CEREBRAL CIRCULATION INSUFFICIENCY OF VASCULAR GENESIS

What nootropic drugs are considered the most famous and widely used in medical practice? What nootropics are commonly used for children, the elderly, for psychoneurological disorders and healthy individuals to stimulate mental activity? We addressed these questions to the Chief Doctor of the Multidisciplinary Medical Center, psychiatrist, psychiatrist-narcologist and psychotherapist Vladislav Sipovich.

What nootropics (list of drugs and their characteristics) are widely used in pediatrics?

First of all, I would like to remind you that nootropics in pediatrics have fairly clear indications for use. These are, first of all, the following conditions: • Prevention and treatment of child retardation in mental, motor and speech (after 3 years) development. • Stimulation of central nervous system functions associated with the processes of learning, concentration, memorization and reproduction of information. • Organic damage to the central nervous system as a result of neuroinfections, traumatic brain injuries, genetic diseases. • Cerebral palsy. • Urinary disorders of neurogenic nature. • Stuttering. • Complex therapy of epilepsy. • Neurotic conditions and asthenia (obsessive-compulsive disorder) • ADHD – attention deficit hyperactivity disorder. Most often, children are prescribed nootropics from the list of so-called true nootropics, which primarily affect the mnestic (memory) and cognitive (cognitive) abilities of a person of any age. These are nootropic drugs such as: • Racetams. • Neuropeptides. • Cholinergic nootropics. • Neuroprotectors. • Activators of amino acids and GABA (gamma-aminobutyric acid). • Antioxidants. Of the Racetams, the most significant and widespread is Piracetam - a drug used by doctors for almost 50 years and being the founder of nootropic drugs, the list of which is constantly expanding and updated. Known under the commercial name nootropil. In children, it is especially effective as a stimulator of speech development, and also helps well with cerebral palsy and mental retardation, during rehabilitation after TBI and GM intoxication, and helps increase learning ability. Available in a wide variety of pharmacological forms - tablets, granules, capsules, syrups, solutions for parenteral administration. Peculiarities of use: not recommended for use in the afternoon.

In childhood, drugs such as: • Cortexin, which is considered the best for children 1 year of life, are also often prescribed. It can be used starting from the first birthday. It has a positive effect on the nervous system, including the peripheral one, counteracts toxic effects, improves blood circulation, and is used in the complex treatment of epilepsy. In addition, cortexin improves memory, increases resistance to stress and is effective when taken by children with developmental delays (psychomotor and speech). Quite popular among students, especially during sessions, to improve memory and assimilate large amounts of information. Cortexin also has positive reviews from parents and pediatricians; it is quite safe, but quite expensive. Available in the form of a lyophilisate (powder dried at sub-zero temperatures). • Semax 0.1% solution is the safest and is produced in the form of nasal drops convenient for use in children. It has virtually no side effects, except for rare and minor irritation of the mucous membrane. It belongs to the peptide series of nootropics and has a positive effect on attention, learning and perception. In addition, it helps restore and adapt the nervous system after anesthesia. In pediatrics, it has proven itself well in the treatment of brain dysfunction in children over 5 years of age. The advantages of Semax include high safety and a convenient release form for use. A relative disadvantage is the need to store the drug in the refrigerator at a temperature not exceeding 8 degrees.

• Cerebrolysin, which is a neuropeptide of animal origin (a concentrate of peptides from the brain of pigs or cattle. It is actively used as an activator of neural metabolism, helps to increase concentration and reduce hyperactivity. Its disadvantage is that it is a relatively expensive drug and is produced only in in the form of injection solutions, and the plus is that this is one of the most effective nootropics for developmental delays in children.Side effects are rare and boil down to individual allergic reactions to the components of the drug, insomnia and, extremely rarely, arrhythmias.

For delayed speech development (DSD), the following nootropics are also effective: • GABA analogues and derivatives (Picamilon, Pantogam), which normalize the conduction of nerve impulses and improve glucose utilization and oxygen consumption in neurons. Being inhibitory mediators, they are effective for hyperactivity and increased excitability of the central nervous system. • Pyritinol drugs (Encephabol, Cerebol), which have a neuroprotective (stabilization of membranes and inhibition of the production of free radicals that destroy the structure of cells) and antihypoxic effects. • Ceraxon is a stimulant of central nervous system activity, containing citicoline, which is responsible for restoring neuronal membranes and their energy supply, as well as reducing the amount of intercellular fluid in the brain and thus providing an anti-edematous effect. It is recommended not only for mental retardation with symptoms of inhibition, but also for autism. To summarize the answer to this question, I would like to say that the choice of nootropic drugs, the list of which, taking into account the new generation drugs, includes more than a hundred items, remains with the pediatrician. Under no circumstances should you prescribe nootropics on your own, even based on the indications indicated in the instructions. Of course, nootropics are quite safe drugs that have a positive effect on the nervous system, but each of them has its own preferential effect and is aimed at different processes in the nervous tissue. By independently prescribing CNS activators to a small patient with hyperactivity, parents can get increased activity and increased excitability in their child, leading him to a nervous breakdown and treatment by a child psychiatrist. To prevent such excesses, the vast majority of nootropics are sold in pharmacies only with a doctor’s prescription. Some of them can be purchased without a prescription, but their list is quite limited. I will dwell on them in more detail at the end of the interview.

Range

Most nootropic drugs are available with a prescription. However, some drugs from the list of nootropics are available without a prescription. Depending on the chemical structure and properties, the following groups of OTC drugs are distinguished:

Table 1. Groups of drugs with nootropic activity (drugs approved for over-the-counter release are indicated)

In addition, there are combination drugs that include nootropics from different groups or nootropics in combination with drugs from other categories.

Table 2. Combined drugs containing components with nootropic activity (drugs approved for over-the-counter release are indicated)

Let's talk about the action of these nootropics (brief descriptions are given in Table 3).

What nootropic drugs are prescribed to older people and for what purpose?

Indications for prescribing nootropics to older people are the following conditions: • Alzheimer's disease. • Syndromes of confused consciousness and fragmented thinking. • Pick's disease. • Disorientation in space and time. • Confusion and instability of attention. • Emotional imbalance. • Anxiety disorder. • Illusory perception. • Memory problems. • Sleep disorders. • Motor overexcitation or retardation.

In addition, nootropics can also be prescribed for preventive purposes to slow down age-related changes in the neuropsychic sphere associated with cerebrovascular accidents, weakening of memory and cognitive abilities. Among the nootropic drugs used for older people, the most common and popular are: • Cavinton, the active ingredient of which is vinpocetine. Its main therapeutic effect is aimed at improving cerebral circulation by reducing blood viscosity and, accordingly, improving the supply of oxygen to the brain. It is characterized by a targeted selective effect on the affected area of ​​the brain, so this nootropic drug is especially effective in the treatment and rehabilitation after stroke, vascular dementia and cerebrovascular accidents. It is also used in the treatment of vascular and retinal lesions and Meniere's disease. Side effects may include nausea, heartburn, weakness, headache and tachycardia, which is a disadvantage of the drug and a contraindication for its use in case of heart rhythm disturbances (arrhythmias). • Encephabol – stimulates metabolic processes in the brain by accelerating the utilization of glucose, normalizes blood circulation in areas affected by ischemia, and helps restore the functions of the nervous system. Other therapeutic effects include improved memory, increased mental activity and overall central nervous system tone. It helps well in overcoming the negative consequences of encephalitis, as well as in the treatment of cerebroasthenic syndrome and mental retardation in children. The downside is the ability to cause allergic reactions in people sensitive to pyritinol, as well as the high price.

• Phenibut is a drug that combines nootropic and tranquilizing effects. Which manifests itself in a decrease in the excitability of the nervous system, a decrease in anxiety and fear. The drug prolongs the duration of action and enhances the effect of sleeping pills. With long-term use, it increases physical and intellectual capabilities, normalizes sleep, and improves memory. Effective in the complex treatment of withdrawal syndrome in alcoholism. The downside is the possibility of withdrawal syndrome after completing the course of the drug.

• Picamilon is a nootropic drug popular among doctors and patients, which has several effects: a psychostimulant, a tranquilizer and an antioxidant. Improves metabolic processes and blood supply to brain tissue, reduces the intensity of headaches, relieves anxiety and nervous tension, and also increases a person’s physical and intellectual capabilities. Has a positive effect on the restoration of motor and speech functions after stroke and toxic lesions of the brain. In older people, it has a good effect in the complex treatment of migraines, cerebrovascular accidents, and retinal diseases. Side effects include the possibility of developing an allergic response to this drug.

The use of nootropics in older people should be treated very carefully, taking into account the depth of age-related changes, possible side effects, prevailing symptoms, the presence of concomitant diseases and the general condition of the body. Only a specialist can objectively evaluate all these aspects and correctly prescribe treatment using nootropics. Prescribing these drugs to your elderly relatives yourself is extremely undesirable and unsafe for their health.

To accept or not to accept?

Nootropics have been gaining popularity lately. But today there is still no clear opinion about the effectiveness of this group of funds. According to available information. Based on available information, these drugs can be judged to improve cognitive abilities. However, nootropics should not be perceived as magic pills that help you become smarter and more capable. Their role is to improve brain activity and increase resistance to psycho-emotional stress. In order not to make a mistake with your choice and notice the effect of nootropics, you should consult with a specialist.

Groups of tools to improve brain function

Piracetam was the world's first nootropic. It was developed back in 1963 as a replacement for psychostimulants, benefiting from the absence of side effects. This substance became the founder of the racetam group, which improves memory.

In the nootropics category you can also find:

• correctors of cerebral circulatory disorders;
• dimethylaminoethanol derivatives, which help absorb oxygen and improve thinking skills;
• derivatives of pyridoxine (vitamin B6), normalizing metabolism in neurons and stabilizing the functioning of the central nervous system;
• neuropeptides that promote the formation of long-term memory.

Neuroprotectors are sometimes identified with nootropics, but there is a difference between them. Neuroprotectors are drugs of mixed action. They have a wider range of effects.

List of used literature

1. Klitochenko G.V., Malyuzhinskaya N.V. "The use of nootropic drugs in pediatrics."

2. Pichikov A.A., Popov Yu.V. "Anorexia nervosa in adolescent girls: course options, relapse factors and suicidal risk in the early stages of treatment."

3. Davydova O.N., Boldyrev A.A. "Glutamate receptors in cells of the nervous and immune systems."

4. Vostrikov V.V. "The place of piracetam in modern practical medicine."

5. Shabalov N.P., Skoromets A.A., Shumilina A.P. “Nootropic and neuroprotective drugs in pediatric neurological practice.”

6. Malykh A., Sadaie R. “Piracetam and piracetam-like drugs: from basic science to novel clinical applications to CNS disorders.”

7. Calliauw L., Marchau M. “Clinical trial of piracetam in disorders of consciousness due to head injury.”

8. Rybak V.A., Matokhina N.V. “Nootropic drugs in the clinical practice of a neurologist.”

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Vitamins to improve brain function

If no serious disturbances in brain function have been identified, you should not abuse medications. You can solve the problem of increasing concentration or learning ability with the help of vitamins:

• beta-carotene, which protects neurons from premature aging;
• B1, a neuroprotector that supports good memory and clarity of consciousness;
• B6, which supports concentration and prevents depression;
• B9, which is taken to prevent stroke;
• B12, a deficiency of which increases the risk of Alzheimer's disease;
• C, slowing down degenerative processes;
• K, which speeds up the processing of signals entering the brain.

There is no miracle pill that will solve all cognitive problems at once. But correctly identifying the cause of the violations allows you to choose the appropriate remedy for their correction.

Contraindications for use

Nootropics are considered one of the safest medications. There are no absolute contraindications to their use. Although doctors do not recommend using them unless any disorder of brain activity is diagnosed. They are not prescribed to pregnant women and infants.

Some drugs have side effects. Their undesirable appearance may become a relative contraindication for use. These include:

• increased blood pressure;
• dizziness;
• sleep disorder (more often - insomnia, less often - drowsiness during the day);
• motor restlessness;
• nausea;
• skin itching;
• irritation of mucous membranes.

So, if a person has psychomotor agitation, medication for brain activity can only worsen the situation. Not everyone experiences drowsiness. Before you get behind the wheel, you should monitor your condition after taking medications.

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If you or your loved ones are faced with atherosclerosis of the lower extremities, we recommend contacting the Professor Kapranov Medical Center. This institution employs only experienced specialists - doctors of the highest category, candidates and doctors of science.

Before starting therapy, the patient undergoes a comprehensive examination: this approach will allow one to accurately determine the degree of development of the pathology and select the most appropriate treatment method.

By contacting our Center, you can:

• consult with leading experts;
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• cope with vascular disease by performing modern operations that guarantee results and patient safety.

If you are planning to contact the Medical Center for Endovascular Surgery and would like to receive more information about our capabilities, call the number provided for a free consultation.

Nootropics: what are they?

Nootropics are a group of drugs for improving higher brain functions. It combines:

• medications to normalize cerebral blood supply;
• brain stimulants that enhance mental activity;
• means to compensate for neurological deficits;
• vitamins that increase the resistance of the central nervous system to adverse factors.

They are mistakenly credited with a non-existent effect - the development of intellectual abilities in children and adults. It's a delusion. Taking the pill doesn't make anyone smarter. But if higher mental functions begin to fade, they can be returned to their previous level. To do this, you need to eliminate the cause - overwork, hypoxia or other brain disorders. This is the purpose of nootropic drugs.

DMAE

DMAE is a naturally occurring molecule found in fish. Human studies since the 70s have shown that taking DMAE increases life expectancy.

DMAE is a precursor to the memory molecule acetylcholine and the molecule that is part of cell membranes, phosphatidylethanolamine.

Additional intake of the supplement improves memory functions and increases the “fluidity” of cell membranes. For example, this makes it easier for red blood cells to bend when passing through small capillaries.

DMAE is an antioxidant and is capable of removing the “aging pigment” lipofuscin that accumulates in cells, which interferes with the normal functioning of cells.

DMAE

399 rub.

Who may need vascular medications?

In early childhood, changes in blood flow in the brain are a consequence of perinatal encephalopathy, birth trauma, hypoxia during childbirth, and pressure drop during cesarean section. If a treatment plan is drawn up correctly, the child’s condition will normalize within 2-3 years. If the baby has cerebral palsy and other serious diseases, he will have to take vascular medications for the rest of his life.

School-age children grow quickly, and vascular medications may be needed due to the increased workload.

In adults, cerebral circulatory disorders are even more common - due to heart disease, osteochondrosis, ischemia, thrombosis, injuries, and operations.

In older people, the blood vessels of the brain suffer from atherosclerosis - blockage of the arteries with plaques. All of these categories of patients have indications for taking vascular drugs.

Why does memory deteriorate?

1. Exhaustion of the body due to prolonged stress, depression or lack of sleep.
2. Lack of B vitamins.
3. Atherosclerosis and cerebral circulatory disorders.
4. Use of drugs or alcohol.
5. General anesthesia or taking certain medications.
6. Traumatic brain injury, surgical treatment of the temporal lobes of the brain.
7. Dementia, Alzheimer's, Parkinson's, etc.
8. Psychiatric diagnoses.
9. Encephalitis or meningitis.
10. Benign or malignant brain tumors.

Diagnostic methods

Atherosclerosis of the leg arteries is diagnosed based on the following studies:

• blood chemistry;
• lipid profile to detect low- and high-density lipoproteins in the blood;
• immunological analysis;
• duplex scanning;
• angiography;
• MRI;
• ECG.

Tests and samples are also performed to identify atherosclerosis of the lower extremities.

One of these methods is to determine the ankle-brachial index. The patient's pressure is measured in the ankles and arms at rest, after which he is asked to walk actively on a treadmill for 5-7 minutes. Then the pressure is measured again. The result is obtained by correlating the highest systolic pressure in the ankle and shoulder area. A value between 0.71 and 0.4 indicates the presence of the disease.

Cost of treatment in our clinic

Rating of the best drugs to improve brain function

Despite the large selection of nootropic drugs in pharmacies, among them there are firmly established leaders. First of all, this is the mentioned Piracetam. It is produced in the form of tablets, capsules and injections.

But there are many more good remedies with a similar effect. They differ in active ingredients and dominant effects. The top five, along with Piracetam, includes: