Mexidol after a stroke. Prescribing medication

V.A. Kraineva

State Research Institute of Pharmacology named after. V.V. Zakusova RAMS, Moscow

Using a model of experimentally induced intracerebral post-traumatic hematoma (hemorrhagic stroke) in rats, it was found that the drug Mexidol is effective at a dose of 100 mg/kg (course - 7 days). The drug statistically significantly reduced the amount neurological disorders(paresis, manege movements), increased the survival rate of animals, improved the learning and memory processes of rats with hemorrhagic stroke, as well as their motor activity.

Key words: Mexidol, hemorrhagic stroke, neurological status, memory

Disorders of the integrative functions of the central nervous system arise as a result of brain damage, in particular, with ischemic and hemorrhagic strokes(GI; cerebral infarctions), injuries accompanied by persistent focal morphological defects of brain structures.

Stroke - vascular lesion brain, caused by insufficient blood supply (ischemic stroke) or hemorrhage in the supra- and subthecal spaces of the brain (GI), occurs due to rupture of cerebral vessels (cerebral hemorrhage, GI), as well as their obstruction (cerebral infarction, ischemic stroke).

Therapy for stroke is aimed at restoring arterial patency (tissue activator), preventing thrombus formation (fibrinolytics, anticoagulants, antiplatelet agents) and the death of viable neurons. To prevent the death of neurons in the area of the “ischemic penumbra”, neuroprotective agents are prescribed, the use of which is especially advisable in the first hours of a stroke (during the so-called “therapeutic window”). Both one and several neuroprotective drugs are used. For this purpose, Cerebrolysin, choline alfoscerate, carnitine chloride, emoxypine, glycine, etc. are used. Some vasoactive drugs(vinpocetine, nicergoline, cinnarizine), which are prescribed to increase blood supply to ischemic tissue. However, it is impossible to exclude the phenomenon of “stealing”, which is manifested by a decrease in blood flow in the ischemic zone due to its increase in healthy tissues.

Antioxidants are considered promising treatments for patients with acute lesions CNS. These assumptions are based on the fact that free radicals, appearing as a result of damaging effects, overload the systems of endogenous antioxidants, which include hydrogen superoxide dismutase, catalase, glutathione, ascorbic acid, and play a significant role in the development of tissue damage.

A special place among antioxidants is occupied by domestic synthetic original drug"Mexidol", developed at the State Research Institute of Pharmacology of the Russian Academy of Medical Sciences in the mid-1980s. . The drug has a pronounced antioxidant and membrane protective effect. By chemical structure it is 2-ethyl-6-methyl-3-hydroxypyridine succinate and is thus similar to pyridoxine.

Mexidol is an inhibitor of free radical processes, lipid peroxidation, and has an effect on physical and chemical properties membranes, increases the level of polar lipid fractions in the membrane, reduces the viscosity of the lipid layer, activates the energy-synthesizing functions of mitochondria, improves energy metabolism in the cell and protects the structure of the membrane. This drug has wide range pharmacological action, which is realized at at least two levels - neuronal and vascular. It has cerebroprotective, anti-alcohol, nootropic, antihypoxic, anxiolytic, anticonvulsant, antiparkinsonian, anti-stress, vegetotropic effects, and also has the ability to potentiate the effects of other neuropsychotropic drugs, improves cerebral circulation, inhibits platelet aggregation, reduces general level cholesterol, has an antiatherosclerotic effect.

The fundamental difference between the mechanism of action of Mexidol and that of traditional neuropsychotropic drugs is its lack of specific binding to known receptors. Mexidol is capable of modulating GABA A receptors. Its antihypoxic effect is due not only to the 3-hydroxypyridine molecule, but also to its constituent succinate, which is capable of oxidizing under hypoxic conditions.

Effects of Mexidol in the treatment of patients with ischemic stroke well studied. Features of the use of the drug in patients with HI have been studied to a much lesser extent.

The purpose of this study was to study the anti-stroke effect of Mexidol in a rat model of HI and to evaluate the spectrum of its pharmacological action.

RESEARCH METHODOLOGY

The experiments were carried out on white outbred male rats weighing 220-250 g. The animals were kept under standard vivarium conditions with free access to water and food.

Modeling of local hemorrhage in the brain - HI (intracerebral post-traumatic hematoma), was carried out according to the method.

To create a stroke, rats were anesthetized with chloral hydrate (400 mg/kg intramuscularly), then craniotomy was performed and brain tissue was destroyed in the area of the internal capsule, followed (after 2-3 min) by introducing blood (0.02-0.03 ml) taken into the site of injury from under the animal's tongue. In this way, we simulated a local autohemorrhagic bilateral stroke in the area of the internal capsule (diameter - 2 mm, depth - 3 mm) without significant damage to the upper structures of the brain and neocortex.

24 hours after the operation, neurological deficits, changes in motor coordination, muscle tone, and orienting and exploratory behavior of the rats were recorded.

Observations were carried out for 14 days after surgery. The behavior and condition of the animals were recorded on days 1, 3, 7 and 14.

The animals were divided into 3 groups. The 1st group included sham-operated (SO) rats that underwent only craniotomy, the 2nd group included animals with GI, the 3rd group included rats with GI that were administered Mexidol (100 mg/kg intramuscularly 3.5-4 hours after surgery , then once daily for 7 days). Animals of groups 1 and 2 were administered saline solution in an equivalent volume.

Behavioral disorders and condition of animals after HI were assessed traditional methods: neurological status - by the method of assessing neurological deficit (according to the McGrow stroke assessment scale (stroke-index) modified by I.V. Gannushkina); registration method muscle tone and coordination of movements; cognitive functions - according to conditioned reflex passive avoidance (PAA) in a dark and light chamber; indicative-exploratory behavior - using the open field technique. The effect of the drug on the survival of rats was assessed.

Statistical processing of the data was carried out with the calculation of arithmetic averages and their confidence intervals at p<0.05. Для оценки достоверности результатов использовали t критерий Стьюдента и критерий χ 2.

RESEARCH RESULTS

On the 1st day after surgery, almost all (90-100%) animals with HI (group 2) exhibited neurological disorders (lethargy, slowness of movements, weakness of the limbs), while in rats of group 1 these disorders were noted at 30 -40% of cases. Severe neurological disorders, manifested in the form of circular movements, paresis and paralysis of the limbs, were not observed in the 1st group of rats, but in animals of the 2nd and 3rd groups they were recorded in 40 and 30% of cases, respectively.

With double administration of Mexidol, neurological disorders in rats of group 3 weakened (Table 1): mild disorders were recorded in 40-60% of animals.

Table 1. Effect of Mexidol on neurological deficit in rats on the 1st day after surgery (% on the McGrow scale)

Possibilities of Mexidol in the recovery of patients after a stroke

The results of treatment of 440 patients who suffered ischemic stroke were analyzed. In the control group, 220 patients received standard therapy. In the second group, 220 patients received Mexidol in addition to standard treatment. It has been established that Mexidol significantly improves the results of rehabilitation of patients after a stroke, promoting both an increase in the degree of restoration of neurological functions and an increase in the level of everyday adaptation of patients. Mexidol is recommended for use at all stages of rehabilitation treatment for patients who have suffered a stroke.

Strokes are the main cause of long-term and profound disability. The lack of timely and adequate restorative treatment leads to irreversible anatomical and functional changes. At the same time, the level of development of post-stroke rehabilitation is still far from perfect and requires qualitative improvement and reorganization. In recent years, disability due to stroke has been steadily increasing. In our country, according to various sources, no more than 3-23% of patients return to work after a stroke, 85% of patients require constant medical and social support, and 30% remain deeply disabled.

The main goal of restorative treatment of patients with strokes, as well as with other diseases, is the return of the victim to household and work activities, the creation of optimal conditions for his active participation in the life of society. Currently, to restore various functions of patients who have suffered acute cerebrovascular accident, specialists use a large number of drugs, the effectiveness of many of which has not been reliably proven. Mexidol, an antihypoxant and antioxidant, is a promising drug for the recovery of patients after a stroke. Mexidol has a nootropic effect and also increases the body's resistance to stress reactions. In addition, when using Mexidol, the rheological properties of blood and the anti-aggregation ability of platelets improve.

Purpose of the study. studying the effectiveness of using Mexidol for the rehabilitation treatment of patients who have suffered a stroke.

Materials and methods

The results of treatment of 440 patients who suffered an ischemic stroke, who were divided into two comparative groups, were analyzed. Patients of the first group received complex conventional therapy at all stages of treatment (drugs that support vital functions, as well as one of the antiplatelet agents: aspirin, cardiomagnyl, chimes or Plavix). Patients of the second group, in addition to standard treatment, received the drug Mexidol. Demographic characteristics of patients in the treatment group: 121 women and 99 men, mean age 65.3 years (range 38 to 79 years). Demographic characteristics of patients in the comparison group: 117 women and 103 men, average age - 64.9 years (from 37 to 80 years). Patients in the compared groups were recruited according to the principle of “matching pairs”, that is, they were comparable in age, gender, degree of impairment of neurological functions, level of severity of everyday adaptation, psycho-emotional state, as well as the types and methods of rehabilitation treatment used. During the study, statistically reliable data were obtained based on the processing of indicators standardized according to the listed criteria of comparability of the treatment and comparison groups.

Mexidol was prescribed at the 1st, 6th and 12th months of stroke. The following regimens and dosages of the drug were used:

1st month - 400 mg intravenously daily for 15 days,
6th month - 200 mg intravenously daily for 10 days,
12th month - 200 mg intravenously daily for 10 days.

Impairment and recovery of neurological functions were determined using the Barthel, Lindmark and Scandinavian scales. Motor functions and everyday adaptation were assessed using the Bar-tel scale; according to the Lindmark scale - functions of movement and sensitivity; according to Scandinavian - motor and higher brain functions. According to the results obtained, the degree of recovery was classified as follows: no recovery - the arithmetic average number of points scored on all three listed scales was less than 30% of points from their maximum number, minimal - 30-49%, satisfactory - 50-74%, sufficient - 75-94%, complete - more than 94%. The level of everyday and social adaptation was determined using the Merton and Sutton scale: self-assessment of everyday life capabilities. According to the results obtained, the degree of household adaptation was classified as follows: no household adaptation - 0 points, minimal - 1-29 points, satisfactory - 30-45 points, sufficient - 46-58 points, complete - 59 points. In addition, the ability to independently perform certain household skills was assessed.

Criteria for inclusion of patients in the study: degree of impairment of neurological functions - 30% or less of the maximum number of points scored on the Barthel, Lindmark, Scandinavian scales; degree of everyday adaptation - 30 or less points scored on the Merton and Sutton scale; dependence when performing household skills.

In this publication, to facilitate the perception of the research results, cases with sufficient and complete restoration of functions and with sufficient and complete everyday adaptation are presented and, accordingly, cases with a lack of restoration and everyday adaptation and their satisfactory and minimal severity are not presented.

Statistical analysis of the study results was carried out using SPSS 12.0 software packages. To compare qualitative characteristics and percentages, the criterion of independence of qualitative (categorical) characteristics χ 2 was used. Fisher's exact test and uncertainty coefficient.

Results and discussion

In table Table 1 presents the results of a study of the effect of Mexidol on the restoration of various neurological functions in patients who have suffered a stroke. Compared with the control group, the use of Mexidol caused a significant improvement in the results of rehabilitation treatment of patients after a stroke, increasing the degree of recovery of neurological functions. Thus, in the group of patients who were prescribed Mexidol, sufficient and complete restoration of these functions was observed in 60% of patients, and in the group of patients who did not receive this drug - in 23.6% (p<0,0001). Кроме того, мексидол вызывал достоверное повышение уровня бытовой адаптации пациентов после инсульта. Так, в группе больных, получавших данный препарат, достаточная и полная степень бытовой адаптации отмечалась в 65,5% случаев, а в группе больных, не получавших мексидол, — в 33,2% случаев (p<0,0001, table 1).

Table 1. Distribution of stroke patients with sufficient and complete recovery

neurological functions and everyday adaptation depending on the use of Mexidol

Function restoration

USE OF THE DRUG "MEXIDOL" FOR THE TREATMENT OF PATIENTS WHO HAVE SUFFERED STROKE

I.M.Kadin

Neurological Department of City Hospital No. 4, Chernigov

The results of using the drug "Mexidol" for the treatment of patients who have suffered a stroke are presented.

It has been established that Mexidol improves the psycho-emotional state, memory, motor activity, regulates cerebral hemodynamics, increases the frequency of the L-rhythm in both hemispheres of the brain, reduces the level of cholesterol, LDL, has a positive effect on the rheological properties of the blood, which improves the quality of life and helps physical adaptation patients who have had a stroke.

Key words: Mexidol, stroke, neurorehabilitation, cognitive impairment, psycho-emotional state

Brain stroke is one of the main causes of morbidity and disability. In Ukraine, the incidence of stroke is 2.5-3 cases per 1000 population per year, and mortality is 1 case per 1000 population. Post-stroke disability is 3.2 per 10,000 population. 20% of stroke survivors return to work. Currently, there is a tendency towards a slight reduction in the number of deaths in patients with ischemic stroke due to early and accurate diagnosis and intensive care. The most effectively impaired functions as a result of a stroke are restored in the first 3 months, and after 6 months the effectiveness of therapy decreases significantly. By the end of the 1st year, only 25.4% of patients who suffered an ischemic stroke do not require outside help; people of working age make up about 30%.

The problem of neurorehabilitation is very important and complex. In the rehabilitation treatment of this category of patients, vasoactive, nootropic, and neuroprotective drugs are used.

Ischemic stroke develops more often in people of older age groups, who usually have a complex of somatic pathologies, so the approach to treatment should be comprehensive.

Mexidol (2-ethyl-6-methyl-3-hydroxypyridine succinate) turned out to be a highly effective drug of combined action. Mexidol belongs to the group of antihypoxic agents with nootropic and anxiolytic, antihypoxic properties. The drug improves cerebral metabolism and blood supply to the brain, microcirculation, rheological properties of blood, reduces platelet aggregation, has a hypolipidemic effect, and reduces the level of total cholesterol and LDL. Mexidol improves cell energy metabolism, synaptic transmission, activates the energy-synthesizing functions of mitochondria, affects the content of biogenic amines, inhibits free radical oxidation of lipids and the synthesis of thromboxane A, enhances the synthesis of prostacyclin, increases the activity of antioxidant enzymes, SOD.

The lipid-lowering effect of this drug is to reduce the amount of total cholesterol and LDL, reducing the cholesterol/phospholipid ratio. Mexidol also modulates the receptor benzodiazepine, GABAergic, acetylcholine complexes of brain membranes, enhances their ability to bind, stabilizes biological membranes, membranes of erythrocytes and platelets.

The nootropic effect of the drug is carried out by stimulating the transmission of excitation in central neurons, metabolic processes, improving the transmission of information between the hemispheres and cerebral blood flow, which helps improve memory, learning, preserving a memory trace and counteracts the process of extinction of acquired skills and reflexes.

Mexidol accelerates the recovery of motor functions in patients who have suffered a stroke. The drug increases the control of the cerebral cortex over subcortical structures, has a psychoanalgesic, anxiolytic effect, and reduces extrapyramidal dysfunction.

The pronounced antihypoxic and anti-ischemic effect is due to a direct effect on the endogenous respiration of mitochondria with activation of their energy-synthesizing function. The antihypoxic effect is due to the presence of succinate in its formula, which, under hypoxic conditions, entering the intracellular space, is capable of being oxidized by the respiratory chain.

Mexidol has a pronounced geroprotective effect, helps restore emotional and vegetative status, smoothes out the manifestations of neurological deficits, reduces the level of aging markers (MDA, cholesterol) in the brain and blood, causes regression of atherosclerotic changes in the main arteries and restores lipid homeostasis.

Mexidol was used to treat patients who had suffered a stroke in the neurological department of City Hospital No. 4 in Chernigov.

RESEARCH METHODOLOGY

We examined 30 patients aged 48-75 years with the consequences of an acute cerebrovascular accident (disease duration up to 1 year) against the background of discirculatory atherosclerotic and hypertensive encephalopathy.

24 patients were diagnosed with ischemic stroke, 6 with stroke hematoma. In 17 patients, the lesion was located in the right hemisphere, in 13 - in the left. Recurrent stroke was recorded in 5 patients, 3 had a history of myocardial infarction. In 7 patients, type 2 diabetes mellitus was a concomitant disease (they took Maninil, Diabeton). 27 patients suffered from arterial hypertension (blood pressure from 160/90 to 190/110) (they took antihypertensive drugs).

All study participants were prescribed Mexidol 4 ml (200 mg) intravenously in 100 ml of isotonic NaCl solution for 10 days in the morning from 9:00 to 10:00 and 2 ml (100 mg) intramuscularly in the afternoon at within 10 days. Next, the drug was prescribed in tablet form (0.125 g 3 times a day for 1 month), and patients also took it after discharge from the hospital.

To assess the clinical effectiveness of Mexidol, a comprehensive clinical examination was carried out using laboratory and instrumental diagnostic methods. The neurological status of the study participants was determined, a subjective and objective assessment of their condition was carried out before and after treatment, an assessment of motor functions and everyday adaptation (Barthel test), studies of cerebral hemodynamics (ultrasound Dopplerography of extra- and intracranial vessels), memory (test for memorizing 10 words ), bioelectrical activity of the brain (EEG), as well as emotional and psychological state (Hamilton Depression Scale). Laboratory tests were performed (general blood count, urine test, hematocrit, prothrombin index, prothrombin time, fibrinogen, total cholesterol, B-lipoproteins), and before treatment, computed tomography or brain tomography was performed.

RESEARCH RESULTS

Before treatment, patients complained of headaches (70%), periodic or constant dizziness (76%), tinnitus (83%), and decreased memory for current events (95%).

2 patients had grade IV hemiparesis, 15 had grade III, 11 patients had grade II, and 2 had grade I.

In 65% of patients, various sensory disorders were identified, in 13 - aphasic (from mild elements of motor aphasia to total motor aphasia in one patient). In 98% of cases, disturbances of cranial innervation were observed, in 78% - pathological foot reflexes of Babinsky, Shtrumpel, in 90% - pathological signs of oral automatism. Positive dynamics in the psychoemotional state of patients was observed (Table 1).

Table 1. Dynamics of indicators of psycho-emotional state and motor activity in patients who have suffered a stroke under the influence of a course of treatment with the drug "Mexidol"

An original domestic antihypoxant and direct-acting antioxidant that optimizes the energy supply of cells and increases the body's reserve capabilities

Use of the drug Mexidol for the treatment of patients who have suffered a stroke

Published in the magazine:
Bulletin of Experimental Biology and Medicine, 2006, Appendix 1

I.M.Kadin
Neurological Department of City Hospital No. 4, Chernigov

The results of using the drug "Mexidol" for the treatment of patients who have suffered a stroke are presented.

Key words: Mexidol, stroke, neurorehabilitation, cognitive impairment, psycho-emotional state

The problem of neurorehabilitation is very important and complex. In the rehabilitation treatment of this category of patients, vasoactive, nootropic, and neuroprotective drugs are used.

Ischemic stroke develops more often in people of older age groups, who usually have a complex of somatic pathologies, so the approach to treatment should be comprehensive.

Mexidol was used to treat patients who had suffered a stroke in the neurological department of City Hospital No. 4 in Chernigov.

RESEARCH METHODOLOGY

We examined 30 patients aged 48-75 years with the consequences of acute cerebrovascular accident (disease duration - up to 1 year) against the background of discirculatory atherosclerotic and hypertensive encephalopathy.

RESEARCH RESULTS

Before treatment, patients complained of headaches (70%), periodic or constant dizziness (76%), tinnitus (83%), and decreased memory for current events (95%).

2 patients had grade IV hemiparesis, 15 had grade III, 11 patients had grade II, and 2 had grade I.

Table 1. Dynamics of indicators of psycho-emotional state and motor activity in patients who have suffered a stroke under the influence of a course of treatment with the drug "Mexidol"

Improvements in the subjective condition of patients were noted: headaches decreased in 50%, and completely stopped in 30%; complaints of dizziness decreased in 20% of patients; complaints of tinnitus decreased in 35%.

In almost 80-82% of patients, sleep returned to normal and their mood improved. Improved memory for current events was noted by about 30% of patients. Changes in the motor sphere were also observed: the index of daily activity increased from 75.14±3.65 to 82.21±4.31.

Overall, the neurological status improved in 50% of patients.

Under the influence of Mexidol, changes in cerebral hemodynamics were recorded.

According to EEG data, nootropic and neurotropic effects of Mexidol were noted (a positive effect of the drug on the bioelectrical activity of the brain). Under the influence of the drug, an increase in spectrum power and activation of fast-wave rhythms were recorded on the EEG. A change in the L-rhythm frequency was detected against the background of an equivalent general increase in frequency in the intact and affected hemispheres (2.28 and 2.29 Hz, respectively; Table 2).

Table 2. Dynamics of the L-rhythm in patients who suffered a stroke under the influence of the drug "Mexidol"

Mexidol contributed to a decrease in the intensity of the Δ-range in the occipital region of the intact hemisphere. According to Doppler ultrasound, the volumetric velocity of blood flow in the cerebral artery of the affected and intact hemisphere increased. There was a decrease in the levels of total cholesterol and B-lipoproteins (Figure).

Indicators of total cholesterol and B-lipoproteins before (1) and after 21 days (2) of treatment with Mexidol.

During treatment with Mexidol, some adverse reactions were identified in patients who had suffered a stroke. In the first 2-3 days of taking Mexidol, 30% of study participants noted drowsiness and general weakness. One patient complained of severe nausea and dry mouth, due to which the drug was discontinued. One patient experienced increased dizziness, which stopped after 3 days without stopping the drug. No allergic reactions were recorded in any patient.

Thus, a pronounced therapeutic effect of the drug "Mexidol" on cognitive impairment in patients who have suffered a stroke has been revealed. The drug helped improve the social and everyday adaptation of patients and their psycho-emotional state. In the restored period, the frequency of the L-rhythm increased in the central, temporal, and occipital regions of the two hemispheres. This drug helped improve memory of motor activity, cerebral hemodynamics, bioenergetic activity of the brain, and reduce the level of total cholesterol and low-density B-lipoproteins in patients in this category.

LITERATURE
1. Gekht A.B., Gusev E.I., Bogolepova A.N., Alferova V.V. // Materials of the VIII All-Russian Congress of Neurologists. Kazan, 2001.
2. Gusev E.I., Shimrigk T., Haas A. et al. // Neurological. magazine 2002. T. 7, No. 5. P. 10.
3. Skvortsova V.I., Gudkova V.V., Ivanova G.E. // Stroke. 2002. No. 7. P. 28-34.

Comments(visible only to specialists verified by the MEDI RU editorial team)

Mexidol– prescribed for strokes and disorders of brain function. This is a broad-spectrum drug, it is effectively used in surgery and psychiatry. Mexidol is produced in the form of ampoules or tablets.

Mexidol is characterized by biological activity. It is effective when there is insufficient oxygen supply to the tissue, or when its absorption is impaired. Instructions for use of Mexidol and its application. When using Mexidol, the body's resistance to conditions such as shock and poor cerebral circulation increases, it improves memory processes, and reduces the influence of toxic effects, for example, from alcohol.

Indications for use of Medixol

Mexidol is prescribed for:

therapy for cerebrovascular accidents,
disturbances in vascular tone due to,
atherosclerotic disorders of brain function,
to relieve withdrawal symptoms,
for alcoholism and drug addiction or other conditions,
in which tissue hypoxia is observed.

Intravenous administration of the drug

Mexidol is administered intramuscularly or intravenously. To relieve withdrawal symptoms and prevent a sharp increase in the concentration of adrenal hormones (adrenaline) in the blood, the drug is administered as a stream, and in case of cerebrovascular accidents - as a drip.

For intravenous injections, the solvent is sterile water for injection. Mexidol is administered in a stream over five to seven minutes, and dropwise at a rate of sixty drops per minute. Doses are selected individually.

Treatment begins with a dose of one hundred milligrams up to three times a day, but the dose is gradually increased until a therapeutic effect is achieved. The duration of treatment and the individual dose depend on the severity of the disease and the effectiveness of the treatment. The maximum daily dose cannot exceed eight hundred milligrams.

Mexidol for diseases

Mexidol is given intravenously by drip, following a dose of two hundred to three hundred milligrams in the first two to four days, and then given intramuscularly at one hundred milligrams three times a day.

For patients suffering from dyscirculatory encephalopathy and vegetative-vascular dystonia, Mexidol is administered intramuscularly at fifty to one hundred milligrams three times a day.

For withdrawal symptoms, one hundred to two hundred milligrams of Mexidol are injected intramuscularly up to three times a day, or intravenously by drip up to two times a day, and for neurotic disorders, injected intramuscularly from 50 to 400 milligrams per day.

The drug Mexidol has nootropic, antihypoxic, antiischemic, antistress, antiamnestic, vegetotropic, cerebroprotective, antiparkinsonian, tranquilizing, anticonvulsant, antialcoholic effects. In addition, Mexidol improves cerebral circulation, lowers cholesterol levels, inhibits platelet aggregation, and has an anti-sclerotic effect.

Mexidol increases the body's resistance to such traumatic factors as stress, conflicts, sleep disturbances, brain injuries, physical activity, intoxication, ischemia, and hypoxia.

Mexidol eliminates anxiety, fear, improves memory, learning processes, reduces stomach ulcers, etc.

It is also very important that Mexidol does not have a negative effect on the liver, but quite the contrary, has hepatoprotective properties ; does not change the composition of the blood, breathing rhythm, color of the skin and mucous membranes; does not change blood pressure, ECG, defecation, urination (urination), salivation (salivation).

It should be noted that no serious scientific safety studies have been conducted use of Mexidol in pregnant women, nursing mothers and children.

Now let’s look at some clinical studies of the use of Mexidol.

Strokes is the main cause of long-term disability in the population, and Mexidol (2-ethyl-6-methyl-3-hydroxypyridine succinate) is one of the medications that is successfully used in the recovery period after a stroke. In the article “The influence of Mexidol on neurological deficits, social and everyday adaptation and syndromes of neglect and “repulsion” in patients after a stroke” (JOURNAL OF NEUROLOGY AND PSYCHIATRY; N. 12; 2011) V.V. Kovalchuk (city hospital N.38 named after N.A. Semashko, St. Petersburg) writes the following:

“The results of the first part of the study showed that patients receiving Mexidol showed a significant (p<0,0001) по сравнению с контрольной группой улучшение результатов восстановительного лечения. Так, в группе пациентов, которым назначался мексидол, достаточное и полное восстановление данных функций отмечалось у 60,0% больных, а в группе больных, не получавших данный препарат, — у 23,6%. Кроме того, у получавших мексидол больных выявлено достоверное (р<0,0001) повышение уровня бытовой адаптации после инсульта. Так, в группе пациентов, получавших данный препарат, достаточная и полная степень бытовой адаптации отмечалась в 65,5% случаев, а в группе больных, не получавших мексидол, — в 33,2% случаев.Также применение мексидола способствовало достижению пациентами более высокого уровня независимости при выполнении основных бытовых навыков, оказывая достоверное (р<0,0001) положительное влияние на независимость при пользовании туалетом, умывании, принятии ванны, одевании, приеме и приготовлении пищи… Согласно результатам второго этапа второй части исследования, применение мексидола достоверно (p<0,001) способствовало устранению синдрома неглекта. Так, в группе пациентов, получавших данный препарат, синдром неглекта отмечался после лечения у 29,3% больных, в то же время среди больных, не получавших мексидол, данный синдром наблюдался в 58,8% случаев. При этом наиболее эффективное (р<0,0001) влияние мексидола прослеживалось в отношении таких проявлений синдрома неглекта, как геминевнимание, зрительное угасание и анозогнозия. Так, в группе пациентов, получавших мексидол, данные симптомы на фоне лечения отмечались у 12,5, 19,1 и 23,8% больных соответственно, среди не получавших мексидол больных эти симптомы наблюдались у 53,5, 50,6 и 61,1% (рис. 1). Применение мексидола также вызывало достоверное (р<0,001) уменьшение распространенности таких проявлений синдрома неглекта, как тактильное угасание, аллоэстезия и отрицание принадлежности конечностей одной стороны своему телу.”

As we can see, the results of this study prove the feasibility of using the drug Mexidol in the rehabilitation treatment of patients who have suffered a stroke.

In the same magazine (N. 3, 2014) V.V. Kovalchuk focuses on the importance of Mexidol in secondary prevention of ischemic strokes in patients with and without concomitant severe pathology. The analysis was based on the results of treatment of almost three and a half thousand patients who suffered an ischemic stroke. These patients were divided into groups : patients with concomitant hypertension (arterial hypertension), diabetes mellitus, metabolic syndrome, etc.

The effectiveness of this drug was judged on the basis of the absence of recurrent ischemic stroke over five years of therapy. The following conclusion was made : the frequency of recurrent strokes, due to the inclusion of Mexidol in complex treatment, is reduced. Moreover, Mexidol helps best in preventing recurrent stroke in patients with arterial hypertension. The author of the article also notes the good compatibility of Mexidol with other drugs in the complex treatment of IS.

At the very beginning of the 21st century, studies of the new domestic drug Mexidol were conducted in a number of Russian clinics. The now deceased academician N.V. Vereshchagin, in one of his scientific works, described a clinical experiment that was conducted at the Research Institute of Neurology of the Russian Academy of Medical Sciences. The effectiveness of a number of medications was studied, and among them was also the domestic drug Mexidol.

The academician points out in his work that the effectiveness of Mexidol was studied in patients with cerebrovascular pathologies (circulatory disorders of the brain). A study of Mexidol on patients in the acute period of stroke showed the following : Seventy-seven percent of the observed patients had a positive effect from the use of Mexidol. Parenterally, patients were administered three hundred mg of Mexidol (in saline solution) three to six times a day intravenously or intramuscularly, and subsequently the dose of Mexidol was reduced to four hundred mg/day. The minimum course of therapy was ten days. The author of the article claims that patients with severe arterial hypertension responded worse to therapy with this drug. The academician draws the attention of specialists to the fact that the result of treatment with Mexidol was significantly better in those who received three hundred to four hundred mg of Mexidol per day than in those who received two hundred mg/day. In the latter cases, the effectiveness of Mexidol was equal to the effectiveness of placebo.

And in the process of treating this disease, the use of the unique drug Mexidol also helps.

“We noted that in patients with the tremulous-rigid form of the disease, in whom the greatest clinical effect was observed, there was a slight decrease in the conduction velocity of the motor fibers of both the median and peroneal nerves. It should be noted the positive effect of Mexidol® on the severity of emotional and personal disorders in Parkinson's disease. especially depression and anxiety. As is known, anxiety and depression are comorbid for this disease and often precede the development of motor symptoms of parkinsonism. The frequency of anxiety and depressive disorders in patients with Parkinson's syndrome reaches 40-50%. Depression significantly affects the condition of patients and reduces the effectiveness of treatment. Prescription of Mexidol® led to a decrease in depressive complaints, fatigue decreased, and physical and social activity increased. Against this background, sleep returned to normal and self-confidence increased. In general, the positive effect of Mexidol® on motor and affective disorders led to an improvement in the quality of life of patients. The drug was well tolerated... Thus, the study showed the effectiveness of the Mexidol® infusion course for Parkinson's disease. There is reason to believe that this may be due to the drug's ability to increase the effectiveness of antiparkinsonian drugs or to its own dopamine-positive effect. The wide spectrum of action of the drug, its gerontopositive effect allows us to recommend Mexidol® in the complex therapy of Parkinson’s disease.”

In the scientific article “The use of Mexidol in general medical practice for the correction of borderline psychoneurological disorders” (candidate of medical sciences L.A. Medvedeva, doctors of medical sciences O.I. Zagorulko and A.V. Gnezdilovy, etc.) in medical Vestnik N. 40(425) we find experimental evidence of the effectiveness of the use of the drug Mexidol with psychoorganic syndrome, with a number of psychosomatic diseases. In 14 patients (46% of those studied), the use of the drug Mexidol led to a complete cessation of panic attacks, in 9 patients (29%) the incidence panic attacks decreased by 50%. The use of Mexidol for neurasthenia turned out to be positive (significant improvements occurred in 50% of patients). In agoraphobia (without panic attacks), significant improvement occurred in 33.3% of patients. The anxiolytic effect of Mexidol was also clearly manifested in the treatment of hypochondriacal disorders. The effectiveness of Mexidol was also achieved when it was used for anxiety-asthenic syndrome (in 75% of cases). Mexidol has proven a pronounced anti-anxiety effect. In addition, the use of Mexidol had a positive effect on dyssomnia disorders (night sleep improved in the absence of daytime sleepiness). It is important to emphasize that all patients tolerated treatment with Mexidol very well.

In surgery , as mentioned above, Mexidol is used for such serious diseases as peritonitis and acute pancreatitis .

But no less difficult problem in surgery is the problem cholelithiasis and gallbladder diseases . The problem of acute cholecystitis ranks second among acute surgical diseases. Moreover, for every 400–500 cholecystectomies, there is on average one injury to the bile ducts. Number of complications operations on the gallbladder bubble quite high, and mortality in acute surgical pathologies, including AC (acute cholecystitis) does not decrease.

Mexidol - Indications for the Use of Tablets

Russian scientists are constantly conducting numerous studies aimed at preventing diseases associated with the harmful effects of free radicals – research aimed at increasing the resistance to oxygen starvation of human organ tissues, in case of any types of hypoxia, acute, chronic circulatory disorders. The unique drug Mexidol, created by brilliant Russian scientists, received permission for use at the end of the last century. This drug belongs to the group of nootropic drugs. effectively improving metabolic processes, especially metabolism in the brain.

Pharmacological action

Mexidol tablets have a miraculous effect on brain cells. The drug delivers more necessary oxygen from the blood to neurons and helps increase the threshold for the generation of convulsive impulses in the brain. The patient recovers memory and habitual skills lost after suffering a serious illness much faster. The cognitive abilities of the brain increase, resistance to various possible stressful situations and intoxications appears.

Also, this new drug reliably protects cell membranes from destruction, which they can undergo when exposed to toxins. Mexidol tablets are used in the treatment of atherosclerosis, vegetative-vascular dystonia, and withdrawal syndrome. This drug significantly reduces the effects of alcohol and drugs on the human body and is a highly effective anticonvulsant.

Indications for use of the drug Mexidol

The main indications for effective treatment with the drug Mexidol are mainly heart attack in the acute and recovery period, as well as the prevention of this serious disease. This drug is widely used for poisoning with neuroleptics, such as aminazine, triftazine, atarax. Mexidol tablets are used to treat chronic or acute stress, but only under the supervision of a doctor.

Mexidol tablets have a very mild but effective effect on metabolic processes in the human body, as well as on the blood supply to the brain and heart muscle. That is why indications for the use of Mexidol tablets are various diseases accompanied by the negative effect of free radicals on organ tissue.

Contraindications to the use of the drug

This drug has its own specific contraindications for use, such as individual intolerance to the ingredients included in Mexidol. It is not recommended for women to take the drug during pregnancy or breastfeeding. When prescribing the drug, a specialist doctor should take into account the patient’s age; Mexidol should not be given to children. If renal or liver function is impaired, caution is required when prescribing this drug to a patient. When prescribing Mexidol in the above cases, it is necessary to consider the use on an individual basis for each individual patient.

Side effects

When using, you should take into account the side effects of this drug, which include sometimes occurring allergies to the components of Mexidol tablets. The patient may experience nausea and vomiting. Dry mouth is also a side effect of this drug.

When using Mexidol, it is important to take into account the patient's blood pressure readings. With elevated levels reaching 100/180 mmHg. The doctor must definitely reconsider the approach to treating such a patient. It is recommended to achieve normalization of blood pressure levels immediately before using Mexidol. It is mandatory to carry out special sedative therapy. Only after consistent implementation of all the above preparatory measures is it recommended to begin treatment with this drug. Mexidol has an excellent effect in the complex treatment of reactive arthritis. pancreatitis, but it cannot be called the main drug for the treatment of the above diseases.

These tablets are produced for internal use, 30 pieces in one package. They are covered with a special shell. One tablet of this drug contains 125 grams of oxymethylethylpyridine succinate. The average course of use of this medicine ranges from approximately 15 days to one and a half months, inclusive. The exact course of treatment with such tablets will be advised by your attending physician in accordance with your health condition. Be healthy!

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The drug Mexidol: instructions for use, price, reviews

Release form of the drug

The solution is intended for intramuscular and intravenous use. Available in ampoules. The color of the drug can be transparent, colorless and light yellow.

Indications for use of Mexidol

The drug Mexidol is prescribed by the attending physician in case of chronic or acute dysfunction of the brain, as well as stagnation of blood circulation. It is a drug for treating the consequences of ischemic stroke.

The solution is also proposed as a treatment for vegetative-vascular dystonia, when the patient has insufficient vascular tone resulting from the consequences of diseases of the autonomic nervous system.

For the treatment of psychosomatic diseases, the drug can be prescribed as both a primary and an auxiliary medicine. In particular, its use is mandatory if the patient experiences neurosis-like disorders accompanied by fear, increased nervous excitability, anxiety and memory impairment.

For elderly patients, the drug is prescribed as a treatment for vascular atherosclerosis.

During alcohol or drug addiction, the drug Mexidol is used to eliminate withdrawal symptoms.

Drug dosage

Depending on the specific disease, the instructions for using Mexidol and the dosage method are very different from each other.

For primary treatment, the drug is administered at a dose of 100 mg 1 to 3 times a day. Based on the severity of the patient’s condition and the degree of his recovery, the doses are gradually increased. However, the daily dosage of the drug cannot exceed 800 mg.

If the patient has an acute condition of circulatory disorders or a stroke, treatment begins with 300 mg. For these indications, the drug is administered intravenously for 4 days. Then the medicine is administered intramuscularly at a dose of 100 mg. The number of appointments is assigned individually.

In case of vegetative-vascular disorders, the drug is prescribed for intramuscular administration at the rate of 50-100 mg at a time.

In elderly patients during the treatment of atherosclerosis, Mexidol is prescribed intramuscularly at a dosage of 100 to 300 mg.

To treat the consequences of neuroleptic poisoning, the drug is prescribed intravenously. For this disease, the optimal dose for treatment can range from 50 to 400 mg.

Contraindications of the drug

The medicine Mexidol, namely, the instructions for use include contraindications for patients with severe kidney and liver diseases, and the presence of allergic reactions to pyridoxine. The solution should not be used by pregnant women and women during lactation.

Pharmacological action of the drug

Utilizes excess glucose;

Stabilizes the condition of membranes;

Stops lipid oxidation;

Activates the antioxidant system;

Maintains macroerg levels;

Has anti-ischemic properties (stimulation of reparative processes, activation of blood circulation);

Eliminates the consequences of extreme stress factors (shock, hypoxia, depression, lack of sleep, brain injury, etc.);

Features of the medicine

An overdose can cause an acute attack of drowsiness. It is not recommended for people whose professions involve strong concentration.

OUR body functions due to the cells that make up various organs and tissues. The raw materials and fuel for the cell are nutrients and oxygen, but in the process of vital activity and poor ecology, metabolism is disrupted, which leads to atherosclerotic changes in blood vessels. Atherosclerosis is the hardening of the vascular wall due to the growth of connective tissue, the deposition of fat-like substances (lipids), so-called “plaques” on the inner walls of the vessels, due to which elasticity decreases, the lumen narrows and the blood supply to organs that feed, in particular, the brain, deteriorates. Ischemia develops, and spasm will lead to stroke - an ailment that, as a rule, does not remain without consequences and ends in disability.

To counter this disease, the leading scientific institutions of Russia (Institute of Biochemical Physics of the Russian Academy of Sciences, Research Institute of Pharmacology of the Russian Academy of Medical Sciences, VSC BAV) have developed an excellent drug Mexidol for the treatment of a wide range of diseases of the nervous and vascular systems.

The drug has no analogues in Russia and abroad.

It took doctors eight years to conduct an in-depth study of the therapeutic effect of Mexidol in leading clinics in Russia and the former USSR on more than 3,000 patients, and the result exceeded all expectations.

What kind of drug is this? This is a water-soluble antioxidant - a membrane protector, an inhibitor of lipid peroxidation, prevents and eliminates the damaging effects of free radicals on cells and membranes and protects vital organs from their destructive effects. Antihypoxant with direct energizing action.

Due to the unique mechanism of action, Mexidol has an effect on two levels at once - neuronal and vascular.

Simply put, Mexidol is used in complex therapy for diseases such as: acute cerebrovascular accident (stroke), discirculatory encephalopathy, vegetative-vascular dystonia, atherosclerotic disorders of brain function, neurotic and neurosis-like disorders. It has anti-stress, nootropic (memory improving), anticonvulsant, antiparkinsonian, tranquilizing effects.

It should be especially noted that with early administration and timely use of Mexidol, mortality among patients in intensive care units after strokes is reduced, and recovery is faster and with the least consequences. And most importantly, this drug is characterized by an almost complete absence of side effects, low toxicity and compatibility with other drugs used in complex therapy.

In order to introduce it into clinical practice, Mexidol was tested in the United Hospital of the Moscow City Hall, in City Clinical Hospital No. 15 and other medical institutions of the country. And according to the chief neurologist of Moscow, Professor A. I. Fedin, Mexidol, having significant advantages over well-known cerebroprotective, nootropic drugs, will take a leading place among drugs used in the prevention and treatment of acute strokes (hemorrhagic and ischemic).

The price of the drug is comparable to the cost of traditional drugs used in neurological practice.

Mexidol is available in the form of a 5% solution for injection, 2 ml N 10.

For more detailed information about the patented drug Mexidol, contact Pharmasoft LLC: tel. 277-11-58, 275-39-40, e-mail: [email protected]