits glutamatergic neurotransmission and the progression of neurodegenerative processes, and has a neuromodulatory effect. Indicated for the treatment of mild to moderate dysfunctions of the central nervous system (weakening of memory, attention, interests, fatigue, psychoorganic decline in personality), muscle spasticity and motor disorders due to damage to nervous structures (brain injuries, multiple sclerosis, Parkinson's disease, etc.). The drug enhances the effect of barbiturates, neuroleptics, anticholinergics, levodopa, dopamine receptor agonists, amantadine, and may change the effect of dantrolene and baclofen.
It is prescribed orally during meals, without chewing and with liquid. Adults - starting from 3 mg/day, if necessary, with a weekly increase in dose by 5–10 mg/day to 30–60 mg/day, and then reducing it to maintenance (10–20 mg/day). Children - 0.5 mg/kg/day or 1 drop per 1 kg of weight.
Side effects: dizziness, internal or motor restlessness, fatigue, increased intracranial pressure. Prescribe with caution to persons whose work requires high concentration of attention.
Contraindications for use: hypersensitivity, confusion, severe dysfunction of the liver and kidneys. Restricted for use in epilepsy, thyrotoxicosis, pregnancy, breastfeeding.
10. Cerebrolyzin. Synonym: Cebrilisin. It is a mixture of metabolically active neuropeptides with pronounced neurotrophic activity. Indicated for the treatment of organic brain damage with cognitive deficits, mental retardation
chemical development in children, dementia syndromes of various origins (Pick's disease, Alzheimer's disease, vascular dementia, etc.), as well as endogenous depression resistant to antidepressants. The drug enhances the effect of antidepressants.
Prescribed daily intravenously or intramuscularly. In acute conditions in adults (ischemic stroke, head injury, complications after brain surgery), it is administered intravenously over 60–90 minutes in an amount of 10–60 ml in 100–250 ml of saline. The course of treatment is 10–25 days. In the residual period - 5-10 ml IV for 20-30 days. For dementia syndromes - 10-20 ml IV for 3 weeks, for psychoorganic syndrome and depression - 5-10 ml IV for 20-25 days. In neuropediatric practice - 1–2 ml (up to 1 ml per 10 kg of weight) intramuscularly for 1 month, repeating the course 2–3 times a year.
Side effects: hyperthermia with rapid intravenous infusion.
Contraindications for use: hypersensitivity, acute renal failure, status epilepticus. Use with caution during pregnancy, especially in the first 3 months.
Release forms: solution of 215.2 mg in ampoules of 1 ml; 215.2 mg in ampoules of 5 ml and 10 ml; 215.2 mg in 30 ml bottles.
11. Pantogam. Nootropic with anticonvulsant and antidysuric effects. Helps normalize GABAergic transmission in chronic alcoholism, has analgesic properties, prolongs the effect of novocaine and sulfonamides, inhibits the increased bladder reflex and detrusor tone. Indicated for the treatment of disorders of higher cerebral functions of various origins in adults and children (vascular, traumatic encephalopathy, atrophic processes, etc.), treatment of epilepsy, trigeminal neuralgia, chronic neuroleptic syndrome, hyperkinesis, PTSD, urination disorders (pollakiuria, urgency , enuresis). The effects of the drug are enhanced by glycine and xidifon. Pantogam, in turn, prolongs the effect of barbiturates, potentiates the effects of anticonvulsants, nootropics, local anesthetics, and prevents the side effects of phenobarbital, finlepsin, and neuroleptics.
It is prescribed orally 15–30 minutes after meals in the morning and afternoon. Adults - 0.25–1 g per dose, 1.5–3 g/day; course of treatment - 1-6 months, repeated course - after 3-6 months. For schizophrenia (in combination with psychotropic drugs) - 0.5-3 g/day, course of treatment - 1-3 months. For epilepsy (in combination with anticonvulsants) - 0.75–1 g/day, course - up to 1 year or more. For extrapyramidal hyperkinesis (as part of complex therapy) - 0.5-3 g/day, course - 4 months or more. For the consequences of neuroinfection and head injury - 0.25 g 3-4 times a day. For asthenic conditions - 0.25 g 3 times a day. For dysuria - 0.5–1 g 2–3 times a day.
Children single dose - 0.25-0.5 g, daily dose up to 1 year - 0.5-1 g, from 1 to 3 years - 1.5-2 g, from 3 to 15 years - 2.5- 3 g. The daily dose is increased over 7–12 days, the maximum dose lasts 15–40 days, after which it is reduced until discontinued within 7–8 days. Breaks between courses of therapy are 2 months. For dysuria in children - 25–50 mg/kg, course 1–3 months.
Side effects: allergic reactions.
Contraindications for use: hypersensitivity, acute severe kidney disease, first trimester of pregnancy.
Release forms: tablets of 250 mg and 500 mg in cans of 50 pieces; 10% syrup, 50 ml and 100 ml.
12. Glycine. Nonessential amino acid. Nootropic with antiepileptic, antistress and sedative effects. Indicated for the treatment of asthenia, PTSD, neuroses and neurosis-like conditions, vegetative dystonia, acute ischemic stroke, consequences of exogenous-organic and intoxication diseases. Glycine reduces the toxicity of anticonvulsants, neuroleptics, antidepressants, and can enhance the effect of hypnotics, tranquilizers and antipsychotics.
Prescribed orally sublingually 0.1 g 2-3 times a day for 2-4 weeks. Children under 3 years old - 0.05 g 2-3 times a day, over 3 years old - 0.1 g 2-3 times a day. For sleep disorders - 0.05–0.1 g 20 minutes before bedtime. For ischemic stroke, during the first 3-6 hours - 1 g (buccal or sublingual with 1 teaspoon of water), then - 1 g / day for 1-5 days, over the next 30 days - 0.1-0 .2 g 3 times a day.
Side effects: allergic reactions are possible. Contraindications for use: hypersensitivity. Release form: tablets of 0.1 g in a package of 50 pieces.
13. Idebenone. Nootropic. Indicated for the treatment of asthenia, asthenodepressive, asthenovegetative conditions, PTSD, psychoorganic syndrome of vascular and other origins, as well as hereditary mitochondrial diseases (MELAS syndrome, Leber optic atrophy, Leigh's disease) and Friedreich's ataxia.
Prescribed orally after meals, 30 mg 2-3 times a day (last dose no later than 17:00). The course of treatment is 1.5–2 months, repeated 2–3 times a year.
Side effects: mental agitation, difficulty falling asleep, headache, dyspepsia, allergic reactions.
Contraindications for use: hypersensitivity. Use with caution during pregnancy and breastfeeding. Use with caution for persons whose work requires high concentration of attention.
Release form: tablets of 30 mg in a package of 10 pieces.
14. Gliattilin. Synonym: Choline alfoscerate. Neuroprotector, centrally acting cholinomimetic. Indicated for the treatment of exogenous-organic, atrophic diseases (cerebrovascular insufficiency, acute and recovery periods of TBI, ischemic stroke, dementia, senile pseudomelancholia).
Prescribed orally, intramuscularly and intravenously. Take 400 mg orally 2-3 times a day. IM and IV (administer slowly!) - 1000 mg/day in the morning for 15–20 days, and then orally 800 mg in the morning and 400 mg in the afternoon for 6 months.
Side effects: nausea.
Contraindications for use: hypersensitivity. It is not recommended to prescribe during pregnancy and breastfeeding.
Release form: capsules of 400 mg in a package of 14 pieces; solution of 1000 mg in ampoules of 4 ml in a package of 3 pieces.
15. Ethylthiobenzymidazol hydrochloride. Antihypoxic, psychostimulant, anxiolytic, antiasthenic agent. Indicated for the treatment of asthenic and asthenodepressive conditions of various origins.
Prescribed orally after meals and no later than 16 hours, 0.25–0.5 g 2–3 times a day (no more than 2 g/day) for 1–4 weeks or 3–5 days in a row with breaks of 2– 5 days (2–3 courses). Treatment can be repeated after 1 month. To improve performance, take 0.25 g 1–2 times a day in cycles of 5 days with 2-day breaks, a total of 4–6 courses. During treatment, you should adhere to a diet rich in carbohydrates.
Side effects: irritability, anxiety, headache, sleep disturbance, nausea, rarely - vomiting, discomfort in the epigastrium.
Contraindications for use: hypersensitivity, severe psychomotor agitation, hyperglycemia. Restricted for use during pregnancy.
Release form: tablets of 0.25 g.
16. Semax solution 0.1% (Solucio Semaxi 0.1%). Gentapeptide in preservative (nipagin). Nootropic, adaptogen. Indicated for the treatment of asthenic conditions of various origins, to increase adaptation in extreme conditions, to prevent mental fatigue during intense and monotonous work.
Prescribed intranasally, 2-3 drops in each nasal passage 2-3 times a day for 3-14 days (single dose - 200-2000 mcg, daily dose - 500-5000 mcg). It is also administered by electrophoresis (the optimal daily dose is 400–600 mcg/day).
There are no side effects observed. Contraindications for use: acute psychosis, severe anxiety, endocrine diseases, pregnancy, breastfeeding.
Release form: 0.1% drops in 3 ml bottles.
17. Deanol aceglumate. Synonym: Nooclerin. Nootropic with cerebroprotective, antiasthenic, antidepressant and hepatoprotective effects. Indicated for the treatment of asthenic, asthenodepressive conditions of various origins, withdrawal symptoms, psychoorganic, neuroleptic syndromes, mnestic-intellectual decline, neurotic, psychosomatic and neurosis-like disorders.
Prescribed orally, 1 teaspoon (1 g of the drug) 2-3 times a day (no later than 18 hours), the course of treatment is 1.5-2 months.
Side effects: allergic reactions. Contraindications for use: hypersensitivity.
18. Biotredinum. Ingredients: L-threonine (100 mg) and pyridoxine hydrochloride (5 mg). Nootropic with anti-alcohol, anti-withdrawal effects. Indicated for the treatment of reduced mental performance and concentration, pathological craving for alcohol and alcohol withdrawal. The drug reduces the side effects of neuroleptics, antidepressants, tranquilizers, and barbiturates.
Prescribed orally sublingually: children - 2 mg/kg; adolescents and adults - 1 tablet 2-3 times a day for 3-10 days. Courses of treatment are repeated 3–4 times a year or more. For chronic alcoholism, 1-3 tablets are prescribed 2-3 times a day for 4-5 days. Courses are repeated 5–10 times a year or more. For alcohol withdrawal, 1-4 tablets 3-4 times a day are prescribed on the first day, then 1-2 tablets 2-3 times a day for 3-4 weeks (the best effect is achieved when combined with 0.1 g of glycine sublingually, glycine is taken 10–15 minutes before biotredin).
No side effects were identified. Contraindications for use: alcohol intoxication. Release form: tablets of 105 mg in packages of 30 and 50 pieces.
19. Tenoten. It has anxiolytic, antidepressant, nootropic, stress-protective, antiasthenic, antihypoxic, neuroprotective effects. Indicated for the treatment of asthenic, neurotic and neurosis-like disorders with manifestations of anxiety, depression, apathy, adynamia, affective lability of various origins, especially with moderately severe organic lesions of the central nervous system.
It is prescribed orally on an empty stomach (keep the tablet in your mouth until completely dissolved). Depending on the severity of the condition, give from 1 to 12 tablets per day, the last dose is no later than 2-3 hours before bedtime. The course of treatment is up to 3 months, if necessary – up to 6 months. Courses of treatment may be repeated.
Side effects: dry mouth, heartburn, flatulence, hyperhidrosis, allergic reactions.
Contraindications for use: hypersensitivity. Release form: tablets in a package of 20 pieces.
20. Tanakan. Synonyms: Bilobin, Ginkgo Biloba, Ginkgo Biloba (BP). A nootropic with antihypoxic, angio-, cerebroprotective and antiaggregation effects, improves cerebral circulation, reduces capillary permeability, and activates intracellular metabolism. It also has an antidepressant effect and slows down the progression of degenerative processes in atrophic diseases of the central nervous system. Indicated in the treatment of the consequences of stroke, TBI, memory impairment, senile dementia, neurosensory disorders, Raynaud's syndrome, pathology of peripheral circulation, diabetic angioia and retinopathy.
Prescribed orally during meals, 3 tablets or 3 doses of solution per day. Side effects: headache, dyspepsia, allergic reactions.
Contraindications for use: hypersensitivity.
Release forms: tablets of 40 mg in packages of 30 and 90 pieces; drinking solution 30 ml in a bottle.
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