Semax (nasal drops): reviews from neurologists, side effects, price, instructions

Compound

The nootropic drug is released in the form of nasal drops .

The therapeutic effect is achieved thanks to the active component - the synthetic polypeptide Semax .

The compound, called methionyl-glutamyl-histidyl-phenylalanyl-prolyl-glycyl-proline, lacks hormonal activity.

For better absorption of the polypeptide by tissues and cells of the body, the following is also used in the preparation of the drug:

parahydroxybenzoic acid methyl ester;
distilled water.

The solution is produced in different concentrations of the active substance: 1% and 0.1%.

The medicine is packaged in 3 ml bottles. The container is equipped with a pipette stopper or a dropper stopper. The drops appear transparent, colorless, and have no specific odor.

Release form and composition

The nootropic drug Semax belongs to the group of new generation drugs in the class of regulatory peptides. It is produced in the form of nasal drops. 1 ml of the drug contains 1 mg of methionyl-glutamyl-histidyl-phenylalanyl-prolyl-glycyl-proline. This substance has psychostimulating, neuroprotective, antioxidant and antihypoxic effects.

Drops are offered in two forms: bottles with a pipette or complete with a dropper. The volume of the drug is always the same, but the percentage composition of the active substance is different and can be 0.1% and 1%.

Pharmacology

The active substance in combination with methyl ester, a derivative of parahydroxybenzoic acid, has the following effect on the body:

helps improve cognitive functions of the brain;
enhances concentration, which makes information analysis better;
has a positive effect on the protective processes of the central nervous system in response to a lack of oxygen (or intoxication/recovery after administration of anesthesia);
improves memory;
stimulates the enzyme acetylcholinesterase, which increases a person’s ability to learn.

The nasal solution also has a neuroprotective effect.

This stops the death of neurons, the inflammatory process, and the development of oxidative stress.

The activity of the synthetic polypeptide normalizes the balance of cytokines and brings into operation a cascade of anti-inflammatory factors.

Price

Nasal drops that have a nootropic effect can be purchased at a pharmacy or through an online store.

One of the main conditions for the sale of the drug is the presence of a prescription , which is written out in Latin.

The cost of a 0.1% solution (3 ml bottle) is determined by the range of 360-380 rubles .

Semax 1% in a bottle of the same volume will cost more - 1700-1790 rubles .

To select the appropriate concentration of the drug and treatment regimen, you must consult your doctor.

Terms of use

The product is intended for intranasal administration. A pipette or dropper is used to ensure accurate dosage. The recommended amount is 2-3 drops in each nasal passage. If the doctor recommends an increased dosage, then the medicine should be administered with a break of at least 10 minutes.

Recommended dosages for various disorders and pathological conditions are given in the instructions for use. But they can be adjusted by the doctor during the treatment process depending on the patient’s condition and the results obtained.

Indications for use

Depending on the pathology and etiology of the disease, the doctor selects the appropriate concentration of the medicinal solution.

The one percent drug is used only for ischemic stroke occurring in the acute phase.

Nasal drops 0.1% are prescribed for the following pathologies:

after TBI during the rehabilitation period or in the subacute phase;
neurogenic infections, toxic brain damage;
cognitive disorders resulting from damage to the blood vessels of the brain or provoked by an organic pathological process;
after anesthesia;
neurotic disorders, neuritis;
optic nerve atrophy;
transient ischemic attacks;
minimal mental and mental dysfunction (in children over 5 years old);
encephalopathy (dyscirculatory type);
rehabilitation period after strokes (ischemic and hemorrhagic).

The drug is also used to increase the cognitive abilities of a person who finds himself in an extreme situation.

The drug is used to prevent and relieve stress due to mental and emotional fatigue.

When are Semax drops prescribed?

Semax, the instructions for use indicate this, is used when symptoms appear that indicate impairment of memory and intelligence. They occur most often against the background of vascular lesions, traumatic brain injuries, and neurosurgical operations. The drug is indicated during the recovery period after a stroke, for neurotic disorders of various origins and dyscirculatory encephalopathy.

Semax is prescribed, the instructions for use confirm this, in extreme situations when it is necessary to increase the adaptive capabilities of the human body. The medicine is considered effective for the prevention of mental fatigue. It is able to maintain performance during monotonous work or performing operations in stressful situations.

The medicine is used in ophthalmology. He is appointed:

In the complex treatment of optic nerve atrophy. This disease often leads to vision loss.
With optic neuritis, which develops against the background of infection or inflammation and is characterized by degradation of visual function.

The product can be used in pediatrics. Drops are indicated for children over 7 years of age to eliminate minimal brain dysfunction. The drug is considered effective for attention deficit hyperactivity disorder.

Instructions for use

Nootropic nasal drops are prescribed exclusively by the attending physician.

The specialist takes as a basis the treatment regimen proposed in the annotation, or develops an individual regimen for taking Semax.

The drug must be taken strictly as prescribed by the doctor in order to eliminate side effects and complications of concomitant pathology.

Self-medication is prohibited, even in the absence of contraindications.

The method of administration of the pharmacological agent is intranasal.

For convenient administration of drops, a bottle pipette is used.

Before using the drug for the first time, you need to cut off the tip of the pipette so that the cap closes tightly.
After preparing the hole, the bottle is turned upside down so that the liquid fills the cavity of the pipette (if the solution does not penetrate well into the hole, you need to lightly tap the bottom with your finger).
The medicine enters the nasal opening after pressing the wide part of the dropper with your fingertips. There is no need to insert the pipette deeply into the nasal passage; it is enough to touch the mucous membrane with the head slightly raised.

Recommended doses (for drops of concentration 0.1%)

A single dosage of the medicine is 50 mcg of active substance, which corresponds to 2-3 drops.

In some cases, it increases to 300 mcg (about 6 drops). This dose should be divided into 2-3 injections with an interval of 10-15 minutes.

The amount of medication is calculated taking into account the patient’s body weight:

single dose - 3 to 30 mcg are prescribed per 1 kg, which corresponds to 200-2000 mcg of the active substance;
daily norm - per 1 kg is prescribed from 7 to 70 mcg, which corresponds to 500-5000 mcg.

The course duration recommended by the manufacturer is 3-5 days. But the attending physician may recommend longer treatment (up to 14 days).

Common treatment regimen for an adult patient:

a single dose of solution is 2-3 drops;
number of repetitions per day – 2-3 times (corresponds to 600-900 mcg/day);
Course duration – 10 days.

For children, the following scheme is recommended:

single dose – 1-2 drops;
number of repetitions per day – 2 times (corresponds to 200-400 mcg/day);
Course duration – 1 month.

Recommended doses (for 1% concentration drops)

For a patient diagnosed with the acute phase of a stroke, the following treatment regimen is recommended:

inject the solution into each nasal passage, 2-3 drops (approximately 2000-3000 mcg);
the interval between procedures is 3-4 hours (in total no more than 4 times per day);
daily norm – 6000-12000 mcg;
Course duration – no more than 10 days.

For seriously ill patients, doses can be increased to a single administration of 3-4 drops, repeated up to 5 times a day.

Semax

Semax is a nootropic drug that has a strong neurometabolic effect, which manifests itself against the background of even small doses of the drug. With increasing dosage, Semax, while maintaining neurometabolic properties, has antioxidant, angioprotective, antihypoxic and neurotrophic effects. After entering the nasal cavity (and the drug is available in the form of intranasal drops), Semax penetrates the blood-brain barrier within 4 minutes, and the pharmacological effect of the drug after administration of a single dose lasts up to 24 hours. Its long-lasting effect is due to sequential degradation, in which fragments of the active substance of the drug retain most of its effects.

Semax has a beneficial effect on cognitive processes (memory, learning, etc.). The drug promotes concentration during learning and analytical processing of information, preserving a memorable trace. It allows the body to better adapt to conditions of hypoxia, cerebral ischemia, the effects of anesthesia and other damaging factors. Semax stimulates the activity of the basal forebrain cholinergic system, which is involved in the regulation of wakefulness and sleep. The concentrated effect of the drug on cholinergic neurons entails a significant increase in the activity of acetylcholinesterase in the synaptic membranes of specific brain structures, which, in turn, facilitates the learning process and strengthens memory.

Semax has a neuroprotective effect, preventing delayed neuronal death, which occurs due to local inflammatory processes, NO formation, oxidative stress and dysfunction of cellular nutrition processes in neurons.

The drug has a pronounced trophotropic effect on cholinergic neurons, comparable to the effect of nerve growth factor, and this effect is realized both under favorable conditions and against the background of glucose and oxygen deficiency. Semax at the gene level activates the process of neutrophin formation. including brain-derived neurotrophic factor. For reference: neutrophins are proteins that regulate the growth and development of nervous tissue. The drug directly acts on the triggering molecular mechanisms and normalizes the cytokine balance. It increases the content of anti-inflammatory factors, reducing the formation of NO, suppressing lipid peroxidation, activating the synthesis of the antioxidant enzyme superoxide dismutase. Semax has virtually no toxic effect on the body, either with a single or long-term use. In clinical studies, neither allergic, nor teratogenic, nor embryotoxic and mutagenic properties of the drug were recorded, nor did it have a local irritant effect.

Semax intranasal drops are available in a bottle sealed with a special plastic pipette stopper. One drop of solution contains 50 mcg of active substance. According to general recommendations, according to the instructions for use, a single dose of Semax is 2-3 drops in each nasal passage. It is maintained even in situations requiring an increase in dosage: in such cases, the drug is administered several times at intervals of 10-15 minutes. The daily dose of the drug is 800-8000 mcg. The duration of the pharmacotherapeutic course is 10-14 days with the possibility of a second course of treatment if necessary.

Restrictions on use

Before using Semax nasal drops, it is recommended to carefully read the instructions, especially with regard to the contraindications section.

The use of the product is prohibited in the presence of the following pathologies:

allergy to one or more components of the composition;
psychosis of any origin, occurring in an acute form;
anxiety syndrome;
history of seizure activity.

Other restrictions include:

age up to 5 years;
pregnancy;
lactation period.

Side effects

When conducting studies to study the effect of the active substance of the drug on the human body, practically no negative reactions were identified.

In rare cases, sleep disturbances and excessive excitability may occur.

Immediately after administering the solution, irritation of the nasal mucosa is sometimes felt, especially if long-term treatment is prescribed.

The most dangerous side effects are:

hives;
rhinitis;
facial skin hyperemia;
Quincke's edema.

They appear due to individual intolerance to the drug. If alarming symptoms are detected, you should immediately seek medical help from specialists.

Restless child

Is increased excitability in a child always a sign of illness? What is the place of herbal remedies in the correction of increased emotional excitability? Why do “growing pains” sometimes require drug treatment?

Increased excitability, emotional lability, sleep disturbances, fatigue - all of these symptoms are familiar to doctors firsthand. With such complaints, parents, tired of the behavior of their own children, often turn to pediatricians, neurologists and family doctors. It does not always turn out that children have severe disorders of the nervous system or psycho-emotional sphere. However, in most cases, pediatric patients require medical attention.

Although practice shows that it is often quite possible to do without medication correction, most parents trust medications more. At the same time, they clearly give preference to so-called “natural” remedies (mainly of plant origin). Sometimes parents equate this concept with homeopathic medicines, which do not always consist exclusively of herbal ingredients. The therapeutic arsenal of allopathic and homeopathic medicines presented in Russia allows you to choose the right remedy for children of any age.

Providing assistance to children with attention deficit hyperactivity disorder (ADHD) seems somewhat more difficult, since these patients require joint efforts on the part of neurologists, psychologists and psychiatrists. Unfortunately, today there are no stimulant drugs (Ritalin, methylphenidate) used in other countries of the world for the treatment of ADHD in our country [1, 2]. Instead, nootropic drugs are used (nootropil, Semax, Pantogam, etc.) in combination with various multivitamin preparations [3]. Drugs like those mentioned should be prescribed exclusively by neurologists (with monitoring of the effect of treatment, individual dosage selection and periodic monitoring).

A special category of patients are children aged from one to three years, whose psycho-emotional status in early childhood is characterized by instability, increased excitability, and various behavioral reactions. To denote this condition in the English literature there is the term temper tantrums; in Russia, a similar concept does not exist, although sometimes they use the expression “hysterics of the second year of life” (which is not entirely true, since, as already indicated, the manifestations described above can be observed to varying degrees of severity in children under 3 years of age) [4 ]. Until relatively recently, the quite acceptable term “neuropathy” was accepted among neuropsychiatrists, but in the International Classification of Diseases, 10th revision (ICD-10), such a concept no longer exists [5]. The described “growing pains”, which is equally a pedagogical and medical problem, most often disappears when children reach the specified age, but sometimes requires additional medications, since it can subsequently transform into neuroses, neurosis-like states and psychopathy. The use of tranquilizers (anti-anxiolytics) such as atarax, elenium, lorazepam is a rather serious method of drug correction, which most parents are not enthusiastic about.

At the same time, there are a number of mild sedatives that, if necessary, can be used for the disorders described above in pediatric patients. In particular, Russian doctors most often prescribe valerian, motherwort and the so-called citral mixture to children of early and preschool (and sometimes infant) age. In this case, citral, which is part of the said mixture, plays a secondary role (it is used as an antiseptic and preservative). The recipe for this mixture can vary: valerian (root extract or extract) and/or motherwort, distilled water or 10% glucose solution, sodium bromide (it has long been known that bromine preparations have the ability to concentrate and enhance inhibition processes in the cerebral cortex ), magnesium sulfate. It is not recommended to add antihistamines to the mixture.

Valerian (medicinal). Preparations based on it (isolated infusions, tinctures, as well as solutions in combination with other complex drugs) reduce the excitability of the central nervous system, as a result of which they are usually used as sedatives for nervous excitement, sleep disorders and similar conditions. It has long been proven that valerian preparations reduce reflex excitability in the central parts of the nervous system and enhance inhibitory processes in neurons of the cortical and subcortical structures of the brain. When treating young children, infusions of valerian root are often used.

Motherwort (five-lobed). In pediatric practice, infusions, tinctures and (less commonly) extracts of motherwort are used. The composition of the plant is so complex that it is still being studied. It is believed that the sedative effect of motherwort tincture is 2-3 times stronger than that of valerian tincture [6]. Therefore, motherwort preparations are used for increased excitability, neurasthenia and neuroses not only in children and adolescents, but also in adults. In domestic medicine, in addition to valerian and motherwort, chamomile is widely used.

Pharmaceutical camomile. This medicinal plant is used in the form of a decoction, tincture or tea, since it is a mild sedative, effective in the treatment of sleep disorders, gastrointestinal dysfunction, etc. Examples include soothing tea and chamomile tea from Hipp, which can be recommended in complex treatment manifestations of perinatal damage to the nervous system with the syndrome of increased neuro-reflex excitability, as well as healthy children - to improve sleep. The active components of chamomile include essential oil, azulene, flavonoids, polysaccharides, vitamins and some other biologically active substances. In addition to oral administration, chamomile decoctions are convenient to use as an external remedy (bath).

Among the most common natural-based sedatives produced by the pharmaceutical industry today, mention should be made of such widely used complex preparations as Novo-Passit (manufactured by Galena A.S./Norton Healthcare Ltd., Czech Republic/UK) and Persen (, Slovenia). Novo-passit is available in the form of an oral solution and tablets, and Persen in tablets. Both drugs are based on a combination of medicinal herbs. For example, novo-passit contains extracts of hawthorn, hops, valerian, St. John's wort, lemon balm, passionflower, black elderberry and guaifenesin (the latter is also an expectorant) [7]. Persen consists of extracts of valerian, as well as peppermint and lemon mint [8]. Below we will consider the most important herbal components of these two drugs.

Peppermint. Extracts from the peppermint herb, along with a choleretic, antiseptic and analgesic effect, have calming and antispasmodic properties, and also have a reflex coronary dilator effect. Lemon balm (melissa), which, like peppermint, is an essential oil plant, also has a similar effect. Mint and lemon balm are included in Hipp children's tea, which can be recommended as a general tonic.

Hawthorn (blood red, prickly and pentapalmed). The cardiotonic and antispasmodic properties of hawthorn preparations (due to the content of triterpene compounds and flavonoids) used in the treatment of diseases of the cardiovascular system are well known. But later it was discovered that infusions and extracts of this plant can improve the oxygen supply not only to the myocardium, but also to the neurons of the brain. The sedative activity of hawthorn preparations has been objectively proven. As a result of this, and also because of the low toxicity of plant preparations, hawthorn has become quite widespread as a sedative (infusion of flowers or fruits of the plant, hawthorn tincture, etc.).

Common hops. The value of this herbaceous perennial plant is not limited to its use as a raw material for the brewing industry. The neurotropic effect of herbal preparations from hop cones is associated with the presence of lupulin in them, which has a calming effect on the central nervous system [6]. Hop oil (along with other components) is part of the drug Valocordin (Crevel Meuselbach, Germany). In pediatrics, it can be used 3-15 drops 3 times a day (before meals with a small amount of liquid) depending on age and symptoms [7].

St. John's wort (perforatum). The herb St. John's wort has multifaceted pharmacological properties, among which the antispasmodic effect deserves special attention, as well as the capillary-strengthening effect typical of compounds containing vitamin P. Therefore, St. John's wort is a valuable component of sedative medicinal preparations and is quite widely used in this capacity.

Among homeopathic remedies, in the light of the problem under consideration, Nervohel (Germany) is of interest to doctors. The drug is available in sublingual tablets, which are recommended to be taken one 3 times a day. There are no contraindications to the use of the drug, and no side effects have been identified while taking it [8]. Another drug with a similar effect is valerianachel. In addition to valerian tincture, this homeopathic remedy includes hawthorn, lemon balm, chamomile, oats (the B vitamin complex contained in oats plays an important role in the trophic function of the nervous system) and other components. Valerianahel is prescribed to children from 2 years of age (children 2-6 years old - 5 drops 3 times a day, patients 6-12 years old - 10 drops 3 times a day) [8].

In some cases, the problem of a restless child can be solved without resorting to prescribing any medications. This is facilitated by certain routine measures (control of the duration of daytime and night sleep, walks in the fresh air, balanced nutrition), hardening, medicinal baths (with herbal or salt collections), proper upbringing, adequate psycho-emotional climate in the family, etc.

Sometimes a restless child is a product of social deprivation or overprotection in the family. It is for this reason that preschool children are recommended to attend kindergartens. Even the practice of involving nannies and tutors in raising a child (popular among financially secure Russians) cannot replace the child’s communication with other children, which contributes to a basic understanding of the norms of social life.

However, physicians must navigate the numerous medications offered as sedatives. Only in this case it is possible to ensure timely correction of the psycho-emotional disorders that have arisen. The concept of evidence-based medicine implies that when making clinical decisions one should be guided by the most reliable and verified information about the effectiveness of the prescribed treatment [9].

Literature

Child Neurology (Menkes JH, Sarnat HB, eds.). 16th ed. Lippincott Williams and Wilkins. Philadelphia-Baltimore. 2000. 1280 rub.
Nelson textbook of pediatrics (Behrman RE, Kliegman RM, Jenson HB, eds., Nelson WE, Sr. Ed.). 16th ed. Philadelphia-London.-WB Saunders. 2000. 2414 rub.
Lebedev B.V., Freydkov V.I., Shanko G.G. et al. Handbook of childhood neurology / Ed. B.V. Lebedeva. M.: Medicine, 1995. 448 p.
Zigelman D. The pocket pediatrician. Doubleday. New York - London, 1995. 432 p.
Bulakhova L. A., Sagan O. M., Zinchenko S. N. et al. Handbook of a child psychiatrist and neurologist / Ed. L. A. Bulakhova. K.: Health, 1985. 288 p.
Sokolov S. Ya., Zamotaev I. P. Handbook of medicinal plants (herbal medicine). 2nd ed. M.: Nedra, 1987. 512 p.
Register of Medicines of Russia “Encyclopedia of Medicines” / Ch. ed. G. L. Vyshkovsky. 9th ed., revised. and additional M.: RLS-2002, 2002. 1504 p.
Vidal Directory. Medicines in Russia: Directory / Ved. ed. E. A. Tolmacheva, 8th ed., revised, corrected. and additional M.: AstraPharmServis, 2002. 1488 p.
Clinical recommendations based on evidence-based medicine: Trans. from English / Ed. I. N. Denisova, V. I. Kulakova, R. M. Khaitova. M.: GEOTAR-MED, 2001. 1248 p.

Patient reviews

Angela, 28 years old:

Preparing for school with my son progressed slowly, the boy barely remembered new letters and words. After classes the next morning, I could not remember the material that seemed to be well learned the day before. I made an appointment with a neurologist, and there I learned about mild mental retardation. The doctor convinced that this defect was easy to correct, Semax attributed.

I gave the medicine to my son for a month, but the effect became noticeable after the first week of treatment. The baby gained perseverance, became indignant less often, and his vocabulary increased.

What I liked most was that the drops are administered into the nose; with tablets things are worse.

Victoria, 34 years old:

After losing in a sports competition, she was exhausted not only physically, but also emotionally. The neurologist prescribed Semax. The domestically produced medicine is affordable, injected into the nasal passage, and acts directly on the brain. The main advantage of the drug is its safety for the gastrointestinal tract. The course of treatment lasted only 10 days, but upon completion, my mood significantly improved and I felt a surge of strength.

Material and methods

110 patients in the recovery period of IS were examined: 43 (39.1%) men and 67 (60.9%) women aged from 29 to 73 years (mean age 58.0±9.7 years, Me 63 years). Diagnosis I.I. in all cases it was confirmed by CT or MRI of the brain. Depending on the start time of rehabilitation programs, 2 groups were formed (Table 1).

Table 1. Demographic and clinical characteristics of patients upon inclusion in the study Note. * - differences are significant between subgroups 2a and 2b at t=8.35 and p=0.0000. The 1st group included 60 patients in whom rehabilitation began 89±9 days from the onset of the disease (early rehabilitation), the 2nd group included 50 patients in whom rehabilitation began 214±22 days (late rehabilitation) . In turn, each group was randomly divided into subgroups of patients who received Semax (subgroups 1a and 2a - with early and late rehabilitation, respectively) and who did not receive it (subgroups 1b and 2b - with early and late rehabilitation, respectively). In subgroup 2a, the time from the development of IS to the start of rehabilitation was significantly longer than in subgroup 2b. Otherwise, the groups and subgroups were completely comparable (see Table 1).

The study protocol included studying the dynamics of the degree of paresis in the arm and leg, the score on the Barthel scale, the content of BDNF in plasma, the tolerability of Semax and the effectiveness of treatment. The patients were examined at four visits: initial (randomization and inclusion in the study), then after 1, 2 and 5 (final) months (Table 2).

Table 2. Protocol for assessing clinical and laboratory parameters and the effectiveness of treatment throughout the study. To assess the degree of paresis, the 6-point scale for assessing muscle strength of the British Medical Research Council was used [22]. The study of activity in daily life and functional independence was carried out on the basis of the Barthel scale, including an analysis of each of its sections [23]. The content of BDNF in serum was determined by enzyme-linked immunosorbent assay using the Human BDNF Immunoassay kit (R&D Systems, USA) according to the manufacturer’s method. The obtained BDNF values were compared with standard values: 0-15 pc/ml - low level, 15-30 pc/ml - average level, more than 30 pc/ml - high level.

Treatment in both groups was unified and included drug therapy, exercise therapy, mechanotherapy, biofeedback methods, massage, individual and group psychotherapy. Patients of subgroups 1a and 2a, along with the indicated therapy, were prescribed a 1% solution of Semax, 2 drops in each nasal passage 3 times a day (6000 mcg/day) for 10 days (1st course). 20 days after the end of the 1st course, the treatment was repeated.

The research results were recorded in an individual protocol and subsequently statistically processed using Excel, EpiStat 7.0 and Statistica 6.0 programs. Descriptive statistics with a normal distribution of the trait (in accordance with the results of the Kolmogorov-Smirnov test) were presented as the mean value and standard error of the mean ( SD

) or the average error of the arithmetic mean (
m
), as well as in the form of the median (Me).
In addition, descriptive statistics of qualitative traits were presented as absolute and relative frequencies (%). To compare two independent groups for one characteristic, the Yates-adjusted χ2 test was used to calculate the odds ratio (OR) and 95% confidence interval (CI). Differences were considered statistically significant at p
<0.05.

Reviews from neurologists

Alekseeva Anna Mikhailovna, experience - 12 years:

I often prescribe Semax at a concentration of 1% for the treatment of the acute phase of stroke. When the drug is prescribed, patients recover noticeably faster, while a slight neurological deficit is observed. The drug is included in complex treatment aimed at neuroprotection of the brain, localization and reduction of the focal zone.

Egorov Valentin Petrovich, experience - 25 years

Analyzing the results of treatment of patients who were prescribed the nootropic drug Semax, we can conclude that in most cases the desired effect was achieved. The medicinal solution activates the protective functions of the brain, helps to increase concentration, and improves the psycho-emotional state to a feeling of euphoria.

This is ideal for eliminating symptoms characteristic of depression or asthenia. I definitely recommend the drug, but only according to the testimony of specialists.