Ceraxon, 10 pcs., 10 ml, 100 mg/ml, oral solution

Nervous system protection

Brain damage during a stroke, deterioration of memory and thinking due to diseases of the nervous system and old age reduce the quality of life and its duration. The situation is complicated by the prevalence of disorders of the blood supply to the brain - strokes are steadily taking their place among the leading causes of death. You can help the brain recover by providing it with building materials for cell membranes and mediators, as well as by protecting cells from oxidative processes and working to improve blood circulation. Good results are shown by drugs with precursors of substances needed by the central nervous system. While Cerakson and Recognan contain the same active ingredient, Cereton is more different from its group neighbors, but acts in a similar way.

Comparison of addiction between Ceraxon and Cereton

Like safety, addiction also involves many factors that must be considered when evaluating a drug.

So, the totality of the values ​​of such parameters as “o syndrome” in Tserakson is quite similar to the similar values ​​in Tsereton. Withdrawal syndrome is a pathological condition that occurs after the cessation of intake of addictive or dependent substances into the body. And resistance is understood as initial immunity to a drug; in this it differs from addiction, when immunity to a drug develops over a certain period of time. The presence of resistance can only be stated if an attempt has been made to increase the dose of the drug to the maximum possible. At the same time, in Tserakson the meaning of the “syndrome” is quite small, however, the same as in Tsereton.

Mechanisms of action of drugs

Citicoline is the active ingredient of Recognan and Ceraxon. In the body, it is involved in the synthesis of cell membrane components called phospholipids: this means that the administration of citicoline helps neurons - the cells of the nervous tissue - recover faster. Additionally, the drug inhibits the work of phospholipases responsible for the destruction of membrane components, prevents the formation of free radicals and interferes with the process of programmed cell death - apoptosis.

The conduction of nerve impulses also improves: citicoline helps synthesize acetylcholine, which is a transmitter and transmits excitation from one neuron to another. The complex effect reduces the area affected by a stroke, helps already damaged areas recover, and helps the patient recover.

The substance has a beneficial effect on memory, level of consciousness, attention, and helps in the treatment of movement disorders.

Citicoline is well absorbed and enters the brain both when administered orally and in the form of injections.

Cereton works due to choline alfoscerate. Breaking down into choline and glycerophosphate, the substance becomes materials for the synthesis of acetylcholine and phosphotidylcholine in cell membranes, and thanks to metabolic protection, choline is released in the brain. Neurons recover faster, are protected from damage, receptors work better, and blood flow and metabolism become more efficient.

Purpose of nootropics

Due to their composition, all three drugs are suitable for treating lesions of the nervous system. In the acute period of a stroke, nootropic drugs help keep the nervous tissue alive until the blood supply is normalized, and in case of disturbances in the thought process, they restore a person’s activity, reducing his dependence on the help of others. Common indications for all drugs include:

• ischemic stroke in the acute period - nootropics are given with other medications;
• recovery after stroke;

• traumatic brain injury;
• disorders of behavior, memory, attention: including in diseases of the brain.

For the treatment of older people, drugs are prescribed in the case of senile dementia—decreased memory, level of thinking, and speech. They try not to give such drugs to children: the necessary studies have not been carried out, so taking medications is limited until the age of 18. The same applies to pregnant women: nootropics are prescribed to women only for serious indications, and nursing mothers are advised to wean their child off the breast during treatment. In animal experiments, however, drugs based on citicoline have proven their safety.

Impact

Cereton, the instructions for use indicate this, has a pronounced cholinomimetic effect. The drug promotes the release of choline in the brain. It is an important nutrient that improves cognitive performance and helps restore brain structures after severe damage.

When taking the drug, blood flow improves and metabolic processes accelerate, which minimizes the risks of developing various pathologies, including those associated with age. Cereton also normalizes brain activity and improves behavioral reactions in the presence of vascular diseases.

Contraindications and side effects

Ceraxon, Recognan and Cereton are relatively safe drugs. The products of their transformations in the body do not differ from those obtained by humans naturally. Citicoline is absorbed almost completely and is little excreted into the external environment, and an overdose has not been identified. Excessive intake of Cereton may cause nausea.

When treated with Cerakson or Recognan, it is better for patients to avoid driving or complex activities: the medicine may affect the reaction.

Hypersensitivity to the components of the medications may force you to interrupt treatment. Ceraxon and Recognan in the form of an oral solution are not prescribed for fructose intolerance, or in any form - in case of vagotonia.

Cereton should not be taken in case of acute hemorrhagic stroke - an outpouring of blood into the brain without injury.

There are fewer adverse reactions indicated for Cereton: they are associated with manifestations of allergies or nausea, which can be eliminated by reducing the dose. Citicoline-based drugs can also cause fever, tremors, headache or dizziness, diarrhea, sleep and appetite disturbances, hallucinations, changes in blood pressure and increased parasympathetic nervous system tone. All types of undesirable effects on the body are extremely rare, and usually the treatment goes smoothly.

Comparison of the effectiveness of Ceraxon and Cereton

Ceraxon is more effective than Cereton - this means that the ability of the medicinal substance to provide the maximum possible effect is different.
For example, if the therapeutic effect of Ceraxon is more pronounced, then with Cereton it is impossible to achieve this effect even in large doses.

Also, the speed of therapy is an indicator of the speed of the therapeutic action; Ceraxon and Cereton are also different, as is bioavailability - the amount of a drug substance reaching the place of its action in the body. The higher the bioavailability, the less it will be lost during absorption and use by the body.

Differences between Recognan and Cerakson

Due to the same active ingredient, Recognan and Ceraxon do not differ in purpose, contraindications and expected effects. The difference between them lies in the features of production. Ceraxon is an original drug, the effectiveness of which has been proven in extensive research, and the mechanism of action and distribution have been studied in detail.

Recognan is one of the generics, for the release of which you only need to prove the similarity to the original medicine.

Generics are cheaper because less research has been done on them.

Recognan may be inferior to Ceraxon in effectiveness. One of the reasons is the formation of isomers by citicoline, the molecules of which have the same composition, but different spatial structures. Different manufacturers have their own synthesis, and therefore generics may include isomers whose activity and safety are inferior to those of Ceraxon.

Both drugs are available in the form of oral solutions with strawberry flavor, as well as in ampoules for intravenous and intramuscular administration. The excipients in the first form of Ceraxon and Recognan are somewhat different, which may affect the effectiveness. The dosages are the same for both: with a solution with a concentration of 100 mg/ml you can buy a bottle or sachet, and 4 ml of the ampoule contents contain 500 or 1000 mg of the active substance.

Comparison of side effects of Ceraxon and Cereton

Side effects or adverse events are any adverse medical event that occurs in a subject after administration of a drug.

Ceraxon's state of adverse events is almost the same as Cereton's. They both have few side effects. This implies that the frequency of their occurrence is low, that is, the indicator of how many cases of an undesirable effect of treatment are possible and registered is low. The undesirable effect on the body, the strength of influence and the toxic effect of Cerakson are similar to Cereton: how quickly the body recovers after taking it and whether it recovers at all.

Courses of treatment with drugs containing citicoline

The solution for oral administration from a bottle of Ceraxon or Recognan is dosed with a syringe from the kit, and when choosing a product in bags, just open it and drink the already measured portion. If desired, the medicine is dissolved in half a glass of water. Drink it between meals or at the same time as them. The solution can be used even if preservative crystals appear at the bottom of the bottle: they disappear if stored correctly and do not affect the quality.

Both drugs should be used immediately after opening the ampoules. It is best to administer the medicine intravenously, slowly or using a drip. If citicoline is prescribed intramuscularly, try not to place the injections in the same place. Dosages depend on the diagnosis.

• Acute period of stroke and trauma - 1000 mg every 12 hours for 6 weeks. They start with injections, after 3-5 days you can switch to a solution.
• Recovery period, illness with impaired memory and thinking - 500-2000 mg of medication per day. The duration of treatment and forms of administration are individual.

1000 mg of medicine is contained in 10 ml of solution from a bottle or 1 sachet. The daily dose of such drugs is taken immediately or divided into two doses. Safety makes it possible not to recalculate the dosage for elderly patients, and according to the standards, Ceraxon and Recognan are identical.

Ceraxon is also available as 500 mg tablets. They are given 1-4 pieces per day. It is difficult to find medicine in this form on sale: solutions are much more popular.

Features of taking Cereton

Cereton is a generic version of the original drug called Gliatilin. Both drugs are sold as solutions for intramuscular and intravenous administration of 250 mg/ml (or 1000 mg per 4 ml for Gliatilin). The original drug can also be purchased in the form of an oral solution, with a 7 ml bottle containing 600 mg of the substance. These drugs are distinguished from drugs with citicoline by the ability to be treated with capsules with a dosage of 400 mg.

Inside Cereton capsules there is a clear oily liquid.

Cereton in the form of injections is prescribed once a day, depending on the diagnosis. During recovery from strokes and injuries, patients are prescribed 2 capsules in the morning and 1 in the afternoon, and the course of treatment is six months.

For dementia and symptoms of circulatory disorders in the brain - cerebrovascular insufficiency - drink 1 capsule three times a day for 3 to 6 months. Cereton capsules should be taken after meals. The generic may still be inferior in quality to Gliatilin, but its effectiveness has been proven in treating patients, and the price is lower.

One of the main directions for reducing mortality and disability in patients with cerebral stroke is the earliest possible start of therapeutic measures with combined reperfusion and cytoprotective therapy [1, 2]. Cytoprotective therapy, including that started at the prehospital stage, allows one to expand the boundaries of the “therapeutic window”, preserve the viability of perifocal brain tissue and improve the outcome of the disease [3]. An important requirement for cytoprotective drugs is the possibility of their use regardless of the nature of the stroke. Increasing attention is being paid to cytoprotectors of multimodal action, which have the properties of antioxidants, antihypoxants, and compensate for the deficiency of neurotransmitters and certain elements of cell membranes [2, 4, 5].

In older people, changes in the pharmacodynamics and pharmacokinetics of drugs are observed [6, 7]. Thus, it has been shown that the sensitivity of target organs to the action of some antihypertensive drugs [8] and drug receptors in the brain [9] changes with age, and therefore an important requirement for cytoprotective drugs is also their effectiveness in older age groups .

The membranes of neurons and glial cells, the structure of which includes phospholipids, are one of the structures obligately damaged during cerebral stroke. Under ischemic conditions, under the influence of phospholipases, the structural components of membranes and, in particular, phosphatidylcholine decompose with the formation of free fatty acids and free radicals, which activates lipid peroxidation, oxidative stress and promotes the uncoupling of oxidative phosphorylation in mitochondria [10]. The synthesis and restoration of phospholipids in the cell membranes of neurons and glial cells occurs due to exogenous choline precursors. One of these precursors is citicoline (nucleotidecytidine-5-diphosphocholine), which is naturally found in all cells of the body. Experimental data indicate that citicoline enhances the synthesis of phosphatidylcholine in cell membranes, helps restore the level of other phospholipids, as well as the activity of glutathione and glutathione reductase [11, 12]. Experimental studies have shown that citicholine can reduce glutamate release at the initial stages of the ischemic cascade [13] and modulate the synthesis of acetylcholine, dopamine and norepinephrine in the brain [14]. The combined use of thrombolytic therapy and citicoline in experimental ischemic stroke can improve its functional outcome [15]. During the recovery period of a stroke, citicoline stimulates the formation of new connections between neurons, including in neurons of layer V of the cortex of the motor areas of the brain [16]. In animals that were administered citicoline in the subacute period of stroke, restoration of the structure of motor neurons and motor functions was more pronounced.

In clinical settings, the effectiveness of citicoline has been studied in cases of traumatic brain injury, acute and chronic cerebrovascular insufficiency, and cognitive impairment. In individuals with the initial stages of chronic cerebral ischemia, it has been shown that long-term use of the drug can stabilize and, in some cases, improve cognitive functions [17, 18]. In patients with acute cerebrovascular accidents (ACVA), the use of citicoline, starting from the first hours of the disease, promotes a more rapid reduction of neurological deficit and more complete functional recovery [4, 19, 20]. In clinical settings, as well as in experiments, the dose-dependent effect of the drug and the relationship between the time of initiation of therapy and the degree of functional recovery have been established [21, 22].

The purpose of the study was to study the effectiveness of intravenous administration of citicoline (trade name - Ceraxon) in patients with moderate ischemic stroke, taking into account gender, age and time of initiation of therapy.

Material and methods

141 patients, 65 men and 76 women, with ischemic stroke of hemispheric localization were examined. The average age of the examined patients was 62.7±12.3 years, the group of women turned out to be significantly older than men - 64.5±11.5 and 61.0±12.8 years, respectively ( p

=0,002).

The diagnosis of stroke was confirmed by CT or MRI of the brain.

All subjects were divided into 2 groups: the main group (89 people), in which the treatment regimen for ischemic stroke included citicoline (ceraxon), and the comparison group (52 patients), in which this drug was not prescribed. In the main group, depending on the time of initiation of Ceraxon therapy, 3 subgroups were divided: 1st subgroup (16 people) consisted of patients in whom Ceraxon treatment was started in the first 12 hours of the disease; 2nd (14) - patients in whom the drug was prescribed within 12-24 hours after the onset of stroke; the third group (59) included patients in whom the drug was prescribed 24 hours after the onset of the first symptoms of stroke. The comparison group was based on retrospectively analyzed medical records of patients who were hospitalized for ischemic stroke and received the same treatment as in the main group, with the exception of citicoline. The selected groups were comparable to each other in terms of demographic and clinical indicators, initial severity of disorders of consciousness and neurological symptoms, and concomitant diseases.

Patients with epileptic seizures at the onset of the disease or with indications of previously existing epileptic seizures were excluded from the study; in the presence of concomitant organic brain damage (traumatic brain injury, tumors); with systolic blood pressure (BP) above 190 or below 90 mmHg; with acute myocardial infarction, liver or kidney failure, cancer; pregnant women; taking direct or indirect anticoagulants.

Citicoline was prescribed according to the following regimen: in the first 7 days - 1000 mg intravenously - 4 solutions, then 1000 mg orally for 2 weeks.

Upon admission, all patients were hospitalized in the intensive care unit, where the functions of vital organs were corrected. The criteria for transfer to the general department were: restoration of consciousness to a clear level, stabilization of breathing, cardiovascular activity, blood pressure and other vital functions.

The clinical examination included a general somatic and neurological examination with assessment using special scales: the severity of neurological symptoms based on the Scandinavian Stroke Scale (SSI) - before the drug was prescribed, then - on the 1st, 7th and 21st days of the disease; the degree of functional independence and daily activity based on the Barthel index and the modified Rankin scale - upon discharge from the hospital on days 21-24 of the disease. Laboratory and instrumental examination included general and biochemical blood tests over time, monitoring of blood pressure, ECG, acid-base status and water-electrolyte balance. If indicated, ultrasound, radiological, electrophysiological and other types of examinations were performed.

Statistical analysis of the obtained data was carried out using the SPSS 6.0 software package using parametric and nonparametric methods. Comparisons were made between the main group and the comparison group in different age categories, as well as within the main group between subgroups with different times of starting treatment with Ceraxon. Differences were considered significant at p

<0,05.

Results and discussion

In the main group, no deterioration of the condition was noted during therapy with the inclusion of Ceraxon. None of the patients had any side effects that required discontinuation of the drug.

In the main group, 9 (9.5%) patients died, in the comparison group - 4 (8.1%), i.e. administration of Ceraxon had no effect on mortality. The causes of unfavorable outcome in both groups were pneumonia, acute coronary insufficiency and pulmonary embolism. When studying the relationship between the time of initiation of therapy with Ceraxon and mortality, it was found that in the subgroup in which treatment with the drug was started on the 1st day, mortality was slightly lower than in the subgroup in which treatment was started later than 24 hours from the development of the disease (7 .4 and 11.5%, respectively), but these differences were not significant. The lack of effect of Ceraxon (including when administered in larger daily doses) on mortality in ischemic stroke was also noted in previous studies [21].

When analyzing the results of treatment on the 3rd and 7th days of the disease, it was found that in the main group and in the comparison group there were positive dynamics in the form of restoration of orientation, normalization of the level of consciousness and a decrease in focal symptoms. At the same time, in the main group, orientation and level of consciousness were restored faster: by the 3rd day of the disease, the transition from the state of orientation in one or two signs to full orientation was recorded in 90.1% of cases, while in the comparison group - in 74.5% (χ2=4.94, p

=0.026, odds ratio OR=3.12, 95% confidence interval CI=1.12-8.77). The faster restoration of orientation in the main group could be due to the fact that the administration of exogenous citicoline is accompanied by an increase in the content of norepinephrine and dopamine in different parts of the brain, including the reticular formation [14], which has an awakening effect. In the main group, a more rapid improvement in speech functions was also noted, which, on the one hand, could be associated with a more complete restoration of the level of consciousness and orientation in these patients, and on the other, with stimulation of acetylcholine synthesis [23] and, as a result, the influence on the processes plasticity in the brain with improved concentration, attention and memory [24].

Analysis of the dynamics of the neurological deficit on the 7th day of the disease did not reveal any significant differences between the groups: the sum of the SHS scores was 41.1±10.3 in the main group and 39.1±10.4 in the comparison group. However, by day 21, patients in the main group had significantly ( p

=0.017) higher sum of points on the SSI than patients in the comparison group: 49.2±10.4 and 44.7±9.8 points, respectively.
When studying the dynamics of neurological disorders in individual components of the SSI, it was found that in the main group, in relation to the comparison group, the most complete restoration of movements in the leg was observed (the increase in the sum of points from the 1st to the 21st day was 1.4 ± 0.8 and 1.0±0.6, respectively, p
=0.036) and walking (increase in total points - 4.5±1.8 and 3.4±1.6, respectively,
p
=0.002). The decrease in motor disorders under the influence of citicoline could be associated not only with the effect of the drug on the size of the lesion, which was previously shown in a study by S. Warach et al. [22], but also with its selective effect on the metabolism of the motor areas of the cerebral cortex [25] and on the structure of pyramidal neurons of the V layer of the cortex [16]. Experimental studies show that the inclusion of citicoline in the diet over a long period of time is accompanied by increased growth and increased branching of dendrites of pyramidal cells, mainly in layer V [26]. In addition to its direct effect on the structure of neurons, citicoline also stimulates the differentiation and growth of glial tissue [27], which may have an additional trophic effect on neurons and promote more complete recovery.

An important factor influencing the nature and activity of recovery processes in the brain, as well as the pharmacodynamics of drugs, is age [7, 28, 29]. In the examined patients in both groups, there was a significant relationship between the severity of regression of neurological symptoms according to the SSI, functional recovery and age ( r

>-0.27,
p
<0.021). Less complete recovery was observed in older age groups. The most effective use of Ceraxon was in those under 70 years of age, which in these patients was expressed in a higher score on the SSI on the 7th and 21st days of the disease, as well as in the Barthel index at discharge from the hospital (Table 1).

The results of the assessment on the modified Rankin scale on the day of discharge from the hospital also showed that under the age of 70 years there were significantly more patients who were able to fully perform daily duties or had minimal impairments (see Table 1).
At the age of over 70 years, the effectiveness of Ceraxon decreased, but the trend towards better recovery in the group receiving Ceraxon remained. The effectiveness of cytoprotective therapy is largely influenced by the time elapsed from the onset of the disease to its administration [30]. A previous study [22] noted that the administration of citicoline in the first 12 hours of ischemic stroke was accompanied by significantly better recovery of the neurological deficit according to the NIHSS stroke scale and a more significant reduction in the size of the lesion than when the drug was administered at a later stage of the disease. The present study also established a significant ( r

>0.21,
p
<0.026) relationship between the time of initiation of therapy and the dynamics of normalization of orientation, consciousness and focal neurological disorders.
In the subgroup of patients in whom the drug was prescribed in the first 12 hours, by the 3rd day of the disease, orientation disturbances persisted in only 1 patient, while in the subgroup in which the drug was prescribed 24 hours later - in 6 observations (χ2= 4.94, p
=0.026, OR=3.12, 95% CI=1.12-8.77).
The differences in the dynamics of orientation restoration were especially significant when comparing patients in whom treatment was started in the first 12 hours of the disease with the comparison group (χ2 = 7.05, p
= 0.008, OR = 4.58, 95% CI = 1.05- 18.31).
Moreover, in the subgroup of patients to whom the drug was prescribed 24 hours later, in relation to the comparison group, only a tendency towards better recovery was revealed. When analyzing the severity of neurological disorders based on the SSI, it was found that neurological symptoms regressed more quickly and completely in the subgroup in which the drug was prescribed on the 1st day. In this subgroup, the total score for the SSI was 49.3 ± 9.7 ( p
= 0.029 relative to the comparison group), while in the subgroup in which the drug was prescribed 24 hours after the development of the disease, the total score was 47. 1±10.9 (differences with the comparison group are not significant).

Analysis of the increase in the sum of points according to the SSI showed that differences in the dynamics of this indicator began to appear from the 2nd week of the disease (Table 2).

In the interval from 7 to 21 days, in the subgroup in which Ceraxon was prescribed on the 1st day of the disease, the increase in the amount of points was significantly greater than in the subgroup in which Ceraxon was prescribed 24 hours later and in the comparison group . The better outcome with early administration of Ceraxon could be due to its effect on the state of the penumbra. In most cases, the viability of perifocal ischemic tissue is maintained during the first hours after the onset of stroke, so the earliest possible start of cytoprotection is the most effective [3, 30]. In the present study, the lack of significant improvement observed in 5 patients from the subgroup in which treatment with Ceraxon was started at an early stage of the disease could be due to the initially low severity or absence of the penumbra [30]. Subsequent studies of the effectiveness of cytoprotective drugs, in particular citicoline, in the first hours of ischemic stroke with the study of the functional state of the penumbra will allow us to propose more clear criteria for prescribing cytoprotectors.

Analysis of the degree of self-care according to the Barthel index on the day of discharge showed that the value of this indicator was greater in patients receiving Ceraxon (89.9±18.5 and 82.3±18.7 points, respectively, p

=0.039). In the main group there were more patients with a score of more than 90, corresponding to almost complete recovery of daily activities.

activity (χ2=11.7, p

=0.006, OR=4.01, 95% CI=1.73-9.37).
In the comparison group there were more patients with unsatisfactory recovery, i.e. with a total score ≤60 (χ2=7.43, p
=0.013, OR=3.48, 95% CI=1.37-8.95). Previously, in a study by A. Davalos et al. [21] also noted a more complete recovery of self-care according to the Barthel index in patients receiving citicoline. At the same time, studying the individual components of this scale makes it possible to more accurately assess the possibilities of daily activity and determine the need for outside care for the patient [31]. In the present study, the analysis of such components made it possible to establish that in the main group, the most complete restoration of functions compared to the comparison group was noted in the sections “personal hygiene”, “dressing”, “eating”, “walking”, “transition from a chair to a bed” , “independent use of the toilet” and “climbing stairs” (Table 3), i.e. Prescription of the drug was accompanied by a decrease in dependence on others in these aspects of daily activity.

When studying the functional outcome according to the modified Rankin scale, differences were also established between the main group and the comparison group. In the main group there were significantly more patients who were able to fully perform daily duties or had minimal impairments and significantly fewer patients who were completely dependent on others (Table 4).

Thus, the present study demonstrated the effectiveness of citicoline (ceraxone) in patients with ischemic stroke. As in previous studies [21, 22], the study noted a positive relationship between the time of initiation of cytoprotective therapy and the degree of reduction of neurological symptoms and restoration of functional activity. Citicoline has shown effectiveness in normalizing orientation and speech disorders, as well as restoring motor functions, in particular the ability to walk independently, which is the basis for self-care and reducing dependence on others in daily activities. The administration of citicoline was accompanied by positive dynamics in all age groups, at the same time, the drug was more effective in patients under the age of 70 years. In the present study, citicoline was administered parenterally and orally throughout the hospital stay, and better functional outcomes compared with previous studies using a similar dose of the drug [21] may have been associated with intravenous administration of the drug from the first hours of stroke.

Analogues and substitutes

Recognan and Cereton are not the only generics designed to replace expensive original drugs. Analogs with citicoline also include Neupilept, one of the domestic substitutes in the form of solutions for intravenous and intramuscular administration, as well as oral administration. The concentration of the solution in ampoules is 125 and 250 mg/ml, for oral administration - 100 mg/ml. It is used similarly to Cerakson, the price corresponds to generics.

Among the substitutes for Cereton, one can highlight Cerepro: solution and capsules with choline alfoscerate. The dosage and method of use are the same for the analogues. In acute conditions, any of the drugs is prescribed intravenously, and after 10-15 days of intensive treatment, the patient can be switched to capsules. None of the complete analogues are recommended for children. To help a child with brain injuries or developmental delays, you need to choose other nootropics.

Cortexin - an option for children

Cortexin is sold as a lyophilisate and is prescribed only intramuscularly. The drug contains polypeptides from the cerebral cortex of livestock, which are able to pass through the blood-brain barrier and protect neurons. Cortexin improves memory, learning, resistance to stress, and is prescribed both for developmental delays in children and in cases of trauma, epilepsy, cerebral palsy, and impaired blood circulation in the brain.

Lidocaine as a solvent for Cortexin increases the likelihood of side effects in children and is therefore not recommended.

Cortexin is well tolerated; it is contraindicated only in cases of intolerance to the drug, during pregnancy and lactation. The usual dosage for children under 20 kg is 0.5 mg/kg, for children with greater weight and adults - 10 mg at a time. The course lasts 10 days, the injection is given once a day.

The list of side effects is limited. The injection site may become red, and the patient has a chance of insomnia, restlessness, tachycardia, and lack of coordination. Dangerous reactions include anaphylactic shock as a type of allergy to a foreign protein. In less serious cases, the allergy is expressed by a rash, itching, and redness.

Differences and Benefits of Nootropics

Cereton, Recognan and Ceraxon are nootropics with the ability to accelerate the restoration of neuronal membranes and the production of the transmitter acetylcholine. Only one of them - Ceraxon - is an original drug with all the necessary studies and a high chance of being better than generics. Recognan is a cheap substitute with a different effectiveness, and Cereton reproduces the composition of the original Gliatilin. The drugs are prescribed in the form of solutions for oral administration or injection. Cereton is also available in capsules.

Indications for nootropics include acute brain damage due to stroke and trauma, as well as the recovery period and age-related brain disorders. All medications rarely cause side effects, but are not recommended for children. Cortexin injections based on polypeptides from the cerebral cortex of cattle can help in this case.