Action of nootropics. Nootropics - features of the pharmaceutical group and a list of the best drugs for effective treatment. Drugs that are currently most widely used in clinical practice

The term "nootropics" appeared in 1972, this word consists of two Greek "noos" - mind and "tropos" - change. It turns out that nootropics are designed to change the human mind, with the help of biochemistry, affecting the central nervous system.

Their predecessors in improving the functioning of the brain were psychostimulants, which had a strong, but short-term effect on a person. They increased the body's endurance, resistance to stress, caused general excitement, activity and euphoria. If not for the strongest negative side effects and the emergence of addiction, psychostimulants would have conquered humanity. But the aftereffect in the form of severe depression and a complete breakdown of strength oppressed a person so much that he could even drive him to suicide.

Synthetic nootropics

After taking nootropics, there are practically no negative effects, they are not addictive. But they also do not have psychostimulants. To feel the result of taking nootropics, you need to take a course lasting 1-3 months.

The action of nootropic drugs is due to the improvement and acceleration of metabolism in nerve tissues, the protection of neurons in the event of a lack of oxygen and toxic effects. In fact, nootropics protect the brain from aging. There are a lot of nootropics on the market right now, but here are some of the more common ones:

Piracetam (Nootropil) is the first of the nootropics. It is prescribed for disorders of attention and memory, nervous disorders, brain injuries, alcoholism and vascular diseases. It can also be used independently (without exceeding the dose) for better perception and assimilation of the training material. The following side effects were rarely noted: drowsiness or agitation, dizziness and nausea, increased sexual activity. The analogue of "Piracetam" ("Nootropil") is "Phenotropil" ("Phenylpiracetam").

"Acephen" ("Cerutil", "Meclofenoksat", "Centrofenoksin") contains the substance of acetylcholine - a transmitter of nervous excitation, an indispensable participant in the work of the human NS. This series of nootropic drugs accelerates all processes of excitation and inhibition, improves blood supply to the brain, and has a psychostimulating effect. It also protects the brain from aging and is used in conjunction with Piracetam to improve mental abilities. There were side effects from the side of the National Assembly: anxiety, insomnia, increased appetite.

"Selegiline" ("Deprenyl", "Yumex") contains the substance selegiline, which suppresses the action of enzymes that inhibit phenethylamine and dopamine. After 40 years of pleasure enzymes of the dopamine series, much less is produced than in youth. "Selegilin" is positioned as for people of middle and old age. It is used in the treatment of Parkinson's and Alzheimer's diseases. With a sufficiently long-term use of the drug, memory, mood and general well-being improve. "Selegiline", according to medical scientists, when taken at 5 mg per day, can increase a person's life expectancy by 15 years!

Disclaimer: Dear friends! The article is for informational purposes only. It must be understood that most of the drugs that will be described are prescription drugs. This article does not encourage you to use something yourself, and even more so, to self-medicate. The article is intended to increase your awareness, including when communicating with your doctors. Only doctors can prescribe treatment for you, write down the dosages that are right for you, and determine the absence of direct and relative contraindications. This is very important, because self-treatment is unacceptable - as a rule, it often leads to undesirable consequences. As you read this article, keep this in mind!

Often, when I comment on some articles and comments on medical topics, I was repeatedly asked to tell in more detail about nootropics, I intend to set out in this article about what nootropics are and what they are eaten with. It will be convenient for those who are interested in this topic, as well as for me - now, when asked to tell more about nootropics, I will refer to my own article, I hope you do too.

I am sure many of you have heard that there is a special group of drugs and biologically active substances, which is called "Nootropics".

Considering the high popularity of this topic and the presence of a mass of myths that often accompany articles on this topic on medical and other resources, in this series of articles I would like to consider an extensive class of nootropics, and in addition, classify them according to the following drugs:

• mechanism of action.
• safety.
• efficiency.
• the presence or absence of a long-term effect.
• toxicity.

This topic is very extensive, so in this article we will consider only the definition of nootropics, their main groups and mechanisms of action. Also, in this article, we will look at the widespread myths directly related to nootropics and their use.

So what are nootropics?

Medicines or other biologically active substances that can stimulate mental activity, enhance cognitive (cognitive) functions, improve memory and increase learning ability. In addition, some nootropics increase the brain's resistance to extreme influences. For example, such as excessive mental stress or "oxygen starvation" of the brain.

Let's take a look at some of the most common myths about nootropics.

Myth 1. Nootropics instantly "accelerate" the brain to unprecedented speeds, allowing you to perform extremely extraordinary tasks and overcome excessive loads (here you can recall the popular movie about the invented drug NZT-48).

R. Nootropics will never make you a "superman" (roughly speaking, if you do not know how to solve triple integrals, then even after taking any of the drugs, this knowledge will not appear in your head). However, the learning process will be much easier and with diligence, nootropics will significantly contribute to learning and other brain activity.

Myth2. Nootropics are very harmful, toxic, have long-term effects, so their use is completely inappropriate.

R. In general, the drugs in this group do not have long-term harmful effects, and a large proportion of them, in addition, have a long-term positive potential. The toxicity of most of them is extremely low. (Keep in mind that there are exceptions, which we'll look at later.)

Myth 3. Nootropics, even with a single use, give a strong, pronounced effect.

R. Almost all nootropic drugs have extremely low effectiveness when used once (moreover, dosages do not play any role at all), however, course use often gives a pronounced positive effect. (again, there are exceptions - we will consider them too).

Now let's briefly consider the main mechanisms of action of nootropic drugs:

1. General metabolic (improvement of the energy state of neurons - increased ATP synthesis, antihypoxic and antioxidant effect).
2. Activation of plastic processes in the central nervous system, including stimulation of neuroplasticity (the formation of new neurons and synaptic connections between them).
3. Strengthening, modulation of synaptic transmission processes in the central nervous system.
4. Modulation of the activity of GABA/GLU receptors responsible for the inhibition of "excessive" CNS activity.
5. Other mechanisms of action.

Now the fun part begins - the practical part.

We'll take a look at some of the most "infamous to the public" drugs. It just so happened that all the most widely advertised drugs in this review are, in fact, "dummy". Patients and "suffering" drink them literally handfuls, but do not notice any positive effect. Why? Let's get started.

Glycine.

This drug is used everywhere, due to its wide availability without a doctor's prescription, and low cost.

As a "sedative" agent, glycine is absolutely ineffective. It is also ineffective as a nootropic, and in any other pharmacological aspect.

A natural question arises - why?

The fact is that glycine is a common amino acid found in almost any food protein. Any protein that enters our stomach is broken down by enzymes into amino acids, which are absorbed by the intestines. That is why protein foods have an energy value.

In addition, glycine is a food additive E640, which is used as a flavor and aroma modifier in the food industry.

To understand what the catch is here, let's give a good example: The protein of a chicken egg contains about 12% protein. The protein consists of amino acids, of which pure glycine - an average of 0.45 grams.

So, one chicken egg contains the equivalent of 4.5 tablets of glycine (450 mg).

If you eat a three-egg scrambled egg, you will take the equivalent of 13.5 glycine tablets. Try to remember if you had a pronounced nootropic activity after eating scrambled eggs? The answer is obvious. So, glycine is completely harmless, and just as ineffective in any dosage.

Piracetam.

Historically, this is the very first compound, discovered back in 1972, which marked the beginning of a whole group of drugs - racetams and their derivatives. But now - let's talk about piracetam itself.

In most countries (with the exception of Russia and some CIS countries) - piracetam is not registered as a drug. The fact is that today there is not a single study (for 42 years since its discovery) that would indicate its effectiveness.

This drug is absolutely harmless. Its lethal dose is 7 times lower than that of table salt. Its effectiveness as a nootropic is near zero at any dosage.

However, in Russia this drug is produced, and, therefore, it is very actively "pushed" by doctors who are "instructed" to prescribe it to patients.

Since the drug is absolutely harmless, the doctor prescribing it does not risk anything, and the patient may suddenly have a “placebo effect”, and everyone is happy. However, in reality - this drug does not cure or "improve" anything.

Afobazol.

One of the most "brilliant" domestic developments. This drug is positioned by the manufacturer as a drug with anti-anxiety, anti-asthenic, and nootropic activity.

Now let's get to the heart of the matter.

This drug does not have a single international study proving its effectiveness. Those studies that took place in Russia do not have a design that would correspond to the level of evidence-based medicine (a small sample of patients, no multicenter studies, no independent research customers). Moreover, all ongoing research was funded exclusively by the manufacturer, which is unacceptable. because the result will always be "twisted" in the right direction - in the one that asks the one who orders it.

Moreover, the substance fabomotizol (the active substance of afobazole) is not used anywhere except in Russia and the CIS countries. It has never been interested in any organization in any country in the world, even to study its potential mechanisms of action.

What's the matter? And the fact is that this drug was originally developed "for general sale." those. a substance has been taken that is potentially harmless. After which it was tested for toxicity - which was not detected. And they decided to sell it, providing it with wide advertising.

Already after its release into production, and the loss of the patent for the Afobazol trademark, the manufacturing company decided to find out how it works. A radioligand study was ordered in France (from CEREP) to try to find what the drug actually interacts with in the body, and, directly, in the central nervous system.

The data obtained was as follows, this drug is excreted after taking 40 minutes, and does not interact with anything at "therapeutic" dosages. Those. This is a substance that simply "passes by" in the body.

And since it is also excreted in 40 minutes, and is taken only once every 8 hours, then, of course, even theoretically, it cannot work "as intended" (for this, the substance must be in the blood or in the brain tissues throughout his actions).

At the time of this writing, there is not a single study in the international pubmed database that does not say anything about its effectiveness - there are simply none in principle.

The result is another drug that is absolutely useless from a clinical point of view.

Aminalon (GABA).

This amino acid is the main "inhibitory neurotransmitter" in the CNS.

An increase in the level of GABA in the brain has anxiolytic (anti-anxiety), antihypoxic, muscle relaxant (relaxing) and other effects useful in clinical practice. Therefore, we can expect that taking GABA will give us "the same" effects.

However, everything is not so simple.

The fact is that our brain is protected from the general bloodstream by a special barrier (hemato-encephalic). This is all "done" so that the "unnecessary" substances in the blood plasma do not enter the brain. These substances include gamma-aminobutyric acid (GABA). Thus, when GABA (aminalon) is taken orally, its level in the central nervous system does not change in any way (more precisely, it changes, but not enough to cause any noticeable effect) - this was theoretically stated, and soon confirmed by numerous independent studies.

Therefore, this drug for a healthy person (whose blood-brain barrier is not broken) will not show any properties at all - neither anti-anxiety nor nootropic.

A natural question arises - why then is this drug widely used in people with certain brain diseases, and with good efficiency?

The thing is that in some patients this very blood-brain barrier is broken - and GABA in some quantities from the blood plasma still penetrates the central nervous system, and can already "perform its duties".

But we are talking about GABA as a nootropic for healthy people - and therefore Aminalon is completely unsuitable for "our purposes".

The drug is absolutely safe, but for a healthy person, its effect does not occur - the active substance simply cannot penetrate from the bloodstream into the brain.

In order for this substance to "can" still penetrate the barrier, its structural molecule is somewhat modified - and quite "working" preparations are obtained - which will be discussed below.

But we are talking about GABA now.

Conclusion - taking GABA is safe, but meaningless as a nootropic.

Now we turn to the consideration of nootropic drugs that have a certain clinical effect. We will review several drugs, discuss their clinical efficacy in terms of nootropic activity, safety, and some interesting facts.

Fonuracetam (phenotropil).

This drug is the "son" of piracetam, the molecule of which has been modified in order to obtain a much greater clinical effect. This drug has an extensive scientific base, in addition, this drug is included in the "hit list" of the World Anti-Doping Committee (WADA), which already hints to us that its clinical effect is quite serious, and definitely present. For those who want to learn the intricacies on their own at English language, this drug is called abroad " Phenylpiracetam".

So what is this drug, what are its clinical effects?

The first, most important and "noticeable" effect is stimulating. This effect is instantaneous - i.e. it is detected immediately, already with a single application. You should know that this effect does not apply to a true nootropic, it is, let's say, a "bonus".

With course use, this drug has many significant clinical effects. But since this article concerns nootropics, I will describe only the most significant effects for us (please do not beat me with slippers for describing these effects in a non-academic language. This is done for a better understanding of the material.

• clear stimulating effect.
• improving short-term memory.
• improvement of "memorization" (transfer to long-term memory).
• improving the preservation of accumulated information in long-term memory.
• improving the "speed of execution" of daily operations.
• improvement of cerebral circulation and energy metabolism in the central nervous system.

Now let's talk about security.

Since this drug has a stimulating and anti-apathetic effect, then, accordingly, this drug can cause "psychological addiction". Therefore, it is important to strictly follow the dosages prescribed by your doctor throughout the entire course of use. The drug is relatively safe, but in no case should it be abused.

I would especially like to note the following. For unknown reasons, this drug, although it is produced by a single company (Valenta), is of extremely low quality - completely unexpected things occur from batch to batch - some patients note that when they open (roughly speaking) the second purchased pack, the effect ceases to be felt. This is not an isolated case, these claims against the company are so voluminous that you can easily read about it on the Internet by typing "Phenotropil Valenta" in the search box. Keep this in mind.

A small theoretical digression.

As we remember, GABA (and some other amino acids) are extremely active in the central nervous system, but their intake does not lead to any effects due to the fact that the blood-brain barrier (hereinafter referred to as the BBB) "does not let" them into the brain .

Scientists have thought about how to “carry” a substance through the BBB by changing the amino acid molecule (today we are considering gamma-aminobutyric acid (GABA)). As a result, two preparations were obtained, which we will consider below.

Picamilon.

This drug was developed in Russia in 1970, studied for 16 years, and by 1980 was approved for use as a nootropic. This drug is a "molecular mix" of nicotinic acid (not to be confused with nicotine) and GABA molecules. It turned out a combination of the properties of both nicotinic acid and, in fact, GABA.

What are its main clinical effects?

• improvement of energy metabolism in the central nervous system.
• vasodilating effect (cerebral vessels, cranial arteries).
• an increase in the rate of cerebral blood flow, due to the factors listed above.
• some tranquilizing (sedative) effect.

The combination of these properties leads to a nootropic effect.

It should be understood that despite the above properties, the drug is not a panacea. All these properties are expressed moderately, and the notorious "wow effect" should not be expected.

The drug is ineffective in a single application, its course use is recommended. It is relatively safe.

Separately, it is worth noting that there are studies on the drug, they were published in peer-reviewed medical journals and are available in the pubmed database, but to put it mildly, there are not very many of them.

Phenibut.

This drug is, like picamilon, a derivative of GABA. This drug freely penetrates the BBB, however, due to a change in its structural formula, the drug has become selective for only one subtype of GABA receptors in the CNS out of three.

To begin with, it is worth noting that this drug has some addictive potential, in addition, it is a prescription drug. Strictly follow the scheme and schedule of appointment with the doctor!

This drug has a unique pharmacological effect, but first, consider its main clinical effects:

• tranquilizing (relaxing).
• anxiolytic (anti-anxiety).
• reduction in muscle stiffness.
• nootropic (because it is to some extent an antihypoxant).
• weak stimulating (reducing apathy and anergy).
• influence on the level of neurotransmitters in the central nervous system (increased dopamine in the senaptic cleft).

Now about what was called "unique pharmacological effect." As you may have noticed, in its clinical properties there are both relaxing and stimulating effects. Yes, it seems strange, but this is not a mistake - this is what is its distinguishing property.

The drug has a pronounced (noticeable) effect. The degree of its activity is regulated by the selection of the correct dosage. The drug has some negative effect on the gastrointestinal tract, because. is an acid. In addition, there are relatively and absolute contraindications to the drug.

As a nootropic drug, the drug should be taken in a course, in low dosages (the maximum will be in the region of 500-750 mg of daily dosage, divided into three doses).

The drug has proven efficacy (although it does not have studies that strictly meet all the criteria for DM).

There are several companies that produce phenibut, but do not worry - the quality is quite good, and it is comparable among all the companies that produce it.

The next format of the article will be somewhat different - in it you will see a summary table for all the drugs you sent, and their classification according to different criteria. I tried to make the table the most convenient for perception, compact and informative.

I prescribed all the preparations in principle - therefore, do not be surprised if you see something unusual among the substances.

I tried to cover the full list of preparations offered to me by you.

For convenience, the following abbreviations are given in the table.

1. Evidence level (DB level):

A: has one (or more) studies that fully meet the criteria for DM.

B: has one (or more) placebo-controlled studies.

C: Has one (or more) study, but it/they do not follow the generally accepted design.

D: have information about the effectiveness, within one or more "case-report" (individual cases of successful application).

E: has no evidence base and / or the drug is "empty" by definition (does not contain an active substance) Also, group E includes drugs that are developed in the Russian Federation, have articles exclusively from one group of researchers.

2. The degree of effectiveness in terms of nootropic activity:

+++: high efficiency.

++: Moderately effective.

+: has low efficiency, but it is present.

O: not effective.

-: there is a slight deterioration.

--: There is a moderate deterioration.

---: there is a significant deterioration.

ppm: Little information exists or the drug is being studied.

3. Group.

The group is indicated by classification (i.e. which class the drug or active substance belongs to).

This line is provided for reference - for example, if you need to know the details of the mechanism of action of a particular drug, use the abbreviation in this line to search in more detail about this group (because there are a lot of groups, I think that there is no need to describe in detail each of them - this will turn out to be a whole book - and in subsequent articles we will touch on these issues anyway).

4. Safety.

For the convenience of "reading" this line - I divided the preparations (conditionally) into four categories, and gave them color designations:

green - the drug is safe when used in adequate dosages, there are relatively few contraindications.

yellow - the drug is safe, but the indicated dosages should be strictly observed. There are many more contraindications in this group.

Orange - the drug is potent, so great, strict attention should be paid to the doctor's prescriptions for its use.

Red - the drug is unsafe. Its use as a nootropic is highly discouraged.

I hope that this table has brought some clarity to all readers who were interested in this or that drug. It contains almost all the substances that are used as nootropics.

H ootropics are pharmaceuticals designed to normalize the metabolism in the brain, stimulating adequate metabolic processes in nerve fibers and tissues.

This group is represented by a huge list of drugs of very different effects. They have one thing in common: the ability to restore metabolism, promote tissue regeneration.

Nootropics are used as part of the correction of the normal state in chronic diseases of cerebral structures, as a measure of rehabilitation after a stroke, also against the background of long-term forms of encephalopathy.

The scope of these drugs is extensive, but unauthorized use is unacceptable because of the likelihood of allergies, the development of unforeseen phenomena.

Positive action is based on a group of key points. The vastness of these directly proves the versatility of nootropic pharmaceuticals in the treatment and prevention of pathological processes.

Restoration of normal metabolism of brain structures

Normalization of metabolism in the brain is the main effect of nootropics. The use of medications involves the participation of at least a neurologist.

The ability to stabilize metabolic processes can significantly increase the efficiency of local energy exchange without harm to tissues and structures, quickly enough to gain weight as part of rehabilitation after a stroke, injuries of nerve tissues.

Attention:

In some cases, for example, with pathologies of the tumor type, neoplasms of the brain, it is impossible to take nootropics. Accelerated growth of neoplasia and a rapid mass effect are possible.

Correction of mnestic functions

The ability to perform basic mental actions, memorize large amounts of information, also perform operations on them, the ability to learn, learn new things, assimilate data.

With many diseases, up to, encephalopathy and other functions of the mnestic series weaken. Then they progressively fade away. Recovery plays a big role in the correction of working capacity.

Stabilization of the state of consciousness

Antiasthenic action is based on the ability to accelerate metabolic processes. It should be considered as part of the nootropic effect that was mentioned earlier.

After taking short course drugs of the group under consideration, a person becomes more active, able to work more, feels cheerful.

Attention:

Such stimulation is ineffective if the factor provocateur of the negative state does not disappear and is not corrected.

Increasing the adaptive capabilities of the patient's body

Resistance to stressful situations, the consequences of psychotraumatic events. Recovery is carried out according to indications. However, drugs can be used, including as a prevention of pathological processes.

Stimulation of mental functions, higher nervous activity

The ability to eliminate manifestations of depression. Nootropics should not be used as drugs for the correction of mental disorders, if we are talking about the main method of treatment. But within the framework of supporting basic therapy with the use of specific antidepressants, it is quite acceptable.

However, it is necessary to take into account the peculiarities of pharmacological interaction. Some types of drugs against dysthymia, to normalize mood, enhance the effect of the parallel use of nootropics.

Partial sedative effect

In terms of the degree and severity of this, the medicines of the group of correctors of metabolic processes are not able to compare with specialized names, tranquilizers.

However, it is quite possible to use them as an aid to the main therapy. Some drugs to eliminate the manifestations of stress last longer against the background of the parallel use of nootropics.

Relief of autonomic symptoms

Dizziness, nausea, other manifestations. Such an effect is necessary, for example, in patients suffering from meteosensitivity. As part of the correction of dysfunction of the central nervous system due to diseases in the structure of which vegetovascular dystonia can be detected. In this case, we are talking about a symptomatic measure.

Correction of signs of parkinsonism

Rigidity (tension) of the muscles, disorders of the central nervous system. A beneficial effect is observed as a result of the ability to influence extrapyramidal structures, the cerebellum, and biochemical processes in the brain.

Improving overall energy metabolism

in muscle and heart muscle. Due to this, the means of the named type can be used as a measure of stabilizing the work of the whole body, this is especially useful during intense physical exertion.

In addition to the main effects, nootropics can affect glucose levels, restore immunity, etc. Such actions are expressed to a much lesser extent. Therefore, they cannot be considered as grounds for the appointment of names in the framework of therapy or prevention.

Classification

Nootropics can be subdivided according to the main active ingredient. Accordingly, such groups of pharmaceuticals are called.

Medications based on pyrrolidone

• Piracetam. It has a complex effect. It is used to treat disorders of cerebral blood flow. The appointment is carried out within the framework of systemic processes: encephalopathy, after a stroke, etc.

Well tolerated by patients, rarely provokes side effects. It is used in courses of 10-15 injections. Long-term oral administration is acceptable according to indications.

• Aniracetam. There are no fundamental differences, but it is more difficult to meet it on the shelves of pharmacies.

Mostly these are nootropic drugs that improve the nutrition and blood circulation of the brain in the system.

Polypeptides

• Cerebrolysin. A new generation nootropic is used as a universal remedy in the treatment of metabolic disorders in the brain and. It has a combined effect and high safety, therefore it rarely provokes side effects.

• Cortexin. Similar remedy.

Both are produced on the basis of fractions obtained from the brain of cattle.

Phenotropil and analogues

Powerful medicine. It is considered the most active drug in the list of nootropics. It is prescribed strictly according to indications, while being universal in terms of beneficial effect.

Can be used in patients with encephalopathy. vascular dementia. Also after a stroke, in the acute phase.

Attention:

As a preventive measure, it is prescribed only if there are real risks of dangerous pathological phenomena.

Means similar in structure to vitamins

Idebenone as the main Used strictly according to indications. It is mainly prescribed for patients with Alzheimer's disease, advanced mental disorders in vascular dementia.

It has an activating, stimulating and disinhibitory effect. Slows down progression of cognitive deviations.

Acetylcholine precursors

Meclofenoxate and its analogues: Centrophenoxin, Cerutil, Acefen. They differ significantly from the drugs under consideration, but are included in the list of nootropic drugs due to the ability to accelerate metabolic processes.

An objectively beneficial effect is manifested by the elimination of asthenia, fatigue, and the correction of basic neurological functions.

Such medicines are used mainly for chronic deviations from the cerebral structures (for example, encephalopathy). It has an average degree of activity when compared with Phenotropil.

Bemitil and analogues

GABA analogs

The main name is Phenibut. A powerful pharmaceutical agent, not used without a doctor's prescription. It is used in difficult clinical cases, with the ineffectiveness of other medicines.

Prolonged uncontrolled intake can provoke a withdrawal syndrome, dependence.

Amino acids

Glycine. Widely used due to its safety. Corrects behavior, eliminates the main symptoms of pathological processes of the ischemic plan.

It is considered a relatively weak drug, and therefore is used more as a prophylactic medication.

Neuropeptides

• Semax. Stimulates the work of the brain, protects tissues from destruction.

• Noopept. An additional effect is the relief of anxiety.

These drugs are similar in nature and activity to GABA analogues, but they act softer.

New generation nootropics

The list of such can be defined by three means:

• Vinpocetine. The main trade name is Cavinton. Quickly and effectively relieves drowsiness, affects vegetative manifestations. It acts selectively, stopping the main symptoms. Used for long courses.
• . Described above.
• Modafinil. Strictly speaking, it is not considered a pure nootropic. It has an analeptic, disinhibitory effect. The result is rapid, which causes a large number of side effects and dangers from the use. At the same time, it will not be possible to find it in Russia and some countries of the former Union. The drug is prohibited. Acquisition is possible in Ukraine.

The list of new generation nootropics is not so wide. In recent years, the development of drugs of this type is not active.

The needs of therapy are covered by those means that are already present in the pharmaceutical markets. They are well tolerated and rarely cause side effects.

Indications for use

Reasons for the use of pharmaceuticals:

• Intense stress. As mentioned earlier, medications can be used as condition correctors with excessive effects on the central nervous system. Nootropics help to reduce the recovery period, better adaptation of structures and nerve fibers to negative effects.
• Psycho-emotional stress. More intense. To the point of being traumatizing. Preparations of this type accelerate adaptation, shorten the period of rehabilitation and recovery from negative affect.
• Decreased performance. Nootropic drugs increase the level of energy, vigor, because a person works faster and more productively throughout the day. If the cause of increased fatigue is not eliminated, the effect will persist as long as the person takes the funds.
• behavioral disorders. In children and adolescents. Hyperexcitability, attention deficit hyperactivity disorder, aggressiveness. Nootropics cannot be used as a corrector for a long time. This is fraught with side effects.
• Consequences of binge drinking. Recovery after heavy drinking. Abstinence included. Of course, psychostimulants cannot be used as the main medicines. It won't have the desired effect. Complex therapy is required using a group of items, including detoxification, saline solutions, and other drugs.
• Organic abnormalities in the work of the central nervous system. different types.
• Sleep disorders.
• encephalopathy. . Accompanied by focal neurological symptoms, inability to normally perform basic functions in Everyday life. With a long existence, the deficit becomes permanent. Progress at different speeds.

• Problems in the work of the central nervous system as a result of functional factors.
• temporary phenomena. Meteosensitivity, episodes of vegetovascular dystonia, crisis states.
• Ischemic stroke in the acute phase. Critical violation of the trophism of nerve tissues. Accompanied by decay, necrosis of fibers, cells, gross neurological defects. Recovery requires the use of a group of drugs. Nootropics alone will not be enough. Detailed description read the symptoms of a pre-stroke condition.

• The period of deviation of the brain after an acute circulatory disorder. Rehabilitation.
• vascular dementia.

Contraindications

Medicines also have a group of contraindications:

• Intolerance to the active ingredients of the drug. Allergic reactions. Especially carefully you need to take medicines of the polypeptide series, amino acids. They are more likely to cause problems.
• A history of brain tumors. Because nootropic drugs can accelerate the growth of neoplasia. It must be borne in mind that we are talking not only about malignant neoplasms. Accelerated development is possible in all cases, cysts are not taken into account. They are not capable of proliferation and increase.
• Polyvalent allergic reaction. Intolerance to a large group of drugs. In this case, you need to be careful when choosing, prescribing and taking.

These are sample lists. More specifically, you can clarify by looking at the annotation to a particular name.

Features of the use of drugs

There are several basic principles for the use of neurometabolic drugs:

• Expediency. A nootropic effect is not always required, therefore, before use, you need to evaluate the indications and the expected result from use. Predict possible side effects, long-term risks. It is quite difficult to do this even for an experienced doctor.
• The need for specialist involvement. The appointment of nootropic drugs is the prerogative of a neurologist.
• Systematic. It does not make sense to take medicines occasionally. For a sufficient result, use for a long time is required, the effect is cumulative, it is observed as it is further taken. Application course, long. But usually not permanent. Breaks are needed.
• Complexity. Nootropics, despite their effectiveness, are not able to solve all therapeutic issues. In some situations, it is necessary to use a group of medicines for a greater result. For example, neurometabolic drugs are used in a system with cerebrovascular, antihypertensive, vitamins, etc. The issue is decided by the doctor.
• The need for constant monitoring. As needed, the course is reviewed or the drugs are canceled altogether.

Side effects

Negative phenomena develop as a result of exceeding the dosage or as an individual response to the use of the drug. Among the most common adverse events:

• Allergic reactions. Of a different nature. From a slight skin rash, urticaria and to severe swelling of the respiratory tract, an attack of bronchial asthma, anaphylactic shock.
• Headache. Usually insignificant. It passes quickly on its own. Localized in the occipital, frontal region.
• Nausea. Characterized by episodic, unstable. Vomiting rarely ends. Appears once. Manifestations are unstable.
• Dizziness.

Fortunately, side effects are relatively rare. Therefore, nootropics can be called safe drugs. Well tolerated by all categories of patients.

It is necessary to take into account the individual reactions of the body. Controversial conditions, suspicious signs and symptoms should be reported to the treating specialist immediately.

Finally

The considered nootropics have proven effectiveness and are used for disorders of the brain and central nervous system. They can only be used with the permission of a doctor and as directed.

The neurologist determines the dosage and the scheme of application. With uncontrolled use, it will be extremely difficult to achieve a positive effect.

Nootropics, the list of drugs of which today is represented by a wide range of products, originate from 1963. At that time, Belgian clinicians and pharmacologists managed to synthesize and apply in medical practice The first drug from the group of nootropics is Piracetam.

Numerous studies have proven clinical improvements in patients of various groups on the background of continuous use of Piracetam, including memory enhancement, facilitating learning processes.

In 1972, the term "nootropics" was proposed, denoting a class of drugs for improving the integrative functionality of the brain. In modern neurology, nootropic drugs are an integral part of the treatment of various disorders in children and adults.

Characteristics of the pharmaceutical group

Nootropics(from the Greek noos - mind, thoughts and tropos - vector, direction) are widely used in neurological practice for a positive impact on the higher integrative functions of the brain. With the help of drugs, they correct some behavioral reactions in people and adults, increase resistance to stressful situations, the ability to learn, and chronic hypoxia. Other functions of drugs are:

maintaining the energy structure of a neuron (nerve cell);

improving the functionality of the central nervous system;

activation of the plastic functionality of the central nervous system;

providing a pronounced neuroprotective effect;

normalization and stabilization of the cell membrane;

minimizes the need for nerve cells in oxygen.

The nootropic effect can be primary with a direct effect on neurons and secondary with an improvement in general cerebral circulation. There are two main groups of nootropics:

true (improvement of mnestic functions of the brain and nervous system);

combined action (a combination of several functions at the same time).

Synonyms of the pharmacological group of nootropics are cerebroprotectors, neuroregulators, neuroanabolics, eutotrophic, neurometabolic drugs. All terms reflect the general effect of drugs - the ability to stimulate metabolic processes in the nervous structures of the human body.

Mechanism of action

Nootropic drugs directly affect a whole range of functional abilities of the brain, contributing to their vigorous activity. Thanks to adequate therapy, concentration of attention improves, interactions between the right and left hemispheres are facilitated. It has been proven that the drugs rejuvenate the body and prolong the life of patients with a burdened clinical neurological history.

The biogenic origin of the drug largely affects all processes of intracellular metabolism, stimulating the synthesis of proteins, the excretion of excess glucose, and the formation of ATP. The following mechanisms and effects of exposure are distinguished:

membrane stabilizing effect;

antioxidant;

antihypoxic;

neuroprotective.

There is a significant increase in the resistance of the brain to the negative effects of exogenous and endogenous factors. The effectiveness of drugs is enhanced with the simultaneous use of angioprotectors, psychostimulants. The main category of patients who are prescribed nootropics are children and the elderly.

Main indications for use

Typical indications for the appointment of nootropic drugs are the following conditions:

psychoorganic syndrome (dystrophic changes in the nervous tissue of any origin);

alcoholism with withdrawal syndrome;

drug addiction;

neuroleptic syndrome (as a combination therapy);

neurotic or organic asthenia;

cerebrovascular insufficiency;

sickle cell anemia;

ophthalmic pathologies (complex therapy).

With the help of nootropics, urinary disorders of a neurogenic nature are treated. Nootropic drugs are a necessary measure for Parkinson's disease, ischemia, cerebral palsy, epileptic seizures.

Contraindications and side effects

Nootropics may be prescribed for relative contraindications at the discretion of the attending physician. Among the absolute contraindications are acute or chronic renal failure, pregnancy and lactation, hepatic diseases with aggravated course, acute hemorrhagic stroke, hypersensitivity, severe psychomotor agitation. Side effects of the drug are the following conditions:

sleep disturbance, insomnia;

dyspeptic disorders;

hyperexcitability:

anxiety syndrome, panic attacks;

hypotension;

increased effect on hepatic or renal functions;

convulsive syndrome, epileptic seizures;

impaired coordination, unsteady gait;

redness of the face, feeling of heat;

severe iosinophilia;

hallucinations and confusion;

thrombophlebitis, febrile syndrome.

Against the background of taking the drug, allergic rashes on the body like urticaria, itching, burning on the skin, mainly in the neck, face, back, are possible. If any discomfort occurs, it is recommended to stop treatment or adjust the daily dosage. Cases of drug overdose are not registered.

Basic nootropics

Which is better in the treatment of neurological diseases? The use of nootropic drugs can be combined and independent. Usually, nootropics as a stand-alone therapy are used for minor disorders. The following drugs with proven efficacy are widely used in neurological practice:

Piracetam.

Probably the most popular nootropic. The drug enhances metabolic processes in the brain. It is used to treat systematic dizziness, correction of dyslexic syndrome. In adult patients, the drug is used as a complex therapy for myocardial infarction, withdrawal syndrome with addictions of any origin. Doctors prescribe a remedy for the treatment of neuroinfections caused by viral agents.

Memoplant

One of the best herbal nootropics. The German drug Memoplant contains a highly purified extract of ginkgo biloba EGb 761®. Many preparations of ginkgo biloba contain a significant amount of harmful impurities - ginkgolic acids. Memoplant is devoid of this drawback, as it is cleaned during 27 production stages.
The drug increases the resistance of the nervous tissue to a lack of oxygen, improves cerebral circulation. It is effective for dizziness, noise in the ears or head, as well as for memory and performance problems.

Vinpocetine.


Against the background of constant intake, the vessels of the brain expand, microcirculation increases. The active substance of the drug provides a full transport of oxygen to the brain tissues, increases the absorption of nutrients. Vinpocetine has a pronounced neuroprotective and antioxidant effect. The treatment regimen changes from the introduction of intravenous solutions first with the transition after to the tablet form of the drug. It is used as an adjuvant in antihypertensive therapy.

Phenibut.


There is a high efficiency in functional disorders of the vestibular apparatus, sleep disorders, neurosthenia, asthenic syndrome. Against the background of long-term use, metabolic processes in the brain tissues at the cellular level are normalized. The strengths of the drug are psychostimulating ability and antioxidant effect. The drug is characterized by low toxicity, low side effects.

Phenotropil.


The drug belongs to a new generation of nootropics with a pronounced adaptogenic effect. Patients have resistance to stressful situations, without causing, at the same time, drug dependence. Phenotropil is prescribed to patients with severe emotional and mental stress.

Phezam.


Nootropic, directly intended for the treatment of impaired blood circulation in the brain. It is effective for serious diseases of the nervous system, circulation disorders in the vascular system of the brain. In complex therapy, headaches are stopped with increased intracranial pressure, improves the functioning of the organs of hearing and vision. Phezam is prescribed for amnesia, it is highly effective in hypoxic syndrome.

Cinnarizine.


A drug designed to strengthen the vascular walls of the brain during their dilatation (stretching). At the same time, blood pressure indicators remain in the usual norm. Effective as a prevention of motion sickness, disorders of the vestibular apparatus. It is prescribed for chronic migraines, with increased hypertension, accompanied by dizziness, tinnitus, headache. Cinnarizine is used in adult women to reduce symptoms of menopause.

Cerebrolysin.


The safety and efficacy of the drug has been proven by numerous studies. Used as adjuvant therapy against serious psychiatric and neurological disorders. With the correct dosage, mental processes are activated, concentration of attention and mood increase. Long-term use improves memory, increases the ability to learn.

Actovegin.


A drug related to nootropics-antihypoxants. Used to treat metabolic disorders in the brain, promotes rapid healing of wounds. The drug is used as a complex therapy for radiation skin lesions, with diabetic polyneuropathy. Actovegin is available in the form of tablets, intramuscular, intravenous solutions and intra-arterial injections. There is a form of the drug for topical use.

Nootropic drugs for the treatment of serious neurological disorders are used in adult neurological practice. When used as a complex therapy, the probability of a decrease or increase in the activity of other drugs is taken into account.

Best nootropics for kids

In pediatric practice, nootropics are used to treat mental retardation, to improve attention, speech development, with poor school performance. Children's nootropics have been widely used since 1952. The main reasons for the appointment are the following conditions in children of different ages:

cerebrosthenia;

hypoxic syndrome in cerebral palsy:

poor development of speech;

intellectual insufficiency;

encephalopathy.

It has been proven that in childhood the tolerability of nootropic drugs is much better than in adults. The following are considered essential medicines for children:

Piracetam(Nootropil, Cerebril, Lucetam, Oykamid).


They are used in children from 1 year old, available in tablets, ampoules, capsules. It is not prescribed for children with increased emotional excitability. The active substance has a beneficial effect on the brain, enhances susceptibility to intellectual stress, stabilizes concentration, and promotes learning.

Pantogam.


An anticonvulsant drug suitable for children from the first days of life. From pharmacies it is released in the form of syrups and tablets. It is used to treat cerebral palsy, improve the condition in autism, schizophrenia. Pantogam is used for children with neurogenic or stress urinary incontinence. Also, against the background of constant use, the emotional background of the child is normalized, especially with a delay in mental and speech development. Reduced and the likelihood of side effects: drowsiness, allergic reactions, dyspeptic disorders.

Picamilon.

The drug, designed to expand the vessels of the brain, is an analogue of Piracetam in terms of active substance and effectiveness. It has a slight tranquilizing effect. From pharmacies it is released in the form of injections for intravenous and intramuscular administration, in tablets. In pediatrics, it is prescribed for children from 3 years old. The nootropic agent is especially effective at high emotional stress, with increased physical and mental activity.

Phenibut.


The tool belongs to the latest generation of drugs. It is prescribed for children to stimulate the normal functioning of the nervous system, increase mental and intellectual activity, at the same time helping to cope with overload. The drug has a low degree of toxicity, suitable for children over 2 years old. The main side effects include nausea, increased drowsiness, dizziness. From pharmacy chains it is released in the form of powder and tablets.

Pyritinol.


The drug is intended for the effect of mild sedation. Necessary in the treatment of depressive syndrome in adolescents, with vegetative-vascular dystonia, excessive fatigue. It is a complex drug for mental retardation and mental development. Not recommended for use in children under 12 months of age. Despite the high activity, the remedy has a number of side effects: loss of taste, dyspnea, polymyositis, nausea and dizziness.

Cinnarizine(Vertizin, Diziron, Tsirizin, Baltsinnarzin, Cinnaron).


Used in pediatrics for the treatment of children over 12 years of age, but in Lately the use of the drug in children from 1 year of age is practiced. The drug has many side effects from typical nausea to epileptic seizures, impaired renal and hepatic function, arterial hypotension. The effectiveness of the drug has not been proven. The drug is released in the form of capsules and tablets.

Semax.


The drug is widely used in pediatric practice due to its high efficiency and convenient pharmacological form. The drug eliminates excessive capriciousness, emotional excitability. Side effects are expressed in dizziness, nausea, irritation of the nasal mucosa. It is used in children with delayed speech development, with sleep disorders.

Glycine.


The active ingredient is aminoacetic acid. The drug is well tolerated by young children, effective in case of excessive emotional arousal. Against the background of long-term use, working capacity, learning ability are activated, night sleep is regulated, concentration of attention increases. Glycine is suitable for the treatment of children at any age.

Gammalon.


New from Japan, is a follower of Piracetam. A similar composition of Gammalon is contained in Aminalon, but the price of the drug is much lower. If the cost of a Japanese nootropic reaches 2500 rubles. per package, then Aminalon costs 100-150 rubles. for packing. The effectiveness of both drugs has not been studied and proven. The price and quality of the Japanese product is more of a marketing ploy.

The opinions of experts about the effectiveness of nootropics in children differ. Some consider drugs indispensable in the treatment of any neurogenic disorders, psycho-emotional disorders. Others doubt the effectiveness of nootropic drugs due to the lack of clinical data for use in childhood. Basically, nootropics are used for "sedation" as an adjunct treatment to the base treatment. All drugs are dispensed from pharmacy chains without a prescription.

List of the best nootropics

What is better to take drugs in a particular clinical situation should be decided by the attending physician. To date, there are several of the most effective drugs that have found the widest application both in pediatrics and in adult practice in the treatment of diseases of a neurogenic nature:

Piracetam;

Nootropil;

• Cerebrolysin;

  Vinpocetine;

  Biotredin;

  Aminalon;

  Biotredin.

The effect of the constant intake of modern nootropic drugs begins only after a few months. As an independent drug, nootropics are used as a prevention of neurological diseases, decreased performance in adults, and impaired concentration.

Combined funds

Among nootropics, there are preparations with a combined composition. Such funds include two or more active components, which, to one degree or another, enhance or reduce the effect of each other. The main drugs of the series are:

Gamalate B6 (as part of Pyridoxine hydrochloride, magnesium glutamate hydrobromide);

Omaron, Phezam, Evryza, Noozom (Piracetam and Cinnarizine, auxiliary components);

Neuronorm (active substances Piracetam and Cinnarizine);

Olatropil (Piracetam and GABA);

(Piracetam and Thiotriazolin).

All funds are similar in effectiveness to Piracetam. Combined drugs are used for severe problems, similarly to popular drugs, they are used in monotherapy and in combination with other drugs.

All drugs, despite the absence of side effects, require a prescription from a doctor. Only on the basis of medical research data can an accurate diagnosis be established, which will determine further adequate treatment.

• Piracetam (Nootropil)

Imagine a situation: there is an important task ahead that requires maximum concentration of mental abilities, and your brain, unfortunately, refuses to work. Thoughts are in the clouds, the head seems to be wadded, and the memory is “leaky”. But there is a whole group of drugs that improve cognitive function!

Norm and pathology

First of all, it would be good to determine the cause of the violations. Memory impairment, decreased mental performance, as well as headache and noise in the head can be the first signs of serious diseases associated with impaired blood flow in the brain.

As a rule, this occurs with vasoconstriction against the background of arterial hypertension or atherosclerosis. Both of these conditions, if not properly treated, progress and often lead to serious consequences, such as a stroke or heart attack.

In addition, mental deterioration may be associated with a disease such as Alzheimer's disease. Therefore, at the first alarming signs, it is better to consult a doctor and figure out what is happening in the body. If the examination confirms the pathology, the person needs long-term and serious treatment.

However, fortunately, memory impairment can also be quite harmless. After all, we often work at a high pace, sparing no effort, and stress, physical and mental overstrain make themselves felt by natural fatigue. And what kind of intellectual success can we talk about if an exhausted organism directs all its efforts to ensure at least the uninterrupted operation of vital systems? This is where you can pay attention to nootropics.

"Smart" pills

The word "nootropic" was first proposed by the Romanian physiologist and chemist Cornelius Girge in 1972. He combined it from two Greek components: noos - mind and tropos - direction. The main task of nootropics is to improve cognitive function.

For decades, in the world psychiatry and neurology, disputes about the advisability of using this group of drugs by healthy people have not ceased. The reasons for this are the possible side effects of drugs along with unproven efficacy. Nevertheless, in 2015, the sales of this group's funds in the world exceeded $1 billion, and the demand for them is constantly growing.

According to the instructions for use, nootropics are able to accelerate the transmission of impulses between the hemispheres of the brain, normalize metabolic processes and enhance microcirculation. It is also said that nootropic drugs improve mental performance, learning and memory, and in addition increase the resistance of the brain to damaging factors, such as high stress or lack of oxygen.

Today, nootropics of different classes are used in domestic practice, including:

• racetams, a prominent representative of which is Piracetam;
• derivatives of gamma-aminobutyric acid (Phenibut);
• herbal preparations such as ginkgo biloba extract;
• amino acids (glycine);
• substances of other groups with a nootropic effect, including correctors of cerebral circulation disorders (Vinpocetine, Cinnarizine) and general tonic drugs (ginseng extract, melatonin).

Let's look at the features of each group.

Briefly about the properties

Each representative of nootropics can be given a separate article, but we will try to characterize them briefly and to the point.

Piracetam. He owns the laurels of superiority: piracetam became the first "drug that improves cognitive function." It is produced under various trade names (Lucetam, Nootropil, Piracetam) in various forms of release (solution for intramuscular and intravenous injections, tablets, capsules) and is used for various conditions and diseases accompanied by intellectual disabilities.

It should be noted that piracetam is not used in the US. The FDA defines drugs in the United States only as drugs that are used to diagnose, treat, or prevent disease. The composition of food supplements should include vitamins, minerals, amino acids, plant compounds. Piracetam, alas, does not satisfy either the first or the second requirement, and therefore, according to American laws, it cannot be either a drug or a dietary supplement. But in European countries it is used, although some experts, including domestic ones, are extremely skeptical about its evidence base. Piracetam is even included in the well-known list of placebo drugs presented by Professor Vorobyov, Chairman of the Formulary Committee of the Russian Academy of Medical Sciences.

Derivatives of gamma-aminobutyric acid (GABA). The drugs of this series include Aminalon, Picamilon, Phenibut, etc. Phenibut, along with improving mental performance, eliminates tension, irritability and improves sleep. True, again in the West, unlike the CIS countries, the funds of this group are not used as nootropics. In addition, Picamilon and Phenibut were included in the list of Professor Vorobyov mentioned above.

Ginkgo biloba extract. According to the instructions for use, it has a combined nootropic, antihypoxic effect, improves blood circulation in the brain, thereby improving cognitive functions and improving memory. It is sold both in the form of drugs (Bilobil, Tanakan, Memoplant), and as part of dietary supplements. How dietary supplements are used in the West. However, clinical studies have not confirmed the beneficial effects of ginkgo biloba on intelligence and memory in healthy individuals.

Glycine. This amino acid regulates metabolic processes in the nervous system, normalizes excitation and inhibition, and at the same time has a very high safety profile. Therefore, over-the-counter Glycine is often used for various disorders of the psycho-emotional state: irritability, insomnia, as well as a decrease in mental performance, including in children. In the USA, glycine is used as a dietary supplement, and in some European countries, such as Poland, Italy, it is part of combined analgesic drugs (Alka-Prim). As an independent nootropic, it is mainly used in the territory of the post-Soviet space.

Normalizing cerebral circulation. Representatives of this group act by improving the blood supply to the brain. For example, Vinpocetine is a synthetic analogue of an alkaloid isolated from periwinkle lesser. The drug was created by Hungarian pharmacologists and is used mainly in Eastern Europe. Cochrane Collaboration studies have not confirmed the positive effect of Vinpocetine on mental performance.

Another popular drug of this subgroup is Cinnarizine, in the West it is mainly used for motion sickness, since it relieves nausea and vomiting in vestibular disorders, and in the post-Soviet space it is often prescribed as an affordable nootropic.

Ginseng extract. Ginseng extract is believed to increase mental and physical performance by stimulating the central nervous system. However, this herbal preparation has not defended its nootropic properties in clinical trials. According to the Cochrane Collaboration, there is no convincing evidence that ginseng extract helps improve mental performance.

To the rhetorical question “to drink or not to drink medicines to improve memory,” everyone can have their own answer. And the truth is its own: one, ugly, among scientists, and completely different, optimistic, among consumers. Despite the depressing research data, many patients readily take nootropics and feel better with treatment. Moreover, most of the funds in this group are well tolerated, and some, such as ginkgo biloba extract and glycine, are sold even without a doctor's prescription.

However, relying on the achievements of pharmacology, it would be good to help the body, which reacts to difficult working conditions and the lack of normal rest with a deterioration in mental abilities. Give yourself a break, switch to other activities, go to the pool or the gym. And, perhaps, soon you will see how deep your intellectual abilities are without any medicinal support.

Marina Pozdeeva

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