Drugs to improve memory: neurologists recommend - Neurology and neurosurgery

Medicines to preserve memory in an elderly person, medicines to improve memory in the elderly, medicines to treat forgetfulness in the elderly are a hot topic. All medications for improving and preserving memory in old age can be divided into 4 categories: medications, dietary supplements, vitamins and nootropics. And all drugs have psychotropic functions, not mnemotropic ones - that is, they activate the capabilities of the psyche, and not memory, as they affect blood circulation and processes that activate attention, perception, and concentration. But they do not directly affect memory. So, unfortunately, any of the existing medications is not a pill that helps you “remember everything.” So let's just talk about those medications that activate cerebral circulation, which improves memory and activates it.

What to drink to improve memory.

Thursday, October 7
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Content

Why does memory deteriorate?
What medications negatively affect memory?
Groups of drugs to improve memory
Top 6 drugs to improve memory
Bilobil Forte
Sermion
Fezam
Memoplant
Vasobral
Tanakan

There are many reasons for memory impairment. To select one or another drug to improve memory, you need to undergo an examination - self-medication is strictly prohibited here.

Memory is given to a person in order, in simple words, to “record” data. If there are no problems, then at any moment the brain can reproduce the accumulated information. But if there is some kind of “breakdown”, the process of memorization and reproduction is disrupted.

Where can you improve your memory in St. Petersburg

Where should you go if it becomes clear that memory impairment is affecting your quality of life and you urgently need to take action? Why did my memory deteriorate? A specialist neurologist at our Center for Neurology, Professor Zhulev, can answer these questions.

Make an appointment with a doctor using the phone number listed on the website. If you notice that your ability to remember dates, faces and other data has sharply deteriorated, then you need to undergo an examination and identify the reasons. Don't let your health take its course. If memory has sharply deteriorated, then this is a signal from the body about problems that have arisen, and the sooner the doctor diagnoses them, the better.

We are located in the Central district of St. Petersburg, the work schedule and map can be found in the Contacts section.

Why does memory deteriorate?

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

Brain training

It is useful to start doing mental exercises at absolutely any age. There are quite a few simple techniques for training your brain:

Pronounce words starting with each letter of the alphabet from the first and so on. This must be done as quickly as possible.
Repeat foreign words that were memorized while studying at school or college.
Count numbers in reverse order. You can start from fifty to zero, and then gradually expand the limits.
Play towns, when names are named by the last letter of the previous one.
Come up with synonyms for a variety of words.

It is useful to solve crosswords, memorize poems, and solve complex problems.

There are many unconventional ways to restore memory. They sound pretty weird, but some people say pretty good things about them.

“Golden water” is one of the unconventional remedies, the effectiveness of which many speak quite positively about. Scientists do not confirm the fact that the noble metal reacts with water, but people who took it speak positively about this remedy.

To feel the effectiveness of the precious metal, you can prepare a special remedy. Gold jewelry without any inserts of precious stones is placed in a half-liter bowl filled with water. Next, place the container on the fire, boil the liquid so that the volume is reduced by half, and take the resulting product three times a day, one teaspoon at a time. After just two weeks, according to reviews, memory improves and the heart muscle strengthens.

What medications negatively affect memory?

Side effects of some drugs include memory impairment. But this “side effect” does not develop in everyone, but is an individual reaction of the body to the main active substance. These medications include:

Antihistamines (used to treat allergies).
Typically these are first-generation allergy medications that suppress the central nervous system. The person feels drowsy and his vision becomes blurred. For example, allergy medications such as Diphenhydramine, Suprastin, and Tavegil have a similar effect. These drugs negatively affect the centers of the brain responsible for memory and learning. It has been proven that long-term use of such drugs can cause the development of dementia in old age. Therefore, it is better to choose new generation antihistamines (“Loratadine”, “Cetirizine”, etc.).
Medicines for angina and hypertension.
Similar drugs, which are prescribed for high blood pressure and pulse, act on adrenaline and norepinephrine (Anaprilin, Atenolol, Bisoprolol, Carvedilol, etc.). They slow down the pulse, but at the same time inhibit the functioning of the central nervous system - a person feels general weakness, fatigue and memory problems. Among the new generation of drugs are those that act only on the heart, practically without affecting the nervous system. Discuss with your cardiologist the possibility of taking selective adrenergic blockers such as Betaxolol, Nebivolol, etc.
Anticonvulsants.
Such drugs are prescribed mainly for epilepsy. The active substance of such drugs, valproic acid, reduces signals entering the central nervous system. Usually a person feels weak in his muscles and finds it difficult to concentrate. Due to the slowdown of the brain, its functions decrease, including memory. Among the new drugs for epilepsy with reduced toxicity is Lamotrigine.
Sleeping pills and sedatives.
Such drugs reduce brain function in its main parts, help you sleep and reduce stress (memory also suffers). Many of us know a drug called Corvalol (it is sold without a prescription, so we think it is safe). In fact, this product contains a serious substance called phenobarbital, which, when used regularly, accumulates in the body and poses a health threat. For anxiety disorders and seizures, doctors often prescribe benzodiazepines. But they are usually used for short periods of time to avoid negative effects on memory.
Antibiotics.
The gastrointestinal tract contains hormones and substances necessary for the brain. Antibiotics destroy not only harmful bacteria, but also beneficial components. If you take a standard course of antibiotics as prescribed by your doctor, there will be no negative effect on your memory. But if you overuse self-medication or are forced to take antibiotics for a long time, you may have memory problems.

Memory problems and prerequisites for their development

The aging process is invariably associated with memory decline. This is understandable: gradually, naturally, nerve brain cells die. Such changes begin to manifest themselves at the age of 50+, reaching a peak at 70–75 years. First of all, short-term memory suffers: an elderly person does not remember where he put his money or keys, has difficulty navigating dates or events, and may forget about visiting a doctor or taking pills. In this condition, help is required, it is necessary to take medications to improve brain function and restore normal life.

A clear memory significantly makes the life of older people easier, helps them feel more confident, independent, and not depend on the constant supervision and care of loved ones.

Pensioners' memory can deteriorate for various reasons:

The condition of the hippocampus (the area of the brain responsible for memories) worsens.
The level of proteins and hormones in the body, which protect brain cells and stimulate the formation of neural connections, decreases.
Blood flow to the brain decreases, which does not have the best effect on a person’s memory and other cognitive skills.

A timely visit to a doctor by an elderly person will help to understand what exactly the existing problems are related to: ordinary forgetfulness or an incipient disease.

Groups of drugs to improve memory

Memory impairment occurs due to impaired cerebral circulation. Typically, able-bodied people who engage in mental work notice this problem. This symptom cannot be ignored, because it often indicates organic brain diseases.

There are three main groups of drugs to improve memory:

Psychostimulants-adaptogens.
Usually these are products of natural origin that stimulate mental and physical activity.
Nootropics.
These drugs activate learning processes, improving the brain's resistance to negative influences.
Energy metabolism correctors.
Such natural-based drugs act gradually and improve brain function.

Traditional methods for improving brain function

You can activate and stimulate memory not only by using pills, but also by using various folk remedies:

Clover tincture. To prepare a homemade preparation, you need to pour 500 ml of vodka into the clover inflorescences and place them in a cool place for 14 days. A tablespoon of this home remedy before bed is enough to improve clarity of consciousness and mind, and get rid of noise in the head.
Horseradish with lemon. The product is easy and simple to prepare. It cleanses blood vessels and normalizes blood circulation. Juice made from 3 lemons is mixed with a jar of horseradish and 3 tablespoons of honey. This mass is left in the refrigerator for 3 weeks, and then taken a teaspoon twice a day.
Pine young buds. They bloom in the spring. There is no need to cook anything from the buds; they are simply chewed before eating, which helps restore memory and slow down the aging process.

Nutrition has a positive effect on the body and memory. It should be rich in protein. The diet must contain dried fruits, baked apples or potatoes, stewed carrots, walnuts, sunflower seeds, salads prepared in olive oil, as well as dark chocolate. Frozen blueberries and fresh blueberries have a positive effect on visual acuity and brain circulation.

13 ideas on how to speed up your brain - How to improve memory and develop mental abilities

Top 6 drugs to improve memory

Our rating includes the most popular and proven effective drugs, which are most often prescribed by neurologists for memory impairment. It is important to remember that such medications should only be recommended by a doctor, having determined the cause of the problem and taking into account possible contraindications and side effects.

Causes of memory impairment

Photos from open sources

How a neurologist treats memory

Before starting treatment, it is necessary to understand what disease caused the problem. Medicines should be used only those prescribed by your attending physician; self-medication is unacceptable. It is optimal to undergo a complete diagnosis of brain activity, vascular health, and electroneuromyography.

It should be remembered that rapid memory deterioration in itself is not a disease; this symptom only warns of the emergence of a more serious disease that needs to be diagnosed and therapeutic or radical treatment begun. This will help restore the previous quality of life, prevent the patient from separating from society and deteriorating adaptive functions. When memory impairment is detected, nootropic drugs are usually prescribed.

Bilobil Forte

Antihypoxic drug from ginkgo leaf extract. "Bilobil Forte" is prescribed for cerebrovascular accidents. This is an excellent remedy for memory problems, ringing in the ears and dizziness. "Bilobil Forte" improves metabolic processes in brain cells, improves blood circulation, dilates and strengthens blood vessels, and serves as a prevention of thrombosis. The memory drug nourishes the brain not only with oxygen, but also with glucose, relieves swelling and reduces the number of free radicals in cells.

Bilobil Forte

KRKA (KRKA), Slovenia

The drug Bilobil Forte is a drug used for dementia.
Improves cerebral circulation and supplies the brain with oxygen and glucose, prevents red blood cell aggregation, and inhibits platelet activating factor. It exhibits a dose-dependent regulatory effect on the vascular system, stimulates the production of endothelium laxative factor (nitric oxide-NO), dilates small arteries, increases the tone of the veins, thereby regulating the blood supply of blood vessels. Reduces the permeability of the vascular wall (anti-edematous effect both at the level of the brain and at periphery). from 152

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Modern ideas about nootropic drugs

Drugs that affect the processes of neuroplasticity of the central nervous system occupy one of the leading positions in the treatment of vascular diseases of the brain. Currently, some researchers (E. I. Gusev, 1992, 2000, 2005; V. I. Skvortsova, 2000, 2003, 2004; N. V. Vereshchagin, 2001; Z. A. Suslina, 2003; etc.) They believe that the reorganization of neuronal processes is a combination of a number of mechanisms, including the functioning of previously inactive pathways, sprouting of fibers of surviving cells with the formation of new synapses, and activation of neuronal circuits. It is known that one of the universal components of the pathogenesis of damage to nervous tissue is trophic dysregulation, leading to biochemical and functional dedifferentiation of neurons with the initiation of a cascade of pathobiochemical reactions (V. I. Skvortsova, 2001; T. L. Deckwirth et al., 1993; RS Freeman, 1994).

Traditionally, angioneurology uses a number of drugs that affect plastic, neurotransmitter, neuroprotective and integrative processes in the brain. Among them, nootropic drugs occupy a special place.

Nootropic drugs are drugs that have an activating effect on cerebral metabolism and higher mental functions. They are characterized by a metabolic and neurotrophic effect, which determines the processes of improving redox reactions, reducing the aggressive effect of lipid peroxidation (LPO) products, and a positive effect on neurotransmission. In addition, these drugs have a vasoactive and mild antiplatelet effect - they reduce platelet aggregation, reduce the adhesion of erythrocytes to the endothelial surface, and reduce blood viscosity.

The group of drugs that nootropic drugs make up is developing very dynamically both in Russia and abroad. About 60 leading pharmaceutical companies in various countries are developing new drugs. According to the Pharmaprojects Yearbook, in 1995, 132 nootropic drugs were in various stages of research, clinical study and introduction to the market, of which 79 were in preclinical research, 34 were in various stages of clinical study, and 19 were at the stage of registration and introduction into the market. market.

The term “nootropics” (from the Greek “noos” - thinking and “tropos” - striving) was first used in 1972 by Cornelia Guirgea to describe the effect of piracetam from the Belgian company UCB.

Subsequently, this term also began to be used to refer to drugs with different chemical structures that can improve cognitive functions. The classification of these drugs is difficult due to the lack of clear criteria for dividing drugs into those that have and/or do not have a nootropic effect. Currently, there are several classes of nootropic drugs.

Pyrrolidone derivatives (piracetam, lucetam, phenotropil).
Dimethylaminoethanol derivatives (demanol, deanol aceglumate).
Pyridoxine derivatives (encephabol, pyritinol).
Derivatives of γ-aminobutyric acid (GABA) (aminalone, picamilon, phenibut, gammalon).
Ginkgo biloba derivatives (tanakan, bilobil).
Drugs that act on N-methyl-D-aspartate (NMDA) receptors (akatinol memantine).
Drugs with tropism for cholinergic structures (gliatilin).
Preparations of animal origin (Cerebrolysin, Cortexin, Actovegin).
Mixed-action drugs (instenon).

As a result of numerous clinical and experimental studies, the main mechanisms of action of nootropic drugs have been determined.

Accelerating the penetration of glucose through the blood-brain barrier and increasing its absorption by brain cells, especially in the cerebral cortex.
Strengthening the conduction of cholinergic impulses in the central nervous system (CNS).
Increased synthesis of phospholipids and proteins in nerve cells and red blood cells (stabilization of cell membranes), normalization of the liquid properties of membranes.
Inhibition of lysosomal enzymes and scavenging of free radicals.
Activation of cerebral microcirculation by improving the deformability of erythrocytes and preventing platelet aggregation.
Improved cortical-subcortical interaction.
Normalization of neurotransmitter disorders.
Activating effect on higher mental functions (memory, learning ability, etc.).
Improving reparative processes in case of brain damage of various origins.

Due to these properties, a group of nootropic drugs is often called neurometabolic cerebroprotectors, which indicates a common property for drugs in this group - to stimulate metabolic processes in nervous tissue, optimizing the level of metabolism. According to the severity of their effect on the central nervous system, nootropics can be arranged in the following sequence: phenibut–aminalone–pantogam–picamilon–piracetam–pyritinol–meclofenoxate.

Phenibut has the most pronounced depressive effect, meclofenoxate has the most distinct psychostimulant properties. The “pioneer” of nootropic therapy is piracetam.

Piracetam has a chemical structure similar to GABA and is considered a derivative of this amino acid, but it is not converted into GABA in the body and the GABA content in the brain does not increase after its use. But in relatively large doses and with repeated administration, the drug can enhance GABAergic inhibitory processes.

There are two main directions of action of piracetam: neuroprotective and vascular. Piracetam promotes the oxidative breakdown of glucose through the pentose phosphate shunt, increasing the metabolism of adenosine triphosphate (ATP), as well as the level of cyclic adenosine monophosphate (cAMP). The functioning of this shunt is associated with the formation of substances that neutralize free radicals and prevent membrane lipid peroxidation. The drug stimulates the activity of adenylate kinase, ensuring anaerobic metabolism without the formation of lactate. After administration of the drug in patients with acute ischemic stroke, glucose metabolism, local cerebral blood flow, extraction coefficient and local oxygen metabolism increase in the affected area and the surrounding functionally inactive zone. Piracetam interacts with the neurotransmitter system, exerting a modulating effect on cholinergic and aminacidergic (aspartate, glutamate) neurotransmission, which is especially important since disorders of synaptic transmission involving acetylcholine and glutamate cause “age-related” changes in memory and other cognitive functions. The drug also stimulates interhemispheric information exchange, which underlies the restoration of speech functions lost after a stroke. The effect of piracetam on the vestibular system is described due to its effect on the mechanisms of signal transmission from sources of visual and proprioceptive sensitivity or its effect on the vestibular nucleus in the brain stem. The vascular effect of the drug is due to a decrease in platelet aggregation, an increase in the deformability of erythrocytes, a decrease in the adhesion of erythrocytes to the endothelial surface, and a decrease in the viscosity of plasma and whole blood. Reducing vasospasm without a vasodilator effect and hypotension makes it possible to have a positive effect on cerebral circulation, not accompanied by a change in general hemodynamics. A peculiarity of piracetam is that its pharmacological effect is manifested only under conditions of prolonged repeated administration of the drug in sufficiently high doses.

Phenotropil (chemical name: N-carbamoyl-methyl-4-phenyl-2-pyrrolidone) is a derivative of pyrrolidone, has a pronounced antiamnestic effect, has an activating effect on the integrative activity of the brain, promotes memory consolidation, increases the resistance of brain tissue to hypoxia and toxic effects . It is characterized by anticonvulsant and anxiolytic effects.

Phenotropil is used with caution in patients with severe organic damage to the liver and kidneys, severe forms of arterial hypertension in patients with atherosclerosis, as well as in those who have previously suffered panic attacks, anxiety or acute psychotic states, especially with psychomotor agitation, due to the possibility of exacerbation of anxiety, panic, hallucinations and delirium.

With excessive psycho-emotional exhaustion against the background of chronic stress and fatigue, chronic insomnia, a single dose of phenotropil on the first day can cause a sharp need for sleep. Such patients on an outpatient basis should be advised to start a course of taking the drug on non-working days.

The group of neuroamino acid drugs includes a number of well-known drugs.

Aminalon 's chemical structure is GABA, which is the most important mediator of inhibition in the central nervous system and is also involved in the energy supply of the brain. In terms of clinical effectiveness, the drug is inferior to piracetam, but unlike it does not provide clear stimulating effects. Under the influence of GABA, the effectiveness of inhibitory GABAergic processes increases.

Picamilon (nicotinoyl-γ-aminobutyric acid) combines the properties of GABA and nicotinic acid, which has vasoactive properties, and affects the processes of tissue respiration. The drug is capable of exerting both neurometabolic and vascular effects: it reduces vascular resistance, increases the linear and volumetric velocity of cerebral blood flow, and improves microcirculation. Picamilon has moderate anxiolytic activity and helps restore mental and physical performance in case of overwork.

Phenibut is a derivative of GABA and phenylethylamine and has nootropic and tranquilizing activity. The drug reduces the manifestations of asthenia and vasovegetative symptoms (headache, feeling of heaviness in the head), irritability, emotional lability, and increases mental performance.

Pantogam (hopantenic acid) is the most mildly acting metabolic cerebroprotector with a minimally pronounced stimulating effect on the central nervous system. The metabolic activity of the drug is presumably due to the replacement of the p-alanine fragment in the pantothenic acid molecule with GABA. The drug improves energy metabolism in the brain, affects the oxidative processes of the tricarboxylic acid cycle, which plays a significant role in ensuring various types of metabolism in the cell, including energy.

Glycine is an inhibitory neurotransmitter and a regulator of metabolic processes in the brain; it has a sedative and antidepressant effect. The glycine site is a structural region of the NMDA receptor that is important for memory processes; its activation underlies the long-term potentiation of hippocampal neurons and, consequently, the strengthening of synaptic transmission. Glycine, as an agonist of the glycine site, has an improving effect on memory both in experiment and in humans (V. I. Skvortsova, 2000). The drug is also effective as an adjuvant for epileptic seizures.

Glutamic acid is a neurotransmitter amino acid that stimulates the transmission of excitation at synapses in the central nervous system. The drug normalizes metabolic processes, stimulates oxidative processes, promotes the neutralization and removal of ammonia from the body, and increases resistance to hypoxia.

Pyritinol consists of two pyridoxine molecules connected by a disulfide bridge. The main coenzyme form of pyridoxine is pyridoxal phosphate, which, along with various other functions, is involved in the metabolism of GABA. The only enzyme for the synthesis of GABA, glutamate decarboxylase, is a pyridoxal-dependent enzyme, which may determine the ability of the drug to stimulate the formation of GABA. The action of pyritinol ensures more economical utilization of energy substrates and the subsequent expenditure of energy for the synthesis of macromolecular compounds (ATP, ribonucleic acid). The drug enhances the transport of glucose across the blood-brain barrier, increases its utilization in conditions when oxygen consumption by tissues is reduced, accelerates the oxidation of glucose, reduces the excess formation of lactic and acetic acids in brain tissue, increases the resistance of brain tissue to hypoxia, has the ability to stabilize cell membranes and improve them functional state.

Encephabol is a pyritinol derivative that increases the density and sensitivity of receptors and normalizes neuroplasticity. The drug has a neuroprotective effect, stimulates learning processes, improves memory, memorization and concentration. Encephabol stabilizes the cell membranes of neurons by inhibiting lysosomal enzymes and preventing the formation of free radicals, improves the rheological properties of blood, increases the conformational ability of red blood cells, increasing the ATP content in their membrane. For adults, the average daily dose is 600 mg for 6–8 weeks. The drug is effective for the treatment of cognitive impairment in menopausal patients.

Choline alfoscerate (gliatilin) has a cholinomimetic effect, stimulating predominantly central cholinergic receptors. In the body it is broken down into choline and glycerophosphate. Provides the synthesis of acetylcholine and phosphatidylcholine of neuronal membranes, improves the functions of receptors and membranes in cholinergic neurons. The drug activates cerebral blood flow, stimulates the metabolism of the central nervous system, and stimulates the reticular formation. Improves mood, stimulates mental activity, improves concentration, the ability to remember and reproduce received information, optimizes cognitive and behavioral reactions, and eliminates apathy.

Ginkgo biloba extract (bilobil, memoplant, tanakan) is a standardized herbal preparation that affects metabolic processes in cells, rheological properties of blood, and microcirculation. The drug improves cerebral circulation, supply the brain with oxygen and glucose, normalizes metabolic processes, has an antihypoxic effect, prevents the formation of free radicals and normalizes the LPO of cell membranes. Ginkgo biloba affects the release, reuptake, catabolism of neurotransmitters (norepinephrine, dopamine, acetylcholine) and their ability to bind to membrane receptors. The drug normalizes the vascular system, stimulates the production of endothelium-dependent relaxing factor, dilates small arteries, increases the tone of veins, reduces the permeability of the vascular wall, has an anti-edematous effect, stabilizes platelet and erythrocyte membranes, and has antiplatelet properties.

Actovegin is a modern drug that is a deproteinized extract of the blood of young calves. Its main effect is aimed at improving the utilization of oxygen and glucose. Under its influence, the diffusion of oxygen in neuronal structures significantly improves, which makes it possible to reduce the severity of secondary trophic disorders. There is also stabilization of cerebral and peripheral microcirculation against the background of improved aerobic energy exchange of vascular walls and the release of prostacyclin and nitric oxide. The resulting vasodilation and decrease in peripheral resistance are secondary to the activation of oxygen metabolism of the vascular walls (A. I. Fedin, S. A. Rumyantseva, 2002). There is evidence of the positive effect of Actovegin on patients with various forms of dementia, including vascular origin. The pace and quality of mental activity in patients may improve during treatment as the duration of drug use increases (W. Jansen, 2002).

Of significant interest are combination drugs that affect various parts of the pathogenetic process. An example of a successful combination is instenon.

Instenon is a combined drug with neuroprotective action, including a vasoactive agent from the group of purine derivatives, a substance that affects the state of the ascending reticular formation and cortical-subcortical relationships, and, finally, an activator of tissue respiration processes under hypoxic conditions (S. A. Rumyantseva, 2002; B V. Kovalchuk, 2002).

The three components of instenon (etophylline, hexobendine, etamivan) jointly affect various parts of the pathogenesis of ischemic brain damage.

Etophylline is a vasoactive component of the purine series that activates myocardial metabolism with an increase in stroke volume. The transition from a hypokinetic type of blood circulation to a normokinetic one is accompanied by an increase in cerebral blood flow. Important components of the action of etophylline are an increase in renal blood flow and, as a consequence, dehydration and diuretic effects.

Etamivan has a nootropic effect, directly affecting memory processes, attention, mental and physical performance as a result of increased activity of the reticular formation of the brain.

Hexobendine selectively stimulates metabolism by increasing the utilization of oxygen and glucose, due to increased anaerobic glycolysis and pentose cycles. At the same time, the physiological mechanisms of autoregulation of cerebral and systemic blood flow are stabilized.

The variety of drugs with combined action used in angioneurology (Cavinton, Instenon, Sermion, Vasobral, Fezam, etc.) requires clear recommendations for use by general practitioners. Taking into account the literature data and the results of our own research, additional indications for prescribing this group of drugs have been identified:

vegetative-trophic disorders;
concomitant peripheral circulatory disorders (retinopathy and angiopathy in diabetes mellitus, atherosclerosis, arterial hypertension);
cochleovestibular disorders;
asthenodepressive disorders;
prevention of chronic cerebral ischemia after a stroke.

Nootropic drugs can be used both in patients with various pathologies of the central nervous system, and in healthy people during fatigue, natural aging, and also in extreme situations.

Indications for prescribing nootropic drugs:

acute cerebrovascular accidents;
traumatic brain injury;
comatose states;
chronic cerebral ischemia;
vascular dementia;
hypertensive and atherosclerotic encephalopathy;
asthenic syndromes;
autonomic dystonia syndrome;
consequences of perinatal encephalopathy;
delayed mental development in children;
attention deficit hyperactivity disorder.

In recent years, the list of indications for the use of drugs has expanded significantly, but the complexity and multicomponent nature of cerebral metabolic disorders, as well as the limitation of extrapolation of experimental data into clinical practice, lead to ambiguity of opinions about neuroprotective and metabolically active therapy. Undoubtedly, this direction is one of the key, the most promising and at the same time the most difficult. Cerebrovascular diseases cause significant damage to the health of the population, as a result of which the percentage of disability and mortality increases. In recent decades, the arsenal of drugs used to treat these diseases has expanded significantly. Every year, new drugs with indirect nootropic effects enter the pharmacological market. Differentiated therapy for vascular diseases of the brain requires knowledge of the etiology, pathogenesis, and mechanisms of pharmacological action of certain drugs. A special place is occupied by the safety of medicines. In addition, a practicing doctor often has to decide the question: “price–quality–clinical effectiveness.” Life expectancy is constantly increasing, with the fastest growing portion of the general population being people over 65 years of age. Consequently, we can expect that the incidence of diseases associated with age, such as dementia and others, will increase significantly, and nootropic drugs will be more and more in demand. Currently, 15 drugs classified as nootropics are registered in Russia. The range of domestic nootropic drugs is significantly smaller than on the foreign medicine market; in other words, they are often not enough to meet the needs of medical practice in our country.

Understanding the mechanism of action of drugs on the body expands the range of possibilities for drug therapy for various clinical syndromes and diseases. The optimal choice of a nootropic drug is facilitated by the doctor’s correct understanding of pharmacokinetics and pharmacodynamics, which is necessary to determine a rational single and daily dose of the drug used. It should be noted that in order to determine the general patterns of treatment, an individual approach to each patient is necessary, taking into account age, gender, medical history, concomitant diseases, metabolic characteristics and hemodynamics. The effectiveness of the drug is determined from the standpoint of evidence-based medicine and is expressed in reducing the clinical manifestations of the disease and improving the patient’s quality of life. Currently, a new strategy in the use of drugs that have a neuroprotective effect is clearly visible. This is, on the one hand, optimally high doses of the drug (piracetam, Actovegin, Tanakan) and, on the other hand, the widespread introduction of forte forms (Instenon, Cavinton). However, it is necessary to observe the following rule: early initiation and long course (up to 3–4 months) of therapy. Modern medicine makes it possible to combine two or more drugs. For example, Actovegin - Instenon, Actovegin - Piracetam, Piracetam - Gliatilin, etc. The final judgment on the effectiveness of the chosen treatment and the need for its correction can be made if there is no therapeutic effect after 2-3 courses lasting at least 3 months. You should not refuse the chosen drug unless its dose has been increased to an individual maximum and well tolerated. If there is no positive response to treatment or side effects occur, it is recommended to replace the selected medication with a drug of a different class. In case of insufficient effectiveness, but good tolerability of the drug substance, a second drug belonging to a different class can be added to it. This combination can provide a more pronounced therapeutic effect with a lower likelihood of side effects, since lower doses are used during therapy.

Thus, nootropic drugs, due to various mechanisms of therapeutic action, can be used in the treatment of neurological patients. The Russian pharmaceutical market offers drugs with varying degrees of effectiveness and tolerability. Therefore, the choice of a particular drug should be based on the results of clinical studies and the personal experience of the doctor.

M. V. Putilina , Doctor of Medical Sciences, Professor of Russian State Medical University, Moscow

Sermion

An adrenoblocker and antihypoxant, which contains nicergoline, which is capable of restoring neurons. Sermion improves cerebral circulation, stimulates metabolic processes and microcirculation in the blood vessels of the brain. The medicine has a positive effect on cognitive function and improves memory. With long-term use of Sermion, there is a significant improvement in mental activity, and the development of dementia is inhibited as much as possible.

Sermion

Pfizer (Pfizer), USA

Sermion improves metabolic and hemodynamic processes in the brain, reduces platelet aggregation and improves hemorheological blood parameters, increases the speed of blood flow in the upper and lower extremities.
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Picamilon and its analogues

To improve brain activity and restore cognitive functions, there are inexpensive but very effective tablets - Picamilon.

Contains sodium salt of gamma-aminobutyric acid. This substance is a powerful nootropic, but, unlike the remedies described above, it additionally dilates cerebral vessels.

Picamilon has a psychostimulant and tranquilizing effect, so it is taken when brain function deteriorates.

After taking the tablets, they normalize metabolism in the nervous tissue and significantly improve the speed of cerebral blood flow and vascular resistance. Also, when taking the drug, the risk of thrombosis is reduced, because it thins the blood. The medicine helps you sleep better, eliminates headaches, feelings of fear, and tension.

Over-the-counter sleeping pills do not have strict contraindications and can be used independently for sleep disorders. Stressful situations often cause a person to suffer from insomnia. Read more in the article: “names of sleeping pills without a prescription.”

If a patient has speech or memory impairments, Picamilon will definitely help him, the treatment standards are as follows:

Advertising:

drink 20-50 mg three times a day, therapy does not depend on food intake;
course of treatment - 30-60 days;
The course must be repeated after 5-6 months.

The medicine is contraindicated in children under 3 years of age, nursing mothers, pregnant women, and severe renal failure. The price of the medicine is 150 rubles. There are a number of analogues of Picamilon in pharmacies - Amylonosar, Pikogam, Picanoil, Aminalon.

Fezam

A nootropic drug, a psychostimulant, which contains two active ingredients: piracetam and cinnarizine. Phezam improves memory and attention, stimulates neural connections, dilates blood vessels, and protects brain cells from oxygen starvation. Cinnarizine improves cerebral circulation, relieves vascular spasm, thins the blood, without affecting blood pressure. Piracetam improves cognitive abilities, improves metabolic processes in the ischemic zone, and regulates connections between the hemispheres of the brain. Phezam is prescribed for neuroses and exhaustion of the nervous system; the drug stimulates mental, emotional and physical activity.

Fezam

ZiO-Zdorovye, Russia

- cerebrovascular insufficiency (cerebral atherosclerosis, recovery period of ischemic and hemorrhagic strokes, after traumatic brain injury, encephalopathy of various origins);
- intoxication; - diseases of the central nervous system, accompanied by a decrease in intellectual and mental functions (impaired memory, attention, mood); — conditions after a traumatic brain injury; — psychoorganic syndrome with a predominance of symptoms of asthenia and adynamia; — asthenic syndrome of psychogenic origin; - labyrinthopathy (dizziness, tinnitus, nausea, vomiting, nystagmus); - Meniere's syndrome; - prevention of kinetosis; - migraine prevention; — as part of complex therapy for low learning ability in children with psychoorganic syndrome. from 259

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Cerebrolysin and Vinpocetine

A rather expensive but highly effective remedy for improving memory is Cerebrolysin. Such tablets are not available - the product is presented only in the form of a solution for intravenous administration.

Price for 10 ampoules - 1200 rubles. The active ingredient is a complex of peptides obtained from pig brain tissue. The properties of the drug are unique - its active neuropeptides easily penetrate the natural protective barriers of the brain, rush to neurons and have the following effects:

increase metabolic rate;
accelerate protein synthesis in cells (relevant for an aging body);
protect cells from damage by free radicals;
reduces the effects of oxygen starvation.

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The medicine is indicated for those who suffer from serious disorders of the nervous system, memory impairment, and intellect. More often it is prescribed after a stroke, for dementia, in children - for mental retardation, after head and back injuries, and for depression.

Vinpocetine has a different composition (vinpocetine) and a low price (140 rubles).

These pills for brain activity and memory are prescribed everywhere for various forms of encephalopathies, after a stroke and for other diseases that have led to cognitive disorders. Vinpocetine, unlike Cerebrolysin, should not be taken before the age of 18.

Memoplant

Angioprotector, the active substance of which is an extract from ginkgo leaves. "Memoplant" is prescribed for cerebral circulatory disorders accompanied by memory impairment, dizziness, ringing in the ears, and problems with cognitive abilities. The drug improves metabolic processes in cells, strengthens blood vessels, thins the blood and reduces the risk of thrombosis, nourishes the brain with oxygen and glucose, and reduces the number of free radicals. Memoplant is often prescribed to older people, since ginkgo-based preparations are considered very effective and safe. The only point: Memoplant cannot be taken in parallel with aspirin (and drugs based on it), since the risk of bleeding increases.

Memoplant

Dr. Willmar Schwabe, Germany

- disorders of brain function, incl.
age-related, associated with cerebrovascular accident and accompanied by the following symptoms: memory impairment, decreased ability to concentrate and intellectual abilities, dizziness, tinnitus, headache; - peripheral circulatory disorders (obliterating diseases of the arteries of the lower extremities with such characteristic symptoms as intermittent claudication, numbness and coldness of the feet, Raynaud's disease); - dysfunction of the inner ear, manifested by dizziness, unsteady gait and tinnitus. from 1025

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Taking vitamins in old age

In the body of older people, there is often a lack of vitamins involved in metabolic processes. Therefore, when memory problems are detected, doctors recommend taking vitamin complexes with herbal supplements (for example, ginseng), since they have a nootropic effect. It is especially important for older people to drink vitamins A and B and ascorbic acid. But old people often simply forget to drink the medicine due to memory problems. Therefore, it is better to choose a complex that combines daily doses of all the necessary vitamins and supplements that improve the nutrition of brain cells and their functioning.

What brain medications can a doctor prescribe for older people? Pensioners are often prescribed medications containing glycine, an amino acid involved in the metabolic processes of various organs of the body. Indications for the use of medicine for cerebral vessels for elderly people are memory impairment, detection of atherosclerotic changes in blood vessels and amnesia.

Thanks to the tablets, metabolic processes are normalized, as a result, performance and brain activity increase, sleep is normalized, and anxiety states disappear. The advantage of such drugs is a small number of side effects. This is due to the fact that glycine is a natural substance for the body. It is extremely rare that an elderly person may develop an allergy to the drug or an individual intolerance to it. In some cases, we are talking only about mild drowsiness at first.

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Vasobral

This memory improving drug contains caffeine and α-dihydroergocriptine. “Vasobral” stimulates tissues to be resistant to lack of oxygen and blocks adrenaline receptors. The drug improves vascular function, has a diuretic effect, relieves excess drowsiness, and improves performance. Patients who took Vasobral note that this drug is well tolerated and really stimulates memory, mental activity and attention. Doctors say that a long course of treatment is required to achieve maximum effect.

Vasobral

Chiesi, France

- decreased mental activity, impaired attention and memory, impaired spatial orientation caused by age-related changes;
- cerebrovascular insufficiency (including due to cerebral atherosclerosis); - consequences of cerebrovascular accident; — migraine prevention; - vestibular and labyrinthine disorders (dizziness, tinnitus, hypoacusia) of ischemic origin; - Meniere's disease; - retinopathy (diabetic and hypertensive); - peripheral arterial circulation disorders (Raynaud's syndrome and disease); - venous insufficiency. from 879

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Content:

Why is it necessary to restore strength and energy after Covid?
What to take after coronavirus: how to choose the right rehabilitation program 2.1. Restoring strength and energy after Covid: main directions of rehabilitation 2.2. Indications for immediate medical attention
Non-drug methods of recovery after coronavirus infection
What to drink after coronavirus for recovery

Despite numerous clinical studies, doctors still cannot say about the long-term consequences of COVID-19. But today it has been established that even with a mild course, coronavirus can lead to chronic pathologies of almost all internal organs and the nervous system. Doctors are convinced that rehabilitation (ideally if it takes place on the basis of a specialized medical center) is needed by all patients without exception. The problem of how to restore strength and energy after Covid requires special attention, because more than 90% of those who have recovered complain of weakness. Typically, such a symptom appears due to severe intoxication, but in some cases this may indicate the development of more serious and dangerous complications.

Tanakan

Another adaptogen and antihypoxant based on ginkgo biloba. "Tanakan" copes well with the main task - improving memory and performance. In addition, the medicine helps improve sleep, improve blood circulation in the brain, and reduce the number of headaches and dizziness. Tanakan is perfect for older people because it has a completely natural composition.

Tanakan

IPSEN (Bofur Ipsen), Ukraine

- cognitive and neurosensory deficits of various origins (with the exception of Alzheimer's disease and dementia of various etiologies);
— intermittent claudication in chronic obliterating arteriopathy of the lower extremities (grade 2 according to Fontaine); - visual impairment of vascular origin, decreased visual acuity; - hearing impairment, tinnitus, dizziness and coordination disorders mainly of vascular origin; - Raynaud's disease and syndrome. from 485

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Symptoms indicating memory impairment

Memory bells that should alert you:

forgetfulness, manifested in everyday matters;
difficulty focusing on a specific object;
problems with learning and remembering information, with its reproduction;
disruption of the thought process, loss of logical connections, loss of mental acuity;
confusion and uncertainty;
autism, social maladjustment;
foggy consciousness.

Often, memory problems begin against the background of deteriorating general health. However, they can be combined:

with headaches;
with pressure surges;
with hand tremors;
with muscle spasms;
with dizziness;
with a decrease in visual acuity.

If, in the presence of 2-3 of the above problems, memory has decreased, you should urgently seek medical help, since these symptoms signal rapidly developing brain pathologies.

Why is it necessary to restore strength and energy after Covid?

The entry gate for the pathogen SARS-CoV-2 is primarily the epithelial membrane of the upper respiratory tract (oral and nasal cavities), stomach and intestines (the role of the latter in infection has not been established, but experts are convinced that it is insignificant).

At the initial stage of infection, the virion penetrates target cells, on the surface of which there is a specific membrane protein - angiotensin-converting enzyme (ACE2). They are localized in the respiratory tract, kidneys, esophagus, bladder, heart, and central nervous system. In the vast majority of cases, the alveoli of the lungs are the first to be hit, which leads to the development of pneumonia. In some patients, the only symptoms of COVID-19 are loss of smell and/or taste, a consequence of damage to neurons in the brain.

Weakness, drowsiness, weakness and other manifestations of asthenic syndrome appear almost immediately after the incubation period. The reason for the loss of strength and energy lies not only in systemic intoxication - an inevitable consequence of the progression of a viral infection. Against the background of Covid (even with relatively moderate damage to the lung tissue), hypoxia develops, which, in turn, leads to metabolic disorders, enzyme production, and circulatory disorders.

Not the least important role is played by the lack of appetite and, accordingly, nutritional deficiency, increased loss of fluid and electrolytes against the background of hyperthermia. Asthenia is a completely logical and understandable consequence of such severe disorders.