Methods of using Actovegin in sports

The drug "Actovegin" stimulates cerebral circulation, triggers the saturation of the brain matter and other body tissues with oxygen. Internal and external use of various forms of medication helps restore damaged organs and skin areas. These properties allow Actovegin to be usefully used in sports, achieving greater training results. With a professional approach to using the composition, you can improve the body's performance and reduce the negative impact of stress on the body. It is recommended to carry out any actions with the drug after consulting a sports doctor or therapist.

The drug stimulates cerebral circulation, triggers the saturation of the brain matter and other body tissues with oxygen.

Composition and effects

The main active component of Actovegin is hemoderivat, which is obtained from the blood of calves. Biomass is taken from healthy animals that have been fed exclusively with milk.

The raw materials are deproteinized - purified from large protein formations. The result is a biologically active mass capable of triggering metabolic processes in human organs and tissues.

Accurate chemical calculations make it possible to obtain a product with a standard composition. Due to the exclusion of large protein molecules, it is not able to provoke rejection or an allergic response.

Results of the effect of the drug "Actovegin" on the body:

improving tissue trophism, establishing the distribution of oxygen and glucose;
reducing the negative impact of hypoxia on cells due to the ability to retain oxygen molecules;
stimulation of the production of ATP, used by the body as an energy source to launch vital processes;
acceleration of collagen fiber synthesis;
potentiation of vascular growth, leading to improved blood flow;
restoration of the structure of damaged tissues, acceleration of healing processes;
stimulation of cerebral circulation.

The medicine stimulates cerebral circulation.
Thanks to its unique properties, Actovegin is useful not only for sick people, but also for those who regularly experience physical activity. The use of various forms of medication can improve general condition and athletic achievements. It also helps reduce the negative impact of intense work on the body by accelerating tissue repair.

What is the reason for the use of Actovegin in sports?

First of all, Actovegin is indicated for athletes to prevent oxygen starvation of tissues. The development of hypoxia negatively affects the general condition of the body, does not allow one to achieve good results, and slows down progress.

Using Actovegin in sports, you can improve the supply of blood to tissues, and therefore oxygen.

This leads to an acceleration of metabolic processes, reduces the intensity of ischemia, and reduces the number of cells dying from it. This is complemented by improved energy, an increase in muscle contractility, and a decrease in the volume of lactic acid in the tissues.

Read also: Instructions for use of the drug "Ethosuximide"

A few more positive effects of using Actovegin when playing sports:

development of maximum endurance;
acceleration of body recovery after exercise;
prevention of overstrain of the heart muscle, which is especially important when exercising in mid-mountain conditions or at altitude;
maintaining high performance;
prevention of muscle tissue ruptures, acceleration of their recovery;
treatment of traumatic brain injuries;
combating frostbite in people exercising in winter;
accelerated and higher-quality muscle mass building;
prevention and treatment of varicose veins;
fight against cerebral insufficiency syndrome in boxers.

The medicine promotes the development of maximum endurance.
Thanks to its properties, Actovegin allows people to achieve better results in sports, while minimizing the severity of negative manifestations. This makes training more useful, less dangerous, complete and effective.

Actovegin solution for injection 40 mg/ml 5 ml amp 5 pcs

Active substance:

1 ampoule of 2 ml contains: Actovegin® concentrate (in terms of dry deproteinized hemoderivative of calf blood)1) - 80.0 mg; 1 ampoule of 5 ml contains: Actovegin® concentrate (in terms of dry deproteinized hemoderivative of calf blood)1) – 200.0 mg;

1 ampoule of 10 ml contains: Actovegin® concentrate (in terms of dry deproteinized hemoderivative of calf blood)1) – 400.0 mg;.

Excipients:

1 ampoule of 2 ml contains: water for injection – up to 2 ml.

1 ampoule of 5 ml contains: water for injection – up to 5 ml.

1 ampoule of 10 ml contains: water for injection – up to 10 ml.

Actovegin® concentrate contains sodium chloride in the form of sodium and chlorine ions, which are components of the blood of calves. Sodium chloride is not added or removed during the concentrate production process. The sodium chloride content is about 53.6 mg (for 2 ml ampoules), about 134.0 mg (for 5 ml ampoules) and about 268.0 mg (for 10 ml ampoules).

Description:

Transparent yellowish solution.

Release form:

Solution for injection, 40 mg/ml.

In the case of production and packaging at Takeda Austria GmbH, Austria: 2, 5, 10 ml of the drug in colorless glass ampoules with a breaking point. 5 ampoules are placed in a plastic blister pack. 1, 2 or 5 blister packs with instructions for use are placed in a cardboard pack. Transparent round protective stickers with holographic inscriptions and first-opening control are glued to the pack.

In the case of production and/or packaging at Takeda Pharmaceuticals LLC, Russia:

2, 5, 10 ml of the drug in colorless glass ampoules with a breaking point. 5 ampoules are placed in a plastic blister pack made of polystyrene film or polyvinyl chloride film. 1, 2 or 5 blister packs with instructions for use are placed in a cardboard pack. Transparent round protective stickers with holographic inscriptions and first-opening control are glued to the pack.

In the case of production and packaging of the drug at ZAO Pharm, Russia:

2, 5 and 10 ml in ampoules of colorless neutral glass with a colored break ring or with a colored dot and notch. The ampoules are additionally coated with one, two or three colored rings and/or a two-dimensional bar code, and/or an alphanumeric coding, or without additional color rings, a two-dimensional bar code, or an alphanumeric coding. 5 ampoules are placed in a blister pack made of polyvinyl chloride film and aluminum foil or polymer film or without foil and film. 1, 2 or 5 blister packs along with instructions for use are placed in a cardboard pack.

Does the use of the antihypoxant Actovegin put athletes in an unequal position?

Actovegin is rarely used in professional sports; pharmacology offers a lot of more effective means for targeted improvement of results. Today it is not a doping product, although it was considered such for several years. The medicine is not a blood derivative due to the use of an extract freed from a significant part of the protein. The biological composition does not provide a stimulating effect in every case. Despite the fact that the product increases strength endurance and allows you to extend training time, it does not provide any benefits in sports.

Special instructions for the use of Actovegin when playing sports

When including the use of any form of the Actovegin product in your training schedule, it is important to remember that this is not a dietary supplement, but a medication based on biologically active substances. Violation of the rules for using the composition will minimize its positive effect on the body and create a risk of developing adverse reactions.

When incorporating the use of any form of medication into your training schedule, it is important to remember that it is a biologically active medication.

Rules for using Actovegin solution when playing sports:

Before starting systematic injection therapy, it is necessary to ensure the tolerability of the composition. To do this, 2 ml of solution is injected intramuscularly for one minute as a test;
to dilute the medication, you can only use saline solution and 5% glucose;
intramuscular administration of the Actovegin solution is performed slowly - the maximum speed is 5 ml of liquid per minute;
It is recommended that the dosage form of the drug, the method, schedule and scheme of its use be agreed upon with a sports doctor or therapist.

"Actovegin" in the form of a solution is a clear liquid with a yellowish tint of varying degrees of intensity. The effectiveness and concentration of the drug do not depend on the brightness of the color.

If the product becomes cloudy, its use is prohibited.

After opening the ampoule, the composition must be used immediately; it cannot be stored for subsequent use.

ACTOVEGIN[edit | edit code]

Sports pharmacology of the Olympic team: Actovegin (view on YouTube)

ACTOVEGIN

- is an extract from the blood of calves. The effect of the drug has not been proven in studies. Some doctors note a positive result from the use of Actovegin, but this can only be explained by the placebo effect.

The use of Actovegin is prohibited in Europe and the USA. In 2014, three patients in Aktyubinsk, who were prescribed the drug Actovegin, died almost simultaneously. One of the most serious and life-threatening side effects is anaphylactic shock.

Composition and release form[edit | edit code]

Dragee forte

: 1 tablet contains deproteinized hemoderivat from calf blood - 200 mg. There are 50 pieces in a package.

Injection

: 2 ml ampoule contains deproteinized hemoderivat from calf blood 80 mg. There are 25 pieces in a package.

Injection

: 5 ml ampoule contains deproteinized hemoderivat from calf blood 200 mg. There are 5 pieces in a package.

Injection

: 10 ml ampoule contains deproteinized hemoderivat from calf blood 400 mg. There are 5 pieces in a package.

Solution for infusion 10%, 20% with sodium chloride 250 ml in a bottle, contains deproteinized hemoderivat from calf blood 1 g and 2 g, respectively.

Solution for infusion 10% with glucose 250 ml in a bottle contains deproteinized hemoderivative from calf blood 1 g.

Pharmacological action[edit | edit code]

Antihypoxant. It is a hemoderivative, which is obtained through dialysis and ultrafiltration (compounds with a molecular weight of less than 5000 daltons pass through). It has a positive effect on the transport and utilization of glucose, stimulates oxygen consumption (which leads to the stabilization of plasma membranes of cells during ischemia and a decrease in the formation of lactates), thus having an antihypoxic effect, which begins to manifest itself no later than 30 minutes after parenteral administration and reaches a maximum on average after 3 hours (2-6 hours). Increases the concentrations of adenosine triphosphate, adenosine diphosphate, phosphocreatine, as well as amino acids - glutamate, aspartate and gamma-aminobutyric acid.

Pharmacokinetics[edit | edit code]

Using pharmacokinetic methods, it is impossible to study the pharmacokinetic parameters of a drug, since it consists only of physiological components that are usually present in the body.

Recommendations for use in sports[edit | edit code]

Acceleration of recovery processes after exercise aimed at developing endurance.
Prevention and treatment of the dystrophic variant of chronic physical overstrain of the cardiovascular system (especially when training in mid-altitude conditions).
Maintaining a high level of performance in high mountain climbing conditions.
Achillodynia and muscle ruptures.
Traumatic brain injuries.
Boxer cerebral insufficiency syndrome.
Frostbite in representatives of winter sports.
Increase in body weight.
Prevention and treatment of sports pseudonephropathy.

Method of administration and dosage[edit | edit code]

Intra-arterial, intravenous (including in the form of infusion) and intramuscular. Due to the potential for anaphylactic reactions, a test is recommended before starting the infusion.

Depending on the indications, the initial dose is 10-20 ml/day intravenously or intra-arterially; then 5 ml intravenously or 5 ml intramuscularly.

When administered in the form of an infusion, 10-20 ml of Actovegin are added to 200-300 ml of the main solution (0.9% sodium chloride solution or 5% dextrose solution). Rate of administration: about 2 ml/min.

Contraindications[edit | edit code]

Hypersensitivity to the drug, decompensated heart failure, fluid retention in the body. With caution: hyperchloremia, hypernatremia.

Side effects[edit | edit code]

Allergic reactions (skin rash, skin hyperemia, hyperthermia) up to anaphylactic shock.

Drug interactions[edit | edit code]

Currently unknown.

Special instructions[edit | edit code]

In the case of intramuscular administration, no more than 5 ml is administered slowly. Due to the possibility of an anaphylactic reaction, a test injection (2 ml intramuscularly) is recommended.

The injection solution has a slightly yellowish tint. The color intensity may vary from one batch to another depending on the characteristics of the starting materials used, but this does not adversely affect the activity of the drug or its tolerability.

Do not use a solution that is opaque or contains particles.

After opening the ampoule, the solution cannot be stored or used.

How is the drug used in bodybuilding?

Studies have not revealed anabolic properties of the drug, despite its ability to stimulate metabolic processes. The product itself cannot cause a rapid increase in muscle mass, but athletes still actively use Actovegin in bodybuilding. Due to the insulin-like effect provided by the composition, an increase in the level of glucose in the blood is achieved, including at the time of its oxidation. This stimulates muscle nutrition and oxygen saturation of tissues during training. Potentiation of tissue trophism makes it possible to load muscle fibers to the maximum, increasing the level of load.

The drug cannot cause a rapid gain of muscle mass, but athletes still actively use it in bodybuilding.

conclusions

At the moment, Actovegin has not undergone a single study according to the GHP rules (the international code of quality medical practice that guides scientists in conducting clinical trials). But at the same time, the company producing the drug does not set such a goal, since a strong evidence base is not required for the fish to enter the main market (CIS countries).

According to studies of medical records of patients with hypertension who were hospitalized, it was revealed that the percentage of money spent on treatment with Actovegin averaged 17% of the total amount. This is irrational spending on a drug without an evidence base for hypertension and concomitant conditions, and its inclusion in the prescription lists is impractical.

Side effects

Dosage forms of the drug "Actovegin" intended for external use extremely rarely provoke negative reactions. In isolated cases, an allergic response occurs, which takes the form of dermatitis or urticaria. Immediately after applying the mass to the problem area, local soreness may occur. This consequence is caused by tissue swelling and is not a sign of intolerance to the composition. The discomfort should go away on its own within half an hour. If this does not happen, you should seek medical help.

The body's reaction to the use of Actovegin solution or tablets is individual. In most cases, all forms of the drug are well tolerated, but there is a possibility of an allergic response, including anaphylactic shock. Most often, negative consequences are limited to skin rashes, itching, tissue swelling, and increased body temperature. Even if such symptoms are mild, it is better to refuse further use of the composition in sports or consult a doctor.

Contraindications

Before starting to use Actovegin in sports, it is recommended to consult a therapist. Despite its biological origin, the drug has a number of contraindications for use. Some of them are not obvious and are often present even in people who are absolutely healthy at first glance.

"Actovegin" is prohibited for the following conditions:

stagnation of fluid in the body, swelling of tissues;
hypersensitivity to product components;
increased levels of sodium and/or chlorine in the blood;
heart failure in the stage of decompensation;
pregnancy, breastfeeding.

The drug is not prescribed for heart failure.
Depending on the specific situation, there may be additional contraindications to the use of the drug in sports. A basic diagnosis carried out by a doctor allows you to identify dangerous situations and reduce the risk of developing negative consequences.

Analogs and cheap substitutes

The only generic (non-patented analogue) of Actovegin is the drug Solcoseryl (the same active ingredient and indications for use and almost the same cost of 600-1700 rubles, depending on the form of the drug).

Actovegin is produced in Austria by a branch of the Swiss pharmaceutical company Nykomed, and Solcoseryl is produced in Germany. The drugs are made from the blood of Austrian and German calves, but in no Western European country is this medicine allowed not only for use, but also for sale.

It is also worth remembering that cattle are susceptible to so-called slow prion infections (including “mad cow disease,” to which humans are susceptible). The pathogen can enter the body through parenteral administration of the drug; it is stable to high temperatures and antiseptics. Prion infection proceeds slowly (the incubation period can reach 8 years), and the clinical manifestations are disguised as other diseases. A case of release of a batch of Actovegin from raw materials that did not undergo appropriate control was registered.

Conditional analogues of Actovegin on the Russian market:

Cerebrolysin;
Cortexin;
Mildronate;
Mexidol.

Interaction with other drugs

"Actovegin", intended for external use, does not enter into dangerous chemical reactions with other medications. It can be combined with any medications for topical use, oral administration and parenteral administration. The only limitation is that external products are not recommended to be applied immediately one after another; at least half an hour should pass between approaches.

Tips for using the drug in sports

The maximum effect of therapy is observed with parenteral administration of the Actovegin solution. Other types of the drug are also actively used in sports. Any approach must be previously agreed with your doctor.

The maximum effect of therapy is observed with parenteral administration of the drug.

The specifics of using Actovegin in sports depend on the dosage form of the product, training goals, and the specifics of the situation:

when exercising in mid-mountain areas at an altitude of up to 3000 m, the drug is administered intravenously or intramuscularly at 80 mg for two weeks. A similar effect is achieved by taking tablets for 2-6 weeks - 1-3 pieces with a concentration of 200 mg up to 3 times a day;
against the backdrop of intensive sports activities, one of three schemes is used. 1 tablet three times a day, 5 ml intramuscularly twice a day, 5 ml intramuscularly once a day;
in the late stages after a TBI, a course of infusion therapy is recommended - 400-800 mg per day for two weeks. Up to 4 courses are carried out with an interval of 3-4 days;
Post-traumatic encephalopathy is fought with courses lasting 1.5-2 months - 2 tablets of medication up to 3 times a day;
for inflammation of the Achilles tendon, injections into the tendon muscles are prescribed - 5 ml per day, 2-3 weeks. For muscle problems, injections are given every other day, supplemented with local gauze bandages with Actovegin ointment.

The combination of oral and injectable forms of medication in sports should be carried out under the supervision of a physician. It is very difficult to provoke an overdose of the active substance of a drug, but theoretically possible. The condition will manifest itself in the form of nausea, general malaise, and abdominal pain if pills are abused. Also, such experiments can lead to signs of allergies.

The use of Actovegin in sports, subject to the rules and recommendations, can be of great benefit. A relatively safe medication increases the body’s endurance, accelerates its recovery process, and protects against the negative consequences of stress. At the same time, it strengthens a person’s immunity, has a positive effect on his performance, and improves results in almost all sports.

Possibilities of the drug Actovegin in the prevention and treatment of dementia

Dementia is understood as a diffuse impairment of mental functions as a result of organic brain damage, manifested by primary disorders of thinking and memory and secondary emotional and behavioral disorders. Dementia is an extreme degree of decline in higher mental functions. It is customary to talk about dementia in cases where impairments in memory and other cognitive functions are so pronounced that they interfere with the implementation of professional and social activities in the same volume and quality. If a person has impairments in memory, thinking or other higher mental functions, but they do not interfere with professional activities and/or do not cause maladaptation of the patient in everyday life, they speak of cognitive impairment (cognitive decline).

There are several types of dementia:

Alzheimer's disease, vascular dementia ("subcortical" dementia, subcortical arteriosclerotic encephalopathy), mixed dementia, alcoholic dementia, etc. Dementia is especially common in the elderly. According to population studies, it is detected in 5–20% of people over 60 years of age. According to a number of authors, the presence of dementia increases the mortality rate of elderly patients by almost 3 times. It is believed that this is due to mnestic-intellectual decline, so patients with dementia cannot adequately assess the severity of their disease and the need for treatment. In addition, due to memory loss (the main diagnostic criterion for dementia), such patients forget to take medications.

Alzheimer's disease and vascular dementia are the most common types of dementia

. In Russia, vascular dementia ranks first in frequency (5.4%), its share is from 10 to 39% of all cases of dementia. According to the ICD-10 definition, vascular dementia is the result of cerebral infarctions due to cerebral vascular disease, including cerebrovascular disease due to arterial hypertension (AH). Heart attacks are usually small, but their cumulative effect is manifested.

The development of vascular dementia is promoted mainly by ischemic brain lesions, both focal and diffuse, and clinically this can be characterized by a progressive deterioration of cognitive functions (memory, thinking, attention, orientation, etc.) and social skills. “Subcortical” dementia is characterized primarily by an increase in the time that the patient spends on performing mnestic-intellectual tasks. There is a decrease in concentration, rapid exhaustion, memory impairment, especially for current events, emotional and behavioral disorders. Memory loss is a characteristic symptom of “subcortical” dementias. However, mnestic disorders, as a rule, are more mildly expressed in comparison with the dementia that develops in Alzheimer's disease. There is no clinically clear amnesia for current or distant events. Memory impairments manifest themselves mainly during learning: it is difficult to memorize words, visual information, and acquire new motor skills. Basically, active reproduction of material suffers, while simpler recognition is relatively intact. External stimulation in the form of assistance with memorization, the establishment of semantic connections during information processing, and repeated presentation of material increase the productivity of memorization. The mnestic defect in subcortical dementias is localized at the stage of “working memory”: a decrease in the volume of information assimilation after the first presentations is noted.

The main pathogenetic role in the formation of mnestic disorders in subcortical dementias is played by dysfunction of the frontal lobes of the brain, which leads to decreased activity, lack of planning, and disruption of the sequence and selectivity of mnestic operations. Patients with vascular dementia are characterized by a slowdown in all mental processes and a narrowing of their range of interests. In later stages, impairments in abstract thinking and judgment may develop. As a rule, focal disorders of higher cortical functions (aphasia, agraphia, alexia, apraxia, acalculia) do not develop, which is typical for cognitive disorders of the subcortical type. The appearance of such severe symptoms accompanies severe dementia.

More than half of patients with vascular dementia experience so-called emotional incontinence (weakness of spirit, violent crying). Vascular dementia is characterized by long periods of stabilization and even a certain reverse development of mnestic-intellectual disorders, and therefore the degree of its severity often fluctuates quite significantly in one direction or another. In such cases, fluctuations in the state of regional cerebral blood flow are important.

In addition to cognitive impairment, patients with vascular dementia also have neurological manifestations: subcortical, pseudobulbar, cerebellar syndromes, impaired control of pelvic functions, mainly urinary incontinence, paresis of the muscles of the limbs, often mild and usually not affecting the functional activity of the patient. The combination of cognitive and marked neurological disorders distinguishes vascular dementia from degenerative diseases, in particular Alzheimer's disease, in which cognitive disorders and symptoms of impairment of higher cortical functions (aphasia, apraxia) dominate.

The leading role in the formation of dementia with vascular lesions of the brain is played by damage to the white matter of the brain and the basal ganglia, which leads to disruption of the connection between the frontal lobes of the brain and subcortical structures (the phenomenon of cortical-subcortical disconnection). The main pathogenetic factor in the development of this phenomenon is hypertension, which leads to changes in the vascular wall (lipohyalinosis), mainly in the vessels of the microvasculature. As a result, arteriolosclerosis develops, which causes a change in the physiological reactivity of blood vessels. Under such conditions, a decrease in blood pressure (BP), including due to inadequate antihypertensive therapy, leads to a decrease in perfusion and the development of ischemia of the white matter of the brain.

On T2-weighted images of magnetic resonance imaging of the brain, a marker of the presence of chronic ischemia is a rarefaction of the periventricular or subcortical white matter - leukoaraiosis (“glow of the white matter”), which is visualized. Morphologically, these zones represent a zone of demyelination, gliosis and expansion of perivascular spaces.

Based on the above, prevention and treatment

vascular dementia and cognitive impairment should primarily include adequate correction of high blood pressure. Achieving target blood pressure is mandatory, but the pace of its achievement should be as gentle as possible. They depend on the initial values of blood pressure in a given patient, the duration and severity of both hypertension and concomitant diseases. But in general, the rule is true - a sharp decrease in blood pressure for an elderly patient with hypertension is no less, but rather more dangerous than its sharp increase. Treatment of hypertension, coronary heart disease, heart failure, prescription of antiplatelet agents, surgical correction of atherosclerotic narrowing of the great arteries help prevent the increase in cognitive impairment and, according to some data, reduce existing ones. Control of hyperglycemia and hyperlipidemia is also necessary. However, in a number of cases, pathogenetic therapy for dementia still seems impossible, since its cause remains either unknown (senile dementia of the Alzheimer's type) or cannot be affected (multi-infarct dementia).

Current approaches to the treatment of dementia are also based on improving the delivery and use of oxygen and glucose. Glucose and oxygen are necessary for brain cells to carry out aerobic glycolysis, during which 38 ATP molecules are produced, which, in turn, provide the cells with an adequate level of functioning. The importance of oxygen and glucose for maintaining the normal functioning of brain cells is evidenced by the fact that for the functioning of the brain (the weight of which is 2% of body weight), 50% oxygen and 10% glucose are extracted from the flowing blood at a normal volume of total blood flow. Indeed, in conditions of deficiency of these substances, the processes of not aerobic, but anaerobic glycolysis occur, as a result of which only 2 ATP molecules are formed. Under such conditions, not only is the normal functioning of brain cells impossible, but they also die.

Therefore, there are other areas for the prevention and treatment of dementia. Thus, for quite a long time in clinical practice, the drug Actovegin, a modern antihypoxant, has been used for this purpose. This is a highly purified hemodialysate obtained by ultrafiltration from the blood of calves. The drug contains organic low-molecular compounds: amino acids, oligopeptides, nucleosides; intermediate products of carbohydrate and fat metabolism; oligosaccharides and glycolipids, as well as electrolytes (sodium, calcium, phosphorus, magnesium) (Fig. 1). The technology for obtaining hemodialysate excludes the presence of protein and other components with antigenic and pyrogenic properties.

Rice.
1. Composition of the drug Actovegin The basis of the pharmacological action of Actovegin is its effect on the processes of intracellular metabolism
. Under the influence of this drug, the transport of glucose into cells and the absorption of oxygen in tissues improves. The entry of a large amount of oxygen into the cell leads to the activation of aerobic oxidation processes, which increases the energy potential of the cell (Fig. 2). Under the influence of Actovegin, glucose transporters are activated, and an increase in glucose transport is noted up to 50% of the maximum effect of insulin. But this action of Actovegin is insulin-independent: due to the presence of glycolipids in its composition, Actovegin directly causes the activation of glucose transporters.

Rice. 2. Pharmacological effect of Actovegin on the processes of intracellular metabolism

There are a large number of studies, both domestic and foreign, that indicate an improvement in cognitive processes during treatment with Actovegin. However, of particular interest, of course, are the results of double-blind, placebo-controlled studies (Fig. 3). The results of these studies indicate that patients with various brain diseases during treatment with Actovegin showed a significant improvement in cognitive functions compared to placebo.

Rice. 3. Results of double-blind, placebo-controlled studies of the drug Actovegin

Thus, B. Saletu et al., using IV Actovegin, found a significant improvement in memory, attention and some parameters of thinking in patients with age-related memory decline compared to placebo. This study included patients aged 50 to 80 years (mean age 64 years) with age-related memory decline, and none of the patients met diagnostic criteria for dementia. The authors noted this effect of Actovegin after 14 days of treatment.

Another group of researchers (WM Herrmann et al.) also used the IV route of administration of Actovegin. However, they examined patients with Alzheimer's disease and multi-infarct dementia (Fig. 5). Therefore, the period of treatment with Actovegin was already 4 weeks. In the Actovegin group, the authors found a significant improvement in cognitive processes for collecting and processing information, severity of dementia symptoms, patients’ general well-being and care needs compared to placebo. Moreover, improvement was noted after the second week of therapy and was even more pronounced after four weeks. Despite the fact that the chosen treatment period was relatively short (at least three months are needed), the required and significant effect was still revealed. This may be due to intravenous use of the drug, which could cause a faster onset of effect.

Rice. 5. Data from a survey of patients with Alzheimer’s disease and multi-infarct dementia after a course of Actovegin (iv)

The literature contains data from double-blind, placebo-controlled studies on the effectiveness of the oral dosage form of Actovegin. Thus, WD Oswald et al. showed that Actovegin increased the speed of cognitive processes in patients with mild to moderate organic brain damage syndrome to a significantly greater extent compared to placebo (Fig. 4). In this study, patients over 60 years of age with mild to moderate psychoorganic syndrome received 400 mg x 3 times or placebo for 8 weeks.

Rice. 4. Data from double-blind, placebo-controlled studies of the oral dosage form of Actovegin

W. Jansen and GW Brueckner studied the therapeutic effects of Actovegin forte tablets (200 mg of active substance) and the dependence of the results of therapy on the dose of the drug in elderly (60–72 years) patients with cerebrovascular insufficiency. Patients were randomized into 3 groups: Actovegin forte 3 tablets 3 times a day (40 people), Actovegin Forte 2 tablets 3 times a day (40 people), placebo (20 patients 3 tablets 3 times a day, 20 patients 2 tablets 3 times a day). The duration of therapy was longer than in the study by WD Oswald et al. and amounted to 12 weeks.

To assess intelligence, a jigsaw test was chosen (it is necessary to sort 16 decks in 7 patterns within a certain time), which requires synthetic and analytical abilities and is considered especially difficult for patients with reduced intelligence and the elderly (Fig. 6). This test also characterizes the degree of age-related decline in intellectual abilities. The authors found that both Actovegin dosage regimens improved thinking and attention in elderly patients to a significantly greater extent than placebo.

Rice. 6. Results of a mosaic test to assess intelligence in the elderly when taking Actovegin according to the regimen

HV Semlitsch et al. In a double-blind, placebo-controlled study, the effect of Actovegin on the so-called P300 component of evoked brain potentials in patients with age-related memory disorders was studied. The late positive component (P300) of potentials (syn.: cognitive evoked potentials) is used in studies of cognitive processes and nootropic drugs, since a close connection has been established between P300 and cognitive functions. This means that a potential nootropic drug should shorten P300 latency and/or increase P300 amplitude, and/or increase the activity of P300 sources.

Each patient in this study received therapy for 2 weeks with either 250 ml of a 20% Actovegin solution or 250 ml of placebo. After using Actovegin, the amplitude of parietal P300 increased in comparison with placebo. This may reflect improved cognitive processes in the parietal cortex, a region that plays a fundamental role in attention but is functionally damaged in dementia.

The results of EEG brain mapping showed that Actovegin, in contrast to placebo, has a significant positive effect on human brain function (decrease in delta and theta activity and increase in slow beta activity adjacent to alpha, decrease in fast beta activity). Topographically, the encephalotropic effects of treatment with Actovegin were more pronounced in the parietal, fronto-central and temporo-occipital areas. At the same time, topographically, the greatest differences between Actovegin and placebo were also observed in the parietal and temporal regions. These data are of interest because in recent studies with EEG brain mapping in Alzheimer's type dementia, it was the parietal and temporal regions that differed from those in the control group of healthy individuals. Indeed, most of the changes are described by neuropathologists, neurobiochemists and neuroradiologists in these areas of the brain. Significant decreases in cortical mass in the parietal and temporal regions have been described, consistent with decreased cerebral blood flow in the central and parieto-occipital regions and decreased glucose metabolism in these regions measured by positron emission tomography (PET) in the disease. Alzheimer's. RP Friedland et al. noticed that glucose metabolism suffers most in the temporo-parietal cortex. The author emphasizes that histopathological changes are most pronounced in this same area.

Thus, the results of double-blind, placebo-controlled studies indicate the effectiveness of the drug Actovegin for the prevention and treatment of dementia.

To prevent dementia in patients with impaired cognitive functions, Actovegin forte 200 mg x 3 times a day is usually used for 1.5–2 months. In patients with vascular dementia, they usually start with intravenous Actovegin 400-800 mg (10-20 ml) intravenously for 10-14 days, and then switch to oral Actovegin forte 200 mg 3 times a day.

An integrated approach to the treatment of elderly patients, including adequate treatment of cardiovascular diseases and the use of drugs with proven effectiveness, will improve the quality of life of elderly people, which is of great medical and social importance.
Literature:
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2. Yakhno N.N., Zakharov V.V. Cognitive and emotional-affective disorders in dyscirculatory encephalopathy. // Russian Medical Journal – 2002 – Volume 10 – No. 12–13 – P. 539–542.

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