Today's aging society, the elderly are often accompanied by brain function loss, severe dementia, the resulting learning, memory disorders are more common, and in the elderly nervous system diseases in addition to Parkinson's disease, Alzheimer's disease and post-stroke cognitive dysfunction, vascular dementia has become an important burden disease in all levels of society.
The main clinical manifestations of dementia are cognitive impairment, memory impairment and behavioral disorders, so drugs to control memory disorders and improve learning and memory have attracted much attention. The main anatomical basis of memory impairment is the atrophy of hippocampal tissue structure, the functional basis is cholinergic neuroexcitatory transmission disorder, acetylcholine receptor denaturation in the central nervous system, and the number of neurons is reduced. Today, Dr. Sun introduces 5 drugs to improve brain function (nootropics) and memory impairment:
Citicoline: Citicoline is a derivative of cytosine nucleotide, close to the inherent components of brain tissue, the main role is to participate in the biosynthesis of lecithin as a coenzyme, increase brain blood flow and oxygen consumption, improve brain tissue metabolism, promote brain function recovery, promote awakening has a certain effect, suitable for large-scale cerebral infarction caused by coma and consciousness disorders, help to restore limb function in patients with hemiplegia after stroke, can be used with drugs that promote brain metabolism and cerebral circulation, It can also be used for acute traumatic head injuries and impaired consciousness after brain surgery.
Piracetam: Piracetam is a cyclic derivative of γ-aminobutyric acid, which can combat brain function damage caused by physical and chemical factors and improve learning and memory ability. Can improve retrograde amnesia caused by hypoxia. The mechanism of action may be to promote the conversion of ADP into ATP in the brain, improve the metabolic energy supply status in the brain, affect the excitatory transmission of cholinergic nerves, promote acetylcholine synthesis, increase dopamine release, and is mainly suitable for acute cerebrovascular disease and memory after brain trauma and mild to moderate brain dysfunction.
Niergoline: Niergoline is a semi-synthetic derivative of dihydroergotine, with α receptor antagonism and vasodilation, can increase cerebral blood flow, enhance the utilization of glucose and oxygen in the brain, improve the energy metabolism of brain cells, improve neurotransmission function by regulating a series of neuronal metabolic processes, suitable for acute or chronic cerebrovascular disorders or cerebral metabolic dysfunction, as well as chronic brain insufficiency caused by mobility, language disorders, tinnitus, dizziness, visual impairment, sensory sluggishness, headache, insomnia Memory loss, inattention, mental depression, restlessness, agitation and dementia in old age.
Donepezil: Donepezil mainly improves cognitive function and memory impairment in patients with Alzheimer's disease by inhibiting cholinesterase activity, increasing the content of acetylcholine in the brain, and is suitable for Alzheimer's disease and vascular dementia with mild to moderate cognitive impairment.
Memantine: Memantine is a low-affinity, non-competitive N-methyl-d-aspartate (NMDA) receptor antagonist. At the receptor level, memantine shows rapid binding kinetics and significant voltage dependence, with glutamatergic neurotransmission system regulation. In the case of reduced glutamate release, memantine can antagonize NMDA receptors, inhibit the excitatory toxic effects of glutamate, prevent excessive calcium ion overflow in neurons, and is suitable for Alzheimer's disease, Parkinson's disease, multiple sclerosis and spasmodic states.
Finally, to summarize, citicoline and piracetam belong to brain metabolism activators, mainly suitable for brain trauma, functional damage caused by cerebrovascular accident; nimergoline belongs to cerebral circulation improvement drugs, mainly suitable for vascular dementia; donepezil belongs to cholinesterase inhibitors, mainly used to improve the cognitive impairment symptoms of mild and moderate Alzheimer's disease, but because the problem of degeneration and death of cholinergic neurons is not solved, it is still symptomatic treatment; memantine belongs to NMDA receptor antagonists, which can inhibit calcium overload. Reduces neuronal death and is used to treat moderate to severe Alzheimer's disease.