Nootropics for children. Medications for delayed speech development in children Nootropics for children Komarovsky

Nootropic drugs are popularly called “smart” pills. After all, such drugs improve the brain. They activate learning and improve memory. The first nootropic synthesized in 1963 was the drug Piracetam. During the study of the drug, scientists confirmed that the drug increases mental abilities, improves memory, and performance. Today, many drugs have been developed that have a similar effect. These are new generation nootropics. We'll talk about them.

Mechanism of action

New generation nootropics do not cause addiction in humans. In addition, they do not provoke psychomotor agitation. Taking them does not cause depletion of physical capabilities.

It is generally well tolerated. But some patients may experience unwanted reactions, which were discussed above. For disturbances in carbohydrate metabolism this remedy not used because it contains sucrose.

The drug "Pantogam"

The medicine can activate mental activity, normalize behavioral reactions, and increase performance. Actively promotes enrichment of the brain with oxygen.

This product is approved for use by children from 1 year of age. Used for babies suffering from cognitive disorders. Mainly for speech delay, hyperactivity syndrome.

The average cost of the drug is 358 rubles.

List of the best nootropics

Today there is simply a huge list of effective medications. In addition, new drugs appear on the pharmacological market from time to time. After all, developments to create the most effective means are ongoing.

If we talk about the best nootropics, doctors highlight the following medications:

• “Piracetam” (even today it ranks as a highly effective remedy).
• "Nootropil"
• "Phenotropil".
• "Glycine".
• "Meclofenoxate."
• "Cerebrolysin".
• "Aminalon".
• "Bemitil."
• "Biotredin".
• "Vinpocetine."

Patient opinions

From the above, it is quite clear how the nootropic is positioned in the instructions for use. Reviews from patients who have tested the medications themselves largely confirm their effective effect on the body.

The same old drug Piracetam occupies a special place. It is prescribed for many pathologies, especially after traumatic brain injuries. Patients who adhere to the course of treatment prescribed by the doctor notice that unpleasant phenomena such as migraines and dizziness are eliminated under the influence of the medicine.

Excellent remedies, especially for VSD, are the drugs “Cinarizine” and “Vinpocetine”. They eliminate such unwanted symptoms as constant dizziness, blue nail plates, cold extremities and many others. However, some patients may experience adverse reactions.

Despite this, it is the patients who assure that nootropic drugs can “simply bring you back to life”! Therefore, love yourself, take care of your health and take the medications your doctor prescribed for you!

A short, sad, but necessary preface.

The uniqueness of the existing order of things is that

• the vast majority of doctors find it much easier to prescribe THIS than to explain why a child does not need THIS;
• for the vast majority of parents it is much easier to go to the pharmacy, buy and feed THIS for weeks to your own child rather than try to read and understand, re-read and still understand;
• and for those who are especially impressionable, THIS is available in injections...

Nootropic drugs are drugs that stimulate metabolic processes in nervous tissue.

The pharmacological effects of drugs in this group are improved memory and learning ability, increased cell stability nervous system to adverse external influences (in particular, lack of oxygen).

All nootropic drugs (nootropics) are close in their chemical structure to natural biological ones active substances- neurotransmitters, vitamins, amino acids. This explains the fact that most nootropics are non-toxic and do not have dangerous side effects.

Basic indications for the use of nootropics in childhood :

• cerebral palsy;
• mental retardation;
• delay speech development;

The pharmacological effects we mentioned above are identified by drug manufacturers; the indications for use are formulated just below - these are again the recommendations of the manufacturers of nootropic drugs.

Nootropic drugs are extremely widely used in pediatrics, but the breadth of their use is limited mainly by the borders of the former Soviet Union.

Despite the vast experience of use, despite the many positive properties found in experiments, despite the extreme attractiveness of the identified pharmacological effects and the breadth of indications for use, so, despite all this, it is necessary to justify the benefits and effectiveness nootropic drugs methods evidence-based medicine so far no one has succeeded.

This is hard for doctors to believe, and even harder for patients and parents of patients, but neither in the USA nor in Western Europe nootropic drugs are not used because, once again, there is no evidence of their effectiveness.

Readers who have read the list of nootropic drugs and discovered well-known, one might even say well-known, drug names in it, are probably expecting detailed stories from the author about when and how to take them. And assurances that all of these are drugs with unproven effectiveness can cause disagreement and bewilderment: nootropic drugs have become too active in the daily lives of doctors, pharmacists, patients, and relatives of patients.

No one doubts the fact that the child (even absolutely healthy child!) is born with an “immature” nervous system, which is very actively improving (“ripening”) in the first years of life. This process of “maturation” is accompanied, firstly, by many specific symptoms (physiological reflexes of the newborn period, increased muscle tone, trembling of the lips, chin and limbs, etc., etc.), and secondly, by a constantly present concern parents.

It is in the first years of life that parents discover certain “strange” behavior in their children that they cannot explain, guided by their own experience. It is in the first years of life that questions and doubts regarding the normality or abnormality of one’s own child constantly bother all mothers and fathers without exception.

Oddities, questions and doubts lead parents to doctors.

The main question looks like this:

- Is it normal or not at our age (insert the desired age) not... - then something is said that the child does not yet know how to do - sit, stand, roll over, crawl, walk, pick up, throw, talk, go to the toilet, sleep all night without waking up , obey your parents, read, count, sing, draw, etc., etc.?

Any answer “normal” actually means that the doctor has no doubt that the child is healthy and that he does not need any treatment.

And here, in fact, a situation is simulated when society experiences a huge need for drugs that “improve the functioning of the nervous system.” I emphasize once again: this is not the need of a child or a doctor, this is a need of the existing model of human relationships in the doctor-parents-child system.

Humiliated by the state and legally defenseless, the doctor does not have the slightest desire to take responsibility.

The doctor knows for sure that without prescribing medication, he automatically becomes, on the one hand, an “inattentive and indifferent specialist,” and on the other, a potential culprit for all theoretically possible neurological troubles in the future. “We are 15, we have headaches every day, but at 6 months we visited a neurologist, complained of a trembling lip, and he said that everything was fine...”

Parents are convinced that there are some magic drops, thanks to which the child will learn to sit, talk, obey his mother and go to the potty.

Parents, as a rule, have no doubt that neurological problems in general and various “delays and deviations” are easy to cure: the main thing is to prescribe the right medicine in time (!!!).

Parents are not able to understand that the metabolism in the child’s nervous tissue occurs so intensely that it is practically impossible to accelerate it pharmacologically.

There are medications that have been experimentally shown to have a positive effect on the nervous system and have proven their safety—numerous nootropic drugs.

Medicines are prescribed, and some time after the prescription, the vast majority of children actually begin to sit, stand, roll over, crawl, walk, pick up, throw, talk, go to the toilet, sleep all night without waking up, obey their parents, read, count, sing, draw and etc., etc. They start, of course, not because the medicines were prescribed, but because the time has come, because it was so conceived by great Nature (God, Evolution). But it is very difficult to agree that “after the medicine” does not mean “thanks to the medicine”...

Thus, nootropic drugs can solve many problems because:

• ease the burden of responsibility on doctors;
• reassure parents;
• improve the financial situation of their producers and sellers;
• in most cases they do not harm patients.

It is not surprising that all the problems described do not concern us at all real owner insurance company. Where it is the private insurance company that pays for treatment, and not the patient or a corrupt official, well, there (in the world of private capital) no one wants to pay for relief, reassurance and “no-harm”. They pay for effective treatment, confirmed by evidence-based medicine. But there are problems with this...

However, I would like to emphasize that the ability of nootropic drugs to positively influence metabolic processes in nervous tissue - this is not at all an invention of greedy pharmacists, this is a real fact.

Nootropics are truly capable of:

• activate energy metabolism in neurons;
• enhance protein synthesis;
• increase the speed of impulse transmission in the central nervous system;
• improve glucose uptake by nerve cells;
• strengthen cell membranes.

These properties are actually revealed in experiments. It is these properties that allow scientists to consider nootropic drugs as a very (!!!) promising group of drugs and continue their intensive study. It is on the basis of these properties that indications for the use of nootropics are formulated.

That is, given the ability of nootropics to activate, strengthen, increase, improve and strengthen, it is assumed that they will help with delayed speech development or with mental retardation. And then the saddest thing - the theoretical assumption does not find its practical confirmation when using drugs in real patients.

Not surprising in this regard two facts:

• Manufacturers of nootropic drugs do not promise anyone a quick and significant effect: - it is strongly emphasized that the effectiveness, firstly, is moderate and, secondly, it is necessary to long-term use- a few months;
• An increasing number of pharmacologists propose to consider nootropic drugs not as drugs, but as dietary supplements that can potentially improve the quality of life.

So, you left the office of the pediatrician or neurologist and in your hands you have a list of prescribed medications, and on this list are nootropic drugs.

You know that nootropic drugs, if used, are used for a reason, but for very specific indications. And this means that if you are prescribed a drug from the group of nootropic drugs, it is because your child has been given a specific diagnosis (see the list of indications and diagnoses above).

No diagnosis - no indications. That is the prescription of nootropic drugs has nothing to do with, muscle hypertonicity, minimum brain dysfunction, pyramidal insufficiency and other fashionably popular domestic diagnoses.

Again, you already know that the effectiveness of nootropics has not been proven, but you also know that in most cases they are safe, and you have neither the strength nor the special desire to argue with the doctor and take responsibility for “not treating” yourself. So, we will be treated... And the main thing here is to do no harm. Therefore, in the subsequent consideration of the main nootropic drugs, we will put the safety of use at the forefront.

Piracetam

It has been used for more than 40 years, being in fact the ancestor of nootropic drugs.

Available in a variety of dosage forms intended for both enteral and parenteral use - tablets, capsules, granules, syrups, solutions for intramuscular and intravenous administration.

Possible side effects are abdominal pain, nausea, vomiting, constipation, diarrhea, dizziness, headache, mental agitation, motor disinhibition, irritability, imbalance, decreased ability to concentrate, anxiety, sleep disturbances.

Neuroamino acid preparations

Gamma -aminobutyric acid . Available in tablets. Taken orally before meals. Strengthens the effect of sleeping pills and anticonvulsants. Possible nausea, vomiting, insomnia, increased body temperature, feeling hot, shortness of breath, hypersensitivity reactions.

Hopanthenic acid . Available in tablets and syrup. During the reception it is possible allergic reactions(rhinitis, conjunctivitis, rash). Not recommended in the first trimester of pregnancy.

Nicotinoyl gamma-aminobutyric acid . Used for enteral administration (tablets) and parenteral administration(i.m., i.v. solutions). Use may be accompanied by nausea, headache, dizziness, irritability, anxiety, and allergic reactions. Contraindicated for pregnant and lactating women.

Gamma-amino-beta-phenylbutyric acid hydrochloride - known by trade name phenibut , available in tablets. Irritates the mucous membranes of the gastrointestinal tract (therefore contraindicated in peptic ulcer). At the beginning of treatment, as a rule, it causes severe drowsiness. Irritability, agitation, anxiety, dizziness, headache, nausea, and allergic reactions are also possible. Not for use during pregnancy and breastfeeding.

Glycine . Available in tablets intended for resorption in the mouth. Very well tolerated - rare allergic reactions.

Glutamic acid . Release forms: tablets and granules. Adverse reactions - increased excitability, vomiting, diarrhea. With long-term use, a decrease in the level of leukocytes and hemoglobin, irritation of the oral mucosa, and cracks in the lips are possible. Contraindicated for feverish conditions, diseases of the liver, kidneys, gastrointestinal tract, hematopoietic organs. During treatment, be sure to do it occasionally clinical tests blood and urine.

Neuropeptides

Neuropeptides are protein molecules produced in the nervous system that have biological activity. Medicines containing neuropeptides have a certain nootropic effect. Some drugs in this group are widely known and are actively used in countries where the concept of evidence-based medicine has not yet been adequately implemented. The most well-known neuropeptide drugs include cerebrolysin , cortexin , actovegin , solcoseryl .

Drugs are administered mainly intramuscularly. They are well tolerated, but allergic reactions are possible, sometimes very severe.

Pyritinol

Taken orally (suspension, tablets, dragees). It has an impressive list of possible side effects - sleep disturbances, increased excitability, headache, dizziness, fast fatiguability, loss of appetite, nausea, diarrhea, allergic reactions, stomatitis, joint pain, reactions from the hematopoietic system. Contraindicated in hypersensitivity, epilepsy, hepatic and renal failure. Not recommended for pregnant and lactating women. During treatment, laboratory monitoring is required (clinical blood and urine tests, liver tests).

Vinpocetine

It is considered as a drug with complex action. It has not only a nootropic effect, but also the ability to improve blood circulation in nervous tissue. However, numerous beneficial features Vinpocetine has not yet been confirmed by evidence-based medicine.

The drug is available in tablets and solutions for intravenous administration. It cannot be administered intramuscularly. Contraindicated for pregnant and lactating women. When taken orally, it is well tolerated (rare hypersensitivity reactions); when administered intravenously, a decrease in blood pressure, dizziness, nausea, and phlebitis are possible.

Due to the large number of side effects (drowsiness, fatigue, headache, trembling limbs, increased muscle tone, depression, dry mouth, abdominal pain, increased sweating, allergic reactions, lowering blood pressure) is currently not recommended either as a nootropic or as a vascular agent. Application is considered justified in complex therapy migraines, dizziness, seasickness.

The list of nootropics does not end there. The stimulating effect on metabolic processes in nervous tissue - that same nootropic effect - seems very, very attractive. It is not surprising that there are many (hundreds!) of a wide variety of medicines, in theory having a nootropic effect.

Even a cursory listing of these drugs may take more than a dozen pages, nevertheless all that can be prescribed to your child to “improve” the nervous system are medications with unproven effectiveness, located in the 4th phase clinical trials(so-called post-marketing research). Only you - moms and dads - have the right to decide whether your child will be a participant in these studies or not.

(This publication is a fragment of the book by E. O. Komarovsky adapted to the format of the article

The term “nootropic” appeared in 1972, literally translated from Greek it means “I change the mind.” Drugs that belong to the group of nootropics are prescribed in cases where there is a need to influence the human central nervous system in order to strengthen/improve mental functions. The main indications for taking nootropic substances by young patients are:

• damage to the central nervous system (including during childbirth);
• cerebral palsy;
• mental retardation;
• consequences of violation cerebral circulation;
• epilepsy, etc.

But often nootropics are taken and completely healthy children, for example, schoolchildren and students, pursuing the goal of using such stimulants to improve memory and attention.

How do nootropic drugs work?

The “family” of nootropics includes drugs from several pharmacological groups who have different mechanisms actions. Typically, these medications improve metabolism in nerve cells (neurons) and speed up the transmission of nerve impulses.

Consequences of taking nootropics

More than 50 years have passed since the appearance of the first psychostimulants. During this time, many experiments and studies were carried out, which testified positive properties nootropics. Thus, taking drugs of this group helps improve blood supply to the brain and has a beneficial effect on the resistance of nerve cells to the effects of undesirable factors (including by stabilizing the cell membrane). Nootropics also have antioxidant effects.

At the same time, without detracting from all the advantages of nootropic drugs, it should be noted that the principle of action of these substances has not yet been fully studied, and there is also no official recognition of their effectiveness by authoritative medical organizations. Parents buying nootropic drugs for children should be aware that they have a number of side effects, including the following:

• headache;
• irritability (typical of almost all psychostimulants);
• feeling of anxiety;
• drowsiness;
• disorders digestive system(constipation, diarrhea, nausea);
• changes in blood pressure;
• psychopathological symptoms (disorders of memory, attention, emotions, movements);
• allergic reactions.

It is also important that some nootropic drugs are toxic and addictive. Given all this, parents should find out from their doctor whether there is anything safer than nootropic drugs for children who need behavior correction or support during periods of increased emotional and mental stress.

Nootropic drugs for children - is there an alternative?

The decision to apply any pharmacological agents should be taken by a specialist who determines the treatment regimen based on the established diagnosis and condition of the patient. In any case, the rule “do no harm” applies - when choosing one or another medicinal product, the doctor is obliged to determine the likely degree of harm and benefit to the person.

In pediatric practice, the drug Tenoten for children has proven itself well, which has not only a sedative, but also a mild nootropic effect, helps to increase concentration and improve the child’s memory. Along with its effectiveness, experts confirm the high safety profile of this product*.

The list of indications for prescribing Tenoten for children is quite wide. It is designed to help young patients who suffer from neuroses, increased excitability, stress and sleep disorders. The drug has also shown its effectiveness in cases where children need medication assistance due to psychological stress caused by a busy school schedule and various stressful situations.

Unlike traditional nootropics, Tenoten for children does not have a direct psychotropic effect, and therefore is not addictive. When taking it, there is no lethargy, drowsiness, apathy or other undesirable effects. side effects. But in any case, the need for use and duration of use is determined by the doctor.

*TREATMENT OF ATTENTION DEFICIT HYPERACTIVITY SYNDROME WITH CHILDREN'S TENOTEN: RESULTS OF A DOUBLE-BLIND PLACEBO-CONTROLLED RANDOMIZED STUDY. Professor, Doctor of Medical Sciences N.N. Zavadenko, Ph.D. N.Yu. Suvorinova Department of Neurology, Neurosurgery and Medical Genetics, Faculty of Pediatrics, State Educational Institution of Higher Professional Education, Russian State Medical University of Roszdrav, Moscow. EF. Neurology. 5/2010

Treatment with nootropic drugs for children with impaired cognitive, emotional, and social function does not have an unambiguous positive or negative assessment. Treatment with nootropics for autism causes greatest number disputes among medical workers and ambiguous assessment of their effectiveness among parents. What are nootropics and what effect do they have?

Nootropics – what kind of medicines are they?

Nootropics are a group of drugs that, according to manufacturers, have a stimulating effect on metabolic processes in the human brain. At first, these drugs were used to treat elderly patients, people with previous brain damage or injuries. In the seventies of the last century, an attempt was made for the first time to introduce nootropics (piracetam) into a separate class of drugs.

Today there are several groups:

1. Racetams are the first drugs in this direction.
2. Gamma-aminobutyric acid preparations.
3. Herbal stimulants (ginseng, ginko biloba).
4. Amino acids. The most common drug in this series is Glycine.

Note! Nootropics do not cause addiction or withdrawal symptoms with long-term use. However, the effect of these drugs has not been sufficiently studied, and their effect is not always predictable.

Who are nootropics indicated for?

Today these are drugs that are common in therapeutic and pediatric practice and are indicated for patients for:

• stimulation of brain neurotransmitters during degenerative, post-traumatic changes;
• improvements psychological state, memory correction, stimulation of cognitive abilities in the treatment of alcoholics and drug addicts;
• facilitating the adaptation process in a stressful situation;
• stimulating patients with lethargy, apathy;
• antidepressant therapy.

It should be understood that nootropics are not drugs that can radically improve an individual’s cognitive abilities. However, they help improve cellular nutrition of the brain, which stimulates memory and mental activity in humans.

Nootropics in the treatment of children

Note! To date, there is no scientific evidence of the effectiveness of nootropics!

The main direction of therapy for autism in children is treatment with nootropic drugs. The nootropic effect manifests itself in the form of improving the energy state of neurocellular structures, accelerating nervous system and impulse processes, oxygen saturation of the brain and strengthening neurocellular membranes.

In addition, nootropics improve metabolic processes in the brain, enliven perception and strengthen memory, and increase intellectual abilities.

Arguments in favor of treatment are based on the biological relationship of the active ingredients of these drugs with natural psychostimulants that are produced by the human body.

Their use is prohibited or strictly limited in Europe and the USA. These drugs have become widespread in the treatment of children in the post-Soviet space.

Drugs that are widely used in pediatrics:

• Piracetam,
• Neuromedin,
• Olatropil,
• Encephabol,
• Cerebrocurin,
• Cortexin,
• Actovegin,
• Neuromultivitis,
• Glycine.

They are written out:

1. with delayed speech development;
2. with pedagogical neglect;
3. with mental retardation, which is caused by gaps in the child’s development;
4. born prematurely;
5. with a diagnosis of cerebral palsy in complex therapy;
6. in autism to stimulate or inhibit the child’s psychophysical reactions.

• Piracetam - is considered the most important nootropic, the founder of more modern medications in this group. It has a beneficial effect on brain structures, simulates memory processes, increases concentration and learning ability. Produced in the form of capsules and tablets, injections. It is not recommended to take Piracetam for children under one year of age, as well as for children with psychomotor agitation.
• Olatropil- a combined nootropic drug. The main components are piracetam and gamma-aminobutyric acid (GABA). Produced in capsule form. The complex effect of the active components of the drug enhances the nootropic and antihypoxic effect, increasing the ability to work and the resistance of external stress factors. Used in children over 8 years old.
• Neuromidin- the instructions for this drug indicate that it is contraindicated for children, however, specialists in the field of neurology often prescribe the medication to young patients. As a result of using the drug in children, nerve impulse transmission is restored, learning and memory are improved, and heartbeat and moderately stimulates nervous system activity.
• Cerebrocurin- enough effective drug for children with autism. The main difficulties with this disease are observed in relation to the performance of certain actions that require coordination of individual parts of the brain. The use of Cerebrocurin helps improve consistency in work various departments brain and stimulates interneuronal interaction. The medication ensures long-term viability of neurons, improves cerebral microcirculation and behavioral reactions, learning and memory.

The nootropic drug Cortexin has earned the trust of some parents; it shows good results in autism. Nootropic medications for autism are considered the mainstay of therapy and are prescribed to almost all patients.

Research shows that the effects of nootropics are more noticeable in children with high IQs. Treatment of mental retardation caused by organic reasons, nootropic drugs do not produce a noticeable effect. There is a slight improvement in motor activity and memory.

For autism

Drug therapy plays a significant role in the treatment of children with autism. However, there is no reliable, systematic data on the effect of neurostimulants on the condition of children with autism.

Treatment is carried out according to the following scheme: taking the drug for 3-5 months without a break, then repeating it at yearly intervals.

Drugs are prescribed depending on behavior:

• If a child with autism is easily excitable and fidgety, then Pentogam and Phenibut are prescribed. These medications have a calming effect, stimulate memory, attention, and increase performance.
• For lethargy, Picamilon, Encephabol, and Cogitum are indicated. Stimulant medications must be given in the morning to avoid sleep disturbances.

Reviews from parents for the most part do not confirm the significant effectiveness of nootropics in the treatment of autism. Some parents report worsening behavior when taking these medications.

Nootropics for children with mental retardation

When the development of a child’s psycho-emotional sphere is delayed, the development of his speech suffers. Diagnose this problem after 3-5 years. It is believed that treatment with nootropics gives good results. A neurologist prescribes treatment. The most common drug for speech delay is Cogitum.

Note! That taking medications without additional classes with teachers, a psychologist, and a speech therapist will not have any effect!

Today, since nootropics are considered safe medications, their purpose is often precautionary or prophylactic in nature. The principle “just in case, there will be no harm” is unacceptable in pediatric practice.

For attachment disorders and hyperactivity

If a child is hyperactive, he may be prescribed Pantogam or Phenibut. Gamma-aminobutyric acid derivatives control inhibition processes in the child’s brain.

Drug therapy with these drugs is prescribed after 3 years. The appointment is made by a neurologist.

Nootropics in injections

In some cases, children are prescribed injections of nootropic drugs:

• Cerebrolysin. The drug shows good effect in the treatment of “talking” autistic people. It stimulates memory and speech. Contraindicated for illnesses internal organs. An examination is required before the appointment.
• Cortexin. Shows good results in the treatment of cognitively intact children with cerebral palsy. Suitable for use in epilepsy.

Nootropics for premature babies

The use of nootropics in the treatment of premature infants cannot be unequivocally recommended or prohibited. Difficult or premature births have different effects on the health and development of the baby. Classic pediatrics uses Piracetam and its derivatives for prematurity to improve brain nutrition at the cellular level.

Thus, today there is no clear answer whether nootropics are beneficial or harmful for children. It should be remembered that no pill can replace love, care and developmental activities for a child with problems.

Neuroleptics

In autism, antipsychotics are considered an essential component of complex therapy. These drugs include medications for the treatment of psychosis and severe mental disorders. Neuroleptics in the treatment of autism in children have a calming effect, reduce reactions to external stimuli, reduce tension and psychomotor agitation, and suppress aggressiveness and fear.

Typically, antipsychotic medications for autism are used to correct aggression and motor disinhibition, self-aggression and anxiety, fears and stereotypic motor excitation.

Some neuroleptics like Rispolept, Triftazin increase speech activity and improve the child’s contact and openness, and increase intellectual productivity. Usually, drugs like Haloperidol or Rispolept, Sonapax or Strattera, etc. are used in the treatment of children.

• Risperpet. The annotation for the drug states that there is no information on its use in patients under 15 years of age. In fact, there is real experience of using Rispolept for autism in children, and it is very successful. These data prove the relative safety of using the drug in pediatrics. By the end of the first week of taking the drug, there is an improvement in mental activity - children concentrate better and are easier to learn.
• Strattera– a common and quite effective drug for the treatment of ADHD in children from 6 years of age. The drug belongs to a new generation of medicines. It is a sympathomimetic that has a central effect, blocking the processes of norepinephrine reuptake. The drug is not an amphetamine derivative and is not a psychostimulant.

Drugs in this group can induce a state of drowsiness and enhance the effects of hypnotic medications, but do not themselves have a pronounced hypnotic effect.

Antidepressants

• Pyrazidol,
• Zoloft,
• Ludiomil,
• Amitriptyline, etc.

The most common drug in this group is Amitriptyline. They take it in courses lasting 4-5 months, then take a break of 4-12 weeks.

The drug helps improve contact with the patient. Positive results appear already at the end of the first or beginning of the second month of therapy, they manifest themselves in the form of increased interest in surrounding life, improving contact with loved ones.

The drug Amitriptyline does not cure autism as such, its action is aimed at increasing contact, which creates the prerequisites for a specialist to work with a small patient. To adverse reactions this drug include frequent adverse reactions such as drowsiness and low blood pressure, nausea and constipation, constant thirst, etc.

Tranquilizers

Tranquilizers are used for severe anxiety and fear. Similar conditions often interfere with the normal development of the child and make it difficult for specialists in psychological and pedagogical practice to work with him.

In patients preschool age Atarax is commonly used.

• This medicine in the form of tablets and syrup, which is prescribed to children over one year of age, the dosage is selected according to weight indicators.
• As a result of taking Atarax, sleep is normalized, fears and anxiety disappear.
• But long-term use of the drug is contraindicated due to the high risk adverse reactions such as drowsiness and nausea, headaches and low blood pressure.

Normotimics

Normotimics control affective manifestations and provide a preventive effect in case of bipolar disorders. The drugs stabilize the mood of autistic adolescents and reduce behavioral disorders.

During treatment, it is necessary to monitor the content of lithium salts in the blood. Among the adverse reactions to the use of lithium mood stabilizers, experts note slight tremor and an increase in the volume of urine excreted, and hypothyroidism.

Carbazepine and its derivatives, Lamotrigine and valproate can also be used in the treatment of autism in children. When using mood stabilizers, constant medical supervision. In fact, the drugs are stabilizers of the psycho-emotional state, helping to normalize the mood of mental patients.

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

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

What are nootropics

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

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

Effects and mechanisms of action of nootropic drugs

The main effects of drugs in this group are:

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

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

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

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

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

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

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

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

Classification of nootropics

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

1. Substances that stimulate metabolic processes in nerve cells:

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

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

• Xanthinol nicotinate;
• Vinpocetine;
• Pentoxifylline;
• Cinnarizine;
• Instenon.

1. Drugs that stimulate memory and learning processes:

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

Indications for the use of nootropics

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

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

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

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

Contraindications to taking nootropics

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

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

Side effects of nootropics

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

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

Brief description of drugs

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

Piracetam (Piracetam, Lucetam, Biotropil, Nootropil)

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

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

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

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

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

Side effects drugs are standard, and they usually occur in elderly and old age provided they receive a dosage of more than 2.4 g of piracetam per day.

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

Contraindicated during pregnancy and lactation.

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

Pramiracetam (Pramistar)

Chemical formula of Pramiracetam

Release form: tablets.

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

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

During pregnancy and lactation, taking Pramistar is contraindicated.

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

Vinpocetine (Cavinton, Neurovin, Vinpocetine, Vicebrol)

Available in the form of tablets and solution for infusion.

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

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

It is used both in neurology (for chronic disorders cerebral circulation and other diseases described in the general part of the article), and in ophthalmology (for the purpose of treating chronic retinal vascular diseases) and in otiatrics (to restore hearing acuity).

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

Phenibut (Bifren, Noofen, Noobut, Phenibut)

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

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

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

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

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

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

Hopanthenic acid (Pantogam)

Available in tablet form.

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

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

Indications are standard.

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

Contraindications and side effects are described above.

Pyritinol (Encephabol)

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

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

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

Glycine (Glycine, Glycised)

Release form: tablets.

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

Use sublingually (dissolving under the tongue).

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

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

Cerebrolysin

Release form: solution for injection.

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

Penetrates the blood-brain barrier.

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

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

Use with caution to treat patients with allergic diathesis.

Actovegin

Release form: tablets, solution for injections and infusions.

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

Used for ischemic and residual effects hemorrhagic stroke, traumatic brain injury. Widely used to treat diabetic polyneuropathy, burns, disorders peripheral circulation, as well as for trophic disorders in order to accelerate wound healing processes.

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

Approved for use during pregnancy and lactation.

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

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

Hexobendine (Instenon)

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

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

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

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

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

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

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

Combination drugs

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

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

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