Nootropic drugs list. What are the best nootropics to take? List of the most effective drugs, the mechanism of action on the body. When Problems Might Occur

Currently, many people, especially those living in megacities, regularly experience mental stress. The bad ecological situation also has a negative impact on the organism of the inhabitants of large cities. Stress is far from harmless. Frequent overexertion of the nervous system eventually leads to its depletion, resulting in more or less pronounced nervous disorders and even mental illness. Exposure to stress factors greatly increases the likelihood of pathologies of the cardiovascular system. On "nervous soil" and often develop.

In a person subject to regular stress, the ability to memorize decreases and cognitive activity worsens. He becomes more irritable and susceptible. For many decades, experts have been trying to find means to prevent and minimize the adverse effects of stress on the human body.

Nootropics are medicines that improve the ability to remember, stimulate mental activity and make the human brain more resistant to factors such as oxygen starvation, the effects of toxic substances, and even injury.

Note:the first effective nootropic - Piracetam was obtained over half a century ago. It was created by pharmacologists from Belgium. The drug passed extensive clinical trials in 1963.

Work on the creation of new drugs-nootropics is actively underway today. Currently, there are a number of very effective means that increase the functional activity of the brain. They help people cope with psycho-emotional overstrain and stabilize the nervous system.

The nootropic effect is a positive effect on the higher functions of the cortex.

Other positive effects of modern nootropics include:

Note:antiasthenic action is to reduce the feeling of general weakness and lethargy, as well as to minimize the manifestations of mental asthenia. The mnemotropic effect implies an improvement in the ability to remember and learn in general. Under the vasovegetative action is understood the stimulation of blood circulation in the so-called. "brain pool". Nootropic drugs are strong adaptogens that allow the body to adapt to the effects of various (mostly unfavorable) environmental factors.

The latest generation nootropics are able to increase the clarity of consciousness. Modern drugs of this class do not provoke psychomotor agitation. They do not cause drug dependence (addiction) and even with prolonged use do not deplete the body's own resources.

Nootropics are able to activate the process of biosynthesis of ribonucleic acid and protein compounds in the central nervous system. They accelerate energy processes in the processes of cells of the nervous system and improve the transmission of nerve impulses. Preparations at the cellular level significantly reduce the formation of free radicals, i.e., have an antioxidant effect. They optimize the utilization of glucose and other polysaccharide compounds. Nootropics are responsible for the formation of proteins and phospholipids in neurocytes, due to which their membranes are stabilized. The drugs of this group increase the concentration of adenylate cyclase in the cells of the nervous system, due to which the ATP process, the main energy base of cells, is normalized. Adenosine triphosphoric acid in conditions of insufficient oxygen supply stabilizes metabolism in the brain.

Important:nootropic drugs increase the level of formation and release of neurotransmitters - serotonin, dopamine, norepinephrine and acetylcholine.

Classification of nootropic drugs

Nootropics include the means of several clinical and pharmacological groups.

1. Metabolic stimulants in nerve cells:
   • GABA derivatives:

• Phenibut;
• Aminalon;
• Hopantenic acid.
  • Pyrrolidone derivatives:
• Piracetam;
• Phenylpiracetam;
• Pramiracetam.

Note:pantothenic acid compounds include the common nootropic Pantogam, and Pyritinol is produced on the basis of vitamin B6.

• Products containing dimethylaminoethanol include:

• Centrophenoxin;
• Acephen.
  • Among the drugs with peptides and amino acids are the following drugs:
• Actovegin;
• Glycine;
• Cerebrolysin.

1. Nootropics that reduce the negative effects of oxygen deficiency include, in particular, Oxymethylethylpyridine succinate.
2. Vitamin-like preparations and nootropic adaptogens include succinic acid, vitamins E and B15, and an extract from ginseng root.
3. Vasotropic, i.e., drugs that positively affect cerebral blood vessels, are Vinpocetine, Cinnarizine and Instenon.
4. To improve memory, tools with a different mechanism of action are used:
   • Anticholesterase agents and cholinomimetics:

• Choline;
• Galantamine;
• Amiridin.
  • Hormonal preparations:
• endorphins;
• enkephalins;
• ACTH;
• Corticotropin.

Indications for the use of nootropic drugs

Drugs of this clinical and pharmacological group are prescribed for such diseases and pathological conditions:

• decreased mental and physical activity;
• deterioration of mental abilities;
• problems with memory and concentration;
• neuroinfections (for example, encephalitis or poliomyelitis);
• effects on the brain of toxic substances;
• consequences of impaired cerebral blood flow;
• senile dementia;
• encephalopathy and abstinence against the background of regular alcohol abuse;
• stuttering;
• consequences of TBI (brain damage);
• ischemic stroke;
• enuresis;
• hyperkinesis.

Note:nootropic drugs are used in the treatment of ophthalmic diseases such as diabetic retinopathy, retinal pathology of vascular origin and open-angle glaucoma

Nootropics in Pediatrics

Pediatricians can prescribe nootropics to children suffering from the following pathologies:

• delayed speech development;
• deviations in general mental development;
• mental retardation of varying severity;
• defeat at the time of birth (for example, with hypoxia).

Contraindications to the use of nootropics

Nootropics are not prescribed to patients when diagnosing:

• hypersensitivity to the active ingredient or intolerance to auxiliary ingredients;
• pronounced decrease in the functional activity of the kidneys (acute or chronic renal failure);
• hemorrhagic stroke (acute period);
• chorea of ​​Hettington (hereditary degenerative disease of the central nervous system).

Important:Nootropics are not prescribed for pregnant and lactating women!

Side effects

The vast majority of patients tolerate nootropic therapy well.

In some cases, the following side effects may develop:

• unmotivated feeling of anxiety;
• night sleep disturbances;
• daytime sleepiness;
• increased irritability;
• instability of blood pressure;
• dyspeptic disorders;
• allergy.

Note:in elderly and senile patients, nootropics in rare cases can provoke an increase in the severity of clinical manifestations of coronary insufficiency.

Drugs that are currently most widely used in clinical practice

1. Piracetam (analogues - Nootropil and Lucetam) It is produced in tablet form for per os administration, as well as in the form of a solution for intramuscular injections and intravenous infusions. The tool improves metabolism in the central nervous system and stimulates cerebral circulation. Piracetam has a negative effect on platelet aggregation, and therefore, in cases of blood clotting disorders, it should be used with caution.

1. Pramiracetam, which is available in the form of tablets, is characterized by a high degree of affinity for choline. The drug increases cognitive abilities and improves memory. It does not have a sedative (sedative) property. The tool is recommended for long-term course treatment; The effect fully develops after 1-2 months from the start of the intake. Use with caution in patients with renal insufficiency!
2. Cavinton (analogues - Vinpocetine and Neurovin). The drug is produced by pharmaceutical companies both in the form of tablets and in an injection solution. It improves blood flow in the cerebral vessels. The tool is widely used in neurology, as well as in ophthalmic practice in the complex treatment of retinal pathologies. It is also effective in improving hearing acuity. Course treatment is recommended for 1-8 months, depending on the nosological form and dynamics. The drug should be canceled by gradually reducing the dose within 4-5 days. In the acute period of the disease, parenteral administration of the solution is indicated; as the condition improves, the injection form is replaced with tablets.

1. Phenibut (analogues - Noobut ​​and Bifren)- Produced in the form of powder, capsules and tablets. The drug allows you to deal with memory impairment and oxygen starvation of nerve cells. It increases not only mental, but also physical performance, allows you to reduce nervous tension, get rid of anxiety and normalize sleep. Phenibut should be prescribed with caution in parallel with hypnotics and antipsychotics, since the nootropic potentiates their effect. The drug is indicated for a decrease in intelligence and neurosis-like disorders. It is recommended to travelers as a remedy for seasickness and motion sickness. Shown course reception for 1-1.5 months.

1. Cerebrolysin- has a positive effect in the treatment of serious organic lesions and neurodegenerative pathologies of the central nervous system, including even Alzheimer's disease. The drug is widely used in the complex therapy of the consequences of head injuries and strokes. The tool is produced in the form of an injection solution.

1. encephabol- for adults it is available in tablets, and for children - in the form of a suspension with a pleasant taste and smell. The drug is a powerful neuroprotector and antioxidant. The tool normalizes behavioral functions and improves cognitive abilities.

Nootropic drugs - what are these medicines? You will receive the answer to the question asked from the presented article. In addition, you will learn the history of their occurrence, principles of action, properties, indications and effects from the application.

General information

Nootropic drugs - what is it? Such drugs improve brain function, rejuvenate the body and prolong life. These are neurometabolic stimulants that have an activating effect on learning. In addition, they significantly improve mental activity and memory. The term "nootropic" is made up of two Greek words νους and τροπή, which means "mind" and "change" respectively.

Description

Nootropic drugs do not have their own class in the classification of medical drugs. That is why they were combined with psychostimulants and began to belong to the pharmacotherapeutic group with the following ATC code: N06BX.

History of occurrence

In 1963, the Belgian pharmacologists S. Giurgea and V. Skondia synthesized the first drug from the presented group - Piracetam. Today, such a nootropic drug is known to most patients under the name "Nootropil". Like a psychostimulant in the middle of the 20th century, it increased mental and at the same time did not have any side effects.

In 1972, one of the creators of this drug proposed the term "nootropic" to refer to a group of drugs that improve intellectual memory, learning and attention, and also affect the transcallosal potential, have antihypoxic activity and do not have a negative effect on the body.

Unlike well-known psychostimulants, nootropics stimulate, which further leads to an increase in their activity, which is quantitative, not qualitative. It should be especially noted that the effect of most of these drugs does not appear after the first dose, but with long-term treatment.

Latest Nootropics

At the moment, more than 10 original nootropics of the pyrrolidine series have been synthesized, which are in phase 3 clinical trials or have already been registered in a number of countries. Among these drugs, one can single out Oxiracetam, Nefiracetam, Etiracetam, Aniracetam, Rolziracetam, Isacetam, Pramiracetam, Cebracetam, Dupracetam, Detiracetam, etc. The presented medicines have common name "Racetams".

Among others, other families of nootropic agents have been synthesized, including GABAergic, cholinergic, glutamatergic, and peptidergic systems. It should also be noted that the nootropic active ingredient is also present in other medicines that have a different chemical origin.

Operating principle

Nootropic drugs - what are these drugs, and what are they prescribed for? The therapeutic effect of such drugs is based on several mechanisms:

• activation of plastic processes in the central nervous system due to increased protein and RNA synthesis;
• improvement of the energy state of neurons, which is manifested in increased ATP synthesis, as well as antihypoxic and antioxidant effects;
• improved glucose utilization;
• strengthening the processes of synaptic transmission in the central nervous system;
• membrane stabilizing effect.

Features of drugs

The main mechanisms of such drugs are considered to be their direct effect on bioenergetics and metabolic processes in nerve cells, as well as interaction with brain systems (primarily neurotransmitter systems).

It has long been proven that nootropics are able to activate adenylate cyclase and increase its concentration in the neuron. In addition, an increased level of cyclic adenosine monophosphate leads through a change in the flow of intracellular Ca2+ and K+ ions to a rapid release of the mediator from the sensory neuron.

It should also be noted that activated adenylate cyclase is able to maintain the stability of ATP production in cells without oxygen, and, under hypoxic conditions, transfer brain metabolism to a conserved mode.

Nootropic drugs for the elderly and children are urgently needed to increase their creativity and restore intellectual retardation. Manufacturers of such stimulants claim that their drugs improve the metabolism of nucleic acids, activate the synthesis of protein, ATP and RNA, penetrate the BBB well, and also increase the rate of glucose utilization.

Properties of nootopes

The effect of a number of nootropic drugs is sometimes mediated through the neurotransmitter system of the brain (cholinergic, monoaminergic, glutamatergic).

According to manufacturers, nootropics can also have other types of effects, including:

• antioxidant;
• membrane stabilizing;
• neuroprotective;
• antihypoxic.

Other drug options

Nootropics are recommended to be used in combination. After all, this is the only way to improve the bioelectrical activity and integrative activity of the brain, which manifests itself in the form of characteristic changes in electrophysiological patterns (a noticeable increase in the level of wakefulness, as well as a dominant peak, facilitated the passage of information between the hemispheres of the brain, an increase in the relative and absolute power of the EEG spectrum of the hippocampus and cortex).

Due to the increase in cortico-subcortical control, the improvement of information exchange in the brain, the positive effect on the reproduction and formation of a memory trace, we can safely say that such drugs lead to an increase in the ability to learn, improve memory, thinking, attention, perception, as well as the activation of intellectual functions. .

By the way, many manufacturers claim that such tools can significantly improve and accelerate cognitive (or However, these statements have not been scientifically confirmed.

effects

According to manufacturers, nootropic drugs have the following effects on a person:

Are Nootropics Effective for Stroke Prevention?

What are these drugs, we figured out. But this raises a new question about how effective they are in the treatment and prevention of strokes. It should be noted that this practice is questionable. This is due to the fact that the use of nootropics in relation to such deviations has not been confirmed.

Clinical Application

Before explaining why such drugs are used in official medicine, it should be noted that nootropic drugs without prescriptions from attending physicians are not dispensed in pharmacies. This is due to the fact that they belong to the same drug group as strong psychostimulants.

Initially, the drugs presented were used to treat brain disorders in older people with an organic brain syndrome. Although in the past few years (usually in third world countries) they have become quite widely used in various fields of medicine, including surgery, pediatrics, psychiatry, neurology, narcology, as well as obstetric and geriatric practices.

Thus, nootropic drugs are used by doctors for:

Indications for children

In developing countries, the presented funds are especially common in pediatrics. Thus, nootropic drugs are prescribed for children with:

• mental retardation;
• delayed speech and mental development;
• children's cerebral palsy;
• the consequences of perinatal damage to the central nervous system;
• attention deficit disorder.

Other indications for use

The best nootropic drug is the drug that has a pronounced therapeutic effect and does not negatively affect the human body. It should be noted that such funds are sometimes used for:

• stuttering ("Pantogam", "Phenibut");
• correction of neuroleptic syndrome ("Hopantenic acid", "Pyritinol", "Deanol aceglumate", "Pantogam");
• hyperkinesis ("Hopantenic acid", "Phenibut", "Memantine");
• urination disorder ("Pantogam", "Nicotinoyl-GABA");
• sleep disorders ("Fenibut", "Calcium gamma-hydroxybutyrate", "Glycine");
• migraine ("Pyritinol", "Nicotinoyl-GABA", "Semax");
• dizziness ("Ginkgo biloba", "Phenibut", "Piracetam");
• for the prevention of motion sickness ("GABA", "Phenibut").

By the way, in ophthalmic practice, such drugs are used as part of combination therapy for open-angle glaucoma, vascular diseases of the retina and macular degeneration (Nicotinoyl-GABA), as well as senile and diabetic retinopathy (Ginkgo biloba).

Natural Nootropics

In addition to drugs, natural substances with similar properties are often used to obtain a therapeutic effect. Of course, natural nootropics are not as effective as pharmacological agents, but within a few weeks after use, patients still begin to notice an improvement in cognitive functions and so on.

Nootropics for adults and children are medicines that have a stimulating effect on learning. They strengthen memory and mental activity. Such funds increase the resistance of the brain to trauma, hypoxia, intoxication. This group has such actions as sedative, antidyskinetic, vasovegetative, mnemotropic and others.

Such drugs are prescribed only by specialists with a decrease in working capacity, sleep disturbances, dizziness, alcoholism and other conditions. Consider the mechanism of action of funds and a list of the best nootropics.

Nootropics: what is it

Nootropic drugs of the new generation are drugs that improve cerebral circulation, the ability to assimilate, and stimulate mental activity. they make the brain more resistant to oxygen starvation and the influence of toxic substances.

A number of substances related to nootropics have a wide spectrum of action. The latest drugs help patients survive psycho-emotional stress, normalize the functioning of the nervous system. When taking this group of funds, nutrition plays an important role. Nootropics increase the resistance of the brain to various adverse effects.

How nootropics work

Natural nootropics can trigger the synthesis of ribonucleic acid and protein compounds in the central nervous system. The drug at the cellular level reduces the appearance of free radicals. The main one is such an action as antioxidant. The main effects of drugs are:

• calming;
• psychostimulating;
• antidepressant;
• antiepileptic;
• adaptogenic;
• mnemotropic;
• vasovegetative;
• antiparkinsonian;
• nootropic;
• increased clarity of consciousness and others.

Nootropics of the new latest generation do not cause psychomotor agitation and dependence in patients. They are based on the following processes:

• launch of energy processes in neurons;
• improving procedures for the processing of polysaccharides;
• decrease in the need of nerve cells for oxygen;
• suppression of the occurrence of free radicals in cells;
• launch of plastic processes in the central nervous system.

New effective nootropics trigger adenylate cyclase, increasing its concentration in nerve cells. Thanks to all the effects, a person's memory, thought processes, attention are strengthened, and the ability to learn increases.

Nootropics for VVD are prescribed to improve the metabolic processes of the nervous tissue and blood supply. But courses of nootropics are only part of complex therapy.

Nootropics and harmful alcohol are incompatible during therapy. Drinking alcohol has a negative effect on the body. Alcohol damages the cells of the nervous system. Stimulants are used to bring the brain into a natural rhythm.

With alcoholism, there will be no therapeutic effect. The drug improves blood flow in the brain, for this reason, alcohol quickly seeps into the tissues and cells of the nervous system. The result is a stronger destructive effect of alcohol.

Indications and contraindications

Modern effective nootropic drugs are prescribed for such problems and autological conditions:

• reducing physical activity and mental abilities to zero;
• difficulties with concentration and memory;
• ischemic stroke;
• complications of changes in cerebral blood flow;
• stuttering
• senile dementia;
• neuroinfections;
• enuresis;
• consequences of TBI.

Important! Medicines can be used in the treatment of such ophthalmic diseases as retinal pathologies of vascular origin, open-angle glaucoma, diabetic retinopathy.

Children's doctors prescribe nootropics of the new latest generation for such ailments:

• delayed speech development;
• changes in the mental development of the child;
• damage to the central nervous system;
• mental retardation of varying degrees of manifestation.

Nootropics for children are indicated in case of diagnosing the syndrome.

A nootropic agent cannot be prescribed to patients who have:

• hypersensitivity to the components in the composition;
• hemorrhagic stroke;
• manifested decrease in kidney activity;
• bearing a baby and lactation;
• chorea of ​​Hettington.

Side effects

Usually, the drug is well tolerated by patients, but in some cases there may be such third-party reactions:

• allergic reactions;
• night sleep disturbance;
• inconsistency in blood pressure;
• excessive nervousness;
• sleepiness during the day;
• dyspeptic pathologies.

In older people, manifestations of coronary insufficiency may become more pronounced. If you take nootropics with severe epilepsy, then seizures may become more frequent.

TOP 9 best nootropics for adults and children: a list of drugs

Consider the best nootropic drugs that can be taken by both adults and children. The best nootropics can improve brain function, human memory, and concentration. After admission, sleep and the general condition of the patient are improved.

Such funds can be released in the form of tablets, syrup, nasal drops. Solutions for intramuscular injection. Drops are instilled into each nasal passage for a long period of time.

Many are interested in the question of which drugs are harmful and which are the most effective and beneficial for the mind. The effectiveness rating is based on patient feedback.

Glycine is used to improve memory and brain function. Glycine has many important functions in the body, primarily in the nervous system. The drug protects against low mental performance, hypertension, aggressiveness, conflict, psycho-emotional stress, poor sleep, bad mood. It is indicated for the complex treatment of craniocerebral injuries, stroke, alcohol poisoning.

The drug is produced in the form of tablets. They should be dissolved, kept under the tongue. The tablets have a sweet taste, so they are well tolerated by children. G Licin is prescribed for such pathologies:

• encephalopathy;
• traumatic brain injury;
• deviant behavior in a child;
• ischemic stroke;
• prolonged stress;
• neuroses and neurosis-like states;
• low mental capacity.

With proven efficacy, the drug is prescribed for vegetovascular dystonia. But with dystonia, you will need to consult a doctor.

The drug has practically no prohibitions for use. They are approved for use by infants, women during lactation and pregnancy. You can not use the tool only in case of personal intolerance to the component in the composition.

After taking it, patients noted the following benefits:

• cheapness;
• no contraindications;
• natural components in the composition;
• has few side effects.

minus there is a weak efficiency from the application.

Prices for Glycine in online pharmacies:

Phenibut plays an important role in brain activity. Taking the drug normalizes the metabolism of nerve tissues. This means that the cortico-subcortical connections are strengthened, which increases the effectiveness of the interaction between different parts of the cerebral cortex.

Phenibut normalizes the blood circulation of the brain, is useful for memory and attention. Taking the drug helps to improve night sleep, has an antioxidant effect, stimulates the activity of mental processes, and increases the emotional stability of the nervous system. The tool can be used in pediatrics and for the elderly.

Indications for use are:

• depression and chronic stress;
• changes in the blood supply to the brain;
• vestibular disorders;
• enuresis;
• for the development of speech;
• excessive fatigue;
• decrease in concentration;
• correction of behavior in children;
• neuroses;
• motion sickness prevention.

The drug should not be given to children under 8 years of age. Also, do not use in case of severe impairment of kidney and liver function.

After taking the drug, the following advantages were noted:

• normalizes sleep;
• helps with depression;
• cheapness.

minus serves what is dispensed with a prescription.

Prices for Phenibut tablets 20 pcs.

Tenoten is the best drug, characterized by anti-anxiety and antidepressant properties. This means that it helps to strengthen the central nervous system. Useful for memory and normal brain function. Does not have a calming effect.

The tool is indicated for use in pediatrics for children with:

• moderately pronounced functional lesions of the central nervous system;
• anxiety and restlessness;
• excessive irritability;
• decrease in memory;
• chronic stress.

The child tolerates the drug well.

Contraindications are:

• personal intolerance;
• lactose deficiency;
• pregnancy and lactation;
• children under 3 years old.

Tenoten adult is not prescribed for children under 18.

The benefits of the drug have been proven and the following advantages have been noted:

• opportunity to give to children;
• gently affects the nervous system;
• absolute compatibility with any other drugs;
• does not directly affect the brain;
• characterized by good efficiency.

minus is that with severe nervous disorders it has no effect.

Prices for Tenoten online pharmacies:

Prices for Tenoten lozenges 40 pcs.

Prices for Tenoten lozenges 20 pcs.

Piracetam is included in the top list of the best drugs. The active ingredient, as it improves its blood supply. The drug belongs to nootropics and helps to improve cognitive functions. Has an effect on the central nervous system. The agent does not cause a vasodilating effect. Its reception helps to improve microcirculation.

The drug is prescribed for:

• treatment of memory disorders;
• intellectual disabilities in the absence of a diagnosis of dementia;
• strong psychoorganic syndrome, accompanied by dizziness.

The tool must not be used when:

• component intolerance;
• end-stage renal failure;
• hemorrhagic stroke;
• chorea of ​​Huntington.

plus is a clear work of the brain after taking.

Minus- at high dosages, there is a difference in the physiological state from drowsiness to overexcitation.

Prices for Piracetam online pharmacies:

Prices for Piracetam capsules 400 mg 60 pcs.

Prices for Piracetam tablets 800 mg 30 pcs.

Prices for Piracetam tablets 200 mg 60 pcs.

Prices for Piracetam tablets 400 mg 60 pcs.

Phenotropil is one of the best remedies, which is characterized by a pronounced antiamnesic effect. Taking this drug affects the integrative activity of the brain. The concentration of a person improves. It has a positive effect on metabolic processes and blood circulation of the brain.

The drug is indicated to be taken with:

• diseases of the central nervous system of various nature;
• neurotic states that are accompanied by lethargy;
• depressive conditions of mild and moderate severity;
• psychoorganic syndromes;
• convulsive states;
• for the prevention of alcoholism.

The drug should not be taken in case of personal intolerance to the composition. It is dangerous to use in acute psychotic conditions, atherosclerosis.

The pluses include:

• enhances the purposefulness and activity of the body;
• increases mental activity and improves brain function.

The disadvantages include:

• the high cost of the drug;
• the drug has a cumulative effect;
• the presence of side effects.

Prices for Phenotropil tablets 100 mg 10 pcs.

Prices for Phenotropil tablets 100 mg 30 pcs.

Prices for Phenotropil tablets 50 mg 10 pcs.

Prices for Phenotropil tablets 50 mg 30 pcs.

Pantogam

Pantogam is characterized by nootropic and anticonvulsant effects. Combines a mild sedative effect with a mild stimulating effect. Improves metabolic processes in alcohol intoxication. Activates mental and physical performance, reduces motor excitability. Able to increase the resistance of the brain to hypoxia.

Adults are prescribed the drug in tablet form. Children are prescribed syrup. The number of drops depends on the patient's disease.

Appointed in such cases:

• cognitive impairment in neurotic disorders;
• schizophrenia, which is accompanied by cerebral organic insufficiency;
• decrease in mental performance;
• children with mental retardation;
• epilepsy with mental retardation.

The tool should not be used with intolerance to the component, with acute kidney disease, pregnancy and lactation.

The pluses include:

• has a mild effect;
• practically no side effects.

minus It is believed that extinguishes the nervous system.

Prices for Pantogam online pharmacies:

Prices for Pantogam tablets 250 mg 50 pcs.

Prices for Pantogam active capsules 300 mg 60 pcs.

Prices for Pantogam syrup 100 ml

Prices for Pantogam active capsules 200 mg 60 pcs.

Prices for Pantogam active capsules 300 mg 30 pcs.

Prices for Pantogam tablets 500 mg 50 pcs.

Cortexin

Cortexin is a polypeptide drug that contains the necessary well-chosen composition of polypeptides. It is characterized by a tissue-specific effect on the cerebral cortex. Cortexin normalizes the learning ability of patients, enhances cognitive skills. Improves the functions of the central nervous system after stress and the bioelectric activity of brain cells. The best drug for students.

Side effects of nootropics

S. Yu. Shtrygol, Dr. med. Sciences, Professor, T. V. Kortunova, Ph.D. farm. Sciences, Associate Professor, D. V. Shtrygol, Ph.D. honey. Sciences, National Pharmaceutical University, Kharkov

The last 30 years have been marked by an increasing use of nootropics. The term "nootropic drug" (from the Greek noos thinking, mind; tropos desire) was proposed in 1972 by S. Giurgea (Dzhurgea) to refer to drugs that have a specific activating effect on the integrative functions of the brain, stimulate learning, memory and mental activities that increase the resistance of the brain to damaging factors, improve cortico-subcortical connections. Nootropics are also called neurometabolic cerebroprotectors, and in the English literature the term cognitive enhancer is often used.

The prototype of this group is piracetam, synthesized by Strubbe (pharmaceutical company UCB, Belgium) in 1963 and initially studied as an antikinetic drug. Only a few years later it turned out that piracetam facilitates learning processes and improves memory, but, unlike classical psychostimulants, does not cause such side effects as speech and motor arousal, depletion of the body's functionality with prolonged use, addiction and addiction. Based on these studies, S. Giurgea identified a new class of drugs nootropics in the classification of psychotropic drugs.

The nootropic concept has become the largest contribution to the development of psychopharmacology, both in applied and fundamental terms. In a short time, a significant number of drugs were created that are used primarily to correct disturbed memory functions, as well as to reduce the level of vital activity that occurs with many diseases and extreme effects. Nootropics are also indicated for disorders of adaptation and mental activity during aging, including presenile and senile dementia. As M. Windish emphasizes, dementia occupies a special place in the list of indications, since in industrialized countries an increasingly important problem is the rapid increase in the elderly part of the population and the increase in the frequency of diseases associated with age.

In addition, nootropics are used for disorders of cerebral circulation, intoxication (including alcohol), withdrawal symptoms, sleep deprivation, fatigue, asthenic and depressive conditions after traumatic brain injuries and neuroinfections, as well as for correcting the side effects of psychopharmacotherapy (in the treatment of neuroleptics, antidepressants, psychostimulants). In pediatric practice, nootropic drugs are used to treat cerebrovascular disease, encephalopathy, intellectual disability, disorders that develop in premature babies as a result of intrauterine hypoxia and other damaging effects.

A feature of nootropics is the possibility of their use not only by sick people, but also by healthy people in extreme situations to relieve mental fatigue, improve mental performance.

In general, nootropic drugs are characterized by relatively low toxicity and relatively infrequent development of undesirable effects. According to OA Gromova, the latter are observed in slightly more than 5% of patients, but the widespread use of these drugs requires systematization of knowledge of their side effects. However, first it is necessary to dwell on the classification of nootropic drugs.

Nootropics include numerous drugs with different chemical structures and mechanisms of action. This circumstance alone makes it difficult to classify them. In addition, for a number of drugs, memory improvement is the leading pharmacological effect (they are sometimes referred to as "true" nootropics, such as piracetam and its analogues). For most drugs, nootropic action is only one of the components of pharmacodynamics. So, many GABAergic drugs, along with nootropics, have anxiolytic, sedative, anticonvulsant, muscle relaxant, antihypoxic effects (even such terms as "nootropic agent", "tranquilonotropic" etc.). The nootropic effect may be associated with an improvement in cerebral circulation (vinpocetine, nicergoline and other cerebrovasoactive drugs). Such polyvalent preparations are sometimes referred to as "Neuroprotectors".

The most complete classification of drugs with nootropic activity (about 100 drugs) is given by T. A. Voronina and S. B. Seredenin (1998). Their main groups are presented in the table.

Table. Basic drugs with nootropic action

pyrrolidone derivatives

Considering the side effects of nootropic drugs, let's start with the historically first group - pyrrolidone derivatives, or racetams. Today, more than 1,500 substances of this structure have been obtained, but only about 12 drugs are used in medical practice. The multicomponent mechanism of their action includes not only activation of energy metabolism, increased synthesis of RNA, protein, phospholipids, facilitation of cholinergic transmission, but also improved blood circulation in the brain.

The main and most commonly used representative of this group is piracetam. Its side effects are rare and mainly in the mentally ill. These effects include dizziness, tremors, nervousness, irritability. Sleep disturbances are possible mainly insomnia, less often drowsiness. Due to the risk of sleep disturbances, piracetam should not be taken at night. In isolated cases, when using piracetam, sexual arousal is noted. Sometimes there are dyspeptic phenomena: nausea, vomiting, diarrhea, abdominal pain. In elderly patients, exacerbation of coronary insufficiency is occasionally possible. In such cases, it is recommended to reduce the dose or stop taking the drug.

Piracetam is contraindicated in acute renal failure, pregnancy (especially in the first trimester), breastfeeding (stop for the duration of treatment), in infancy (up to 1 year). According to the data summarized by A.P. Kiryushchenkov and M.L. Tarakhovskiy, G.V. Kovalev, the effect of piracetam and many other nootropic agents on the fetus has not been studied enough, although experimental data indicate the absence of embryotoxicity and teratogenicity. Obviously, in-depth studies are needed, including elucidation of the possible long-term effects of the long-term effect of piracetam on the fetus. At the same time, there are indications of a positive effect of high doses of piracetam (up to 3-10 g) on ​​distress syndrome in newborns (the drug was administered intravenously to parturient women).

Relative contraindications associated with the side effects of piracetam are states of psychomotor agitation (manic, hebephrenic, catatonic, hallucinatory-paranoid, psychopathic). Special care is needed when deciding whether to prescribe piracetam to patients with increased convulsive readiness, as well as in severe diseases of the cardiovascular system with severe arterial hypotension. There are indications that it is not advisable to prescribe the drug to children with diabetes mellitus, with a history of allergic reactions to the use of fruit juices, essences, etc. When treating with piracetam in granules, it is recommended to exclude sweets from the diet.

Drugs that enhance cholinergic processes

Currently, this group of nootropics is developing most rapidly, since it is with it that progress in the treatment of Alzheimer's disease is associated. The use of classical pyrrolidone drugs in this disease usually brings only a temporary effect, followed by a rapidly progressive decline in memory and intelligence. Since the mechanisms of mnestic disorders in Alzheimer's disease are mainly associated with a deficiency of cholinergic transmission in the brain, the use of drugs that enhance it has the greatest positive effect. The leading place today is occupied by anticholinesterase drugs, namely amyridine and tacrine. They contribute to the accumulation of acetylcholine due to the inhibition of the cholinesterase enzyme that destroys it.

Amiridin has not only central, but also peripheral anticholinergic action. Therefore, its relatively infrequent side effects include hypersalivation, nausea, vomiting, increased peristalsis, diarrhea, and bradycardia. In addition, the drug may cause dizziness.

Amyridine is contraindicated in patients with hypersensitivity, as well as in diseases where increased cholinergic transmission is associated with a risk of worsening the condition: epilepsy, extrapyramidal and vestibular disorders, angina pectoris, bradycardia, peptic ulcer. In addition, amyridine should not be prescribed during pregnancy and lactation.

Tacrine has more known side effects. The frequency is dominated by ataxia (discoordination of movements, instability), anorexia (loss of appetite), abdominal cramps, diarrhea, nausea, vomiting, and hepatotoxic effects. Less common side effects from the cardiovascular system (bradycardia or tachycardia, cardiac arrhythmias, arterial hyper- or hypotension), hypersalivation, rhinitis, sweating, skin rash, swelling of the feet and ankles, fainting. In isolated cases, there are bronchial obstruction (difficulty breathing, a feeling of pressure in the chest, cough), changes in mood and psyche (aggressiveness, irritability), extrapyramidal disorders (stiffness and trembling of the limbs), obstruction of the urinary tract (difficulty urinating).

The list of contraindications to the appointment of tacrine is quite large. Along with hypersensitivity to this drug or other acridine derivatives, it includes bronchial asthma, arterial hypotension, bradycardia, sick sinus syndrome, epilepsy, head injuries with loss of consciousness, increased intracranial pressure (in this case, the development of convulsive syndrome is facilitated), obstruction of the gastrointestinal intestinal tract or urinary tract, liver dysfunction (even in history), Parkinson's disease and symptomatic parkinsonism, peptic ulcer of the stomach and duodenum.

Antagonists of anticholinesterase drugs are m-cholinergic blockers. However, the use of the latter for the correction of side effects cannot be considered justified, since the blockade of cholinergic receptors in the brain aggravates mnestic disorders in Alzheimer's disease. It is advisable to select doses of anticholinesterase agents that are well tolerated by patients.

Another approach to enhance cholinergic transmission involves increasing the synthesis of the mediator acetylcholine. This mechanism of action is gliatilin (choline alfoscerate). In the body, it is broken down into choline and glycerophosphate. Choline is used for the synthesis of acetylcholine, and glycerophosphate is used for the synthesis of phosphatidylcholine in neuronal membranes. Unlike anticholinesterase drugs, gliatilin is almost devoid of side effects. May cause nausea, apparently associated with the activation of dopaminergic transmission and, if necessary, eliminated by antiemetic drugs (metoclopramide, etc.). Allergic reactions to gliatilin are extremely rare. It is contraindicated in case of individual hypersensitivity, it is not recommended for use during pregnancy and lactation.

GABAergic drugs

The mechanisms of the nootropic effect exerted by GABAergic substances are associated both with an increase in energy processes in the brain (activation of Krebs cycle enzymes, an increase in glucose utilization by brain cells), and with an improvement in cerebral blood flow, its autoregulation. The GABAergic component is also inherent in the mechanism of action of piracetam, which can be considered as a cyclic analogue of GABA.

Gamma-aminobutyric acid (aminalon, gammalon) usually well tolerated. Only sometimes such side effects as a feeling of heat, insomnia, nausea, vomiting, dyspeptic disorders, fluctuations in blood pressure (in the first days of treatment, are associated with the vasoactive properties of GABA), an increase in body temperature are possible. When the dose is reduced, these phenomena usually pass quickly. This drug is contraindicated in case of hypersensitivity to it.

Using pantogam (hopantenic acid) allergic reactions (rhinitis, conjunctivitis, skin rash) are possible, disappearing with the withdrawal of the drug. Pantogam is contraindicated in severe acute kidney disease, as well as in the first trimester of pregnancy.

When prescribing picamilon, which predominantly intensifies the GABA metabolic shunt, irritability, agitation, anxiety, dizziness, headache, mild nausea are possible. In these cases, you need to reduce the dose. Occasionally, an allergic rash and itching of the skin occur, requiring discontinuation of the drug. Contraindications, along with individual intolerance, are acute and chronic kidney disease.

Phenibut, due to increased inhibitory GABA-ergic processes, can cause such a side effect as drowsiness during the first doses. Sometimes allergic reactions are noted. Contraindicated in case of individual intolerance, liver failure.

sodium oxybutyrate, combining nootropic, antihypoxic, hypothermic, sedative, hypnotic, anesthetic effects, has side effects most often with rapid intravenous administration. The drug is capable of causing motor excitation, convulsive twitching of the limbs and tongue, even cases of respiratory arrest are known. Therefore, a slow introduction of sodium hydroxybutyrate into a vein is necessary. During recovery from anesthesia, motor and speech excitation is possible. When used in high doses, it sometimes causes nausea and vomiting. Some patients experience daytime sleepiness. With prolonged use of large doses of the drug, hypokalemia may develop (the corrector for this side effect is potassium chloride, asparkam, panangin).

Contraindications to the use of sodium oxybutyrate are hypokalemia, myasthenia gravis (due to the muscle relaxant property), epilepsy, severe arterial hypertension, eclampsia, delirium tremens. It should not be prescribed for glaucoma. Due to the hypnosedative effect, sodium oxybutyrate should not be used during the daytime for people whose work requires a quick physical or mental reaction.

Glutamatergic drugs

The glutamatergic system plays one of the important roles in the implementation of synaptic plasticity and higher integrative functions of the brain, including the processes of learning and memory. Therefore, it is being intensively studied as a target for pharmacological action. Glutamate is an excitatory neurotransmitter, and glutamate receptors (particularly NMDA receptors) are increasingly involved in the mechanisms of memory impairment in various CNS diseases.

Glycine, which is a non-essential amino acid and affects the glycine site of the NMDA receptor, is well tolerated and has virtually no side effects. This drug can be considered contraindicated only in case of individual intolerance.

Memantine, a non-competitive NMDA receptor antagonist, along with a nootropic effect, has a neuroprotective effect, is able to correct movement disorders in various lesions of the brain and spinal cord. The drug can cause a number of side effects from the central nervous system. These include dizziness, anxiety, including motor anxiety, a feeling of fatigue, heaviness in the head. In addition, nausea is sometimes possible. Contraindications to the appointment of memantine are confusion and severe renal dysfunction, since this slows down the excretion of the drug.

Neuropeptides and their analogues

The peptidergic direction of memory correction is also promising. A significant number of drugs of this group are being developed, many of which, obviously, will soon appear on the pharmaceutical market. Let us dwell on two drugs semax and cerebrolysin.

Semax is a synthetic analogue of adrenocorticotropic hormone, but lacks hormonal activity. This drug, used intranasally, exhibits nootropic and adaptogenic effects. The drug is well tolerated, there is no information about its side effects. Semax is contraindicated during pregnancy, breastfeeding, acute psychotic conditions.

Cerebrolysin is a complex of neuropeptides (15%) with a molecular weight of not more than 10,000 daltons, free amino acids (85%) and trace elements (O. A. Gromova, 2000) obtained from the brain of young pigs. It has been used as a neuroprotector and nootropic for over 20 years. Recently, it has been proven that the neuroprotective activity of cerebrolysin is associated mainly with the peptide fraction. The drug has a multimodal effect increases the intensity of energy metabolism, protein synthesis in the brain, exhibits anti-radical, membrane-protective and neurotrophic activity, inhibits the release of excitatory amino acids (glutamate), improves cerebral blood flow.

Cerebrolysin shows good tolerance. Its side effects are infrequent and are represented by an increase in body temperature (pyrogenic reaction), which occurs mainly with rapid intravenous administration. Therefore, it is necessary to administer the drug intravenously by drip.

Cerebrolysin is contraindicated in acute renal failure, in the first trimester of pregnancy, in convulsive conditions, including epilepsy, and allergic diathesis. It should be noted that this drug is one of the few highly effective neuroprotectors that can be used in neuropediatric practice and even prescribed to newborns.

Considering cerebrolysin, one should dwell on such a brain hydrolyzate containing neuropeptides as cerebrolysate. The latter cannot be considered an analogue of Cerebrolysin either in terms of composition or pharmacotherapeutic efficacy and safety. Cerebrolysate obtained from the brain of adult cows contains high molecular weight neuropeptide fractions. It carries a potential danger due to the possibility of transmission of the bovine spongiform encephalopathy virus ("rabies" of cows), which causes an incurable neurodegenerative disease in humans - Creutzfeld's disease. Cerebrolysate should not be injected into a vein, and when administered intramuscularly, it often causes severe irritation. The appointment of cerebrolysate to children is unacceptable.

Antioxidants and membrane protectors

Free radical processes that damage the neuron membrane are involved in the basic mechanisms of synaptic plasticity disorders, memory and learning processes. Many nootropics have a multicomponent mechanism of action, including anti-radical properties. However, such drugs as mexidol, meclofenoxate, pyritinol have a particularly pronounced antioxidant effect.

Since 1993, Mexidol has been used in the clinic, which contains a residue of succinic acid and has a pronounced nootropic and neuroprotective activity. Along with antioxidant and membrane-protective action (inhibition of free-radical oxidation processes, activation of superoxide dismutase, lipid-regulating properties), it increases the intensity of cerebral blood flow, inhibits platelet aggregation, modulates GABA-, benzodiazepine- and cholinergic transmission. The drug is well tolerated and rarely side effects, which include nausea, dry mouth, drowsiness (the latter mainly when using high doses). Mexidol is contraindicated in acute disorders of the liver and kidneys. The experiment did not reveal embryotoxic, teratogenic, mutagenic effects of the drug.

Meclofenoxate (Cerutil) also well tolerated, only occasionally causing sleep disturbances (therefore, it is not recommended to take the drug later than 16 hours), anxiety, slight pain in the stomach, heartburn, increased appetite. In rare cases, allergic skin reactions are possible. A feature of meclofenoxate is the ability to exacerbate psychotic symptoms (delusions, hallucinations in which the drug is contraindicated), as well as contribute to the emergence of fear and anxiety. It is not recommended to prescribe the drug with a pronounced state of anxiety and arousal. With regard to pregnancy, meclofenoxate can be used if there is a strong indication.

Pyritinol (pyriditol, encephabol), which is a molecule of pyridoxine (vitamin B6, which has an antihypoxic effect) doubled with the help of a disulfide bridge, is devoid of vitamin activity. It exhibits pronounced nootropic properties in combination with antidepressant and sedative effects, being a low-toxic drug. Comparatively infrequent side effects include nausea, headache, insomnia, irritability, in children - psychomotor agitation, sleep disturbance. In such cases, the dose of the drug is reduced, do not prescribe it in the evening. In addition, in some cases, there may be a decrease in appetite, a change in taste, cholestasis, an increase in the level of transaminases, dizziness, fatigue, leukopenia, joint pain, lichen planus, skin allergic reactions, hair loss.

Pyriditol is contraindicated in severe psychomotor agitation, convulsive conditions, including epilepsy, severe liver and kidney dysfunction. Contraindications also include changes in the composition of the blood (leukopenia), autoimmune diseases, fructose intolerance (for oral suspension).

ginkgo biloba preparations

Standardized extracts of the relict gymnosperm Ginkgo biloba ( bilobil, memoplant, tanakan etc.) contain a composition of flavonoids, in particular amentoflavone and ginkgetin, flavone glycosides, diterpene lactones and alkaloids. Along with these components, in the studies of O. A. Gromova et al. in the extract of ginkgo (bilobil) neuroactive elements were found magnesium, copper, manganese, selenium, high activity of superoxide dismutase was revealed.

These drugs have a complex of valuable pharmacological properties, providing an antioxidant effect, enhancing energy metabolism in the brain, increasing the sensitivity of m-cholinergic receptors to acetylcholine, weakening the activation of NMDA receptors, reducing cerebral edema, improving blood rheology and microcirculation. Usually, ginkgo extracts allowed for over-the-counter sales are well tolerated - the frequency of side effects, according to O. A. Gromova, is about 1.7%. These isolated cases manifest themselves in the form of self-limited dyspepsia, even less often in the form of headache and allergic skin rash.

However, the side effect of ginkgo preparations, such as hemorrhages, is little known and not included in the reference books. In the review by A. V. Astakhova, summarizing the data of clinical observations, cases of intracranial hemorrhages and postoperative bleeding after laparoscopic cholecystectomy are given. Apparently, these complications are associated with the effect of ginkgolides, which inhibit the platelet activating factor and reduce their aggregation. The risk of bleeding increases in surgical patients who are advised to stop taking ginkgo preparations at least 36 hours before surgery. Obviously, the combination of these drugs with various antithrombotic agents (antiplatelet agents, anticoagulants, fibrinolytics) should be avoided, since they can increase the risk of hemorrhages. It is also inappropriate to use ginkgo preparations, including as part of various food supplements, in patients with thrombocytopenia, thrombocytopathies.

Ginkgo preparations are contraindicated in case of individual hypersensitivity. Their appointment is not recommended during pregnancy and lactation, as well as in childhood.

Calcium channel blockers

An increase in intracellular calcium concentration plays an important role in the mechanisms of memory impairment, ischemic damage, and apoptosis of neurons. In this regard, calcium channel blockers, which mainly improve cerebral blood flow and are used in cerebral ischemia, also have a proper nootropic effect, the mechanism of which remains not fully understood. Among the numerous "anti-calcium" drugs, nimodipine and cinnarizine demonstrate the greatest affinity for cerebral vessels and the nootropic component of pharmacodynamics. The relatively good tolerability of calcium channel blockers is explained by the wide breadth of their therapeutic action.

The efficacy of nimodipine in patients with dementia has been confirmed in at least 15 controlled clinical trials. Unlike acute cerebral ischemia and subarachnoid hemorrhages, when nimodipine is used by injection, in dementia, the drug is used in tablets. The spectrum of its side effects is quite wide. Lowering of arterial pressure (due to systemic vasodilation) and dizziness lead in frequency. In addition, the drug can cause dyspepsia, headache, attention and sleep disturbances, psychomotor agitation, a feeling of heat and redness of the face, sweating, less often tachycardia, thrombocytopenia, angioedema and skin rash.

Nimodipine is contraindicated in pregnancy and lactation, severe liver dysfunction, cerebral edema. Great care must be taken when deciding whether to prescribe the drug to patients with low blood pressure, increased intracranial pressure. You can not use nimodipine during work to persons whose profession is associated with the need for a high concentration of attention (drivers, etc.)

It should be borne in mind that various antihypertensive drugs enhance the hypotensive effect of nimodipine, and β-blockers, in addition, potentiate the negative inotropic effect and, in combination with nimodipine, can decompensate the work of the heart.

Cinnarizine (stugeron) is a popular drug that improves cerebral circulation and has nootropic and vestibuloprotective properties, as well as antihistamine activity. With good tolerance, it can sometimes cause side effects such as dry mouth, drowsiness, headache, extrapyramidal disorders, weight gain, dyspepsia, cholestatic jaundice, allergic reactions (despite the antihistamine effect). Some women with long-term treatment with cinnarizine have polymenorrhea, so in such cases it is advisable to cancel it on the days of menstruation.

Contraindications, with the exception of individual intolerance, have not been established. Drowsiness, dry mouth, and gastrointestinal disturbances do not require discontinuation of cinnarizine; it is usually sufficient to reduce the dose of the drug. Since cinnarizine mainly dilates cerebral vessels and has little effect on other vascular pools, at therapeutic doses it practically does not reduce blood pressure, but in patients with severe hypotension, it is recommended to take the drug at a reduced dose. Apparently, care should be taken when prescribing cinnarizine to patients with parkinsonism, since there is a risk of exacerbating extrapyramidal disorders. When using the drug, it is advisable to avoid driving a car, since drowsiness with reduced attention is possible.

Cerebral vasodilators

The drugs of this group have different mechanisms and multifaceted neuro- and psychopharmacological effects. Their nootropic effect, as already noted, is largely a consequence of improved cerebral circulation, although other ways of its implementation are possible. Thus, vinpocetine (Cavinton) is able to block NMDA receptors, inhibit calcium and sodium channels, inhibit cAMP phosphodiesterase, increase the neurophysiological parameter of long-term potentiation (long-term potentiation), which indicates an increase in the plasticity of neuronal transmission.

Vinpocetine (Cavinton), obtained from the small periwinkle, has been used for about 30 years. It causes almost no side effects. Unlike the vinca alkaloid devincan, vinpocetine lacks a sedative effect. Usually, when it is used, the level of wakefulness and the parameters of systemic hemodynamics are preserved. Sometimes there is a temporary decrease in blood pressure due to vasodilation and baroreflex tachycardia. Therefore, parenteral administration of the drug is contraindicated in severe coronary heart disease and cardiac arrhythmias. In addition, Cavinton is contraindicated during pregnancy. Its combination with heparin is undesirable, since the risk of bleeding increases.

The use of the α-blocker nicergoline can be accompanied by a variety of side effects, but their frequency is low. It should be noted that with an increase in the duration of the course of treatment, they are less common. More often than others, erythema, a feeling of heat with reddening of the skin of the face, fatigue, sleep disturbances, decreased appetite, nausea, increased acidity of gastric juice and abdominal pain (stopped by antacids), diarrhea occur. Orthostatic hypotension is less common (due to the risk of which, after the injection of nicergoline, the patient must lie down for some time). It is possible to enhance the effects of antihypertensive drugs, anticoagulants, antiplatelet agents and alcohol.

Contraindications to the use of nicergoline are bleeding, recent myocardial infarction, arterial hypotension, severe bradycardia, pregnancy and lactation. You can not combine this drug with other α-blockers, as well as with β-blockers in order to avoid increasing adverse effects on the circulatory system.

Instenon, which is a combination of three components - hexobendin, etamivan and etophylline, has recently attracted attention not only as a corrector of cerebral circulation, but also as a drug with proper nootropic properties. Compared with previous cerebrovascular drugs, it is somewhat more likely to show side effects, especially when administered intravenously. The frequency of their occurrence is about 4%. There may be a pronounced decrease in blood pressure, tachycardia, headaches due to increased intracranial pressure, discomfort in the heart, flushing of the face. Therefore, intravenous administration should be only drip and very slow (within 3 hours), and the appearance of these symptoms requires the infusion to be stopped. With intramuscular injections, and even more so when using tablets, side effects are less common. It is necessary to take into account the ability of instenon to enhance the antiplatelet effect of acetylsalicylic acid, which is fraught with hemorrhagic complications.

The drug is contraindicated in epilepsy, increased intracranial pressure, cerebral hemorrhage. During pregnancy and lactation, it is permissible to use it only under strict indications.

In conclusion of the review of the side effects of the most commonly used nootropic drugs, it should be emphasized that their prevention and correction, taking into account contraindications and adverse drug interactions by doctors and pharmacists are an important reserve for improving the safety of pharmacotherapy.

Literature

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Many people notice that with age or for other reasons (after strokes, traumatic brain injuries, asphyxia at birth and other lesions of the central nervous system), their thinking becomes more difficult to solve production and domestic problems. And sometimes the mental load is too high for normal perception (for students during exams). In such cases, new generation nootropics prescribed by a neuropathologist come to the rescue.

Patients often ask questions: what are nootropics and how do they affect the central nervous system? It is worth learning more about this in order to use these funds more competently.

Nootropic drugs are drugs that improve metabolic processes in the brain and protect it from harmful effects. Due to this, they have a positive effect on the memorization of information, mental activity and the ability to learn.

Nootropics for the brain are officially classified as psychotropic drugs, but they differ from them in their ability to protect the brain from hypoxia () and a much smaller number of side effects (do not cause drowsiness, do not reduce responsiveness, do not depress brain activity, there is no addiction to them).

Groups

The list of nootropic drugs for the brain is very extensive, therefore, for convenience, they are divided into the following main groups:

• Preparations of gamma-aminobutyric acid ("Aminalon", "Pikamilon" and others).
• Preparations of pyrrolidone (piracetam) and diaphenylpyrrolidone (phenotropil).
• Pyridoxine derivatives (pyritinol).
• Polypeptides (cerebrolysin).
• Vitamin-like substances (idebenone).
• Amino acids (glycine, tyrosine).
• Other groups.

Neuroprotective substances that reduce oxygen starvation of the central nervous system, prevent convulsions, and relax muscles are considered close to nootropics in terms of effects.

Means with a nootropic effect stimulate cognitive functions, contribute to better memorization and assimilation of information, learning. They improve interneuronal connections in the brain. The protective effect of nootropics (cerebroprotectors) consists in the normalization of carbohydrate metabolism in the central nervous system, stimulation of neuronal recovery, antioxidant effect, and stabilization of cell membranes.

The mechanism of action of nootropics on the brain includes the following effects:

• antioxidant;
• antihypoxic;
• neuroprotection;
• membrane stabilization.

In order for a positive effect to occur, nootropic drugs must be taken in courses for a long time, since their effect usually does not appear or is minimal after one tablet. Often they are prescribed in combination with other drugs that strengthen and protect the nervous system (vitamins, statins, psychostimulants).

As a rule, such treatment is indicated for elderly people, or those who have had an organic one, and sometimes it is prescribed for children so that they develop normally.

Indications

Which nootropics are best for the brain should be decided individually by a neurologist.

There are such indications of nootropics for their appointment:

• Diseases leading to degenerative phenomena in the central nervous system, such as dyscirculatory encephalopathy, ischemic stroke, traumatic brain injury, brain infections, epilepsy.
• Constant abuse of alcohol.
• Constant drug use.
• Asthenic syndrome, insufficient sleep.
• various neuroses.
• Mental illness.
• Mental retardation in childhood.

Contraindications

Contraindications to these drugs depend on the group of a particular drug. For people who have had an allergic reaction to the nootropic, it is contraindicated. However, they can pick up a drug with a similar effect with a different composition.

It is also impossible to take nootropics after a hemorrhagic stroke, with renal or hepatic insufficiency, during pregnancy and breastfeeding. It must be remembered that in order to avoid undesirable effects, treatment with nootropic substances should be prescribed by a doctor. With self-medication, the risk of various complications is much higher.

Side effect

When taking modern nootropic drugs, side effects occur much less frequently.

The following undesirable effects are possible:

• sleep disturbance;
• general weakness;
• increased excitability;
• digestive disorders (dyspepsia);
• toxic effects on the liver and kidneys;
• feeling of heat in the face and its redness;
• allergic rash;
• increase in body temperature;
• deterioration in balance;
• sometimes - worsening of the current.

Description

New generation nootropics for the brain are usually more effective and have fewer side effects compared to older drugs:

1. Piracetam: has a positive effect on metabolic processes in the central nervous system. Indications for it are bouts of dizziness, speech disorders in children, memory impairment. It is used as part of a complex emergency treatment for alcoholic delirium, inflammatory processes in the brain, heart attacks.
2. Phezam: used when . It improves the passage of blood through the microvasculature and promotes metabolic processes in the brain tissue. It also has a positive effect on the auditory and visual centers, has a pronounced antihypoxic effect, helps with headaches, memory and attention disorders.
3. Cerebrolysin: The positive effect of this medicine has been proven in studies. There are forms for oral and intravenous administration. In complex therapy, it helps with strokes, craniocerebral injuries. It is also used for mental disorders. It has a positive effect on the mood and general well-being of patients, improves cognitive functions.