How to take nootropic drugs. Pharmacological group - Nootropics

The list of drugs in this group contains substances that help protect the brain from damage and stimulate nerve cells to restore them to the level of healthy people.

Nootropic drug, what is it?

The concept of “nootropic drug” was first introduced in the last century by Belgian pharmacologists.

Nootropics are neurometabolic stimulants that activate metabolic processes in the brain, increasing its overall resistance to extreme situations and influences.

A distinctive factor from psychostimulants is that nootropics are antihypoxants (resist oxygen starvation of the brain), but do not negatively affect the human body, do not lead to disruptions in the functioning of the brain, and do not impair coordination of movements.

In terms of effectiveness, nootropics do not have a hypnotic or analgesic effect on the human body.

Medicines in this group are often of interest to students and people who experience severe intellectual or stress loads, since the instructions indicate that the drugs promote better assimilation of information, quick thinking, improvements in studies and smooth out the effect on the brain under stress and mental stress.

In pharmacology, there is one division of nootropics into two groups:

Which pharmacological group do they belong to?

The nootropic group includes drugs with nootropic action, and they are classified in pharmacology under the code (ATC code: N06ВХ).

The first drug in the group of nootropic drugs is Piracetam.

It was opened back in 1963, and gave rise to their development. The nootropic became the main competitor of psychostimulants, since the side effects from it were not so serious.

Nootropic therapy does not cause addiction, toxic damage, agitation and exhaustion of the body, which are inherent in psychostimulants. In the initial stages of the drug's development, it was used to treat brain dysfunction in older people.

Fact! In modern pharmacology, Piracetam is listed under the name Nootropil.

The table shows a list of drugs that are most often prescribed in nootropic treatment.

Drug derivatives	Species
Pyrrolidone derivatives	Piracetam, Polziracetam, Dipracetam, Miracetam, Oxiracetam, Aniracetam, Etiracetam, etc.
	Dimanol, Acetojumate, Euclidan, Meclofenoxate, Dimethylaminoethanol, etc.
Pyridoxine derivatives	Gutamin, Pyritinol
GABA derivatives	Nicotinol GABA, Phenibut, Pantogam, Gammalon, etc.
Cerebrovascular agents	Nicergoline, Vinpocetine, Vincam, Hidergin, etc.
Neuropeptides and analogues	ACTH and its fragments, vasopressins and Oxytocin, Thyroliberin and melanostatin, endogenous opioids.
Antioxidants	2-ethyl-6methyl-3-hydroxypyridine, ionol, metadoxyl.
Various substances with a nootropic component	Etimizole, Orotic acid, Methyl glucoorotate, Oxylitacyl, Naftidrofuryl, ginseng, lemongrass, etc.

Mechanism of action of nootropics

Most drugs in the nootropic group affect neurotransmitters (substances that promote the interaction of nerve cells with each other).

Nootropic therapy affects acetylcholine (which carries out neuromuscular transmission), serotonin (the hormone of happiness), dopamine (the precursor of norepinephrine, which is a necessary part of the “reward system” of the brain, as it induces a feeling of pleasure, which affects the processes of motivation and learning) and norepinephrine ( one of the most important “mediators of wakefulness”).

Modern nootropics improve the joint work of the left and right hemispheres, and the main centers localized in the cerebral cortex.

The effect of a nootropic can prolong life and rejuvenate the body.

Also, these drugs protect nerve cells from deformation and eliminate oxygen starvation, stimulate metabolic processes and simply improve blood circulation in brain tissue.

Different drugs from the nootropic group can have different effects on the body, it all depends on the group to which the drug belongs.

Among them:

Drugs	Effect on the body
Amino acids and substances affecting the excitatory amino acid system	The best remedies for performing various tasks in stressful conditions
Cerebrovascular agents	One of the most effective remedies is Ginkgo Biloba, a tree extract of plant origin. The best drug to increase the brain's resistance to negative influences
Vitamin-like	The most commonly prescribed is Idebenone - the best remedy for stimulating blood circulation in the brain
Polypeptides and organic composites	The components of these drugs are amino acid peptides. For the development of nerve cells, the brain uses similar proteins. The action of these nootropics is aimed at the growth and maintenance of neurons, which improves memory and helps to concentrate more intently on one task.
Pyrrolidine derivatives	The most common type is Piracetam. The action of the drug is aimed at improving blood circulation and activating metabolic processes in the brain cavity. The substance promotes the activation of neurotransmitters.
Pyridoxine derivatives	The main remedy is Pyritinol, which enhances blood circulation and metabolic processes in the brain cavity.
Neuropeptides and similar agents	Such drugs have found their application in ambulances, emergency services and stroke therapy. There is no exact definition of the mechanism of action, but the instructions say that it acts “originally”.
Dimethylaminoethanol derivatives	They affect acetylcholine, improving memory processes. Effective in learning.
Derivatives and analogues of gamma-aminobutyric acid	Helps deal with stressful situations. They have a calming effect, but do not inhibit the reaction, as with conventional sedative therapy.
2-mercaptobenzimidazole derivatives	They enhance the saturation of brain cells with oxygen and counteract extreme effects on the brain and intellectual stress.

Fact! To stimulate biochemical processes in the brain, it may take from a couple of days to a couple of weeks, depending on the drug used. This explains why nootropics are used in courses. There is no point in taking pills immediately before exercising your brain; you should start using them about a month in advance.

What effect do nootropics have?

The impact on the above mechanisms in the brain makes it possible to conclude that the following positive effects have on the body and its systems:

• Vasovegetative action characterized by acceleration of blood circulation and elimination of the main signs of neurocircular dystonia;
• Antihypoxic effect due to the formation of increased resistance of brain cells to oxygen starvation;
• Antidepressant effect. Certain nootropics are prescribed for depression and are aimed at counteracting it;
• Psychostimulating effect caused by stimulation of brain functioning in people with mental disorders suffering from apathy and motor retardation;
• Antiepileptic effect characterized by the fact that it prevents convulsions, confusion and complete loss of consciousness, as well as the prevention of behavioral and autonomic system disorders;
• Sedative effect characterized by a calming effect;
• Nootropic effect is aimed at stimulating cognitive activity;
• Antitoxic action e - this is neutralization, or removal of toxins from the human body;
• Adaptogenic effect due to the development of the body’s resistance to the influence of negative factors;
• Immunostimulating effect characterized by strengthening the immune system and increasing the body’s overall resistance;
• Lipolytic action due to the use of fatty acids as a source of energy.

Pay attention! Nootropics, in most cases, are prescribed for the elderly and children. This is explained by the fact that in old age it is necessary to correct deviations in the functionality of intellectual activity (memory, attention). Prescription in childhood occurs in the fight against intellectual development disorders of the child.

Is it dangerous to be treated with nootropics and are they harmful?

Drugs in this group rarely exhibit side effects, so there are almost no contraindications for them.

The consequences of using nootropics can range from headaches and dizziness to overexcitation of the nervous system.

But since they are not pathologically dangerous, the catalog of drugs can be prescribed to almost any patient.

The most serious and common side effect is withdrawal symptoms.

It can occur when the use of medications is abruptly stopped, which leads to suffering in the body.

Its most common manifestations can be headaches, lethargy, aggressiveness, loss of sleep, dizziness, etc. This is why cessation of the course of treatment occurs with a gradual reduction in the drugs used.

The main side effects reported with nootropics are listed below:

Indications for the use of nootropics

The main indications for nootropics and their therapy are the following:

Contraindications to the use of nootropics are:

• Hemorrhagic stroke;
• Severe kidney pathologies;
• The period of bearing and feeding a child;
• Kidney or liver failure;
• Clearly manifested psychomotor agitation;
• Sensitivity to the active ingredients of the drug.

Most Common Nootropics

Nootropic therapy medications are divided into groups of new and old generation. The latter include medications that were discovered a long time ago, even at the start of neurostimulants. These are the production forms of Piracetam.

Such drugs are:

• Pramiracetam;
• Aniracetam;
• Oxiracetam;
• Isacetam;
• Etiracetam;
• Detiracetam;
• Nefiracetam.

After the nineties of the twentieth century, a new round took place in the history of the development of nootropics. New drugs have a selective effect on individual body functions.

The most commonly prescribed new generation drugs are:

• Pantogam– the most effective nootropic drug, often used for treatment in childhood. The main active ingredient is vitamin B15, which is found in almost all plant substances;
• Phenibut is prescribed for a state of general weakness, neuroses, sleep disorders and deviations in the normal functioning of the vestibular apparatus. The interaction of Phenibut helps children overcome stuttering and various tics. This drug normalizes metabolism, stimulates mental processes (memory, attention, etc.), and also has an antioxidant effect. This drug contains virtually no toxins and does not cause allergies;
• Fezam is a nootropic prescribed in combination with other drugs for problems with blood circulation in the brain cavity. This drug eliminates the effects of oxygen starvation, helps against headaches, migraines, dizziness and memory loss. Long courses of treatment are prescribed for stroke, traumatic brain injury and inflammation of the membranes and tissues of the brain;
• Piracetam is a classic remedy prescribed to improve metabolic processes in the brain. Effectively treats dizziness, improves memory, and treats encephalopathy in childhood. The drug quickly relieves the negative effects of excessive consumption of alcoholic beverages. It is used for neuroinfections of the viral type and as one of the drugs for restoration after death of cardiac muscle tissue. The drug is sold both in tablets and in ampoules, solutions, syrups and capsules, which helps to choose the most convenient form of use;
• Cinnarazine– a drug from the nootropic group that helps expand the walls of the blood vessels in the brain and helps increase their size without affecting blood pressure. Nootropil cinnarizine is an effective drug against motion sickness, as well as suppressing nystagmus. The drug helps relieve high blood pressure, tinnitus, general weakness, headaches, restores normal sleep, removes aggressiveness, etc.;
• Actovegin– a drug from the group of nootropics, aimed at combating oxygen starvation of the brain, restoring metabolic processes, and promoting rapid healing of wounds. The drug is available in tablets and as an ointment or cream;
• Cerebrolysin is a nootropic used in combination with other medications. This drug has passed all tests and has confirmed its safety and effectiveness. Stimulates mental activity and improves mood. Long-term use of the drug improves memory processes, increases concentration and the ability to learn.

What actions will help you recover faster and keep your body normal?

Preventive actions to prevent the use of nootropics are:

• Maintaining a daily routine with proper rest and sleep (at least 8 hours);
• Proper nutrition should be balanced and varied, with plenty of vitamins and nutrients;
• Maintaining water balance (at least 1.5 liters of clean water per day) will help the blood not to thicken and circulate normally;
• Avoid stressful situations, psycho-emotional and intellectual excessive stress;
• Stop smoking, alcohol and drugs;
• Get a full examination once a year.

Conclusion

Nootropic drugs are effective means used to improve the functioning of brain processes.

It is especially effective to take them in courses, in advance of intellectual or psycho-emotional stress.

A wide range of drugs and a low chance of side effects make the drugs accessible and effective. To avoid complications, it is best to consult with a qualified physician.

Modern medicine has a wide arsenal of various means that affect the functioning of the nervous system. A fairly well-known group of drugs are nootropics. Many of us remember well the Hollywood blockbuster “Dark Areas”, where the main character took NRT.

These tablets contributed to the expansion of consciousness and allowed the use of brain resources by 100%. Despite the fact that the plot of the film is fictional, most people probably have a question about whether there are medications that can improve brain function.
These drugs include nootropics.

Doctors have mixed opinions about them.
Some consider them ineffective, while others see a positive clinical result. But in spite of everything, their prescription is included in many treatment regimens for neurological and other diseases. What are nootropics, a list of drugs, which ones are best to take depending on age? The answers to these questions can be found in this article.

What is a nootropic drug

This group of drugs was developed many decades ago, but still does not have a separate classification. They are combined into one class with psychostimulants, but unlike the latter they are not addictive and have fewer side effects.
Which in some cases allows you to take nootropics without prescriptions.
The literal translation from Greek of the concept of nootropic means guiding mind.
According to the manufacturers, their intake is aimed at improving the functioning of the central nervous system, which determines a beneficial effect on the cognitive aspects of its functioning.

In this way, it is expected to improve the quality of the processes of recognition, memorization and attention, speech, counting, and thinking. A positive effect on psychomotor orientation, the ability to take directed actions, planning, and mental control cannot be ruled out.

Until now, evidence-based medicine has not provided clear and reliable facts about the immediate effectiveness of using such drugs.

But rich clinical experience in prescribing them indicates the presence of positive reactions in the functioning of the brain. Apparently this is due to the fact that drugs for memory and attention are widely used in adults and children in Russia, the CIS and China.

New generation and old-style nootropics have the following functions:

1. Increased production of ATP (the main source of energy for neurons);
2. Reducing oxygen consumption by neurons under conditions of its lack (hypoxia);
3. Protection of cell membranes from free radicals and peroxidation, which prevents their destruction;
4. Ensuring the formation of complex structures (proteins) from simpler substances responsible for the accumulation of energy potential;
5. Increasing the speed of signal transmission between nerve endings;
6. Increased absorption of glucose - the main nutrient substrate of nerve cells;
7. Improving microcirculation in cerebral vessels;
8. Stabilization of cell membranes (shells);
9. Protecting neurons from a variety of damaging factors;
10. Beneficial effect on the bioelectrical activity of nerve cells.

All declared mechanisms are aimed at improving brain function, which should provide a beneficial effect on the functions of attention, thinking, and memory.

Who should take nootropics?

Tablets for the mind and memory are prescribed to patients of different ages who have certain problems in neurological health.
This does not exclude the use of such drugs by healthy people who wish to improve their cognitive abilities. This is especially true for people engaged in intensive mental work, schoolchildren and students, the elderly and those who need increased concentration and reaction speed.

The following situations are identified when the use of nootropics is justified:

• Chronic disturbances in the blood supply to the brain;
• Difficulties in learning, learning new information, forgetfulness, absent-mindedness, restlessness, etc.;
• Some types of epilepsy;
• Attention deficit disorder;
• Dementia of various origins;
• Depressive states;
• Neuroses, psychoorganic and asthenic syndromes;
• Tics of various origins;
• Consequences of injuries, including birth injuries;
• Vegetative-vascular dystonia;
• Consequences of an infectious lesion of the central nervous system;
• Perinatal encephalopathy of various origins;
• Toxic effects of toxic substances on brain tissue;
• Increased intracranial pressure;
• Chronic alcoholism.

Their range of applications is very wide; they are sometimes used in related areas of neurology. Nevertheless, even if a person is absolutely healthy, it is better to coordinate the use of such medications with a doctor.

Nootropics for adults

Tablets for memory and brain function for adults are inexpensive, but have a certain therapeutic effect, and are usually prescribed for any neurological pathologies and for elderly people.

Nootropics (Greek) noos- thinking, mind; tropos- direction) - means that have a specific positive effect on the higher integrative functions of the brain. They improve mental activity, stimulate cognitive functions, learning and memory, increase the brain’s resistance to various damaging factors, incl. to extreme stress and hypoxia. In addition, nootropics have the ability to reduce neurological deficits and improve cortico-subcortical connections.

The concept of nootropic drugs arose in 1963, when the first drug of this group, piracetam, was synthesized and clinically used by Belgian pharmacologists S. Giurgea and V. Skondia. Subsequent studies have shown that piracetam facilitates learning processes and improves memory. Like psychostimulants, the drug increased mental performance, but did not have the side effects inherent in them. In 1972, K. Giurgea proposed the term “nootropics” to designate a class of drugs that have a positive effect on the higher integrative functions of the brain.

There is a group of “true” nootropic drugs, for which the ability to improve mnestic functions is the main, and sometimes the only effect, and a group of nootropic drugs of mixed action (“neuroprotectors”), in which the mnestic effect is complemented and often overlaps with other, no less significant ones. manifestations of action. A number of substances belonging to the group of nootropic drugs have a fairly wide range of pharmacological activity, including antihypoxic, anxiolytic, sedative, anticonvulsant, muscle relaxant and other effects.

The nootropic effect of the drug can be either primary (direct effect on the nerve cell) or secondary, due to the improvement of cerebral blood flow and microcirculation, antiplatelet and antihypoxic effects.

There are a number of synonyms to designate substances in this group: neurodynamic, neuroregulatory, neuroanabolic or eutotrophic agents, neurometabolic cerebroprotectors, neurometabolic stimulants. These terms reflect the general property of the drugs - the ability to stimulate metabolic processes in nervous tissue, especially in various disorders (anoxia, ischemia, intoxication, injury, etc.), returning them to normal levels.

After the successful introduction of piracetam into medical practice, more than 10 original nootropic drugs of the pyrrolidine series were synthesized, currently in phase III clinical trials or already registered in a number of countries: oxiracetam, aniracetam, etiracetam, pramiracetam, dupracetam, rolisiracetam, cebracetam, nefiracetam, isacetam , detiracetam, etc. These nootropic drugs, based on their chemical structure, are called “racetams”. Following them, other groups of nootropic drugs began to form, including cholinergic, GABAergic, glutamatergic, peptidergic; in addition, nootropic activity was identified in some previously known substances.

Existing nootropic drugs can be classified as follows:

1. Pyrrolidine derivatives (racetams): piracetam, etiracetam, aniracetam, oxiracetam, pramiracetam, dupracetam, rolisiracetam, etc.

2. Dimethylaminoethanol derivatives (precursors of acetylcholine): deanol aceglumate, meclofenoxate.

3. Pyridoxine derivatives: pyritinol, Biotredin.

4. GABA derivatives and analogues: gamma-aminobutyric acid (Aminalon), nicotinoyl-GABA (Picamilon), gamma-amino-beta-phenylbutyric acid hydrochloride (Phenibut), hopantenic acid, pantogam, calcium gamma-hydroxybutyrate (Neurobutal).

5. Cerebrovascular agents: ginkgo biloba.

6. Neuropeptides and their analogues: Semax.

7. Amino acids and substances affecting the system of stimulating amino acids: glycine, Biotredin.

8. Derivatives of 2-mercantobenzimidazole: ethylthiobenzimidazole hydrobromide (Bemityl).

9. Vitamin-like agents: idebenone.

10. Polypeptides and organic composites: Cortexin, Cerebrolysin, Cerebramin.

11. Substances of other pharmacological groups with a nootropic component:

Correctors of cerebrovascular disorders: nicergoline, vinpocetine, xanthinol nicotinate, vincamine, naftidrofuryl, cinnarizine;

General tonics and adaptogens: acetylaminosuccinic acid, ginseng extract, melatonin, lecithin.

Psychostimulants: salbutiamine;

Antihypoxants and antioxidants: oxymethylethylpyridine succinate (Mexidol).

Signs of nootropic activity are present in the pharmacodynamics of glutamic acid, memantine and levocarnitine.

In addition, the experiment showed the nootropic effect of a number of neuropeptides and their synthetic analogues (ACTH and its fragments, somatostatin, vasopressin, oxytocin, thyrotropin-releasing hormone, melanostatin, cholecystokinin, neuropeptide Y, substance P, angiotensin II, cholecystokinin-8, peptide analogues of piracetam, etc. .).

Currently, the main mechanisms of action of nootropic drugs are considered to be the influence on metabolic and bioenergetic processes in the nerve cell and interaction with the neurotransmitter systems of the brain. Neurometabolic stimulants improve penetration through the BBB and glucose utilization (especially in the cerebral cortex, subcortical ganglia, hypothalamus and cerebellum), improve the exchange of nucleic acids, and activate the synthesis of ATP, protein and RNA. The effect of a number of nootropics is mediated through the neurotransmitter systems of the brain, among which the most important are: monoaminergic (piracetam causes an increase in the content of dopamine and norepinephrine in the brain, some other nootropics - serotonin), cholinergic (piracetam and meclofenoxate increase the content of acetylcholine in synaptic endings and the density of cholinergic receptors, choline alfoscerate, pyridoxine and pyrrolidine derivatives improve cholinergic transmission in the central nervous system), glutamatergic (memantine and glycine act through N-methyl-D-aspartate (NMDA) receptor subtype).

As a result of clinical studies and animal experiments, a number of additional mechanisms have also been identified that contribute to the nootropic activity of neurometabolic stimulants. Nootropics have membrane-stabilizing (regulation of the synthesis of phospholipids and proteins in nerve cells, stabilization and normalization of the structure of cell membranes), antioxidant (inhibition of the formation of free radicals and lipid peroxidation of cell membranes), antihypoxic (reducing the oxygen demand of neurons under hypoxic conditions) and neuroprotective effects ( increasing the resistance of nerve cells to the effects of unfavorable factors of various origins). A significant role is played by improving microcirculation in the brain by optimizing the passage of red blood cells through the microvasculature and inhibiting platelet aggregation.

The result of the complex effect of nootropic drugs is an improvement in the bioelectrical activity and integrative activity of the brain, which is manifested by characteristic changes in electrophysiological patterns (facilitation of the passage of information between the hemispheres, an increase in the level of wakefulness, an increase in the absolute and relative power of the EEG spectrum of the cortex and hippocampus, an increase in the dominant peak). Increased cortico-subcortical control, improved information exchange in the brain, a positive effect on the formation and reproduction of a memory trace lead to improved memory, perception, attention, thinking, increased learning ability, and activation of intellectual functions. The ability to improve cognitive functions has given rise to the designation of nootropic drugs as “cognitive stimulants.”

In the spectrum of pharmacological activity of nootropics (neurometabolic stimulants), the following main effects are distinguished:

1. Nootropic effect (impact on impaired higher cortical functions, level of judgment and critical capabilities, improvement of cortical control of subcortical activity, thinking, attention, speech).

2. Mnemotropic effect (effect on memory, learning ability).

3. Increasing the level of wakefulness, clarity of consciousness (impact on the state of depressed and darkened consciousness).

4. Adaptogenic effect (increasing the body’s overall resistance to extreme factors).

5. Antiasthenic effect (reducing the severity of weakness, lethargy, exhaustion, mental and physical asthenia).

6. Psychostimulating effect (influence on apathy, hypobulia, spontaneity, poverty of motives, mental inertia, psychomotor retardation).

7. Antidepressant effect.

8. Sedative/tranquilizing effect, reducing irritability and emotional excitability.

In addition, nootropics affect the autonomic nervous system and help correct disorders in parkinsonism and epilepsy.

Of the above pharmacodynamic properties, some are common to all nootropic drugs, others are inherent only in some of them.

The stimulating effect of nootropics on mental activity is not accompanied by speech and motor excitation, depletion of the body's functional capabilities, or the development of addiction and addiction. However, in some cases they can cause restlessness and sleep disturbances. The positive properties of nootropics are their low toxicity, good compatibility with drugs from other pharmacological groups and the virtual absence of side effects and complications. It should be noted that the effects of this group develop gradually (usually after several weeks of use), which makes it necessary to prescribe them for a long time.

Initially, nootropics were used primarily to treat brain dysfunction in elderly patients with organic brain syndrome. In recent years, they have become widely used in various fields of medicine, including geriatric, obstetric and pediatric practice, neurology, psychiatry and addiction medicine.

Nootropic drugs are used for dementia of various origins (vascular, senile, Alzheimer's disease), chronic cerebrovascular insufficiency, psychoorganic syndrome, the consequences of cerebrovascular accidents, traumatic brain injury, intoxication, neuroinfection, intellectual-mnestic disorders (impaired memory, concentration, thinking ), asthenic, asthenic-depressive and depressive syndrome, neurotic and neurosis-like disorder, vegetative-vascular dystonia, chronic alcoholism (encephalopathy, psychoorganic syndrome, abstinence), to improve mental performance. In pediatric practice, indications for prescribing nootropics include delayed mental and speech development, mental retardation, consequences of perinatal damage to the central nervous system, cerebral palsy, attention deficit disorder. In acute conditions in the neurological clinic (acute ischemic stroke, traumatic brain injury), the effectiveness of piracetam, choline alfoscerate, glycine, and Cerebrolysin has been shown. Some nootropics are used to correct neuroleptic syndrome (deanol aceglumate, pyritinol, pantogam, hopantenic acid), stuttering (Phenibut, pantogam), hyperkinesis (Phenibut, hopantenic acid, memantine), urinary disorders (nicotinoyl-GABA, pantogam), sleep disorders (glycine , Phenibut, calcium gamma-hydroxybutyrate), migraines (nicotinoyl-GABA, pyritinol, Semax), dizziness (piracetam, Phenibut, ginkgo biloba), for the prevention of motion sickness (Phenibut, GABA). In ophthalmology (as part of complex therapy), nicotinoyl-GABA is used (open-angle glaucoma, vascular diseases of the retina and macula), ginkgo biloba (senile macular degeneration, diabetic retinopathy).

The last decade of the 20th century was marked by a high pace of research activity related to the search and study of the mechanism of action of new and existing nootropic drugs. The search for a basic hypothesis of the action of nootropics that can integrate already known aspects of the mechanism of action of nootropics and determine their future fate is still ongoing. It is urgent to search for new drugs that would have greater pharmacological activity and would have a selective effect on the integrative functions of the brain, correcting the patient’s psychopathological state, his mental activity and orientation in everyday life.

Drugs

Drugs - 3563 ; Trade names - 148 ; Active ingredients - 26

Active ingredient	Trade names
No information available

Nootropic drugs - what are these medications? 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 of use.

General information

Nootropic drugs - what are they? Such medicines 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 literally mean “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: N06ВХ.

History of origin

In 1963, 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 mid-20th century, it increased mental performance and did not have any side effects.

In 1972, one of the creators of this medication proposed the term “nootropic” to denote groups of drugs that improve intellectual memory, learning and attention, and also affect transcallosal potential, have antihypoxic activity and do not have a negative effect on the body.

Unlike well-known psychostimulants, nootropic drugs 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.

Newest nootropics

Currently, more than 10 original nootropic drugs 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 such drugs one can highlight “Oxiracetam”, “Nefiracetam”, “Etiracetam”, “Aniracetam”, “Rolziracetam”, “Izacetam”, “Pramiracetam”, “Cebracetam”, “Dupracetam”, “Detiracetam”, etc. The presented medications have generic name "Racetams".

In addition to all others, other families of nootropic drugs have been synthesized, including GABAergic, cholinergic, glutamatergic and peptidergic systems. It should also be noted that the nootropic active component is also present in other medications that have different chemical origins.

Operating principle

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

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

Features of the 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).

It has long been proven that nootropics are capable of activating adenylate cyclase and increasing its concentration in the neuron. In addition, increased levels of cyclic adenosine monophosphate lead, through changes in the flow of intracellular Ca2+ and K+ ions, to rapid release of the transmitter 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 maintained mode.

Nootropic drugs for the elderly and children are extremely necessary to increase their creative activity and restore delayed intellectual development. Manufacturers of such stimulants claim that their medications improve the metabolism of nucleic acids, activate the synthesis of protein, ATP and RNA, penetrate well through the BBB, and also increase the rate of glucose utilization.

Properties of nootropics

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 have other types of effects, including:

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

Other drug options

Nootropic drugs 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 the dominant peak, easier passage of information between the hemispheres of the brain, increased relative and absolute power of the EEG spectrum of the hippocampus and cortex).

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

By the way, many manufacturing companies claim that such tools can significantly improve and accelerate cognitive skills (or However, these statements have never been scientifically confirmed.

Effects

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

Are nootropic drugs effective for stroke prevention?

We figured out what kind of medicines these are. 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 subject to doubt. 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 are not sold in pharmacies without prescriptions from attending physicians. This is explained by the fact that they belong to the same drug group as strong psychostimulants.

Initially, the medications presented were used to treat brain disorders in elderly people with organic brain syndrome. Although in the last 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 products presented are especially common in pediatrics. Thus, nootropic drugs are prescribed to children for:

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

Other indications for use

The best nootropic drug is the one 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 (“Phenibut”, “Calcium gamma-hydroxybutyrate”, “Glycine”);
• migraines (“Pyritinol”, “Nicotinoyl-GABA”, “Semax”);
• dizziness (Ginkgo biloba, Phenibut, Piracetam);
• for the prevention of motion sickness (GABA, Phenibut).

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

Natural nootropics

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

Disclaimer: Dear friends! The article is for informational purposes only. You need to understand that most of the drugs that will be described are prescription drugs. This article does not encourage you to use something yourself, much less self-medicate. The article is intended to increase your awareness, including when communicating with your doctors. Only doctors can prescribe treatment for you, prescribe the correct dosage for you, and determine the absence of direct and relative contraindications. This is very important because... self-medication is unacceptable - it, as a rule, often leads to undesirable consequences. While reading this article, do not forget this!

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

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

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

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

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

So, what are nootropics?

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

Let's look at common myths about nootropic drugs.

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

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

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

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

Myth 3. Nootropics, even with one-time use, give a strong, pronounced effect.

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

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

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

Now comes the fun part - the practical part.

We will look at several of the most “infamous” drugs. It just so happens that all the most widely advertised drugs in this review are in fact “dummies”. Patients and “suffering” drink them literally by the handful, but do not notice any positive effect. Why? Let's get started.

Glycine.

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

Glycine is absolutely ineffective as a “sedative” agent. It is also ineffective as a nootropic and in any other pharmacological aspect.

A natural question arises - why?

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

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

To understand what the catch is, let’s give a clear example: Chicken egg white contains about 12% protein. Protein consists of amino acids, of which pure glycine is an average of 0.45 grams.

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

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

Piracetam.

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

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

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

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

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

Afobazol.

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

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

This drug does not have a single international study behind it that proves its effectiveness. Those studies that took place in Russia do not have a design that would correspond to the level of evidence-based medicine (small sample of patients, no multicenter studies, no independent commissioners of the study). Moreover, all research conducted was financed exclusively by the manufacturer, which is unacceptable. because the result will always be “twisted” in the right direction - in the direction requested by the person who orders it.

Moreover, the substance fabomotizol (the active substance of afobazole) is not used anywhere except Russia and the CIS countries. No organization in any country in the world has ever been interested in it, even to study its potential mechanisms of action.

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

After releasing it into production and losing the patent for the Afobazol trademark, the manufacturing company decided to find out how it works. A radioligand study was ordered in France (from the company CEREP) so that they would try to find what the drug actually interacts with in the body, and directly in the central nervous system.

The data obtained were as follows: this drug is eliminated after administration in 40 minutes, and does not interact with anything in “therapeutic” dosages. Those. This is a substance that simply “passes by” in the body.

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

At the time of writing this article, there is not a single study in the international pubmed database that not only speaks about its effectiveness - there are simply none at all.

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

Aminalon (GABA).

This amino acid is the main “inhibitory neurotransmitter” in the central nervous system.

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

However, it's not that simple.

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

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

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

The thing is that in some patients this same blood-brain barrier is broken - and GABA in some quantities from the blood plasma still penetrates into the central nervous system and can already “fulfill its duties.”

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

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

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

But we are talking now about GABA.

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

Now let's move on to considering nootropic drugs that have a certain clinical effect. We will look at several drugs, discuss their clinical effectiveness in terms of nootropic activity, their safety, and some interesting facts.

Phonuracetam (phenotropil).

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

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

The first, most important and “noticeable” effect is stimulating. This effect is instantaneous - i.e. it is detected immediately, even after a single use. You should know that this effect does not apply to a true nootropic, it is, so to speak, a “bonus”.

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

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

Now let's talk about safety.

Since this drug has a stimulating and anti-apathetic effect, then, accordingly, this drug can cause “psychological addiction”. Therefore, it is important to strictly follow the dosages prescribed by your doctor throughout the entire course of use. The drug is relatively safe, but should not be abused under any circumstances.

I would especially like to note the following. For unknown reasons, this drug, although produced by a single company (Valenta), is of extremely low quality - completely unexpected things occur from batch to batch - some patients note that after opening (roughly speaking) the second pack they purchased, the effect is no longer felt. This is not an isolated case; these claims against the company are so voluminous that you can easily read about it on the Internet by typing “phenotropil Valenta” in the search bar. Keep this in mind.

A small theoretical digression.

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

Scientists have thought about how to “pass” a substance through the BBB by changing the amino acid molecule (today we are looking at gamma-aminobutyric acid (GABA)). The result was two drugs, which we will consider below.

Picamilon.

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

What are its main clinical effects?

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

The combination of these properties leads to a nootropic effect.

It is worth understanding that despite the properties described above, the drug is not a panacea. All these properties are expressed moderately, and the notorious “wow effect” should not be expected.

The drug is ineffective when used once, its course use is recommended. It is relatively safe.

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

Phenibut.

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

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

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

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

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

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

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

The drug has proven effectiveness (although there are no studies that strictly meet all the criteria for DM).

There are several companies producing phenibut, but don’t worry - the quality is quite good and comparable among all the companies that produce it.

The next format of the article will be slightly different - in it you will see a summary table of all the drugs you sent, and their classification according to different criteria. I tried to make the table as easy to read as possible, compact and informative.

I basically prescribed all the medications - so don’t be surprised if you see something unusual among the substances.

I tried to cover the complete list of drugs you offered me.

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

1. Level of evidence (Level DB):

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

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

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

D: have information about effectiveness within one or more “case-reports” (individual cases of successful application).

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

2. Degree of effectiveness in terms of nootropic activity:

+++: highly effective.

++: has moderate effectiveness.

+: has low efficiency, but it is present.

O: Not effective.

-: there is a slight deterioration.

--: there is a moderate deterioration.

---: There is significant deterioration.

m.d.: there is little information, or the drug is being studied.

3. Group.

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

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

4. Security.

For the convenience of “reading” this line, I divided the drugs (conditionally) into four categories and gave them color codes:

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

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

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

Red - the drug is unsafe. Its use as a nootropic drug is highly not recommended.

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