Nootropics - features of the pharmaceutical group and a list of the best drugs for effective treatment. Pharmacological group - Nootropics
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, using biochemistry to influence the central nervous system.
Their predecessors in improving brain function were psychostimulants, which had a strong but short-term effect on a person. They increased the body's endurance, resistance to stress, and caused general excitement, activity and euphoria. If not for the severe negative side effects and addiction, psychostimulants would have conquered humanity. But the after-effect in the form of severe depression and complete loss of strength depressed the person so much that it could lead 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 results of taking nootropics, you need to take a course lasting 1-3 months.
The effect of nootropic drugs is due to the improvement and acceleration of metabolism in nerve tissues, the protection of neurons during a lack of oxygen and toxic effects. In fact, nootropics protect the brain from aging. Nowadays many nootropic drugs are produced, here are the most common ones:
"Piracetam" ("Nootropil") is the first of the nootropics. It is prescribed for attention and memory disorders, nervous disorders, brain injuries, alcoholism and vascular diseases. It can also be used independently (without exceeding the dose) for better perception and assimilation of educational material. The following side effects have been rarely reported: drowsiness or agitation, dizziness and nausea, increased sexual activity. An analogue of Piracetam (Nootropil) is Phenotropil (Phenylpiracetam).
"Acefen" ("Cerutil", "Meclofenoxate", "Centrophenoxine") contains the substance acetylcholine - a transmitter of nervous excitation, an indispensable participant in the functioning of the human nervous system. 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 together with Piracetam to improve mental abilities. Side effects from the nervous system were noted: anxiety, insomnia, increased appetite.
"Selegiline" ("Deprenyl", "Yumex") contains the substance selegiline, which suppresses the action of enzymes that inhibit phenylethylamine and dopamine. After 40 years, the pleasure enzymes of the dopamine series are produced much less 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 sufficiently long-term use of the drug, memory, mood and general well-being improve. “Selegiline,” according to medical scientists, when taken 5 mg per day can increase a person’s life expectancy by 15 years!
Nootropics or neurometabolic stimulants are medicinal substances that help improve mental and mental activity of the brain. Nootropic drugs directly affect the higher state, and also protect the central nervous system from various negative factors and everyday phenomena. In this article we will take a detailed look at what nootropics are, how they affect processes in the human body, and how this can affect.
Description and mechanism of action of the group
The first developments and scientific research of nootropic substances that could improve the psycho-emotional component of the human body began at the dawn of the 60s of the twentieth century. 
Since then, many neurometabolic stimulants have been developed that can improve brain function by stimulating blood microcirculation. Moreover, such stimulants protect the brain from all sorts of harmful external influences, including.
Did you know?Corneliu Giurgea is a Romanian psychologist and chemist who is considered the inventor of nootropics. In 1964, he isolated neurotransmitter substances from the Piracetam cocktail.
Today, there are two main groups of nootropics: true and neuroprotectors. Substances that make up the first group contribute to the activation of the mnestic function of the brain, and no longer affect the psycho-emotional component. 
While neuroprotectors are able to have a complex effect on the mental system. The effect of neurometabolic stimulants can be both primary (the substance binds directly to the neuron and interacts with it) and secondary (has an antihypoxic and antiplatelet effect).
Doctors and scientists call nootropic substances by many different terms: neuroanabolic, neuroregulatory, neurodynamic or eutotrophic agents.
The mechanism of action of such agents is complex; it is divided into several components.:
- The components of neuroregulatory substances help accelerate the process of synthesis of proteins and RNA, which activate the activity of the central nervous system, in particular its plastic component.
- Antioxidant and antihypoxic effects make it possible to enhance the processes of ATP synthesis, and this directly affects the energy component of the state of neurons.
- Neuroprotectors are the main utilizers of glucose.
- Synaptic transformation of impulses in the central nervous system increases significantly under the influence of nootropics.
- Stabilization of the functionality of CNS membranes.
Moreover, nootropics are able to interact with neurotransmitters, substances that are responsible for the frequency and speed of impulses that transmit information to the central nervous system. The direct effect of neurometabolic stimulants on adenylate cyclase promotes the release of seratonin from sensory neurons.
This effect also helps the production of ATP in brain cells without the participation of oxygen, and this contributes to the normal functioning of the central nervous system under conditions of hypoxia (lack of oxygen).
Nootropic compounds are able to correct the processes of neuron-neuron interactions and prevent mental and intellectual developmental delays in adolescence.
The main mechanism of action of neurometabolic substances is aimed at stimulating the metabolism of nucleic acids and improved synthesis of protein, ribonucleic acid and ATP under extreme conditions. Classification by chemical composition
Nootropic drugs are classified according to their chemical composition as follows::
- dimethylaminoethanol derivatives;
- pyrrolidone derivatives;
- pyridoxine derivatives;
- diaphenylyrrolidone derivatives;
- neuropeptide analogues and the neuropeptide itself;
- analogues and derivatives of gamma-aminobutyric acid;
- 2-mercantobenzimidazole derivatives;
- amino acids and analogues that have a stimulating effect on the amino acid system of the central nervous system;
- organic composites and polypeptides;
- products based on vitamin complexes;
- other nootropic substances (psychostimulants, neuromodulators, adaptogens, antihypoxants, etc.).
Each of the above-mentioned positions of nootropic substances has a different chemical composition and is produced by manufacturers under different names. Accordingly, the mechanism of action of each substance will differ. Indications for use
At first, any class of neurometabolic stimulants was used only in the fight against mental impairment in age.
A little later, when all sorts of laboratories around the world began to speak out about their supposedly proven effectiveness of nootropics, they began to be used in narcology, pediatrics, psychiatry, and neurology. 
Today, a doctor can prescribe a therapeutic course of treatment with such chemicals in cases of the following diseases:
- Alzheimer's disease and or senile dementia;
- neuroinfection, intoxication;
- neurosis-like or neurotic disorder;
- psychoorganic syndrome;
- vegetative-vascular dystonia;
- cranial and impaired blood circulation in the brain;
- chronic cerebrovascular insufficiency;
- chronic (withdrawal, encephalopathy);
- syndromes and intellectual-mnestic disorders.
Popular drugs
Today, there are many nootropic drugs, in particular the new generation, which are derivatives of various chemicals, they have different effects on the central nervous system. 
We will provide a list of nootropics that are best to take for various clinical indications below, but which will be most effective for you should be decided by your physician.
"Piracetam" ("Nootropil")
This drug belongs to chemically active substances, the effect of which on the human body has not been fully proven. 
“Nootropil” is a prominent representative of the group of neurostimulating substances, which, according to manufacturers, can improve brain activity, promote the processes of ribonucleic acid synthesis, and improve cerebral microcirculation of red blood cells.
In our country, this drug is often used for Alzheimer's disease and various diseases of the central nervous system. 
Many medical professionals around the world believe that Piracetam, other than the “Placebo effect,” has no effect, but recent clinical studies have confirmed the fact that this drug helps reduce platelet aggregation, thereby improving blood microcirculation in the brain.
"Pramiracetam"
Like the previous substance, it is a neurometabolic stimulant (a derivative of piracetam), but with a more pronounced effect, and therefore is used in smaller dosages. 
According to manufacturers, it stimulates and. The full effect of the drug has not been proven, therefore "Pramiracetam" It is considered to be a homeopathic remedy.
Cavinton (Vinpocetine)
It is a Hungarian neurodynamic drug that has a therapeutic effect on the affected areas of the brain. It improves blood microcirculation in ischemic areas by relaxing smooth muscles. 
Since the mid-80s it has been produced synthetically based on vincamine. Used to treat cerebral (acute) disorders of cerebral blood flow. The effectiveness of Cavinton has often been questioned over the decades. At the beginning of the 19th century, the drug was included in the list of biologically active additives (BAA).
It is a pharmaceutical drug, the main component of which is hopantenic acid, which is involved in many processes of brain activity. This remedy is most effective in the treatment of chronic intoxication, as well as during periods of increased risk of hypoxia. 
"Pantogam" stimulates various functional actions in the neuronal system and helps accelerate neuron-neuron signal transmission.
This sedative is included in the list of the best nootropics of the latest generation, the effect of which has been largely proven. Clinical studies have shown that Pantogam is able to improve the mental activity of adolescents who have speech and writing disorders.
A domestic tableted nootropic drug that is used in medical practice in Russia (it has not found its use in other countries of the world).
Included in the list of the most important medicines. Widely used as a neuroprotective, antihypoxic and psychostimulant agent. 
Medical professionals often prescribe Semax for recovery from ethanol intoxication, inflammation of the nerves in areas near the brain, and chronic disorders of cerebral blood flow.
In addition, this drug has been used in pediatrics for decades, where its effectiveness and safety have been repeatedly proven.
Semax does not cause addiction or withdrawal symptoms. Moreover, it easily overcomes the blood-brain barrier and stabilizes all brain processes.
It is a neurometabolic stimulant that has stimulating, anticonvulsant and antitoxic effects. In 2007, Phenotropil was recognized as an obsolete drug, the frequency of its use for therapeutic purposes has sharply decreased. 
Moreover, this drug was recognized as one of those nootropics, the effectiveness of which has not been proven. However, "Phenotropil" has found its application in the world, where it is actively used as a doping, some global companies even produce the active substance "Phenotropil" under a different name.
Nootropic agent, a derivative of gamma-aminobutyric acid. It is a domestic drug, which was included in the list of important medicines in the mid-70s. 
The developers talked about what would lower the level of stress and stabilize too high levels of CNS activity. Almost all tablets based on gamma-aminobutyric acid can calm and improve sleep, in addition, they enhance the effect of sleeping pills and narcotics.
Important!Phenibut can be addictive when used for a long time.
For stuttering, chronic stress, Meniere's disease. "Phenibut" can be indicated as a medicine. The main substance of "Phenibut" directly affects neurons and reduces their activity, which promotes calm and. 
In large dosages it exhibits an analgesic effect. Phenibut is contraindicated for children under 10 years of age and people who regularly use drugs and alcohol.
This pharmaceutical drug belongs to nootropic drugs, the derivatives of which are simple amino acids. developed on the basis of aminoacetic acid, it exhibits a calming, sedative, anti-stress and hypnotic effect. 
Moreover, as the manufacturers claim, “Glycine” helps improve memory and protect the central nervous system from various unpleasant external stimuli (consequences of intoxication due to drug addiction and alcoholism).
And “Glycine” is one of the few drugs that can reduce and stimulate the production of seratonin (which causes joy in people).
Side effects and contraindications
Side effects from the use of neurometabolic stimulants may arise from a psychological component. Often, such effects occur with overdoses or long-term use of drugs. 
Patients may experience hyperactivity of central nervous system processes, which manifests itself in the form of increased, disturbance. in 5% of cases it causes side effects when dosages are increased.
Discontinuation of the drug entails the disappearance of any side effects. In addition, Piracetam and Acefen should not be used as sedatives and mild hypnotics, as they stimulate the central nervous system.
Did you know?One in four Harvard students takes nootropics, although these substances are not considered drugs in their country (doctors say they are practically ineffective).
From the neuralgic component, tendon reflexes, tremor, and dizziness may occur. From the side of the somatic system, there are also a number of unpleasant side effects.
Sometimes loss of taste and dry mouth may occur. Elderly people complain of high blood pressure and dizziness with long-term use of nootropics. 
In addition, improper and uncontrolled intake of neurometabolic stimulants can cause various types. "Pyriditol" can complicate the course of the disease in people suffering from rheumatoid arthritis.
Also, nootropics are prohibited for use by people who have suffered a hemorrhagic stroke and those who suffer from a hereditary disease of the central nervous system - Gettington's chorea.
Who Prescribes Nootropics?
Nootropics have a wide range of applications in medical practice in our country. In almost all other countries of the world, homeopathic medicines have long faded into the background. However, our doctors prescribe nootropics for a variety of diseases, as we have already discussed. 
For example, even a cardiologist can prescribe the drug Phenibut. The whole point is that patients with vegetative-vascular dystonia, for the most part, first of all turn to a cardiologist because of surges in blood pressure and a constant “feeling” of rhythm.
And since VSD is not serious, which can lead to unpleasant consequences, the cardiologist often prescribes various homeopathic medications, including nootropics.
Important!Some nootropic substances in high dosages can cause narcotic intoxication.
But to a greater extent, nootropic drugs are prescribed by psychiatrists, neurologists and pediatricians. In addition, toxicologists and narcologists can also prescribe nootropics with caution.
We can conclude that the safety of using nootropic drugs is quite high, but their effectiveness has not been fully proven. Therefore, it is up to you to decide whether to take such drugs or not.
Psychostimulants include drugs that increase physical and mental performance. There are many different classifications of psychostimulants. But conditionally, psychostimulants can be divided into 2 large subgroups:
1) psychomotor stimulants - caffeine, phenamine and others, giving a quick stimulating effect, temporarily eliminating the feeling of fatigue, improving mood, reducing the need for sleep;
2) nootropic drugs - piracetam, pyriditol and others, which gradually normalize metabolic processes and restore impaired brain functions (memory, speech, etc.).
PSYCHOMOTOR STIMULANTS
PHENAMIN - a strong psychostimulant with central adrenergic and dopaminergic effects. Phenamine reduces fatigue, the need for sleep, temporarily increases performance, and reduces hunger. Phenamine has a peripheral adrenomimetic effect: it constricts blood vessels, increases blood pressure, and increases the heart rate. Phenamine weakens the effect of anesthesia and hypnotics. Phenamine is used mainly for asthenic conditions, subdepression, accompanied by drowsiness, etc. The use of phenamine is limited, as addiction and drug dependence (drug addiction) develop to it. Phenamine requires a special prescription form (as for all other drugs). Side effectswhen appliedphenamine: dizziness, insomnia, arrhythmias, sometimes a paradoxical reaction (CNS depression instead of a stimulating effect). Contraindications to the use of phenamine: insomnia, diseases of the cardiovascular system (arterial hypertension, atherosclerosis), diabetes mellitus, liver disease. Release formfenamina: tablets of 0.01 g. List A.
An example of a phenamine recipe in Latin:
Rep.: Tab. Phenamini 0.01 N. 10
D.S. 1 tablet per day.
MERIDIL(pharmacological analogues: centedrine ) - is inferior in psychostimulating effect to phenamine, but lacks peripheral adrenomimetic action, and therefore Meridil does not affect the function of the cardiovascular system. Meridil is used for increased mental fatigue and neurotic conditions accompanied by lethargy and apathy. Side effects when using Meridil: insomnia, increased irritability. Contraindications to the use of Meridil: neuroses occurring with increased excitability of the nervous system, irritability; insomnia; old age. Meridil release form: tablets of 0.01 g. List A.
Meridil recipe examplein Latin:
Rep.: Tab. Meridili (Centedrini) 0.01 N. 20
D.S. 1 tablet 2 times a day in the morning.
SIDNOKARB(pharmacological analogues: mesocarb ) is a psychostimulant with a weak peripheral adrenomimetic effect. Sidnocarb is used for asthenic conditions; schizophrenia, occurring with lethargy and apathy; neurotic states accompanied by lethargy, etc. Side effects when using syndocarb: insomnia, headache, increased blood pressure. Sidnocarb is contraindicated for atherosclerosis, hypertension, insomnia, and liver diseases. Sidnocarb release form: tablets of 0.005 g and 0.01 g. List A.
Example of a sidnocarb recipe in Latin:
Rep.: Tab. Sydnocarbi 0.005 N. 20
SIDNOFEN- the action is close to mesocarb. Sidnofen has the same indications for use, side effects and contraindications. Unlike mesocarb, the psychostimulating effect of sydnofen is combined with a moderate antidepressant effect, and therefore sydnofen is a valuable drug for the treatment of asthenodepressive conditions. Sydnofen release form: tablets of 0.005 g. List A.
Example of a sydnofen recipe in Latin:
Rep.: Tab. Sydnopheni 0.005 N. 20
D.S. 1 tablet 2 times a day.
CAFFEINE- found in tea leaves, coffee seeds, cola nuts. Caffeine has a psychostimulant effect; increases mental and physical performance, reduces the need for sleep, regulating and enhancing excitation processes in the cerebral cortex. This effect depends on the type of higher nervous activity, which must be taken into account when dosing caffeine. Caffeine stimulates the respiratory and vasomotor centers. The direct stimulating effect of caffeine on the heart is expressed in an increase in the frequency and strength of heart contractions. The effect of caffeine on blood pressure depends on the predominance of a central (through the vasomotor center) vasoconstrictor effect, or a peripheral (directly on the vascular wall) vasodilator effect. Caffeine generally does not change normal blood pressure levels. Caffeine drugs and derivatives increase urination and increase the secretion of gastric glands.
D The effect of caffeine is mediated through cAMP, and its central effects are realized through adenosine receptors. Side effects when using caffeine can manifest themselves in the form of insomnia, tachycardia, arrhythmia, increased excitability of the central nervous system, which in itself is a contraindication for use, as well as severe atherosclerosis, hypertension, organic heart disease, glaucoma. Caffeine is used for depression of the functions of the central nervous system and cardiovascular system, overdose of drugs that depress the central nervous system, to increase physical and mental performance, as well as for migraines, etc. Caffeine is widely used in combination with other drugs (non-narcotic analgesics, etc.). Caffeine release form: powder.
Example of a caffeine recipe in Latin:
Rp.: Coffeini 0.05 Sacchari 0.2
M. f. pulv.
D.t. d. N. 10
S. 1 powder 2 times a day.
SODIUM CAFFEINE BENZOATE- similar in action, indications for use and contraindications to caffeine. Caffeine sodium benzoate is more soluble in water and is absorbed and eliminated from the body faster. Sodium caffeine benzoate is prescribed orally or injected under the skin. Doses of sodium caffeine benzoate are selected individually. Release form caffeine sodium benzoate: powder, tablets of 0.1 and 0.2 g (for adults), 0.075 g (for children). Ampoules of 1 ml and 2 ml and syringe tubes of 1 ml of 10% and 20% solution of the drug.
Example recipe for caffeine-sodium benzoate in Latin:
Rep.: Tab. Coffeini natrio-benzoatis 0.1 N. 6
D.S. 1 tablet 2 times a day.
Rp.: Sol. Coffeini natrio-benzoatis 10% 1 ml
D.t. d. N. 6 in ampull.
S. 1 ml 2 times a day under the skin.
COFFETAMINE- a combination drug consisting of caffeine (0.1 g) and ergotamine tartrate (0.001 g). The pharmacological properties of caffeamine are determined by its constituent ingredients. Caffeamine is prescribed for arterial hypotension, migraine, to normalize intracranial pressure in vascular, traumatic and infectious lesions of the central nervous system. Caffeamine is taken orally, 1 tablet 2-3 times a day. Caffeamine release form: film-coated tablets. List B.
Example of a caffeamine recipe in Latin:
Rp.: Tab. "Coffetaminum" obducta N. 10
D.S. Take 1 tablet 2 times a day.
MILDRONATE- increases performance, reduces fatigue and overstrain phenomena during physical overload (including among athletes). Mildronate is prescribed for adults orally at 0.25 g 2-4 times a day (30 minutes after meals) or administered intravenously at 0.5 g once a day for 10-14 days. Mildronate release form: capsules 0.25 g ; ampoules of 5 ml of 10% solution.
Example of a mildronate recipe in Latin:
Rp.: Caps. Mildronati 0.25 N. 100
D.S. 1 capsule 3 times a day (after meals).
Rp.: Sol. Mildronati 10% 5 ml
D.t. d. N. 10 in ampull.
S. Administer 5 ml intravenously once a day.
BEMITIL- belongs to the group of actoprotectors; has psychoenergizing and antihypoxic activity. Bemitil increases the body's resistance to physical stress, preserves and restores performance. Bemitil is used for patients with neuroses, neurosis-like conditions in cases of cerebrovascular accident, traumatic brain injury, and in the postoperative period. Bemitil is prescribed to adults orally after meals, 0.25-0.5 g. The daily dose of bemitil is 0.5-1 g. The course of treatment is 15-30 days (there may be other treatment regimens). Side effects when using bemitil: possible nausea, vomiting, discomfort in the stomach and liver, facial flushing, runny nose, headache. Bemitil release form: tablets of 0.25 g. List B.
Example of a bemitil recipe in Latin:
Rep.: Tab. Bemithyli 0.25 N. 100
D.S. 1 tablet 2 times a day (after meals).
NOOTROPIC AND GABA-ERGIC DRUGS (PIRACETAM, PYRITHINOL, ACEPHEN)
Of interest are drugs whose introduction into the body causes an improvement in metabolic processes in brain cells, as a result of which mental activity is stimulated, perception, memory, and thought processes are improved. The effect of these drugs is manifested when metabolic processes in the brain are disrupted due to various diseases: inflammatory, atherosclerosis, alcoholic encephalopathies, traumatic brain injuries, etc. Such drugs are called metabolic psychostimulants (nootropics). They do not cause excitement, they do not develop addiction and drug dependence. GABA-ergic drugs are also close to nootropics, also acting on metabolic processes in the brain, improving its blood supply, restoring memory, etc.
PIRACETAM(pharmacological analogues: nootropil ) - used for various diseases of the nervous system caused by metabolic disorders in the brain tissue, accompanied by impairments of memory, attention, speech, and dizziness; for atherosclerosis of cerebral vessels, etc. Piracetam is a typical nootropic agent: it normalizes metabolic processes in the brain, cerebral circulation, and increases the resistance of brain tissue to hypoxia and toxic effects. Side effects when using piracetam: increased irritability, sleep disturbances, dyspeptic symptoms; in older people there may be an exacerbation of coronary insufficiency. Piracetam is contraindicated for kidney disease and pregnancy. Piracetam release form: tablets of 0.2 g; capsules 0.4 g; ampoules of 5 ml of 20% solution. List B.
Example of a piracetam recipe in Latin:
Rep.: Tab. Pyracetami 0.2 N. 60
D.S. 2 tablets 3-4 times a day.
Rp.: Sol. Pyracetami 20% 5 ml
D.t. d. N. 6 in ampull.
S. Administer intramuscularly (or intravenously) 10-20 ml per day.
PYRITINOL(pharmacological analogues: pyriditol, encephabol ) - like piracetam, activates metabolic processes in the central nervous system. Pyritinol is used for the same indications as piracetam; has the same side effects. Pyritinol is contraindicated in cases of psychomotor agitation, convulsive conditions, and epilepsy. Pyritanol release form: tablets of 0.05 g and 0.1 g; "Encephabol" in the form of syrup, 200 ml (5 ml - 0.1 g of the drug) - for children.
Example of a recipe for pyritanol in Latin:
Rep.: Tab. Pyritinoli 0.1 N. 60
D.S. 1 tablet 2-3 times a day.
ACEPHEN- activates metabolic processes in the central nervous system, has a psychostimulating effect. Acefen is used for cerebrovascular accidents, traumatic and vascular diseases of the brain, etc. Acefen is contraindicated for infectious diseases of the central nervous system. The drug acefen is well tolerated; in some cases, patients with mental illness experience exacerbation: delirium, hallucinations. Release form of acephen: tablets of 0.1 g. List B.
Example of acephen recipe in Latin:
Rep.: Tab. Acepheni 0.1 N. 50
D.S. 1 tablet 3-4 times a day.
AMINALONE(pharmacological analogues: gammalon ) - is a gamma-aminobutyric acid, which is a mediator of the central nervous system and is involved in bioenergetic processes in the brain. Aminalon is used for diseases affecting memory, attention, speech, for example, for cerebrovascular accidents after a stroke, for mental retardation in children with decreased mental and motor activity, etc. Side effects when using aminalon: dyspeptic disorders, sleep disorders, feeling of fever , fluctuations in blood pressure that disappear when the dose of the drug is reduced. Aminalon release form: 0.25 g film-coated tablets.
Example of an aminalon recipe in Latin:
Rep.: Tab. Aminaloni 0.25 obductae N. 100
D.S. 1-2 tablets 3 times a day.
CEREBROLYSIN- contains essential amino acids. Indications for use and side effects when using Cerebrolysin are the same as for aminalon. Cerebrolysin release form: ampoules of 1 ml of 5% solution.
Example of a Cerebrolysin prescription in Latin:
Rp.: Sol. Cerebrolysini 5% 1 ml
D.t. d. N. 10 in ampull.
S. Administer 1-2 ml intramuscularly every 2-3 days (course of injections).
SODIUM OXYBUTYRATE- penetrates well through the blood-brain barrier, gives a sedative effect, and in large doses causes anesthesia (see section “Anesthetics”). Sodium hydroxybutyrate has an antihypoxic effect on the tissues of the brain, heart, and retina. Sodium hydroxybutyrate is used for hypoxic cerebral edema, to eliminate retinal hypoxia, as a sedative, for anesthesia, etc. Sodium oxybutyrate is contraindicated for hypokalemia and myasthenia gravis. Sodium hydroxybutyrate release form: powder; ampoules of 10 ml of 20% solution; bottles - 5% syrup (400 ml) and 66.7% solution (37.5 ml).
Example of a recipe for sodium hydroxybutyrate in Latin:
Rp.: Sirupus Natrii oxybutyratis 5% 400 ml
D. S. Take 2-3 tablespoons at night (as a sleeping pill), 1 tablespoon 2-3 times a day as a sedative for neuroses.
PHENIBUT- its properties are similar to sodium hydroxybutyrate. Phenibut is used for neuroses and psychopathic conditions, as a sedative. Phenibut release form: tablets of 0.25 g.
Example of a Phenibut recipe in Latin:
Rep.: Tab. Phenibuti 0.25 N. 50
D.S. 1 tablet 3 times a day.
PANTOGAM- its action is similar to aminalon and sodium hydroxybutyrate, it has the same indications for use. Pantogam release form: tablets of 0.25 g and 0.5 g.
An example of a pantogam recipe in Latin:
Rep.: Tab. Pantogami 0.5 N. 50
D.S. 1 tablet 4-6 times a day
PICAMILON- improves blood circulation and the functional state of the brain, normalizes metabolic processes in brain tissue. Picamilon is used as a nootropic and vasoactive agent for acute and chronic cerebrovascular accidents, vegetative-vascular dystonia, as well as for conditions accompanied by anxiety and increased irritability. Picamilon can be used for asthenic conditions of various etiologies, depressive disorders in people of the older age group, to restore performance and increase resistance to physical and mental stress. Picamilon is prescribed orally at a dose of 0.02-0.04 g 2-3 times a day. The average daily dose of picamilon is 0.06 g. Side effects when using picamilon: possible increased irritability, agitation, anxiety, dizziness, headache, allergic rash (in this case, reduce the dose or discontinue the drug). Picamilon is contraindicated in case of kidney disease and individual intolerance to the drug. Picamilon release form: tablets of 0.02 g and 0.05 g. List B.
Example of a picamilon recipe in Latin:
Rep.: Tab. Picamiloni 0.02 N. 30
D.S. 1 tablet 3 times a day (for 1-2 months).
The majority of the population of our planet, especially residents of large cities, are forced to live in conditions of constant environmental and psycho-emotional stress. It has been proven that stress is not harmless to the human body, it is a risk factor for many, and also has a negative effect on the nervous system, as a result of which a person becomes irritable, his performance decreases, his memory and thinking processes deteriorate. In this regard, scientists are continuously searching for ways to prevent and correct the negative effects of stress on the nervous system. About 50 years ago, the concept of nootropic drugs arose, Piracetam was synthesized and tested. This gave a powerful impetus to the search and creation of other substances with a similar principle of action; these studies continue to this day.
From this article, the reader will get an idea of what nootropics are and what effects they have, get acquainted with the indications, contraindications, side effects of these drugs in general, and also learn the characteristics of individual representatives of drugs in this group, in particular new generation nootropics. Let's begin.
What are nootropics
According to the definition of the World Health Organization, nootropic drugs are drugs that have an activating effect on learning, improve mental activity and memory, and increase the resistance (stability) of the brain to such aggressive influences as injury, intoxication, and hypoxia.
The first nootropic in history is Piracetam, which was synthesized and used clinically by Belgian pharmacologists back in 1963. During the study, scientists found that this medicinal substance significantly increases mental performance, improves memory and promotes learning. Subsequently, other drugs with similar effects were synthesized, which we will discuss below.
Effects and mechanisms of action of nootropic drugs
The main effects of drugs in this group are:
- psychostimulant;
- sedative;
- anti-asthenic (reducing feelings of weakness, lethargy, mental and physical asthenia);
- antidepressant;
- antiepileptic;
- actually nootropic (impact on impaired higher cortical functions, which is manifested by improved thinking, speech, attention, and so on);
- mnemotropic (effect on learning and memory);
- adaptogenic (increasing the body’s ability to resist harmful environmental influences);
- vasovegetative (improved blood supply to the brain, which is manifested by a decrease and, as well as the elimination of other autonomic disorders);
- antidiskinetic;
- increasing clarity of consciousness and level of wakefulness.
These drugs do not cause pharmacological dependence and psychomotor agitation; taking them does not deplete the physical capabilities of the body.
The action of drugs in this group is based on the following processes:
- activation of plastic processes in the central nervous system by enhancing the synthesis of proteins and RNA;
- activation of energy processes in neurons;
- activation of the processes of transmission of nerve impulses in the central nervous system;
- optimization of polysaccharide utilization processes, in particular glucose;
- inhibition of the formation of free radicals in cells;
- decreased oxygen demand of nerve cells under hypoxic conditions;
- membrane-stabilizing effect (regulate the synthesis of proteins and phospholipids in nerve cells, stabilize the structure of cell membranes).
Nootropic drugs activate the enzyme adenylate cyclase, increasing its concentration in nerve cells. This substance is necessary to maintain the stability of the cell’s production of the main source of energy for biochemical and physiological processes - adenosine triphosphoric acid, or ATP, which, moreover, under hypoxic conditions, transfers metabolism in the brain to an optimally maintained mode.
In addition, nootropics affect the neurotransmitter systems of the brain, in particular:
- monoaminergic (increase the content of dopamine and norepinephrine, as well as serotonin in the brain);
- cholinergic (increase the content of acetylcholine in nerve endings, necessary for adequate transmission of impulses from cell to cell);
- glutamatergic (also improve signal transmission from neuron to neuron).
As a result of all the effects described above, the patient’s memory, attention, mental processes and perception processes improve, his ability to learn increases, and intellectual functions are activated.
Classification of nootropics
The class of nootropic drugs includes substances of various pharmacological groups that have a positive effect on the functioning of nerve cells and improve their structure.
- Substances that stimulate metabolic processes in nerve cells:
- pyrrolidone derivatives: Piracetam, Pramiracetam, Phenylpiracetam and others;
- derivatives of gamma-aminobutyric acid (GABA): Aminalon, Picamilon, Hopanthenic acid, Phenibut;
- pantothenic acid derivatives: Pantogam;
- derivatives of vitamin B6 - pyridoxine: Pyritinol;
- products containing dimethylaminoethanol: Acefen, Centrophenoxin;
- preparations containing neuroaminoxylates and peptides: Glycine, Cerebrolysin, Actovegin;
- antihypoxants: Oxymethylethylpyridine succinate;
- vitamins, vitamin-like, general tonic substances: vitamin B15, vitamin E, folic acid, succinic acid, ginseng extract and others.
- Drugs that have a positive effect on blood vessels, or vasotropic drugs:
- Xanthinol nicotinate;
- Vinpocetine;
- Pentoxifylline;
- Cinnarizine;
- Instenon.
- Drugs that stimulate memory and learning processes:
- cholinomimetics and anticholinesterases: Galantamine, Choline, Amiridin and others;
- hormones: Corticotropin, adrenocorticotropic hormone;
- endorphins, enkephalins.
Indications for the use of nootropics
Medicines of the nootropic class are used to treat the following diseases:
- of various nature (vascular, senile);
- chronic cerebral vascular insufficiency;
- consequences of cerebrovascular accident;
- neuroinfections;
- intoxication;
- psychoorganic syndrome with symptoms of memory impairment, decreased concentration and general activity;
- cortical myoclonus;
- dizziness, with the exception of dizziness of vasomotor and mental origin;
- chronic alcoholism (for the purpose of treating encephalopathy, withdrawal and psychoorganic syndromes);
- reduced mental performance;
- astheno-depressive, depressive, astheno-neurotic syndromes;
- neurosis-like disorders;
- traumatic brain injury;
- hyperkinesis;
- sleep disorders;
- migraine;
- in the complex treatment of open-angle glaucoma, retinal vascular diseases, diabetic retinopathy, as well as age-related macular degeneration.
In pediatric practice, nootropics are used to treat the following conditions:
- mental retardation;
- delayed mental development and speech development;
- cerebral palsy;
- consequences of damage to the central nervous system during childbirth;
- attention deficit disorder.
Contraindications to taking nootropics
Medicines in this group should not be taken in the following cases:
- in case of individual hypersensitivity of the patient’s body to the active substance or other components of the drug;
- in case of an acute period of hemorrhagic stroke (bleeding in brain tissue);
- with Gettington's chorea;
- in case of severe renal impairment (if creatinine clearance is less than 20 ml/min);
- during pregnancy and lactation.
Side effects of nootropics
Medicines in this group rarely cause any side effects, however, some patients may experience the following undesirable reactions while taking them:
- headache, irritability, anxiety, sleep disturbances, drowsiness;
- rarely, in elderly patients, increased symptoms of coronary insufficiency;
- nausea, stomach discomfort, or;
- increased psychopathological symptoms;
Brief description of drugs
Since there are actually quite a lot of medicines belonging to the class of drugs we are describing, we will not be able to consider all of them, but we will only talk about those that are most widely used in medical practice today.
Piracetam (Piracetam, Lucetam, Biotropil, Nootropil)
Available in the form of tablets for oral administration and solution for injections and infusions.
The drug has a positive effect on blood circulation and metabolic processes in the brain, resulting in increased resistance of brain tissue to hypoxia and the effects of toxic substances, as well as improved memory, integrative brain activity, and increased learning ability.
When taken orally, it is well absorbed from the gastrointestinal tract, the maximum concentration in the blood is determined after 1 hour. Penetrates into many organs and tissues, including through the blood-brain and placental barriers. The half-life is 4 hours. Excreted by the kidneys.
Routes of drug administration: orally or parenterally (intramuscular or intravenous). It is recommended to take the tablets before meals. The dosage and duration of treatment are determined individually, depending on the disease and the characteristics of its clinical course.
When treating patients suffering from, caution should be exercised and the dose adjusted depending on the level of creatinine clearance.
Side effects of the drug are standard, and they usually occur in elderly and senile patients, provided they receive a dosage of more than 2.4 g of piracetam per day.
It has an effect on platelet aggregation, therefore it is used with caution in persons suffering from hemostasis disorders and a tendency to hemorrhage.
Contraindicated during pregnancy and lactation.
If sleep disturbances develop while taking piracetam, you should stop taking it in the evening and add this dose to the daytime dose.
Pramiracetam (Pramistar)
Chemical formula of Pramiracetam Release form: tablets.
Has a high degree of affinity for choline. Improves learning ability, memory and mental performance in general. Does not have a sedative effect and does not affect the autonomic nervous system.
Absorbed from the gastrointestinal tract quickly and almost completely, the maximum concentration of the active substance in the blood is determined after 2-3 hours. The half-life is 4-6 hours. Excreted by the kidneys.
During pregnancy and lactation, taking Pramistar is contraindicated.
When treating patients with impaired renal function, you should carefully monitor the development of side effects of the drug in them - this will be a sign of an excess of the active substance in the body and require a dose reduction.
Vinpocetine (Cavinton, Neurovin, Vinpocetine, Vicebrol)
Available in the form of tablets and solution for infusion.
Improves microcirculation in the brain, increases cerebral blood flow, and does not cause the “steal” phenomenon.
When taken orally, it is absorbed by 70% of the digestive tract. The maximum concentration in the blood is determined after 60 minutes. The half-life is almost 5 hours.
It is used both in neurology (for chronic cerebrovascular accidents and other diseases described in the general part of the article), and in ophthalmology (for the treatment of chronic retinal vascular diseases) and in otiatrics (to restore hearing acuity).
If therapy is started in the acute period of the disease, vinpocetine should be administered parenterally, and then continued orally at a dose of 1-2 tablets three times a day after meals.
Phenibut (Bifren, Noofen, Noobut, Phenibut)
Release form: tablets, capsules, powder for the preparation of oral solution.
The dominant effects of this drug are antihypoxic and antiamnestic. The drug improves memory, increases mental and physical performance, and stimulates learning processes. In addition, it eliminates anxiety, fear, psycho-emotional stress, and improves sleep. Strengthens and prolongs the effect of sleeping pills, anticonvulsants and antipsychotics. Reduces manifestations of asthenia.
After oral administration, it is well absorbed and penetrates into all organs and tissues of the body, in particular through the blood-brain barrier.
It is used for decreased emotional and intellectual activity, concentration, memory impairment, asthenic, anxiety-neurotic and neurosis-like conditions, insomnia, Meniere's disease, as well as for the prevention of motion sickness. In the complex treatment of preliriious and delirious alcoholic conditions, osteochondrosis of the cervicothoracic spine, menopausal disorders.
It is recommended to take 250-500 mg orally, before meals, three times a day. The maximum daily dose is 2.5 g, the maximum single dose is 750 mg. Duration of therapy is from 4 to 6 weeks.
In different clinical situations, the dosage regimen may vary.
It has an irritating effect, so it is used with caution in people suffering.
Hopanthenic acid (Pantogam)
Available in tablet form.
Reduces motor excitability, normalizes behavioral reactions, increases performance, and activates mental activity.
Rapidly absorbed from the gastrointestinal tract. The maximum concentration of the active substance in the blood is determined 60 minutes after administration. Creates high concentrations in the kidneys, liver, stomach wall and skin. Penetrates the blood-brain barrier. It is eliminated from the body after 2 days.
Indications are standard.
Take the drug orally, half an hour after eating. A single dose for adults is 250-1000 mg. Daily dose – 1.5-3 g. Course of treatment – 1-6 months. After 3-6 months you can repeat the course. When treating different diseases, the dose of the drug may vary.
Contraindications and side effects are described above.
Pyritinol (Encephabol)
Available in the form of tablets and suspension for oral use (this dosage form is intended for children).
It has a pronounced neuroprotective effect, stabilizes neuronal membranes, reduces the number of free radicals, and reduces red blood cell aggregation. Positively affects behavioral and cognitive functions.
If the drug dosage regimen is followed, the development of side effects is unlikely.
Glycine (Glycine, Glycised)
Release form: tablets.
Improves metabolism in muscles and brain tissue. Has a sedative effect.
Use sublingually (dissolving under the tongue).
To treat depression, anxiety and irritability, take glycine 0.1 g 2-4 times a day. For chronic alcoholism, it is prescribed according to recommended treatment regimens.
Contraindications: hypersensitivity to glycine. Side effects are not described.
Cerebrolysin
Release form: solution for injection.
Improves the function of nerve cells, stimulates their differentiation processes, activates protection and recovery mechanisms.
Penetrates the blood-brain barrier.
It is used for metabolic, organic and neurodegenerative diseases of the brain, in particular, and is also used in the complex treatment of strokes and traumatic brain injuries.
Daily doses of the drug vary widely depending on the pathology and range from 5 to 50 ml. Routes of administration: intramuscular and intravenous.
Use with caution to treat patients with allergic diathesis.
Actovegin
Release form: tablets, solution for injections and infusions.
Contains exclusively physiological substances. Increases the brain's resistance to hypoxia and accelerates the processes of glucose utilization.
It is used for ischemic and residual effects of hemorrhagic stroke, traumatic brain injury. Widely used for the treatment of diabetic polyneuropathy, burns, peripheral circulatory disorders, as well as for trophic disorders in order to accelerate wound healing processes.
As a rule, it is well tolerated. In some cases, the reactions described at the beginning of the article develop.
Approved for use during pregnancy and lactation.
Contraindicated in case of individual hypersensitivity to the components of the drug.
Contains sucrose, so it is not used in patients with hereditary disorders of carbohydrate metabolism.
Hexobendine (Instenon)
Available in the form of tablets for oral administration and solution for intramuscular and intravenous administration.
It has a stimulating effect on metabolic processes in the brain and myocardium, improves cerebral and coronary circulation. Antispasmodic.
Indications for the use of this drug are diseases of the brain of an age-related and vascular nature, the consequences of insufficient blood supply to the brain, dizziness.
Contraindicated in case of individual sensitivity to the components of the drug, increased intracranial pressure, epileptiform syndromes. During pregnancy and lactation it is used exclusively according to indications.
It is recommended to take orally during or after meals, without chewing, with plenty of water. The dosage is 1-2 tablets three times a day. The maximum daily dose is 5 tablets. The duration of treatment is at least 6 weeks.
The injection solution is administered intramuscularly, slowly intravenously or by drip. The dosage depends on the characteristics of the clinical course of the disease.
During treatment with this drug, you should not drink tea and coffee in large quantities. If the drug is administered intravenously, only a slow infusion is allowed, and the intravenous injection should last at least 3 minutes. Rapid administration of the drug can lead to a sharp decrease in blood pressure.
Combination drugs
There are many drugs that contain 2 or more components that are similar in action or mutually enhance the effects of each other. The main ones are:
- Gamalate B6 (contains pyridoxine hydrochloride, GABA, gamma-amino-beta-hydroxybutyric acid, magnesium glutamate hydrobromide; prescribed for adults in the complex treatment of functional asthenia; recommended to take 2 tablets 2-3 times a day for 2-18 months);
- Neuro-norm (contains piracetam and cinnarizine; indications are standard for nootropics; dosage – 1 capsule three times a day for 1-3 months; take the tablet after meals, do not chew, drink plenty of water);
- Noozom, Omaron, Fezam, Cinatropil, Evriza: drugs similar in chemical composition and other indicators to Neuro-norm;
- Olatropil (contains GABA and piracetam; recommended for use before meals, 1 capsule 3-4, maximum 6 times a day for 1-2 months; if necessary, the course can be repeated after 1.5-2 months);
- Thiocetam (includes piracetam and thiotriazoline; it is recommended to take 1-2 tablets three times a day; the course of treatment is up to 30 days; in some cases it is used in the form of an injection solution: 20-30 ml of the drug is administered intravenously in 100- 150 ml of saline solution or 5 ml intramuscularly once a day for 2 weeks).
So, above you got acquainted with the most popular nootropic drugs today. Some of them are the first drugs of this class, but many were developed much later and are much more effective, so they can safely be called new generation nootropics. Please note that the information provided in the article is not a guide to action: if you experience any unpleasant symptoms, you should not self-medicate, but rather seek help from a specialist.
Stimulants are conventionally divided into 4 large groups:
1. PSYCHOSTIMULANTS
a) psychomotor:
Phenamine;
Sidnocarb.
b) psychometabolic (nootropics):
Nootropil (piracetam);
Cerebrolysin;
Gamalon et al.
2. ANALEPTICA
a) direct action:
Bemegrid;
Etimizole, etc.
b) reflex action:
Tsititon et al.
c) mixed action:
Cordiamin et al.
3. SPINAL CORD STIMULATORS
Strychnine;
Sekurenin et al.
4. GENERAL TONIZERS (ADAPTOGENS)
a) of plant origin:
Ginseng preparations, Eleutherococcus
ka, aralia, golden root, ma
Raleigh root, Bittner's balm and
b) animal origin:
Pantocrinus et al.
PSYCHOSTIMULANTS and NOOTROPICS
PSYCHOSTIMULANTS
Psychostimulants (or psychotonics, psychoanaleptics, psychomotor stimulants) increase mood, the ability to perceive external stimuli, and psychomotor activity. They reduce the feeling of fatigue, increase physical and mental performance (especially when tired), and temporarily reduce the need for sleep (drugs that invigorate a tired body are called “doping” - from English to dope - to give drugs).
Unlike CNS depressants, stimulants are less important because they lack selectivity of action. In addition, stimulation of the central nervous system is accompanied by its subsequent inhibition.
Classification of psychostimulants
1) Means acting directly on the central nervous system:
a) stimulating primarily the cerebral cortex (xanthine alkaloids, phenamine, sydnocarb, methylphenamine, meridol, etc.);
b) stimulating mainly the medulla oblongata (cortex
ash, cordiamine, bemegride, camphor, carbon dioxide);
c) stimulating primarily the spinal cord (strychnine).
2) Drugs that act on the central nervous system reflexively(lobelin, verat
rum, nicotine).
It should be remembered that this division is conditional and when used in large doses they can stimulate the central nervous system as a whole.
A typical representative of psychostimulants is PHENAMIN(amphetamine sulfate; table of 0.005; drops in the nose, in the eye 1% solution). Chemically it is a phenylalkylamine, that is, similar in structure to adrenaline and norepinephrine.
MECHANISM OF ACTION associated with the ability to release NORADRENALINE and DOPAMINE from presynaptic endings. In addition, phenamine reduces the reuptake of norepinephrine and dopamine.
Phenamine stimulates the ascending activating reticular formation of the brain stem.
PHARMACOLOGICAL EFFECTS
INFLUENCE ON THE CNS
Powerful central nervous system stimulant. It increases mental and physical performance, improves mood, causes euphoria, insomnia, tremors, and anxiety. In therapeutic doses, it has an awakening effect, eliminates fatigue, and increases physical capabilities. Stimulates the respiratory center and in this regard acts as an analeptic.
INFLUENCE ON THE CARDIOVASCULAR SYSTEM
Increases both systolic and diastolic blood pressure. Tachyphylaxis is known in relation to the hypertensive effect of phenamine.
SMOOTH MUSCLE
Phenamine increases the tone of the bladder sphincter and relaxes the muscles of the bronchi, but only at high doses. Phenamine reduces appetite (on the hypothalamus), has some anticonvulsant effect (for Petit mal).
