Possibilities of using the drug Dimephosphone in neurology and neurosurgery

Cost of treating alcoholism with coding

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Dimephosphon®

Dimephosphone is taken orally after meals with water.

The course of treatment depends on the nature of the disease and lasts from 3 days to 2 months.

In complex therapy of the following diseases and conditions:

For acute and chronic cerebrovascular accidents, consequences of ischemic and hemorrhagic strokes,
traumatic brain and neurosurgical trauma
for adults, 15 ml (1 tablespoon) 3-4 times a day. The duration of the course is 2-3 weeks, in some cases up to 6 weeks.

During planned neurosurgical operations

15 ml (1 tablespoon) for 5 days before and 2 months after surgery.

For osteochondrosis

adults: 10 ml (1 dessert spoon) 3-4 times a day for 2-3 weeks, improvement is observed on the 8-10th day of treatment.

For multiple sclerosis

adults: 100 mg/kg (45 ml) per day - 15 ml (1 tablespoon) 3 times a day for 10 days in the autumn-spring period monthly.

For chronic nonspecific lung diseases with signs of respiratory and pulmonary heart failure

adults: 15 ml (1 tablespoon) 3-4 times a day. Course - 7-10 days. The use of dimephosphone does not relieve asthma attacks and does not affect the frequency of use of beta-agonist aerosols.

For vegetative-vascular dystonia of the parasympathetic type

adults 15 ml (1 tablespoon) 3 times a day for 2-3 weeks, children over 12 years old 50 mg/kg (10-15 ml) 3 times a day for 3 weeks.

For chronic cerebrovascular insufficiency due to atherosclerosis and hypertension

15 ml (1 tablespoon) 3 times a day for 2-3 weeks.

For migraine

15 ml (1 tablespoon) 3 times a day for 2-3 weeks.

For Meniere's disease

15 ml (1 tablespoon) 3 times a day for 3 weeks.

For respiratory diseases, acidosis, atonic bronchial asthma and hay fever

adults are prescribed 15-25 ml, children are prescribed 15-25 ml, children are prescribed a dose of 75-100 mg/kg: children under 3 years old - 5 ml (1 teaspoon), 3-8 years old - 10 ml (1 dessert spoon), over 8 years old - 15 ml (1 tablespoon) 3 times a day, in severe cases - 4 times a day for 4-5 weeks.

For atonic bronchial asthma in combination with hay fever

prescribed 2-3 weeks before the onset of deterioration and taken throughout the entire flowering period. For dosing, you can use the measuring cup included in the package.

Externally

For infectious-inflammatory-allergic diseases of the skin and mucous membranes

in the form of bandages, turundas and lotions with a solution daily for

3-14 days.

For complex treatment of acne

wipe the skin 3-4 times a day, apply lotions in the evening.

With erysipelas

- lubricate the inflammation area 3 times a day for 3-5 days.

On the area of ​​seams and places where the knitting needles exit

Apply gauze pads soaked in dimephosphone daily for 7-14 days.

For the prevention of radiation mucositis

- gauze wipes soaked in dimephosphone are placed in the projection of the radiation beams 20 minutes before dose exposure.

Methods for coding alcoholism

• Drug therapy. Treatment is carried out through the introduction of medications into the body, which ensures the rejection of alcohol at the cellular level. When drinking alcohol, a chemical reaction occurs in this case, and the addict feels a deterioration in health. The most common medications include Vivitrol, Esperal, Algominal, Disulfiram, etc.
• Psychotherapy. Common methods are hypnosis and the Davzhenko method. During coding, the specialist gives an aversion to alcohol.
• Laser therapy. Effective in the first and second stages of alcoholism. A method with high efficiency and a complete absence of side effects.

Dimephosphone, 1 piece, 100 ml, 15%, solution for oral and external use

Inside

, after meals, with water.

The course of treatment depends on the nature of the disease and lasts from 3 days to 2 months.

In complex therapy of the following diseases and conditions:

For acute and chronic cerebrovascular accidents, consequences of ischemic and hemorrhagic strokes, traumatic brain injury

- adults 15 ml (1 tablespoon) 3-4 times a day. The duration of the course is 2–3 weeks, in some cases up to 6 weeks.

During planned neurosurgical operations

- 15 ml (1 tablespoon) for 5 days before and 2 months after surgery.

For osteochondrosis

— adults, 10 ml (1 tablespoon) 3–4 times a day for 2–3 weeks, improvement is observed on the 8–10th day of treatment.

For multiple sclerosis

- adults 100 mg/kg (45 ml) per day (15 ml (1 tablespoon) 3 times a day) for 10 days in the autumn-spring period monthly.

For chronic nonspecific lung diseases with signs of respiratory and pulmonary-heart failure

- adults 15 ml (1 tablespoon) 3-4 times a day. Course - 7–10 days. The use of Dimephosphone® does not relieve asthma attacks and does not affect the frequency of use of beta-agonist aerosols.

For vegetative-vascular dystonia of the parasympathetic type

— adults 15 ml (1 tablespoon) 3 times a day for 2–3 weeks, children over 12 years old — 50 mg/kg (10–15 ml) 3 times a day for 3 weeks.

For chronic cerebrovascular insufficiency due to atherosclerosis and hypertension

— 15 ml (1 tablespoon) 3 times a day for 2–3 weeks.

For migraine

— 15 ml (1 tablespoon) 3 times a day for 2–3 weeks.

For Meniere's disease

- 15 ml (1 tablespoon) 3 times a day for 3 weeks.

For respiratory diseases, acidosis, atopic bronchial asthma and hay fever

- adults are prescribed 15-25 ml, children are prescribed at a dose of 75-100 mg/kg: up to 3 years - 5 ml (1 teaspoon), 3-8 years - 10 ml (1 teaspoon), over 8 years - 15 ml (1 tablespoon) 3 times a day, in severe cases - 4 times a day for 4-5 weeks. For atopic bronchial asthma in combination with hay fever, it is prescribed 2-3 weeks before the onset of deterioration and taken throughout the entire flowering period.

Externally.

For infectious-inflammatory-allergic diseases of the skin and mucous membranes

- in the form of bandages, turundas and lotions with a solution daily for 3–14 days.

For complex treatment of acne

wipe the skin 3-4 times a day, apply lotions in the evening.

For erysipelas

lubricate the inflammation area 3 times a day for 3–5 days.

To the area of ​​sutures and exit points of Ilizarov wires

Apply gauze pads soaked with Dimephosphone® daily for 7–14 days.

For the prevention of radiation mucositis

gauze wipes moistened with Dimephosphon® are placed in the projection of the radiation beams 20 minutes before dose exposure.

Advantages of alcohol coding at Alkoklinik

Our clinic offers a full range of services. To recover from alcoholism, to cleanse the body and restore its functions, to cope with psychological problems - we will help in any situation.

Our clinic differs from similar institutions:

• Providing services 24 hours a day. We provide cheap and effective treatment for alcohol addiction at any time of the day or night. Do you urgently need to relieve the symptoms of alcohol intoxication, organize withdrawal from binge drinking, or inexpensive coding for alcoholism? All you need to do is dial the number. Our consultants will advise you in detail on all issues of interest and provide information on how much coding costs using one or another method.

• Modern drugs and equipment. Coding for alcoholism is a rather complex process, and medications must be tested and effective. We use reliable methods and modern drugs to eliminate intoxication, normalize cellular metabolism of the brain and blood pressure, and restore liver function. Patients are offered intravenous coding for alcoholism, the price of which is affordable for people with average incomes, tablet forms of drugs, sewing in implants, coding for drunkenness using hypnosis and suggestive methods.
• Complete anonymity. We provide only anonymous coding for binge drinking and alcoholism. All information that our clinic employees receive from patients is not subject to disclosure.
• Comfortable conditions of stay. If treatment at home is not possible, cozy rooms designed for single, double and triple occupancy are at your service. The price of a daily stay in the ward includes the cost of the entire complex of treatment measures for detoxification, three meals a day, round-the-clock supervision by medical staff and consultations with a narcologist-psychologist. The cost of encoding is paid separately.
• Individual approach to each patient. Our qualified doctors work with a variety of techniques, which allows us to most accurately select a method that will help alleviate the condition of patients or give them the opportunity to be free from alcohol even for 5 years.

Get a free consultation

+7(495) 798-30-80

The text was checked by expert doctors: Head of the socio-psychological service of the Alkoklinik MC, psychologist Yu.P. Baranova, L.A. Serova, a psychiatrist-narcologist.

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Possibilities of using the drug Dimephosphone in neurology and neurosurgery

The original domestic drug Dimephosphone (dimethyloxobutylphosphonyl dimethylate) was synthesized in 1952 by A. N. Pudovik at the Institute of Organic and Physical Chemistry named after. A. E. Arbuzova[1]. It belongs to the group of metabolics and is a dimethyl ester of 1,1-dimethyl-3-oxobutylphosphonic acid, which has anti-acidotic and antioxidant effects. Dimephosphone has been produced since 1983; during clinical use, vaso- and neurotropic activity of the drug was also discovered.

The antioxidant effect is realized by preventing the activation of lipid peroxidation and increasing the activity of antioxidant enzymes in brain tissue [8].

Dimephosphone enhances energy processes in the brain both directly - acting directly on mitochondria - and indirectly - by stimulating and increasing tissue consumption of thyroid hormones, which is accompanied by activation of energy and catabolic processes in cell mitochondria. It also exhibits the properties of some neurotransmitters: it has GABAergic, N-cholinergic and dopaminergic activity.

The anti-acidotic effect of the drug is realized through the intensification of the renal and pulmonary mechanisms for regulating the acid-base state, enhancing intraorgan blood flow and tissue metabolism. In addition, when using Dimephosphone, the content of lactic and pyruvic acids in brain tissue decreases. Unlike known anti-acidotic drugs, which directly affect the acidity of the blood by introducing an appropriate alkaline solution, the drug produces its effect by interfering with metabolic processes.

One of the most valuable properties of Dimephosphone is its ability to influence the mechanisms of regulation of cerebral circulation and the function of the nervous system. It has been experimentally established that the drug reduces the phenomena of circulatory hypoxia, improves the regulation of cerebral circulation, normalizes the reactivity of cerebral vessels and blood supply to the brain and improves venous outflow. In addition, Dimephosphon normalizes neuromediation, has a beneficial effect on the electrical activity of the brain, and restores the sleep-wake cycle [1].

Recently, electrophysiological studies at the neuromuscular junction demonstrated that Dimephosphone has ion channel blocking properties. This explains why it, like phenytoin, exhibits anticonvulsant and antiarrhythmic activity. The channel blocking property of Dimephosphone may be directly related to the calcium-dependent effects of this drug [2].

The drug is available in the form of a 15% solution for oral administration in bottles of 100 and 200 ml.

The presence of vasoactive, neuroprotective, antioxidant, antihypoxic and neurotropic effects of Dimephosphone justifies the possibility of its use in various forms of cerebral pathology. Over more than 30 years of use of Dimephosphone in practical medicine, numerous clinical studies have been conducted that have demonstrated its effectiveness in various forms of pathology of the nervous system.

A long-term experimental clinical study assessing the effectiveness of Dimephosphone in the treatment of victims with TBI was conducted in Kazan[6]. Over 7 years, 2324 patients with severe TBI were treated in the intensive care unit, whose treatment regimen included Dimephosphone. When comparing the processes of restoration of consciousness and reflexes with and without the use of the drug, faster positive dynamics were noted in relation to the emergence of consciousness, restoration of adequacy of behavior and reflexes in patients receiving Dimephosphone. When using Dimephosphone, the normalization of respiration and systemic hemodynamics accelerated, the drug contributed to the rapid regression of focal brainstem and hemispheric symptoms. As a result, a decrease in the average mortality rate in patients with severe TBI was recorded to 27% versus 38.6% in the previous period, when Dimephosphone was not part of the course of treatment. Thus, the inclusion of Dimephosphone in the complex treatment of patients with severe TBI led to a reduction in mortality by 30%.

In 1994, the results of a study assessing the effect of Dimephosphone on the cerebral circulation regulation system in patients with brain tumors were published[5]. We observed 53 patients aged from 5 to 66 years with tumors of various histological structures of supra- and subtentorial localization who received monotherapy with Dimephosphone. It has been shown that a five-day course of treatment with Dimephosphone (30 mg/kg orally 3 times a day) in the preoperative period improves the regulation of cerebral circulation in patients with cerebral tumors. The drug restored the linear velocity of blood flow in the internal jugular veins and the impaired reactions of pulse blood filling to a unified anti-orthostatic load. At the same time, the reactions of the internal carotid arteries and basilar artery to stress with carbogen inhalation were normalized. In conditions of high intracranial pressure caused by an additional volumetric tumor process, liquor hypertension and cerebral edema, the use of the drug led to the restoration of the activity of regulatory mechanisms of circulatory support of both chemical and physical homeostasis and increased their tolerance to surgical trauma. During the treatment, a decrease in motor and speech disorders, easing of headaches, improved sleep, and stabilization of hemodynamics and breathing were noted.

In patients who received Dimephosphone before surgery, by the end of the first day, normal reactivity of cerebral vessels was recorded near the area of ​​surgical intervention, in contrast to patients who did not receive Dimephosphone as a preoperative pharmacological correction [5].

Dimephosphone also demonstrated a good effect in the treatment of 49 patients with cerebrovascular accidents caused by surgical trauma and thrombosis of the internal carotid arteries[12]. Patients took 15 ml of the drug 3 times a day for 14 days. In cases of cerebrovascular accidents caused by surgical trauma, rapid regression of neurological disorders occurred during a course of drug use. Dimephosphone relieved headaches caused by vasospasm well. In cases of severe spasm of the peripheral parts of the middle cerebral artery, transcranial Dopplerography revealed a decrease in elevated values ​​of systolic and average blood flow velocity and normalization of the systolic-diastolic ratio. Using the hydrogen clearance method, the normalizing effect of Dimephosphone on the initially low reactivity of cerebral vessels was revealed.

In patients with consequences of thrombosis of the internal carotid arteries, motor and speech disorders decreased during a course of use of Dimephosphone. At the same time, the drug effectively eliminated migraine-like headaches. The duration of the analgesic effect with a single dose was up to three hours. Dimephosphone was well tolerated by patients: no side effects from the gastrointestinal tract were noted, there were no local or allergic reactions[12].

Based on the Research Institute of Neurosurgery named after. N. N. Burdenko assessed the effect of Dimephosphone on the functional state of stem structures in neurosurgical patients in the early postoperative period [15]. In patients after removal of tumors of the hypothalamic-pituitary and pontobulbar localization with a clinical picture of transient ischemic brain damage, impaired consciousness with intact central mechanisms of visceral-autonomic regulation, the use of Dimephosphone in a daily dose of 40–60 mg/kg provided regression of cerebral and focal symptoms starting from 2–3 -th day from the start of therapy. At the same time, there was a tendency towards normalization of the EEG pattern.

In patients with tumors of the hypothalamic-pituitary localization who received Dimephosphone, in comparison with the control group, where this drug was not used, there was a tendency to more rapid restoration of circulating blood volume after surgery, which was probably due to the normalization of the functions of the paraventricular nuclei of the hypothalamus. In case of tumors of the fourth ventricle, the use of Dimephosphone made it possible to prevent the development of heart failure of central origin. A similar stress-protective effect of Dimephosphone was observed in patients in the acute period of TBI, and it was most pronounced with symptoms of damage to the midbasilar structures of the brain. In patients receiving Dimephosphone, there was a tendency to reduce the depth of disturbance of consciousness [15].

In 1996, the results of the use of Dimephosphone in the treatment of Meniere's syndrome were published[16]. In a hospital setting, 30 patients aged 26 to 70 years received monotherapy with the drug in a daily dose of 45 ml for 2–3 weeks. The duration of observation of the treated patients was 1.5 years. A stable positive effect was observed in 67% of patients. At the same time, the best results were observed with a relatively short duration of the disease (up to 5 years), unilateral damage to the labyrinth, and vestibular disorders at the onset of the disease. With the “cochlear” onset of the disease, the effectiveness of treatment was 50%. The data obtained on the positive effect of Dimephosphone in patients with damage to the peripheral part of the cochleovestibular analyzer due to hydrops of the labyrinth are most likely associated with the anti-acidotic effect of the drug, as well as with its beneficial effect on microcirculation in the vessels of the vertebrobasilar system.

According to the results of a clinical trial of the drug Dimephosphon [11], in patients with vegetative dystonia syndrome, its three-week course led to an improvement in subjective status: patients had reduced headaches and dizziness, improved sleep, and smoothed out the phenomena of hypochondria and irritability. Manifestations of angiodystonia decreased, pulse and blood pressure levels stabilized. A tendency towards leveling cerebral vascular dystonia was observed in the results of rheoencephalography. Among patients suffering from migraine, relief of headache attacks under the influence of Dimephosphone was not observed; the frequency of attacks remained unchanged throughout the entire period of taking the drug. At the same time, in the interictal period, most patients noted a subjective improvement in their condition: neurosis-like layers disappeared, sleep improved, and senestopathic manifestations decreased.

The effect of Dimephosphone on the dynamics of neurological deficit in patients with diseases of the spinal cord and its roots has been studied[7]. Dimephosphone was prescribed orally 15 ml (2.25 mg) 3-4 times a day for 2-3 weeks. In 14 patients with radiculopathy, after removal of a herniated disc, on the 3rd–4th day of treatment with the drug, radicular pain and numbness in the projection of the dermatomes of the affected roots disappeared. In cases of spinal circulation disorders caused by dyscirculatory myelopathy, under the influence of Dimephosphone, organic disorders were significantly reduced: paraparesis regressed and the functions of the pelvic organs were restored.

The authors also provide the results of treatment of a patient with lower paraplegia after total removal of an extramedullary spinal cord tumor. During treatment with Dimephosphon, rapid regression of motor disorders, warming below the upper level of conduction disorders and a decrease in leg pain were noted [7].

The results of treatment of patients with chronic cerebral circulatory disorders in the vertebrobasilar region aged from 26 to 60 years who took Dimephosphone for 3 weeks were analyzed[10]. In vertebrobasilar vascular insufficiency, Dimephosphone reduced headaches, dizziness, tinnitus, gait instability, and also improved memory and concentration. The corrective effect of Dimephosphone in the vertebrobasilar area was associated with inhibition of the development of tissue edema and improvement of the rheology of circulating erythrocytes. The drug smoothes shifts in the microblood supply of the spinal cord and medulla oblongata and has an antihypoxic effect on brain structures.

Studies conducted at the Kazan State Medical Academy found that Dimephosphone can have a beneficial effect on the clinical course of multiple sclerosis [9]. The researchers observed 21 patients with the cerebral form of multiple sclerosis, whose average age was 32.6 years. Dimephosphone was administered orally at a dose of 15 ml (2.25 mg) 3 times a day for 10 days. Clinical improvement was observed in 16 patients (76.2%). Subjectively, it was expressed in improved well-being and increased mood. Objectively, there was a decrease in tremor and unsteadiness when walking. In a number of cases, nystagmus disappeared and strength in the legs increased. Proprioceptive reflexes improved, and in some cases spasticity decreased. There were no side effects or worsening of the disease while taking the drug.

The effectiveness of Dimephosphone in patients with ischemic stroke and dyscirculatory encephalopathy (DE) was studied by the team of the Central Military Clinical Hospital named after. P. V. Mandryka (Moscow)[4]. For 20–25 days, 50 patients aged 64–80 years with this form of cerebral pathology took Dimephosphone orally at a daily dose of 45 ml. While taking the drug, headaches and dizziness decreased or completely stopped, and memory also improved. In a number of cases, the clinical manifestations of acute vestibular syndrome disappeared. When performing ultrasound echopulsography of the main artery, an increase in its lumen was noted while taking Dimephosphone. At the same time, the drug, without having a pronounced vasodilator effect, had a positive effect on the metabolism of ischemic brain tissue. The treatment was well tolerated by the patients.

On the basis of the Institute of Clinical and Experimental Neurology named after. P. M. Sarajishvili (Georgia) conducted a study of the effectiveness of the drug Dimephosphone in acute and chronic vascular diseases of the brain in comparison with cinnarizine [13]. We observed 54 patients with acute cerebrovascular accidents (ischemic and hemorrhagic strokes) and 102 with chronic ones.

Dimephosphone turned out to be more effective against manifestations of vestibular dysfunction in both acute and chronic cerebrovascular accidents. In patients with cerebral stroke during therapy with Dimephosphone, after 3–4 days the general condition improved and focal symptoms decreased. Positive dynamics were more often observed when the lesion was localized in the vertebrobasilar region. In 42.6% of cases of ischemic stroke, complete recovery was recorded. In chronic cerebrovascular accidents, already on the 2nd–3rd day of taking Dimephosphone, a decrease in both subjective vestibular disorders and objective ones was observed: nystagmus, vestibular hypo- or hyperreflexia, imbalance in simple and sensitized Romberg poses. Compared with the use of cinnarizine, regression of the vestibulo-atactic syndrome when taking Dimephosphone occurred in a shorter time and was more persistent[13].

In order to assess the possibility, effectiveness and safety of using the drug Dimephosphon in patients with DE in 2013 at the Department of Nervous Diseases of the Institute of Professional Education of the First Moscow State Medical University named after. I.M. Sechenov conducted an open comparative study to study the effectiveness of three methods of treating non-motor manifestations of DE: monotherapy with Dimephosphone, the use of Dimephosphone in combination with vinpocetine, as well as the isolated use of vinpocetine [14].

MATERIALS AND METHODS

The study involved 58 patients with different stages of DE. The average age of the patients was 70.4 ± 7.0 years (from 60 to 83 years); There were 13 men, 45 women. The first stage of DE was present in 8.6%, the second stage in 84.5%, and the third stage in 6.9% of patients.

Depending on the treatment method, three groups of patients were formed: monotherapy with vinpocetine (n = 20), monotherapy with Dimephosphone (n = 20) and combined treatment with Dimephosphone and vinpocetine (n = 18). The groups did not have statistically significant differences in age and gender composition, as well as in the severity of DE.

Dimephosphone was prescribed at a dose of 45 ml/day, vinpocetine at a dose of 15 mg/day. When taken in combination, patients took Dimephosphone together with vinpocetine. The course of taking the drugs was 21 days.

Before treatment, all patients were assessed for cognitive performance using the Mini-Mental State Examination (MMSE), emotional status using the Hospital Anxiety and Depression Scale, and sleep quality using the Subjective Sleep Characteristics Questionnaire. Repeated testing on the same scales was performed on the 21st day of treatment, and the results were entered into the patients’ outpatient records.

Statistical analysis used the Pearson Chi-square test with Bonferroni correction for multiple comparisons. Differences in indicators between groups were considered statistically significant at p values ​​<0.05.

RESULTS

The table shows comparative data between the study groups by the number of patients who received improvement in any of the non-motor indicators assessed. Responders were determined by the total scores of the corresponding questionnaires; a change of more than 0% was considered an improvement.

Table Number of patients with improvement in non-motor manifestations of dyscirculatory encephalopathy during treatment, n (%)

* The differences between the group of patients taking only Dimephosphone and the group of vinpocetine monotherapy are statistically significant (p < 0.05).

** The difference between the group of patients taking Dimephosphone with vinpocetine and the group of vinpocetine monotherapy is statistically significant (p < 0.05).

Note. Responders for individual non-motor indicators were determined by a change in the total scores of the corresponding questionnaires by more than 0%.

As can be seen from this table, in the groups of patients receiving Dimephosphone as monotherapy and Dimephosphone together with vinpocetine, there was a greater number of responders on all scales. Monotherapy with Dimephosphone contributed most to improving subjective assessment of sleep and reducing anxiety levels. The combined use of Dimephosphone and Vinpocetine was accompanied by the most pronounced positive dynamics of indicators on the MMSE scale and the level of depression on the hospital scale.

During the treatment period, some patients receiving only Dimephosphone complained of stomach pain and heartburn, but these sensations did not require discontinuation of the drug. When taking Dimephosphone with vinpocetine during the course of treatment, a single increase in blood pressure to 160 mm Hg was observed. Art. (in one patient), stomach pain (in two patients), heartburn and staggering when walking (in one patient). No side effects were observed with the isolated use of vinpocetine.

DISCUSSION

The results obtained in this study confirmed the effectiveness of Dimephosphone in the treatment of non-motor manifestations of DE. The effect of Dimephosphone, a drug belonging to the group of antiacidotic drugs, turned out to be comparable to the effect of vinpocetine, a “classical” vasodilator that improves cerebral circulation. It is known that the main mechanism of action of vinpocetine on cerebral blood flow is its antivasoconstrictor effect [17]. This effect is realized by blocking vascular noradrenergic reactions. The clinical effect of Dimephosphone is determined by the normalization of the acid-base state in acidosis of various etiologies, due to which the drug has a vasoactive, antioxidant and membrane-stabilizing effect. In our study, the use of Dimephosphone in patients with chronic cerebrovascular insufficiency for 21 days was accompanied by a statistically significant (p < 0.05) improvement in cognitive functions and sleep indicators, as well as a decrease in anxiety levels.

Among the non-motor disorders assessed, the use of Dimephosphone resulted in the greatest improvement in subjective sleep characteristics. This observation seems to us very important, since elderly and senile patients are characterized by a high prevalence of sleep disorders [3]. Improving the quality of sleep when taking Dimephosphone may help reduce the dose of sleeping pills already taken, the use of which among patients in older age groups should be limited due to undesirable side effects.

The greatest degree of reduction in non-motor disorders in chronic cerebrovascular insufficiency was observed during combination treatment with Dimephosphone in combination with vinpocetine. Along with improvements in sleep indicators, cognitive functioning and a decrease in anxiety levels, a decrease in depression levels was also observed during combination therapy.

The study showed good tolerability of the drug Dimephosphone. Side effects were noted in only 12% of cases. Symptoms of upper gastrointestinal irritation—stomach pain and heartburn—were observed. All adverse reactions were mild and did not require drug discontinuation or corrective therapy. In general, the data on the tolerability of Dimephosphone obtained in our work are comparable with the results of the mentioned studies and the data of the review by L. Z. Podorozhanskaya et al. (1996)[4, 7, 9, 11–13].

CONCLUSION

The presented results of the use of Dimephosphone, including data obtained in our own study, demonstrate the presence of a clinically significant effect of the drug in various forms of CNS pathology. More than 30 years of history of the use of Dimephosphone in domestic neurology and neurosurgery allows us to state the presence of diverse medicinal effects of the drug and a high level of safety of its use.