What does a nootropic drug mean? The best nootropic drugs for the elderly. List of nootropics with proven effectiveness for children and adults. Review of drugs, cost

The majority of the population of our planet, especially residents of large cities, are forced to live in conditions of constant environmental and psycho-emotional stress. It has been proven that stress is not harmless to the human body, it is a risk factor for many, and also has a negative effect on the nervous system, as a result of which a person becomes irritable, his performance decreases, his memory and thinking processes deteriorate. In this regard, scientists are continuously searching for ways to prevent and correct the negative effects of stress on the nervous system. About 50 years ago, the concept of nootropic drugs arose, Piracetam was synthesized and tested. This gave a powerful impetus to the search and creation of other substances with a similar principle of action; these studies continue to this day.

From this article, the reader will get an idea of what nootropics are and what effects they have, get acquainted with the indications, contraindications, side effects of these drugs in general, and also learn the characteristics of individual representatives of drugs in this group, in particular new generation nootropics. Let's begin.

What are nootropics

According to the definition of the World Health Organization, nootropic drugs are drugs that have an activating effect on learning, improve mental activity and memory, and increase the resistance (stability) of the brain to such aggressive influences as injury, intoxication, and hypoxia.

The first nootropic in history is Piracetam, which was synthesized and used clinically by Belgian pharmacologists back in 1963. During the study, scientists found that this medicinal substance significantly increases mental performance, improves memory and promotes learning. Subsequently, other drugs with similar effects were synthesized, which we will discuss below.

Effects and mechanisms of action of nootropic drugs

The main effects of drugs in this group are:

psychostimulant;
sedative;
anti-asthenic (reducing feelings of weakness, lethargy, mental and physical asthenia);
antidepressant;
antiepileptic;
actually nootropic (impact on impaired higher cortical functions, which is manifested by improved thinking, speech, attention, and so on);
mnemotropic (effect on learning and memory);
adaptogenic (increasing the body’s ability to resist harmful environmental influences);
vasovegetative (improved blood supply to the brain, which is manifested by a decrease and, as well as the elimination of other autonomic disorders);
antidiskinetic;
increasing clarity of consciousness and level of wakefulness.

These drugs do not cause pharmacological dependence and psychomotor agitation; taking them does not deplete the physical capabilities of the body.

The action of drugs in this group is based on the following processes:

activation of plastic processes in the central nervous system by enhancing the synthesis of proteins and RNA;
activation of energy processes in neurons;
activation of the processes of transmission of nerve impulses in the central nervous system;
optimization of polysaccharide utilization processes, in particular glucose;
inhibition of the formation of free radicals in cells;
decreased oxygen demand of nerve cells under hypoxic conditions;
membrane-stabilizing effect (regulate the synthesis of proteins and phospholipids in nerve cells, stabilize the structure of cell membranes).

Nootropic drugs activate the enzyme adenylate cyclase, increasing its concentration in nerve cells. This substance is necessary to maintain the stability of the cell’s production of the main source of energy for biochemical and physiological processes - adenosine triphosphoric acid, or ATP, which, moreover, under hypoxic conditions, transfers metabolism in the brain to an optimally maintained mode.

In addition, nootropics affect the neurotransmitter systems of the brain, in particular:

monoaminergic (increase the content of dopamine and norepinephrine, as well as serotonin in the brain);
cholinergic (increase the content of acetylcholine in nerve endings, necessary for adequate transmission of impulses from cell to cell);
glutamatergic (also improve signal transmission from neuron to neuron).

As a result of all the effects described above, the patient’s memory, attention, mental processes and perception processes improve, his ability to learn increases, and intellectual functions are activated.

Classification of nootropics

The class of nootropic drugs includes substances of various pharmacological groups that have a positive effect on the functioning of nerve cells and improve their structure.

Substances that stimulate metabolic processes in nerve cells:

pyrrolidone derivatives: Piracetam, Pramiracetam, Phenylpiracetam and others;
derivatives of gamma-aminobutyric acid (GABA): Aminalon, Picamilon, Hopanthenic acid, Phenibut;
pantothenic acid derivatives: Pantogam;
derivatives of vitamin B6 - pyridoxine: Pyritinol;
products containing dimethylaminoethanol: Acefen, Centrophenoxin;
preparations containing neuroaminoxylates and peptides: Glycine, Cerebrolysin, Actovegin;
antihypoxants: Oxymethylethylpyridine succinate;
vitamins, vitamin-like, general tonic substances: vitamin B15, vitamin E, folic acid, succinic acid, ginseng extract and others.

Drugs that have a positive effect on blood vessels, or vasotropic drugs:

Xanthinol nicotinate;
Vinpocetine;
Pentoxifylline;
Cinnarizine;
Instenon.

Drugs that stimulate memory and learning processes:

cholinomimetics and anticholinesterases: Galantamine, Choline, Amiridin and others;
hormones: Corticotropin, adrenocorticotropic hormone;
endorphins, enkephalins.

Indications for the use of nootropics

Medicines of the nootropic class are used to treat the following diseases:

of various nature (vascular, senile);
chronic cerebral vascular insufficiency;
consequences of cerebrovascular accident;
neuroinfections;
intoxication;
psychoorganic syndrome with symptoms of memory impairment, decreased concentration and general activity;
cortical myoclonus;
dizziness, with the exception of dizziness of vasomotor and mental origin;
chronic alcoholism (for the purpose of treating encephalopathy, withdrawal and psychoorganic syndromes);
reduced mental performance;
astheno-depressive, depressive, astheno-neurotic syndromes;
neurosis-like disorders;
traumatic brain injury;
hyperkinesis;
sleep disorders;
migraine;
in the complex treatment of open-angle glaucoma, retinal vascular diseases, diabetic retinopathy, as well as age-related macular degeneration.

In pediatric practice, nootropics are used to treat the following conditions:

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

Contraindications to taking nootropics

Medicines in this group should not be taken in the following cases:

in case of individual hypersensitivity of the patient’s body to the active substance or other components of the drug;
in case of an acute period of hemorrhagic stroke (bleeding in brain tissue);
with Gettington's chorea;
in case of severe renal impairment (if creatinine clearance is less than 20 ml/min);
during pregnancy and lactation.

Side effects of nootropics

Medicines in this group rarely cause any side effects, however, some patients may experience the following undesirable reactions while taking them:

headache, irritability, anxiety, sleep disturbances, drowsiness;
rarely, in elderly patients, increased symptoms of coronary insufficiency;
nausea, stomach discomfort, or;
increased psychopathological symptoms;

Brief description of drugs

Since there are actually quite a lot of medicines belonging to the class of drugs we are describing, we will not be able to consider all of them, but we will only talk about those that are most widely used in medical practice today.

Piracetam (Piracetam, Lucetam, Biotropil, Nootropil)

Available in the form of tablets for oral administration and solution for injections and infusions.

The drug has a positive effect on blood circulation and metabolic processes in the brain, resulting in increased resistance of brain tissue to hypoxia and the effects of toxic substances, as well as improved memory, integrative brain activity, and increased learning ability.

When taken orally, it is well absorbed from the gastrointestinal tract, the maximum concentration in the blood is determined after 1 hour. Penetrates into many organs and tissues, including through the blood-brain and placental barriers. The half-life is 4 hours. Excreted by the kidneys.

Routes of drug administration: orally or parenterally (intramuscular or intravenous). It is recommended to take the tablets before meals. The dosage and duration of treatment are determined individually, depending on the disease and the characteristics of its clinical course.

When treating patients suffering from, caution should be exercised and the dose adjusted depending on the level of creatinine clearance.

Side effects of the drug are standard, and they usually occur in elderly and senile patients, provided they receive a dosage of more than 2.4 g of piracetam per day.

It has an effect on platelet aggregation, therefore it is used with caution in persons suffering from hemostasis disorders and a tendency to hemorrhage.

Contraindicated during pregnancy and lactation.

If sleep disturbances develop while taking piracetam, you should stop taking it in the evening and add this dose to the daytime dose.

Pramiracetam (Pramistar)

Chemical formula of Pramiracetam

Release form: tablets.

Has a high degree of affinity for choline. Improves learning ability, memory and mental performance in general. Does not have a sedative effect and does not affect the autonomic nervous system.

Absorbed from the gastrointestinal tract quickly and almost completely, the maximum concentration of the active substance in the blood is determined after 2-3 hours. The half-life is 4-6 hours. Excreted by the kidneys.

During pregnancy and lactation, taking Pramistar is contraindicated.

When treating patients with impaired renal function, you should carefully monitor the development of side effects of the drug in them - this will be a sign of an excess of the active substance in the body and require a dose reduction.

Vinpocetine (Cavinton, Neurovin, Vinpocetine, Vicebrol)

Available in the form of tablets and solution for infusion.

Improves microcirculation in the brain, increases cerebral blood flow, and does not cause the “steal” phenomenon.

When taken orally, it is absorbed by 70% of the digestive tract. The maximum concentration in the blood is determined after 60 minutes. The half-life is almost 5 hours.

It is used both in neurology (for chronic cerebrovascular accidents and other diseases described in the general part of the article), and in ophthalmology (for the treatment of chronic retinal vascular diseases) and in otiatrics (to restore hearing acuity).

If therapy is started in the acute period of the disease, vinpocetine should be administered parenterally, and then continued orally at a dose of 1-2 tablets three times a day after meals.

Phenibut (Bifren, Noofen, Noobut, Phenibut)

Release form: tablets, capsules, powder for the preparation of oral solution.

The dominant effects of this drug are antihypoxic and antiamnestic. The drug improves memory, increases mental and physical performance, and stimulates learning processes. In addition, it eliminates anxiety, fear, psycho-emotional stress, and improves sleep. Strengthens and prolongs the effect of sleeping pills, anticonvulsants and antipsychotics. Reduces manifestations of asthenia.

After oral administration, it is well absorbed and penetrates into all organs and tissues of the body, in particular through the blood-brain barrier.

It is used for decreased emotional and intellectual activity, concentration, memory impairment, asthenic, anxiety-neurotic and neurosis-like conditions, insomnia, Meniere's disease, as well as for the prevention of motion sickness. In the complex treatment of preliriious and delirious alcoholic conditions, osteochondrosis of the cervicothoracic spine, menopausal disorders.

It is recommended to take 250-500 mg orally, before meals, three times a day. The maximum daily dose is 2.5 g, the maximum single dose is 750 mg. Duration of therapy is from 4 to 6 weeks.
In different clinical situations, the dosage regimen may vary.

It has an irritating effect, so it is used with caution in people suffering.

Hopanthenic acid (Pantogam)

Available in tablet form.

Reduces motor excitability, normalizes behavioral reactions, increases performance, and activates mental activity.

Rapidly absorbed from the gastrointestinal tract. The maximum concentration of the active substance in the blood is determined 60 minutes after administration. Creates high concentrations in the kidneys, liver, stomach wall and skin. Penetrates the blood-brain barrier. It is eliminated from the body after 2 days.

Indications are standard.

Take the drug orally, half an hour after eating. A single dose for adults is 250-1000 mg. Daily dose – 1.5-3 g. Course of treatment – 1-6 months. After 3-6 months you can repeat the course. When treating different diseases, the dose of the drug may vary.

Contraindications and side effects are described above.

Pyritinol (Encephabol)

Available in the form of tablets and suspension for oral use (this dosage form is intended for children).

It has a pronounced neuroprotective effect, stabilizes neuronal membranes, reduces the number of free radicals, and reduces red blood cell aggregation. Positively affects behavioral and cognitive functions.

If the drug dosage regimen is followed, the development of side effects is unlikely.

Glycine (Glycine, Glycised)

Release form: tablets.

Improves metabolism in muscles and brain tissue. Has a sedative effect.

Use sublingually (dissolving under the tongue).

To treat depression, anxiety and irritability, take glycine 0.1 g 2-4 times a day. For chronic alcoholism, it is prescribed according to recommended treatment regimens.

Contraindications: hypersensitivity to glycine. Side effects are not described.

Cerebrolysin

Release form: solution for injection.

Improves the function of nerve cells, stimulates their differentiation processes, activates protection and recovery mechanisms.

Penetrates the blood-brain barrier.

It is used for metabolic, organic and neurodegenerative diseases of the brain, in particular, and is also used in the complex treatment of strokes and traumatic brain injuries.

Daily doses of the drug vary widely depending on the pathology and range from 5 to 50 ml. Routes of administration: intramuscular and intravenous.

Use with caution to treat patients with allergic diathesis.

Actovegin

Release form: tablets, solution for injections and infusions.

Contains exclusively physiological substances. Increases the brain's resistance to hypoxia and accelerates the processes of glucose utilization.

It is used for ischemic and residual effects of hemorrhagic stroke, traumatic brain injury. Widely used for the treatment of diabetic polyneuropathy, burns, peripheral circulatory disorders, as well as for trophic disorders in order to accelerate wound healing processes.

As a rule, it is well tolerated. In some cases, the reactions described at the beginning of the article develop.

Approved for use during pregnancy and lactation.

Contraindicated in case of individual hypersensitivity to the components of the drug.

Contains sucrose, so it is not used in patients with hereditary disorders of carbohydrate metabolism.

Hexobendine (Instenon)

Available in the form of tablets for oral administration and solution for intramuscular and intravenous administration.

It has a stimulating effect on metabolic processes in the brain and myocardium, improves cerebral and coronary circulation. Antispasmodic.

Indications for the use of this drug are diseases of the brain of an age-related and vascular nature, the consequences of insufficient blood supply to the brain, dizziness.

Contraindicated in case of individual sensitivity to the components of the drug, increased intracranial pressure, epileptiform syndromes. During pregnancy and lactation it is used exclusively according to indications.

It is recommended to take orally during or after meals, without chewing, with plenty of water. The dosage is 1-2 tablets three times a day. The maximum daily dose is 5 tablets. The duration of treatment is at least 6 weeks.

The injection solution is administered intramuscularly, slowly intravenously or by drip. The dosage depends on the characteristics of the clinical course of the disease.

During treatment with this drug, you should not drink tea and coffee in large quantities. If the drug is administered intravenously, only a slow infusion is allowed, and the intravenous injection should last at least 3 minutes. Rapid administration of the drug can lead to a sharp decrease in blood pressure.

Combination drugs

There are many drugs that contain 2 or more components that are similar in action or mutually enhance the effects of each other. The main ones are:

Gamalate B6 (contains pyridoxine hydrochloride, GABA, gamma-amino-beta-hydroxybutyric acid, magnesium glutamate hydrobromide; prescribed for adults in the complex treatment of functional asthenia; recommended to take 2 tablets 2-3 times a day for 2-18 months);
Neuro-norm (contains piracetam and cinnarizine; indications are standard for nootropics; dosage – 1 capsule three times a day for 1-3 months; take the tablet after meals, do not chew, drink plenty of water);
Noozom, Omaron, Fezam, Cinatropil, Evriza: drugs similar in chemical composition and other indicators to Neuro-norm;
Olatropil (contains GABA and piracetam; recommended for use before meals, 1 capsule 3-4, maximum 6 times a day for 1-2 months; if necessary, the course can be repeated after 1.5-2 months);
Thiocetam (includes piracetam and thiotriazoline; it is recommended to take 1-2 tablets three times a day; the course of treatment is up to 30 days; in some cases it is used in the form of an injection solution: 20-30 ml of the drug is administered intravenously in 100- 150 ml of saline solution or 5 ml intramuscularly once a day for 2 weeks).

So, above you got acquainted with the most popular nootropic drugs today. Some of them are the first drugs of this class, but many were developed much later and are much more effective, so they can safely be called new generation nootropics. Please note that the information provided in the article is not a guide to action: if you experience any unpleasant symptoms, you should not self-medicate, but rather seek help from a specialist.

Nootropic drugs include a large group of psychotropic drugs that help a person get rid of numerous effects on his nervous system. The newest nootropics are devoid of many of the dangerous side effects that were characteristic of the first generations of medicines, and are considered completely safe.

Modern nootropic drugs (neurometabolic stimulants) or simply nootropics are a large group of medicinal substances that have such an effect on the brain when its mental functions improve. As a result, the action of these drugs activates the thinking and memory ability (cognitive functions), increases the brain's resistance to the influence of negative exogenous factors - lack of oxygen, polluted atmosphere, toxins, stress and emotional overload, traumatic effects. In other words, they have an important ability to reduce neurological deficits.

The main principle of action of nootropics is based on their active participation in the metabolism and biological energetics of neurons, and is also carried out by influencing the mediators of neuroprocesses in the brain. In particular, they increase the level of adenylate cyclase in nerve cells and accelerate the production of ATP, which significantly affects cellular energy. The effect on the production of RNA and some proteins leads to the acceleration of plastic processes in the nervous system.

As a result of a series of metabolic transformations, serotonin is released, which is a catalyst for intracellular potassium and calcium ions. Adenosine triphosphoric acid helps maintain the speed of metabolic processes during oxygen deficiency, which reduces the risk of oxygen starvation. Finally, nootropics optimize glucose utilization.

The best nootropic drugs can have the following effects:

Stabilization of membranes by normalizing phospholipid and protein synthesis, as well as streamlining the structure of membrane cells.
Antioxidant capacity resulting from inhibition of free radical formation and lipid oxidation.
The antihypoxic effect is due to a decrease in oxygen consumption.
Neuroprotection is characterized by an increase in the resistance of neurons to the action of aggressive exogenous factors.
Improving blood microcirculation by improving the penetration of red blood cells through the vascular walls and blocking platelet production.
Improvement of electrophysiological patterns, which provides easier transmission of signals between the hemispheres, increased level of wakefulness and EEG power of the cerebral cortex and hippocampus. This ultimately leads to optimization of integrative brain function.
Optimization of control of cortico-subcortical processes, information exchange between parts of the brain, and the formation of a memorable imprint. These effects provide improved attentiveness, mental reaction, memory, perception of information, and contribute to increased intelligence and cognitive functions.

When are nootropics prescribed?

Neotropic drugs were developed to treat brain dysfunction and were intended primarily for older people. The development of pharmacology in this direction has made it possible to significantly expand the abilities of nootropics, which makes it possible to use them in various branches of medicine (neurology, psychiatry, pediatrics, surgery, gynecology, etc.).

Dementia of various types, incl. for Alzheimer's disease, vascular and senile pathologies.
Cerebrovascular pathologies of a chronic nature.
Syndrome of psychoorganic damage.
Post-traumatic syndrome caused by poor circulation as a result of damage to the skull.
Severe intoxication.
Diseases caused by the penetration of neuroinfections.
Deviations of intellectual-mnestic, asthenic, depressive nature.
Neurotic type disorders.
Dystonia of the vegetative-vascular system.
Chronic alcoholism and associated pathologies such as encephalopathy, abstinence.
Mental retardation.

A child, like an adult, in some cases needs psychotropic therapy. Nootropic drugs for children are remembered in pediatrics for amino acid deficiency, leading to a deterioration in protein synthesis and, in general, disruption of metabolic processes. The reasons for prescribing such drugs are the following circumstances: a significant lag in the mental and speech development of the child; noticeable deviation in mental development; signs of congenital, perinatal disorders of the nervous system; cerebral paralysis; pronounced signs of attention deficit disorder.

New generation neotropics also cope well with some other diseases that are affected by processes occurring in the brain. According to the decision of a specialist, nootropic drugs can be used in the following conditions:

Elimination of manifestations of neuroleptic syndrome. Hopanthenic acid, Pantogam and other drugs can be used.
Treatment of stuttering and hyperkinesis. The drug Phenibut is effective.
For disorders of the urinary organs, Pantogam can be prescribed.
Glycine helps fight chronic insomnia.
For migraines, Pyritinol or Semax are recommended.
Such an unpleasant phenomenon as motion sickness and seasickness can be treated with Phenibut.
Complex therapy of ophthalmological problems often includes the use of Nicotinoil.

When problems might arise

Nootropics also have contraindications in circumstances where their use can cause negative consequences. They should not be taken if you are hypersensitive to the main active substance or any additional ingredient of the drug; pronounced course of renal failure, both in acute and chronic forms; at the acute stage of a hemorrhagic stroke; congenital Gettington's chorea associated with degenerative lesions of the central nervous system. Only in exceptional cases is it possible to prescribe drugs to pregnant women and nursing mothers. With extreme caution, nootropics are given to young children and only after reaching 1 year of age.

New nootropic drugs are quite easily tolerated by patients. However, individual reactions are possible in the form of such side effects - the appearance of an incomprehensible anxious feeling; temporary insomnia at night and craving for sleep during the day; irritability; blood pressure surges; dyspeptic disorders; allergic reactions of various types. Elderly people rarely experience cardiac problems, in particular heart failure, when taking nootropics.

What medications are there?

The list of nootropic drugs includes many drugs, divided into groups that differ in chemical composition, focus, and mechanism of action. The following main categories are distinguished.

Stimulators of metabolic processes in neurons:

Based on gamma-aminobutyric acid (GABA). The main representatives are Phenibut, Picamilon and Aminalon. An analogue is hopantenic acid.
Compounds based on pyrrolidone (racetams). The most common drugs are Piracetam and Phenylpiracetam. Derivatives such as Aniracetam, Oxiracetam and Pramiracetam may be prescribed.
Pantothenic acid derivatives – Pantogam.
When using the active substance dimethylaminoethanol, Acefen and Centrophenoxin are produced. Drugs such as Phenotropil and Meclofenoxate have gained popularity.
Preparations containing amino acids and peptides. The most famous are Glycine, Actovegin, Biotredin and Cerebrolysin. Popular neuropeptides are Noopept, Semax, Selank. Polypeptides include Cortexin, Cerebramin.

Drugs to reduce the effects of hypoxia. The best remedy is Hydroxymethylethylpyridine succinate.

Nootropics with the effect of vitamin-like substances or adaptogens. These include products based on folic and succinic acid, vitamins E and B15, and ginseng root. Idebenone stands out in this category.

Drugs to normalize the condition of blood vessels (vasotropes). They help get rid of cerebral problems. Stand out - Instenon, Cinnarizine. Vinpocetine may be prescribed.

Memory improvement is achieved by using nootropics from the following subgroups:

cholinomimetic and anticholesterase drugs – Amiridin and Choline;
hormonal-type drugs - Corticotropin, ACTH, as well as a number of drugs related to endorphins and enkephalins.

A significant difference in the effectiveness of nootropics is revealed when considering such a feature as the time of their development. Older or first-generation drugs continue to be used, but they have an increased risk of side effects. These drugs are mainly derivatives of Piracetam - most are racetams.

Most popular drugs

Currently, depending on the type of psychogenic deviation, first and second generation nootropics are used, as well as drugs from the latest developments. You can make an indicative list of the most popular nootropic drugs:

Piracetam or similar products (Lucetam, Nootropil). The form of administration to the body is oral tablets, intramuscular injections and intravenous droppers. The most characteristic effects are the normalization of metabolic processes and blood circulation. Considering that Piracetam belongs to the first generation of drugs, one can expect side effects such as an increase in platelet levels, leading to a deterioration in blood clotting.
Pramiracetam is available in tablet form. Although it is an older development, it has high cognitive properties, which helps improve memory. Has sedative abilities. Can be used for a long course of therapy. The drug should not be taken if you have kidney failure.
Cavinton. Analogs are Neurovin and Vinpocetine. In addition to neuralgia, this drug is recommended for some ophthalmological pathologies and hearing problems. The course of treatment is quite long – 2-7 months. During the acute phase of the disease, it is administered by injection, and as the disease weakens, a transition to tablets is made.
Phenibut. You can use its analogues - Bifren and Noobut. Release form: tablets, powder for injection solutions, capsules. This nootropic is effective for increasing mental response and physical performance, relieving stress, getting rid of anxious feelings and phobias, and improving sleep quality. Prescribed for hypoxia. Useful when traveling by water, because... eliminates the influence of pitching. The course of treatment lasts 30-40 days. The drug should not be taken simultaneously with sedatives and sleeping pills.
Hopantenic acid (often sold under the name Pantogam). Recommended to reduce motor excitability. A positive effect is detected within 25-30 days after the start of administration, but the full course can last 5-6 months.
Glycine. Best known as an anti-stress drug. Helps relieve excessive excitability and irritability. It has a pronounced sedative effect and also helps normalize metabolism in the body.
Cerebrolysin. It is used for serious damage to the central nervous system, incl. useful for Alzheimer's disease. It is most often administered by injection, and is most widely used in the treatment of post-traumatic syndrome and the consequences of stroke.
Encephabol. It can be prescribed to both adults and children, while in the latter case a suspension with additives that improve taste is used. The drug is a strong neuroprotector and antioxidant with high cognitive abilities.

Latest generation drugs

Pharmacology around the world is taking active measures to improve nootropics, resulting in more effective and safe drugs. The following nootropic drugs have gained popularity:

Phezam - used to normalize blood supply to the brain, improve protein metabolism and energy. It has vasodilating properties.
Phenylpiracetam – necessary during the period after stroke rehabilitation. Often used to improve memory, concentration, and to eliminate convulsive phenomena.
Noopept is especially effective for normalizing cognitive brain functions, eliminating anxiety and phobias, and for chronic headaches of a neurogenic nature.
Selank – helps relieve stress and eliminate anxiety. It increases mental reaction, fights apathy and gloomy mood.

Nootropics also find a worthy place in child psychiatry and pediatrics. For babies, these drugs are available in the form of granules for making syrup or in the form of ready-made syrup. The most common use is for cerebral and encephalopathic disorders, as well as for significant retardation in intellectual development and lack of memory. For children, we can recommend stimulant drugs such as Picamilon and Cogitum, as well as drugs with a sedative effect - Cortexin and Phenibut.

City people do not have time to take care of their health. The fast pace of life forces us to work exhaustingly and to rest with rare opportunities. Vitamins, which are considered a panacea, do not actually help to adapt to the high demands of the metropolis.

A person often needs help in resisting stress factors, accelerating brain activity and maintaining psycho-emotional balance. In this case, drugs from the group of nootropics become indispensable and help to avoid negative consequences due to nervous tension.

What are nootropics

Nootropics are a group of drugs that have a positive effect on brain activity and cognitive function. Due to their ability to improve metabolic processes in nervous tissue, these drugs enhance higher integrative activity and also increase mental abilities.

The human body physiologically produces special substances called neurotransmitters. Their role is to ensure the occurrence of chemical reactions that are necessary for the proper functioning of organs. Such connections exist in the brain. They are involved in the transmission of nerve impulses, and when they are deficient, various disorders occur. Medicines from the group of nootropics are similar in chemical structure to some neurotransmitters, and therefore are able to perform the same functions, eliminating their deficiency in pathological conditions.

The nervous system and brain work at an accelerated pace if a person is under stress, anxiety or under conditions of increased psychological stress. In this case, there is a higher need for certain chemicals and the activation of additional capabilities of the body. Nootropic drugs can help cope with unfavorable factors and strengthen the protective properties of cells.

The mechanism of action is to increase the utilization of glucose, which leads to increased energy production and full functioning of cells. Nootropics affect the biosynthesis of proteins and nucleic acids, which improves tissue structure and also accelerates the regeneration process.

An important pharmacological effect is antioxidant - by eliminating free radicals, medications in this group stabilize cell membranes and increase resistance to adverse factors. Proper nutrition of nervous tissue leads to restoration of cell structure and function. After using nootropics, hypoxia conditions are better tolerated, blood circulation and metabolic processes are normalized.

The advantage of drugs in this group is the absence of toxicity and dangerous side effects. Nootropics are used in conditions of existing stress, as well as in preparation for it (for example, during exams or reports), as a protective agent for brain cells.

However, despite the results of treatment and wide experience of use, some doctors believe that nootropic drugs are drugs with unproven effectiveness. Research into this group of drugs continues, since the possibilities of their use and the need for such medications are quite large.

Indications for use

The list of conditions for which nootropic drugs are effective is as follows:

Decreased mental or physical performance.
Neuroinfection.
Deterioration of memory or attention.
Ischemic stroke.
Exposure to toxic substances.
Senile dementia.
Cerebral circulation disorders.
Post-traumatic period.
Encephalopathy.
Withdrawal syndrome, including alcohol.

Encouraging treatment results for brain tissue damage of various origins are explained by the wide range of pharmacological effects of this group of drugs:

Improvement of metabolic processes of the cortical layer, a positive effect on human judgment, speech, thinking.
Getting rid of depression or fatigue.
The antiasthenic effect is manifested by the elimination of lethargy, physical and psychological weakness.
The adaptogenic effect is to enhance protective properties and increase resistance to adverse factors.
Increased learning ability, improved memory.
Reduced irritability and emotional excitability.

The instructions for use of most nootropic drugs allow them to be sold over-the-counter from pharmacies. During a stressful period or mental exhaustion, everyone can take them independently according to the regimen specified by the manufacturer.

Contraindications

For a healthy person, nootropic drugs are safe. But people with diseases need to be careful, since the group of drugs in question has contraindications:

Hemorrhagic stroke.
Individual intolerance to a drug component.
Hereditary degenerative diseases of the central nervous system.
Kidney failure.
Pregnancy period.
Arterial hypotension.

Before starting treatment, you should study the instructions for the specific product that the doctor prescribed to the patient.

Which drug to buy

Considering that most of the drugs in the group of psychostimulants and nootropics are sold without a prescription, there is a need to understand the differences and selection criteria:

If the drug is selected without the help of a doctor, the patient should first read the contents of the instructions. The decision is made on the active substance, indications, dosage regimen or specified restrictions.
After this, the patient must decide which form of the drug is suitable in a particular situation. For example, it is more convenient for children to give the drug in liquid form, so many manufacturers offer syrups or nootropic powders. Capsules or tablets are suitable for adult patients.
Based on one active ingredient, pharmacies may offer several trade names. To make a final decision, you need to pay attention to the price, dosage regimen and manufacturing company.

Despite the over-the-counter availability, self-medication is still not recommended. Before starting to take any medication, it is better to consult a doctor or consult with a pharmacist.

Nootropics: list of drugs

Below is a list of drugs from the group of nootropics that have earned positive reviews from patients and the trust of doctors.

The main active ingredient is a synthetic analogue of the natural neurotransmitter - gamma-aminobutyric acid. The drug affects inhibition processes in the brain and also regulates the metabolism of the central nervous system. Acts as an antioxidant and antitoxic agent.

Glycine can improve mood, increase mental activity, reduce negative vegetative-vascular manifestations, protect cells from the toxic effect of alcohol or the adverse effects of stress.

The medicine has a high safety profile, rarely causes adverse reactions and is approved for use in children from three years of age. It is a cheap and effective remedy that every patient can buy at a pharmacy without a prescription.

Piracetam

The main component is a derivative of gamma-aminobutyric acid, which is produced by the human body. This nootropic improves the cognitive functions of the brain. For the patient, this is manifested by increased concentration, better memory and high learning ability.

Positive effects are achieved by reducing pathological excitation in the brain, increasing the metabolism of nerve cells, and normalizing microcirculation. The drug is produced in the form of capsules and tablets and is used only for the treatment of adults.

Available in several dosages. The main active ingredient is piracetam. The pharmacological action is similar to the two previously described medications. Not for use in children. Patients often choose this drug due to its Belgian quality.

A drug with nootropic properties, however, belongs to a group of drugs intended for the treatment of alcohol dependence. Contains two active components - vitamin pyridoxine and threonine. The second of them regulates tissue metabolism processes (cells are quickly restored, and the patient’s craving for alcohol decreases).

The first active ingredient (vitamin) also performs important functions: it stimulates redox reactions, respiration and energy metabolism of cells. The medication is prescribed for the treatment of alcoholism, as well as for the relief of withdrawal symptoms. In the second case, it is better to take the tablet under the tongue, then the positive effect will occur within 20 minutes.

Available in capsule form. It is a combination product based on cinnarizine and piracetam. Individually, they exhibit nootropic properties and improve brain microcirculation, and when combined, they enhance each other’s effects.

The therapeutic effect begins within an hour after the start of administration, however, to achieve a stable result, doctors prescribe the drug in a course. In addition to its effect on nerve cells, Combitropil has a positive effect on the rheological properties of blood. It protects red blood cells from destruction, reduces viscosity and improves blood flow.

Nootropic based on a synthetic derivative of gamma-aminobutyric acid. Its composition differs from other drugs in this group, but it exhibits similar pharmacological effects. In addition to psycho-emotional disorders, it is also prescribed in the complex treatment of migraines, autism, alcoholism and even urological diseases. Effective for depression and other conditions that are accompanied by anxiety. Approved for use from three years of age. In most cases, it is well tolerated and does not cause side effects.

A unique nootropic, which is available in the form of nasal drops. Contains a mixture of amino acids necessary for the treatment of brain lesions. Prescribed in the post-traumatic period, during neurosurgical operations, neurotic disorders. It has a good positive effect when used under conditions of stress or psycho-emotional overload. In addition to increasing the adaptive properties of the nervous system, the drug has found application in ophthalmology (neuritis) and pediatrics (autism). The instructions for using the drops are described in detail.

The medicine has a positive effect on the nervous system. Indications for use are very wide - from traumatic brain injuries to functional disorders and withdrawal syndrome. Due to the parenteral form of release, it is often prescribed for acute conditions (intoxication, inflammatory processes, cerebrovascular accidents).

Latest generation nootropics

Use for children

Recently, pediatric neurologists have begun to prescribe nootropics more often. Doctors in various fields of medicine, especially pediatricians, do not always agree with such decisions and doubt the validity of such prescriptions.

There are direct indications for which nootropics of any generation should be used in childhood. In practice, it often happens that drugs are prescribed for other reasons. For example, a child’s hyperactivity, delay in speech or first steps do not always indicate a developmental disorder. Due to the high safety profile of nootropics, some doctors still prefer to prescribe these drugs, which does not comply with the instructions and official treatment protocols.

When medications are truly necessary, the choice of active substance and specific dosage is made by the doctor. Drugs that are approved for use in children have an additional release form, for example, syrup or powder. Diagnoses for which nootropics are indicated for childhood:

Encephalopathy.
Cerebrostenia.
Consequences of neuroinfection.
Mental retardation.
Speech delay.

Drugs that are approved for use in pediatrics:

Glycine. It contains a substance that is synthesized by the body naturally, which is why the drug is very popular. It extremely rarely causes adverse reactions. Despite the data in the instructions, it is prescribed by some doctors even to small children with adjustment of the daily dose.
Pantogam. In the pharmaceutical market it is known as a children's nootropic. Available in syrup form for children and tablets for older patients. Effectively eliminates symptoms caused by autonomic disorders.
Cogitum. Available in ampoules. It is a safe and non-toxic product.
Picamilon. Used from the age of three for asthenic conditions and mental retardation.

The list of drugs is constantly expanding, and pharmaceutical companies are successfully working to create new products that are of high quality, effectiveness and safety.

Doctor's report

Nootropics have a wide range of applications. The pharmacological properties of representatives of this group are indispensable for traumatic brain injuries and functional disorders caused by cerebrovascular pathologies. In addition, drugs are prescribed to children with developmental delays, adults during periods of severe psycho-emotional stress, and elderly people to improve the functioning of the nervous system.

Nootropics exhibit good compatibility with drugs from other groups and rarely cause side effects. Adults can safely take them along with a multivitamin 1 or 2 times a year to maintain a healthy body.

Imagine the situation: there is an important task ahead that requires maximum concentration of mental abilities, and your brain, as luck would have it, refuses to work. Thoughts are in the clouds, your head seems wobbly, and your memory seems “full of holes.” But there is a whole group of drugs that improve cognitive function!

Norm and pathology

First of all, it would be good to determine the cause of the violations. Memory deterioration, decreased mental performance, as well as headaches and noise in the head may be the first signs of serious diseases associated with impaired blood flow in the brain.

As a rule, this occurs when vasoconstriction occurs against the background of arterial hypertension or atherosclerosis. Both of these conditions progress without proper treatment and often lead to serious consequences such as stroke or heart attack.

In addition, mental decline may be associated with a disease such as Alzheimer's disease. Therefore, at the first alarming signs, it is better to consult a doctor and figure out what is happening in the body. If the examination confirms the pathology, the person needs long-term and serious treatment.

However, fortunately, memory impairment can also be completely harmless. After all, we often work at a high pace, sparing no effort, and stress, physical and mental overstrain make themselves felt by natural fatigue. And what kind of intellectual success can we talk about if an exhausted body directs all its efforts to ensure at least the uninterrupted operation of vital systems? This is where you can pay attention to nootropics.

"Smart" pills

The word “nootropic” was first proposed by the Romanian physiologist and chemist Cornelius Ghirge in 1972. He combined it from two Greek components: noos - mind and tropos - direction. The main goal of nootropics is to improve cognitive function.

For decades, debates have continued in world psychiatry and neurology about the advisability of using drugs in this group by healthy people. The reasons for this are the possible side effects of drugs along with unproven effectiveness. However, in 2015, global sales of this group’s products exceeded $1 billion, and demand for them is constantly growing.

According to the instructions for use, nootropics are able to accelerate the transmission of impulses between the hemispheres of the brain, normalize metabolic processes and enhance microcirculation. It is also said that nootropic drugs improve mental performance, learning and memory, and in addition increase the brain's resistance to damaging factors, such as high stress or lack of oxygen.

Today, nootropics of different classes are used in domestic practice, including:

racetams, of which Piracetam is a prominent representative;
derivatives of gamma-aminobutyric acid (Phenibut);
herbal preparations such as ginkgo biloba extract;
amino acids (Glycine);
substances from other groups with a nootropic effect, including correctors of cerebral circulatory disorders (Vinpocetine, Cinnarizine) and general tonics (ginseng extract, melatonin).

Let's look at the features of each group.

Briefly about the properties

Each representative of nootropics can be given a separate article, but we will try to describe them briefly and to the point.

Piracetam. He owns the laurels of primacy: piracetam became the first “drug that improves cognitive function.” It is produced under various trade names (Lucetam, Nootropil, Piracetam) in various forms of release (solution for intramuscular and intravenous injections, tablets, capsules) and is used for various conditions and diseases accompanied by intellectual disabilities.

It should be noted that piracetam is not used in the USA. The FDA defines drugs in the United States as drugs that are intended to diagnose, treat, treat, or prevent disease. Food supplements should include vitamins, minerals, amino acids, and plant compounds. Piracetam, alas, does not satisfy either the first or the second requirement, and therefore, according to American laws, it cannot be either a drug or a dietary supplement. But in European countries it is used, although some experts, including domestic ones, are extremely skeptical about its evidence base. Piracetam is even included in the well-known list of placebo drugs, presented by the Chairman of the Formulary Committee of the Russian Academy of Medical Sciences, Professor Vorobyov.

Gamma-aminobutyric acid (GABA) derivatives. Drugs in this series include Aminalon, Picamilon, Phenibut, etc. Phenibut, along with improving mental performance, eliminates tension, irritability and improves sleep. True, again in the West, unlike the CIS countries, funds from this group are not used as nootropics. In addition, Picamilon and Phenibut were included in Professor Vorobyov’s list mentioned above.

Ginkgo biloba extract. According to the instructions for use, it has a combined nootropic and antihypoxic effect, improves blood circulation in the brain, thereby helping to improve cognitive functions and improve memory. It is sold both in the form of medicines (Bilobil, Tanakan, Memoplant) and as part of dietary supplements. How dietary supplements are used in the West. However, clinical studies have not confirmed the beneficial effects of ginkgo biloba on intellectual performance and memory in healthy people.

Glycine. This amino acid regulates metabolic processes in the nervous system, normalizes excitation and inhibition, and at the same time has a very high safety profile. Therefore, over-the-counter Glycine is often used for various disorders of the psycho-emotional state: irritability, insomnia, and decreased mental performance, including in children. In the USA, Glycine is used as a dietary supplement, and in some European countries, for example Poland, Italy, it is part of combined analgesic drugs (Alka-Prim). As an independent nootropic, it is used mainly in the post-Soviet space.

Normalizing cerebral circulation. Representatives of this group act by improving blood supply to the brain. For example, Vinpocetine is a synthetic analogue of an alkaloid isolated from Vinca minor. The drug was created by Hungarian pharmacologists and is used mainly in Eastern European countries. Studies by the Cochrane Collaboration have not confirmed the beneficial effects of Vinpocetine on mental performance.

Another popular drug of this subgroup is Cinnarizine, in the West it is used mostly for seasickness, since it relieves nausea and vomiting in vestibular disorders, and in the post-Soviet space it is often prescribed as an affordable nootropic.

Ginseng extract. Supposedly, ginseng extract improves mental and physical performance by stimulating the central nervous system. However, this herbal preparation did not defend its nootropic properties in clinical studies. According to the Cochrane Collaboration, there is no convincing evidence that ginseng extract helps improve mental performance.

To the rhetorical question “to take or not to take medications to improve memory,” everyone may have their own answer. And there is a truth of its own: one, unsightly, among scientists, and a completely different, optimistic one, among consumers. Despite the depressing research data, many patients readily take nootropics and feel improvement with treatment. Moreover, most of the products in this group are well tolerated, and some, such as ginkgo biloba extract and glycine, are even sold without a doctor’s prescription.

However, relying on the achievements of pharmacology, it would be good to help the body, which reacts to difficult working conditions and lack of normal rest with a deterioration in mental abilities. Give yourself a temporary break, switch to other activities, go to the pool or gym. And perhaps you will soon see how deep your intellectual capabilities are even without any drug support.

Marina Pozdeeva

Photo istockphoto.com

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).

Thanks 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.