Nootropics for students. The best nootropic drugs without additional effects. How nootropics work

The mechanism of action is based on a change in bioenergetic processes in the nerve cell:

increases the consumption of glucose and oxygen by neurons;

increased utilization of glucose;

activation of adenylate cyclase;

strengthening the ATP circulation;

stimulation of RNA and protein synthesis;

increase in the brain tissue exchange of phosphatidylethanolamine and phosphatidylcholine.

Nootropics also affect the metabolism of mediators: they have N-methyl deaspartate potentiating activity, as well as the ability to activate glutamatergic and GABAergic processes.

Thus, nootropic drugs, called neurometabolic cerebroprotectors, have both a neurotransmitter effect and a metabolic one, which is realized by stimulating the speed and activity of neuronal energy supply processes.

Pharmacodynamics of nootropics.

Nootropic effect - affect developmental delay or disruption of higher cortical functions, increase the level of judgment and critical brain capabilities;

psychostimulating effect - apathy and mental retardation are eliminated;

sedative effect - irritability and emotional excitability decrease;

antiasthenic action;

mnemotropic action (help improve memorization).

antidepressant action;

adaptogenic effect (increase the resistance of the brain to the effects of adverse environmental factors);

antiepileptic action - prevent the degradation of the personality when using antiepileptic drugs;

antiparkinsonian action;

immunocorrective action;

increase in the level of wakefulness of consciousness.

show an antihypoxic effect.

Indications for use.

Oligophrenia: the treatment of oligophrenia with nootropics is carried out in order to increase the intellectual capabilities of the brain, as well as stimulate learning.

In gerontological practice for the treatment of senile dementia, including Alzheimer's disease. The use of nootropics allows you to save the intellectual abilities of older people for a longer period.

Treatment of alcoholic dementia.

Various cerebrovascular disorders (consequences of traumatic brain injuries, strokes) to accelerate and expand the processes of functional rehabilitation.

Comprehensive therapy for depression.

Epilepsy is in complex therapy with antiepileptic drugs.

IHD and other diseases accompanied by ischemia.

Side effects.

Dyspeptic disorders;

stimulating effect (piracetam);

drowsiness (phenibut and sodium hydroxybutyrate);

decrease in blood pressure and bradycardia (aminalon and cavinton).

Adaptogens.

Adaptogens – This is a group of drugs that increase the nonspecific resistance of the body and increase its resistance to the effects of adverse environmental factors.

Classification of adaptogens.

Herbal preparations.

ginseng tincture;

Eleutherococcus extract;

tincture of Schisandra chinensis;

echinacea preparations (echinacea tincture, imunal).

Preparations of animal origin.

rantarin;

pantocrine.

The mechanism of action of adaptogens.

They activate the adaptive synthesis of RNA and proteins due to the membrane-protective action and the regulation of selective membrane permeability. Antioxidant action, which is realized by increasing endogenous antioxidants in the body. Weaken biochemical and functional shifts during stress reactions.

Pharmacodynamics.

Adaptogenic action - increase the body's resistance to extreme factors;

tonic effect - improve the functions of the central nervous system, without causing euphoria and without disturbing circadian rhythms;

actoprotective action;

increase the body's resistance to infectious agents;

antioxidant action, which is realized by increasing endogenous antioxidants in the body;

protective effect in xenobiotic intoxication.

Indications for use:

neuroses and borderline states.

asthenic conditions.

General weakening of body functions after past illnesses.

Chronic fatigue syndrome (CFS).

To prevent stress reactions.

Rules for taking adaptogens.

The duration of the course is about 3 months.

Reception time: autumn, winter.

Reception mode: tinctures are taken on an empty stomach 30 minutes before meals, 15-20 drops.

Diet: exclusion from the diet of fatty and spicy foods, alcohol.

Side effects:

CNS excitation;

increased blood pressure (rare).

Actoprotectors.

Actoprotectors– This is a group of drugs that increase physical and mental performance in extreme conditions. These include the following drugs:

Mechanism of action.

Improve the metabolism of body cells. Bemitil stimulates the activity of gluconeogenesis enzymes, which stimulates aerobic glucose degradation pathways.

Indications for use: (see adaptogens).

Side effects:

hyperglycemia;

dyspeptic disorders.

Lecture number 11.

MEDICINES USED IN CORONARY INSUFFICIENCY (ANTIANGINAL MEDICINES).

Ischemic heart disease (CHD) is an acute or chronic disease that occurs as a result of a decrease or cessation of blood supply to the myocardium due to damage to the coronary vessels.

IHD is a collective concept and includes angina (anginapectoris) and myocardial infarction (MI).

The key link in the pathogenesis of coronary heart disease is the discrepancy between myocardial oxygen demand (blood) and its delivery.

Etiopathogenesis of IHD.

Causes of reduced oxygen delivery to the heart:

atherosclerosis of the coronary arteries;

thrombosis of the coronary arteries;

spasm of the coronary arteries;

violation of microcirculation in the myocardium due to increased platelet aggregation and reduced fibrinolysis;

hypotension and bradycardia;

heart failure.

The reasons causing an increase in myocardial oxygen demand (blood):

psycho-emotional stress;

severe physical stress;

myocardial hypertrophy (in athletes);

thyrotoxicosis;

hypertension and tachycardia;

infectious myocarditis.

What nootropic drugs new generation and how they differ from other drugs of this group, what active ingredients they contain and for what diseases and disorders they are indicated, the rules for using nootropics.

Nootropic drugs of the new generation are drugs that are responsible for stimulating the brain and its work, protect nervous reactions. The list of new drugs in this group is quite large. As a rule, these are complex substances that consist of the nootropic component itself, as well as a number of additional ingredients, such as amino acids, antioxidants, vitamins that improve the functioning of brain cells.

Features and types of new generation nootropics

Nootropics in various forms have been used by people since ancient times. The simplest and very first known nootropic is choline. The substance contains eggs, meat, fish, seafood. After eating a meal that is rich in animal protein, the hormone serotonin is produced in the brain.

It is responsible for the feeling of pleasure, and also positively affects the connections of neurons. The brain is included in active work, memory becomes better, as well as thought processes. Similar nootropic simplest substances are found in green tea, coffee, nicotine, amphetamines.

After nootropic drugs were developed and studied in the middle of the 20th century in laboratory conditions, a classification of these drugs was created: stimulants, reversible inhibitors acetylcholinesterases, racetams, vasodilators, metabolic enhancers.

Currently, racetams are mainly used in medicine. These substances are the basis of new nootropics. Racetams are a chemical structure that is derived from pyrrolidine. Today, there are many different pharmacological preparations new generation.

Earlier in order to improve mental activity, herbal ingredients such as lemongrass, ginseng, ginkgo biloba were widely used. These plants are now the ingredients of nootropic drugs. Unlike natural natural stimulants the latter have a more precise effect on specific areas of the brain.

This makes it possible to use new drugs not only to enhance memory and improve intelligence, but also in the treatment of more serious abnormalities and ailments, such as Parkinson's and Alzheimer's diseases. Due to this, these drugs are considered the most effective among all nootropics.

Composition and characteristics of the components of new nootropics

As a rule, such drugs contain two or more components that complement each other's action. Often in the composition of new nootropics can be found:

1. Dimethylaminoethanol. This is a substance that is actively involved in the synthesis of acetylcholine. Acts as an antioxidant, improves memory, mental capacity, physical endurance.
2. Gamma aminobutyric acid. The main inhibitory neurotransmitter of the CNS. It takes an active part in the metabolism of the brain, as well as in neurotransmitter processes.
3. Pantothenic acid (B5). Participates in the metabolic processes of the brain, the synthesis of acetylcholine. Participates in the synthesis of neurotransmitters.
4. Pyridoxine (B6). This is a coenzyme of proteins, which is involved in the uniform supply of glucose to the cells of the body, is involved in the processing of amino acids.
5. Vitamin B15. Helps eliminate cell hypoxia, has a vasodilating effect, has a detoxifying property.
6. Vitamin E. It takes part in the synthesis of hormones, acts as an antioxidant, prevents the formation of blood clots, and helps the muscles to function normally.
7. Folic acid. Participates in the processes of DNA replication, in cell division.

Useful properties of new generation nootropics

According to the definition of the World Health Organization, the group of new generation nootropics should include drugs that have a direct activating effect on the learning process, memory, and mental activity. In addition, these drugs increase the resistance of the brain to various aggressive factors.

The general properties of new nootropic drugs are as follows:

• Improving thought processes - learning or cognitive functions;
• Increasing the speed of memorization and durability of data storage;
• Growth of intellectual activity, increase in the volume of intellectual abilities;
• Oblivion stressful conditions and information about various pain;
• Stimulation of metabolic processes in neuronal tissue, mainly during different pathologies such as intoxication, trauma, anoxia;
• Improving the impact on mental condition and higher nervous activity with morphological and functional pathologies;
• The growth of the resistance of the mental processes of the brain to unfavorable factors internal and external environment: stroke, trauma, hypoxia.

New generation nootropic drugs do not affect the psyche and higher nervous activity of a healthy person.

Indications for the use of new nootropics

Let us consider in more detail what are the indications for taking new generation nootropic drugs to increase mental activity:

1. Psychoorganic Syndrome. In medicine, it is understood as an extensive group of diseases that manifest themselves in dystrophic changes in nervous tissues. These are such ailments: epilepsy, various types of dementia, Parkinson's disease, neuroinfections, cerebral palsy, ischemic stroke.
2. Chronic alcoholism, which is accompanied by withdrawal symptoms and delirium.
3. Addiction.
4. Asthenia of organic and neurotic origin, asthenoneurotic and asthenodepressive syndromes, VVD, migraine, sleep disturbances, emotional lability.
5. Correction of the neuroleptic syndrome.
6. Violation of proper urination of neurogenic etiology.
7. Somatic-vegetative disorders.
8. Neurotic and neurosis-like pathologies.
9. Chronic cerebrovascular insufficiency.
10. Sickle cell anemia.
11. Chronic psychopathology, schizophrenia, childhood oligophrenia, neurosis-like disorders, depression.
12. Organic brain syndrome elderly people.
13. As part of complex treatment ophthalmic pathologies.

Side effects and contraindications of new nootropics

Each drug of the nootropic class has its own contraindications. AT in general terms can be identified as:

• Pregnancy;
• Lactation;
• Individual intolerance to the components;
• Psychomotor agitation;
• bulimia;
• kidney failure;
• Liver failure;
• Chorea of ​​Huntington;
• Period after acute hemorrhagic stroke;
• Severe renal impairment.

The mechanism of action of new generation nootropic drugs

Nootropic drugs directly affect a number of brain functions. As a result, the interaction between the hemispheres and the main centers of the cortex improves.

New generation drugs increase the utilization of sugar, as well as the formation of ATP, have a stimulating effect on the synthesis of RNA and proteins. The process of oxidative phosphorylation under their influence is suspended, and cell membranes are stabilized.

The mechanisms of action of new nootropics include:

1. Antioxidant;
2. Membrane stabilizing;
3. Neuroprotective;
4. Antihypoxic.

The advantage of this mechanism of action is that there are no irreversible changes in the cortex. With the ease with which racetam molecules bind to receptors, they are detached.

Moreover, since human body does not produce racetams on its own, unlikely to occur by-products, which may cause negative effects. Thus, a powerful nootropic effect is achieved without side effects.

Each racetam is uniquely formulated to bind to specific neuroreceptors. As a rule, such drugs are used in groups in order to achieve the best effect.

The effectiveness of new generation nootropic drugs for the elderly increases if they are combined with psychostimulants and angioprotectors. Thus, disturbed intellectual functions are stimulated and corrected. For children, neurometabolic stimulants are recommended to combat mental retardation.

Instructions for using new nootropics

Self-administration of new generation nootropic drugs without a doctor's recommendation is prohibited. Permissible only use without the appointment of vegetable medicines based on ginkgo biloba, lemongrass and other plants. Such drugs are rather biologically active additives than medicines.

There are many different drugs in this group. They have different shape and direction of action. They are mainly produced in the form of tablets, capsules, injection solutions and suspensions.

It should be noted that the maximum effectiveness of the use of these drugs is achieved only after several weeks and even months.

Overview of New Generation Nootropics

The list of new generation nootropic drugs is quite extensive. Usually, the latest medicines have combined composition and combine racetams and excipients.

Popular means are:

• Phezam. It is a combination of Piracetam and Cynarizine. The medicine is in the form of capsules. It is recommended as a tool in the complex therapy for the treatment of circulatory disorders in the brain. After its use, microcirculation in the brain improves, blood vessels expand, vision and hearing improve. The drug eliminates the effects of hypoxia, relieves headaches, dizziness, fights amnesia. As a rule, people who have suffered a stroke, encephalitis and various traumatic brain injuries are prescribed long-term use Phezam. The price for a package of the drug (60 capsules) ranges from 170 to 250 rubles.
• Orocetam. The combination of piracetam and orotic acid. These are intravenous injections. The drug helps to overcome severe brain intoxication. Improves metabolic processes in brain cells. Activates the reparative and detoxifying function of the liver. The price is about 50 rubles per ampoule of the drug.
• Thiocetam. Combination of piracetam and thiotriosalin. It is in the form of tablets and injections. It is used to improve cerebral circulation in the cerebral cortex. Often used to treat speech disorders and consequences alcohol intoxication. The price of the new generation nootropic drug Thiocetam is 540 rubles per pack of 60 tablets.

Nootropic drugs are popularly called "smart" pills. After all, these drugs improve the brain. They activate learning, improve memory. Piracetam was the first nootropic synthesized in 1963. During the study of the drug, scientists confirmed that the drug increases mental abilities, improves memory, and performance. Today, many drugs have been developed that have a similar effect. These are new generation nootropics. We will talk about them.

Mechanism of action

Nootropics of the new generation do not cause addiction in humans. In addition, they do not provoke psychomotor arousal. Their reception does not cause depletion of physical capabilities.

It is usually well tolerated. But some patients may have adverse reactions, which were discussed above. For violations in carbohydrate metabolism this remedy not applicable because it contains sucrose.

The drug "Pantogam"

The medicine is able to activate mental activity, normalize behavioral reactions, increase efficiency. Actively contributes to the enrichment of the brain with oxygen.

This tool is approved for use by children from 1 year. It is used for crumbs suffering from cognitive disorders. Mainly with speech delay, hyperactivity syndrome.

The average cost of the drug is 358 rubles.

List of the best nootropics

Today there is just a huge list of effective drugs. In addition, new drugs appear on the pharmacological market from time to time. After all, developments to create the most effective means are carried out constantly.

If we talk about the best nootropics, then doctors distinguish the following medicines:

• "Piracetam" (it still belongs to the rank of highly effective drugs).
• "Nootropil".
• Phenotropil.
• "Glycine".
• "Meclofenoxate".
• "Cerebrolysin".
• "Aminalon".
• "Bemitil".
• "Biotredin".
• Vinpocetine.

Patient opinions

From the above, it is quite clear how the instructions for use position the nootropic. Reviews of patients who have tested the drugs on themselves largely confirm the effective effect on the body.

A special place is occupied by the same old drug"Piracetam". It is prescribed for many pathologies, it is especially in demand after traumatic brain injuries. Patients who adhere to the course of treatment prescribed by the doctor notice that unpleasant phenomena, such as migraine, dizziness, under the influence of the drug are eliminated.

Excellent means, especially for VVD, are the drugs "Cinarizine", "Vinpocetine". They eliminate such unwanted symptoms as constant dizziness, blue nail plates, cold extremities, and many others. However, some patients may experience side effects.

Despite this, it is the patients who assure that nootropic drugs can “just bring back to life”! Therefore, love yourself, take care of your health and use the medicines that the doctor has prescribed for you!

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 (Giurgea) 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 excitation, exhaustion functionality body 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, which are used primarily to correct disturbed mnestic 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 special place in the list of indications, because 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 cerebral circulation, intoxication (including alcohol), withdrawal syndrome, sleep deprivation, fatigue, asthenic and depressive states after traumatic brain injuries and neuroinfections, as well as for the correction of side effects of psychopharmacotherapy (in the treatment of neuroleptics, antidepressants, psychostimulants). In children's practice, nootropic drugs are used to treat cerebral palsy, 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 patients, but also 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. unwanted 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 1500 substances of a similar structure have been obtained, but in medical practice only about 12 drugs are used. 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 is occasionally possible coronary insufficiency. 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 positive effect high doses of piracetam (up to 3-10 g) for distress syndrome in newborns (the drug was administered to women in labor intravenously).

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 when serious illnesses of cardio-vascular system with severe arterial hypotension. There are indications of the inappropriate use of the drug in children suffering from diabetes, if there is 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, disorders heart rate, arterial hyper- or hypotension), hypersalivation, rhinitis, sweating, skin rash, swelling of the feet and ankles, fainting. In isolated cases, bronchial obstruction is noted (difficulty breathing, a feeling of pressure in chest, cough), mood and mental changes (aggressiveness, irritability), extrapyramidal disorders (stiffness and trembling of the limbs), obstruction 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), obstruction of the gastrointestinal tract or urinary tract, abnormal liver function (even in history), Parkinson's disease and symptomatic parkinsonism, peptic ulcer 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 of GABAergic substances are associated both with increased energy processes in the brain (activation of Krebs cycle enzymes, increased glucose utilization by brain cells), and with improved 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. Contraindicated this drug with 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 diseases kidneys, 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. In these cases, you need to reduce the dose. Occasionally meet allergic rash and itching skin requiring discontinuation of the drug. Contraindications, along with individual intolerance, are acute and chronic diseases kidneys.

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 hydroxybutyrate 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 belongs to one of 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, glutamate receptors (in particular, NMDA receptors), as evidence is accumulating, are involved in the mechanisms of memory impairment in various diseases CNS.

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 states.

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 is observed 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, with convulsive states, including epilepsy, 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 liver and kidney functions. 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 violations liver and kidney functions. 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, there are cases intracranial hemorrhages and postoperative bleeding after laparoscopic cholecystectomy. 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, have a proper nootropic effect, the mechanism of which remains not fully elucidated. 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 high concentration attention (drivers, etc.)

It should be taken into account 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. When well tolerated, it can sometimes cause side effects such as dry mouth, drowsiness, headache, extrapyramidal disorders, weight gain, dyspepsia, cholestatic jaundice, allergic reactions (despite antihistamine action). In some women with long-term treatment cinnarizine has 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 disorders do not require discontinuation of cinnarizine, it is usually enough to reduce the dose of the drug. Since cinnarizine mainly dilates the vessels of the brain and has little effect on other vascular pools, in 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 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 blood pressure due to vasodilation and baroreflex tachycardia. Therefore, parenteral administration of the drug is contraindicated in severe course ischemic 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 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 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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The nervous system of a newly born person is still immature. It will improve over the years. It is not surprising that caring parents peer intently at their crumbs - but does he have any deviations?

Is your baby restless before bed? Sometimes the chin trembles, arms and legs twitch, does the baby spit up profusely and often, lag behind in development from their peers? Does the little one have a delay in speech development or does he not want to sit down and walk in the average period? All these symptoms can be a sign of both natural immaturity of the nervous system for crumbs, and a serious illness.

According to statistics, nootropic drugs in Russia are prescribed to every third child.

When the question arises, as they say, point-blank, parents and pediatricians have no time to wait whether anxiety symptoms with time.

After all, what older child, the more difficult it is to correct deviations caused by neurological pathologies. In this situation, children are prescribed nootropic drugs. You should not be afraid - according to statistics, they are prescribed to every third baby.

What it is?

Nootropics are neurometabolic stimulants. Simply put, drugs that actively act on higher mental functions brain, improve blood circulation and the functioning of the nervous system, stimulate metabolic processes in nervous tissues. AT international classification nootropics do not separate group, they were combined with psychostimulants. But this is also not a cause for concern.

Action

Nootropic action is based on several processes. They improve the energy state of nerve cells (neurons), accelerate the processes occurring in the central nervous system, saturate the brain with oxygen, strengthen the membranes of nerve cells, and increase the speed of impulses in the brain. As a result, the metabolic processes in the brain are significantly improved, memory "strengthens", perception "revives". Nootropics have a positive effect on the mechanisms of thinking, increase intellectual abilities. It is for this that nootropics got their second unofficial name - “cognition stimulants”.

Nootropics Improve Blood Circulation in Brain Tissues

Nootropic drugs are different classification There are more than 20 types in total. There are over a hundred titles.

Indications for use

Nootropic drugs for children are prescribed for the following diseases and states:

• Lag in the development of the child's psyche,
• speech development delay,
• The consequences of intrauterine suffering of the baby, during which the central nervous system was affected,
• Head injuries (concussion, TBI)
• attention deficit disorder,
• Various forms of mental retardation,

Besides, certain types nootropic drugs are most likely to be prescribed for severe stuttering, sleep disturbance in a child, urination disorders, migraines, severe dizziness. Nootropics are used to treat hyperkinesias (these are chaotic convulsive random movements of the arms and legs in children), as well as to prevent motion sickness. In addition, nootropic drugs for the treatment of children are used in ophthalmology, toxicology, and traumatology.

Nootropic drugs are used not only for the treatment of neurological diseases.

Pros and cons

Despite its rather positive effect on the body, controversy and scientific discussions around nootropics do not subside. These drugs are widely used only in Russia and the countries of the former CIS. Probably because they began to be used in our medicine in the middle of the 20th century. European and american doctors, for example, refuse to prescribe nootropics to their little patients.

The reason is that the effectiveness and benefits of nootropics have not yet been scientifically proven. Although everyone agrees that there is no particular harm from them either. And what then is the point of treating everyone and everything with nootropics, if, of course, we are not talking about the list of diseases indicated above? This view is held, in particular, famous doctors Roshal and Komarovsky. Some experts even suggest moving nootropic drugs from the category of medicines to the category of dietary supplements.

What drugs can a doctor prescribe?

• The main and very first nootropic in history, the "founding father" of all other drugs in this family, is Piracetam. Most Russians and residents of the countries of the former CIS are also familiar with other synonymous names: Nootropil, Cerebril, Lutsetam, Oykamid, etc.

Piracetam was synthesized more than half a century ago. The drug has a beneficial effect on the brain, stimulates memory, increases the ability to intellectual stress and motivates learning, promotes concentration. Available in capsules, ampoules and tablets. Piracetam is not recommended for children under one year old. In addition, this drug is not suitable for babies with psychomotor agitation.

Piracetam should be used with caution, it has a number of side effects

Among the side effects from taking Piracetam are insomnia, impaired coordination of movements, irritability, confusion.

• Another very popular drug among Russian pediatricians is Pantogam. It is a nootropic anticonvulsant. Available in the form of tablets and syrup. His doctor can prescribe to your baby from the first days of life.

  The medicine improves the condition of children with various forms cerebral palsy, schizophrenia, autism. In addition, Pantogam helps with urinary incontinence, children nervous tics, hyperactivity syndrome and delayed speech development. Side effects are minimized, to drowsiness and allergic reaction on any component of Pantogam.

Piracetam has virtually no side effects

• Picamilon is a nootropic drug that expands the vessels of the brain, an analogue of Piracetam. Among other things, it has a psychostimulating and mild tranquilizing effect. Available in ampoules for intravenous and intramuscular injection and in tablets. Not recommended for children under 3 years old.

  Often, Picamilon is prescribed to overly anxious, emotionally unstable children. In addition, this nootropic is taken to increase endurance in conditions of physical and mental overload, for example, by athletes.

Picamelon is not recommended for children under 3 years of age.

Side effects include headache, nausea, itchy skin. The drug should not be taken by a child with kidney problems.

• Phenibut is a modern nootropic that is often prescribed to children. It stimulates the activity of the nervous system, increases mental performance, improves memory, helps students cope with overload in the learning process. The effect of a tranquilizer helps relieve anxiety, irritability, improve sleep. Available in tablets and powders. This drug is low-toxic, and therefore it is prescribed to children from 2 years old. Side effects include dizziness, drowsiness, and nausea.

Phenibut is prescribed for children over 2 years old

• Pyritinol is a nootropic agent with a slight sedative effect. Often it is advised to take it in depressive states, vegeto - vascular dystonia, fatigue, mental retardation. Suitable for children from 1 year old. It has a fairly large list of side effects from nausea to polymyositis, dyspnea and loss of taste sensations.

Pyritinol has a number of side effects, but despite this, it is prescribed from 2 years

• Cinnarizine (synonyms Balcinnarzine, Vertizin, Diziron, Cinnaron, Cyrizin) is a nootropic, the instructions for use of which say that it is not recommended for children under 12 years of age. However, many doctors have long been prescribing this drug to babies up to a year old, and claim its positive effect. However, the effectiveness of the drug has not been proven, but side effects patients were recorded. With this drug, they are satisfied with serious: violations of the liver and kidneys, pressure drop, headaches. Cinnarizine is available in capsules and tablets.

Cinnarizine may cause serious problems with the liver, kidneys and pressure surges

• Semax is one of the pediatricians' favorite nootropics. It is available in the form of drops in the nose, and therefore it is convenient to use it even for the smallest patients. Semax comes to the rescue in cases where children have a delay in speech development, sleep disturbances, hyperexcitability, capriciousness. Among the side effects are dizziness, irritation of the nasal mucosa.

The drug Semax fell in love with domestic pediatricians

• The simplest aminoacetic acid Glycine can be an excellent option. It has all the advantages of nootropics, but is devoid of frightening side effects. Glycine is prescribed for babies of any age. The drug regulates the processes of excitation and inhibition. As a result, the child's attention increases, learning significantly improves, night sleep normalizes.

Glycine is able to normalize sleep in a child

It is almost impossible to list all the drugs of the nootropic family, there are a lot of them, besides, the pharmaceutical industry does not stand still, and almost every year presents something new. It is profitable to look for new formulas in nootropic drugs, because these funds are quite in demand by both adults and children.

• From the "new products" I would like to note the Japanese nootropic Gammalon. The cost of this drug exceeds the cost of its ancestor Piracetam by more than 100 times. Packaging of the drug from the country rising sun costs about 2500 rubles per package (100 tablets).

The cost of Gammalon is quite high

According to reviews on the Internet, it helps even children with severe forms of autism and childhood cerebral palsy, alleviates their condition. But a number of physicians have doubts about Gammalon. The fact is that even a superficial analysis of the instructions for use for observant patients can suggest that the composition of the Japanese “miracle drug” contains a single amino acid - gamma-aminobutyric.

A nootropic with the same exact composition is Aminalon. Only it costs only 99 rubles. A practical approach to the issue suggests that the Japanese Gammalon is just a successful marketing move, especially since its effectiveness and benefits, like those of other nootropic drugs, have not yet been scientifically proven.

Aminalon is in fact an analogue of Gammalon, but it costs several times cheaper.

Conclusion about diagnostics in Russia

In Russia, a peculiar practice of diagnostics has developed. Doctors in the clinic for the sake of "reinsurance" can put a neurological or even psychiatric diagnosis any child who is excitable, very active or anxious. By and large, there would be a person, but there would be a diagnosis.

Doctors cannot be blamed for this. They are ordered by the Ministry of Health. After all, missing the beginning of the disease is even worse. Parents begin to treat the baby with nootropic drugs prescribed by a cautious doctor, not really knowing whether they are harmful. When real an existing disease nootropics are effective, but in the case of medical "reinsurance", the drug will bring absolutely nothing to a healthy child, except for possible "side effects".

Doctors do not have precise and uniform criteria for assessing the behavior of young children. Therefore, it is quite difficult to draw a line between an ordinary restless child and a child with a neurological disease.

Despite all the methods of diagnosis, the solution to the dilemma "Norm or pathology" falls on the shoulders of the doctor and ultimately will be determined only by him. And this is fertile ground for medical errors and those same reinsurance "just in case."

The main principle of any doctor is “Do no harm”, and testing drugs on a child in search of an opportunity to finally get a list of drugs with proven effectiveness is at least short-sighted and unethical. Let laboratory animals fill up the statistics better.

For more information about nootropics, see the following video.