Interaction of Nootropic Drugs with Neurotransmitter Enzyme Acetylcholinesterase: An Insilico Approach: A Review

Nootropic drugs are the class of drugs or supplements that are claimed to enhance cognitive functions, specifically executive functions, memory and creativity in healthy individual. They are sometime referred as cognitive enhancers or smart drugs as they are associated with memory improvement functioning. Some of them are well known drugs and clinically approved by the Food and Drug Administration (FDA). All metabolic reactions are purely dependent on enzymatic actions as they play a very important role in regulating and maintaining most of the biological responses and various processes. An enzyme Acetylcholinesterase (AChE) seems to play an essential role in the conduction of cholinergic brain synapses and neuromuscular junctions. There have been different nootropic drugs identified and approved for curing neurodegenerative disorders such as Alzheimer, Parkinson and Huntington's disease. Their binding efficiency and energy have been well studied an established by using the in-silico docking tools. There are different docking tools available today for analysis of molecules such as PyRx, Auto dock and schrodinger suite. The advent of these tools is being widely used by the pharmaceutical industries for the virtual screening of the formulated drugs against the desired target molecule. It has made the drug formulation process more time efficient and cost effective. Thus, an in-silico approach has been widely accepted for drug discovery and its design.

Role of citicoline and choline in the treatment of post-stroke depression: an exploratory study

Objective To compare selective serotonin reuptake inhibitors (SSRIs) and nootropic drugs in the reduction of anxiety and depressive symptoms in post-stroke patients. Methods This retrospective cohort study included patients diagnosed with post-stroke depression that were treated with either SSRIs or nootropic drugs (i.e. citicoline or choline alphoscerate). Depression and anxiety were assessed using the Hamilton Rating Scales. Statistical associations between the use of nootropic drugs and mood disorder improvements were determined by measuring assessment scores at 6-months. Results A total of 44 post-stroke patients with depression (aged 45–75 years) were enrolled in the study: 20 were treated with SSRIs and 24 received nootropic drugs. From baseline to follow-up, the SSRI group showed a large effect size with regard depression (success rate difference [SRD] 0.57; 95% confidence interval [CI] 0.21, 0.79) and anxiety (SRD 0.49; 95% CI 0.14, 0.74), whereas the nootropic group showed a small effect size for depression (SRD 0.16; 95% CI –0.17, 0.46) and a small effect size for anxiety (SRD 0.36; 95% CI –0.03, 0.62). Conclusion The administration of nootropic drugs could be a valid therapeutic strategy to manage post-stroke patients suffering from mild–moderate anxiety or anxious-depressive syndrome, but this requires further research.

Neuroimaging of the Intracentral Brain of Cats by Normalization of Electrograms under the Action of Semax

Normalization of FFT-transformed brain electrograms under the action of Semax was performed. The adequacy of the approach to assessing the pharmacodynamics of nootropic drugs exhibiting an activating effect on intracentral relations of the brain was shown. The high-frequency components of encephalograms (the γ-range in particular) were confirmed to be the most important indicators of the effects of psychotropic drugs.

Experience of application of nootropics in complex therapy of persons with dependence on psychoactive substances at the modern stage

The paper considers the issues of impaired cognitive functions in patients with dependence on psychoactive substances (PAS), describes the experience of using nootropic drugs (ND) for people of this category with the definition of drug shortcomings, requirements for ND when choosing a drug and recommendations for prescription and application features ND in patients with dependence on PAS.

Analysis of the assortment and economic affordability of noоtropic drugs

Aim. To analyze the range and assess the economic availability of nootropic drugs at the Ukrainian pharmaceutical market in 2018. Materials and methods. The study object was information about nootropic drugs available at the pharmaceutical market of Ukraine in 2018 based on the data of the “PharmXplorer” analytical system of the information retrieval company “Morion”. The study included drugs used for the treatment of cerebrovascular diseases from the N06B X pharmacotherapeutic group (according to the ATC classification) – “Other psychostimulative and nootropic drugs”. An indicator of the adequacy of solvency (Ca.s.) was calculated using the data taken on the prices of drugs and the average level of wages for 2018. Results. At the Ukrainian pharmaceutical market in 2018 a wide range of nootropic drugs was presented. The range of retail prices per drug pack was significant, indicating the possibility of a doctor and a patient to choose the drug taking into account its efficacy, safety and affordability. Most trade names of nootropics (52 %) were registered as oral dosage forms, being compliant for patients with chronic cerebral circulatory disorders. 48 % were injectable and infusion drugs, which were topical for acute ischemic attack. Conclusions. It was found that in 2018 drugs containing piracetam, vinpocetine, gamma-aminobutyric acid (GABA) and its derivatives, most drugs based Phenibut (84.6 % of TN) and citicoline (68 % of TN) were highly available to the consumer. Most of the injectable dosage forms of nootropics based on hydrolyzates and tissue derivatives were readily available (50 % of TH) for the average consumer in Ukraine. Considering a fairly wide range of nootropic drugs and the economic availability of most of them the principle of superiority of clinical efficacy, safety and affordability should be the basis for creating and developing new nootropic drugs. Key words: nootropic drugs; assortment; economic affordability; Ukrainian pharmaceutical market.

Nootropic drugs for correction of cognitive functions through the focus of evidence-based medicine (literature review)

Relevance. In today's world, the first cause of death is pathology of the cardiovascular system. Vascular disease is influenced by many factors: lack of sleep, physical inertia, poorly balanced diet, obesity, heart disease. The fast pace of life forces a person to be in permanent stress, so as not to miss anything and have time for all the goals. This is why there is a demand for excipients and substances that could improve the peak of human cognitive abilities, maintain psychological stability. Today, the pharmaceutical market offers drugs that, according to pharmaceutical marketers, have solutions to the problems outlined above. These substances are classified to group of nootropic drugs (racetams). Objective. Review of high quality research on the effectiveness of nootropic drugs. Materials and methods. The literature review was performed using such scientometric databases as: PubMed, Cochrane Library, Scopus, BMJ Evidence-Based Medicine, Ingecta, Web of Science, UpToDate. The review included studies of randomized trials, placebo-controlled randomized trials, meta-analyzes, and systematic reviews. Data meet criteria A and B of evidence-based medicine. In the absence of high quality studies, studies with a lower level of evidence were selected. The search was made by topics: improving of cognitive functions, improving ability to work, improving sleep, improving mood, treatment of mental and psychiatric pathologies (Alzheimer's disease, dementia with various etiologies, depression), application in pediatrics. Results. The literature review included more than 40 high quality studies, but no conclusive evidence was found on the effectiveness of any drug. Conclusions. Data on the undeniable efficacy in relation to the cognitive functions of any of these nootropic drugs were not found in any study. In the treatment of Alzheimer's disease, some (Cerebrolysin, Nicergoline) drugs show controversial results of efficacy and safety. They require continued clinical research and they need to be approved by the FDA.

ANALYSIS OF PRIMARY HEADACHES MANAGEMENT IN POLTAVA REGIONS

The aim: Assess quality of diagnosis and treatment of primary headaches (PH) in Poltava region. Materials and methods: There were examined 195 patients with PH who were previously consulted by different specialists due to headaches. We analyzed previously established diagnoses, previous consultations and prescribed investigations due to headache, drugs that were prescribed for headache treatment. Results: The misdiagnoses of PH were made due to considering the headache as secondary (as sign of dyscirculatory encephalopathy, arterial hypertension, autonomic dysfunction, cervical ostheochondrosis). Patients older 40 years were misdiagnosed more often with dyscirculatory encephalopathy, while patients under 40 years were more frequently misdiagnosed with autonomic dysfunctions. Patients sought medical help for headache problem and were repeatedly examined by different specialists (general practitioner, neurologist, cardiologist, ophthalmologist, oyorhinolaryngologist, neurosurgeon). Doctors prescribed a large number of identical uninformative neuroimaging and neurofunctional methods regardless of PH nosologies. Also it had been often prescribed therapy with the use of vascular, metabolic, nootropic drugs without specific pathogenetic effects for PH. Conclusions: It is necessary to improve the diagnosis and treatment of PH according to international standards by raising awareness among general practitioners, neurologists and other specialists about the basics of PH diagnosis and treatment.

Application of Ayurvedic Principles in Prevention and Management of Behavioural Problems in Children

Introduction: Behavioral problems are commonly prevalent worldwide. It is important to diagnose and treat timely as if untreated, increase the risk of getting psychiatric illnesses. Present review is aimed at providing Ayurvedic guidelines in the form of Sadvritta (Code of conduct), Achar rasayan-AR (ethical principles) and few Ayurveda interventions corelating with recently developed interventions of Psychology which may prove helpful in prevention and management of behavioral problems in children. Material and Methods: This review is based on data collected from classical Ayurvedic literature, published research works in various journals and counseling experiences. Observations and Results: Behavioral problems are generally multi-factorial in origin and arise as a result of conflict between the children’s personality, attitudes of parents, teacher or peers. Counseling with family and adoption of Ayurveda principles can manage and prevent further progress of behavioral problems in children. Satvavjay Chikitsa-SC (non-drug psychotherapy), Achar Rasayana and Sadvritta, Yog are Ayurvedic ways to balance Satva (good qualities of mind), (Passionate, agitated), Tama (Laziness, lack of concentration) applicable in prevention of behavioral problems. Conclusion: Ayurvedic principles such as AR, Sadvritta and SC are best non-pharmacological modalities required for early detection and prevention of behavioral problems. Knowledge, education and proper expressions of code, conduct or etiquettes along with Ayurveda interventions such as use of Medhya (nervine tonic/nootropic) drugs, Panchkarma pre-procedures can prove to be a significant therapeutic way to combat behavioral disorders.

A Conceptual Study on Prevention & Management of Behavioral Disorders in Children through Complimentary & Alternative Medicine

In India, behavioral problems are prevalent and estimated to the tune of 33.4%. Such a problem if untreated increases the risk of suffering children from various psychiatric illnesses. Around 6 million children are affected by Behavioral problems worldwide. There are few guidelines in Ayurveda which can prove beneficial in the prevention and management of behavioral problems. The present review is aimed at providing Ayurvedic guidelines in the form of Sadvritta (Code of conduct), Acharrasayan-AR (ethical principles) and few Ayurveda interventions correlating with recently developed interventions of Psychology which may prove helpful in prevention and management of behavioral problems in children. This review is based on data collected from classical Ayurvedic literature, published research works in various journals and counseling experiences. Observations and Results: Behavioral problems are generally multi-factorial in origin and arise as a result of conflict between the children's personality, attitudes of parents, teacher or peers. Counseling with family and adoption of Ayurveda principles can manage and prevent further progress of behavioral problems in children. Satvavjay Chikitsa-SC (non-drug psychotherapy), Achar-Rasayana and Sadvritta, Yog are Ayurvedic ways to balance Satva (good qualities of mind), (Passionate, agitated), Tama (Laziness, lack of concentration) applicable in the prevention of behavioral problems. Knowledge education and proper expressions of code, conduct or etiquettes along with Ayurveda interventions such as the use of Medhya (nervine tonic/nootropic) drugs, Panchkarma pre procedures can prove to be a significant therapeutic way to combat behavioral disorders. Ayurvedic principles such as AR, Sadvritta and SC are best non-pharmacological modalities required for early detection and prevention of behavioral problems.