The study of the efficacy and safety of Mexidol and Mexidol Forte in patients with chronic cerebral ischemia
Author:
V.A. KUTASHOV, O. V. ULYANOVA
Voronezh State Medical University. N.N. Burdenko, Voronezh, Russia
Summary:
Objective. To study the efficacy and safety of Mexidol used intravenously (500 mg 1 time per day) for 14 days, followed by the oral administration of Mexidol Forte 250 in a dose of 250 mg 3 times a day for 60 days, in patients with chronic cerebral ischemia (CCI). Material and methods. The study included 56 patients with CCI due to a combination of hypertension and atherosclerosis. The results of physical examinations (control of blood pressure, heart rate etc.), dynamics of complaints, scores on CGI, MoCa, MFI‑20, HRSD, HARS and the Tinetti test were evaluated. Results and conclusion. The high level of efficacy and safety of intravenous injections of Mexidol followed by the oral administration of Mexidol Forte 250 are demonstrated. This scheme of therapy contributes to a significant decrease in the objective and subjective symptoms of CCI, leads to improvements in the emotional, cognitive and motor spheres.
Keywords: chronic brain ischemia, atherosclerosis, arterial hypertension, motor disorders, cognitive disorders, Mexidol, Mexidol Forte 250.
Effect of mexidol on physical and mental performance under stressogenic conditions in experiment
Author:
I.G. KAPITSA, E.A. IVANOVA, T.A. VORONINA
FSBI «Zakusov Institute of Pharmacology», Moscow
Summary:
Resume. The effect of Mexidol on physical performance of mice under the extreme conditions of the weight-loaded forced swim test and on the mental performance of rats under the conditions of a neurosis-like state caused by a functional disturbance of a defensive instrumental conditioned active avoidance reflex was studied. A single dose (50 and 100 mg/kg) or a subchronic regimen (100 mg/kg) of Mexidol administered intrapertoneally enhances the physical performance of mice similarly to mildronate (100 mg/kg). Mexidol improves the rate of operant conditioning, the preservation of the memory trace and its restoration after single or multiple instances of disruption of the conditioned active avoidance reflex, and its effect does not differ from the effect of the comparison drug piracetam (300 mg/kg).
Keywords: performance; learning; memory; functional disturbance.
Efficacy and safety of the drug mexidol FORTE 250 as part of sequential therapy in patients with chronic ischemia of the brain
Author:
E.I. CHUKANOVA, A.S. CHUKANOVA
Pirogov Russian National Research Medical University, Moscow, Russia
Summary:
Objective. To study the efficacy and safety of mexidol dripped intravenously (500 mg once a day) in the form of infusions for 14 days, followed by oral administration of mexidol FORTE 250 at a dose of 250 mg (1 tablet) 3 times a day for 60 days, in treatment of chronic brain ischemia in patients with hypertension and atherosclerosis. Material and methods. The open observation program included 60 patients with an established diagnosis of chronic brain ischemia confirmed by neuroimaging methods. Results and conclusion. The results of the study show the high efficacy and safety of sequential therapy (injections followed by tablets of mexidol FORTE 250). The treatment improves emotional and cognitive status, decreases motor disorders and severity of subjective manifestations. High adherence of patients to the therapy is shown.
Keywords: chronic cerebrovascular disease, arterial hypertension, atherosclerosis, ethylmethylhydroxypyridine succinate, mexidol, c ognitive impairment.
Review of clinical guidelines for the treatment and prevention of ischemic stroke
Author:
A.I. FEDIN, K.R. BADALYAN
Pirogov Russian National Research Medical University, Russian Ministry of Health, Moscow, Russia
Summary:
One of the leading causes of death, disability and severe maladaptation of patients is ischemic stroke, which accounts for about 80% of all types of acute cerebrovascular accidents. At the same time, approximately 2/3 of the patients show residual effects of cerebral circulation disorders of varying severity. Currently, the problem of ischemic stroke attracts great attention and international and domestic recommendations developed for the prevention, treatment and rehabilitation of stroke patients are one of the aspects of work in this area. The article provides an overview of the latest clinical guidelines for the early management of patients with acute ischemic stroke of the American Heart Association and the American Stroke Association, as well as features of stroke therapy and prevention in Russia, Europe and USA. Keywords: ischemic stroke, clinical guidelines, therapy of ischemic stroke.
The effect of mexidol in the combination with antidepressants on sleep disturbance in young patients with panic disorder
Author:
E.S. KURASOV, R.S. REMIZEVICH
Kirov Academy of Military Medicine, St.-Petersburg
Summary:
We studied 70 patients with panic disorder, 30 men and 40 women, mean age 34,5±1,8 years. All patients had insomnia. Patients were classified into the main and control groups. Patients of the control group received antidepressants only (fevarin in dosage 150 mg daily). Patients of the main group were additionally treated with mexidol (375 mg daily). The treatment duration was two weeks. A clinical and instrumental (polysomnography) examination revealed that the use of mexidol enhanced the decrease in anxiety disorders, autonomic disturbances and insomnia and improved quality of life of the patients.
Keywords: panic disorder, antidepressant, mexidol.
The use of mexidol in urgent treatment of alcoholic delirium
Author:
O.I. KLINDUKHOVA, O.E. NOVGORODOV, N.N. SERGIENKO, P.V. DANILYUK, O.V. BELOTSERKOVICH
Summary:
Results of the clinical study of efficacy and tolerability of mexidol administered in intravenous drop-by-drop introduction during 5—7 days in the therapy of 50 cases of complicated alcoholic delirium are presented. The patient condition and changes in device test data were assessed in comparison with those of a control group of patients receiving a basic therapy without mexidol. It is shown that mexidol has stopped psychosis in shortest terms thus decreasing secondary complications and lethality.
Keywords: mexidol, antioxidant, antihypoxant, alcoholic delirium, stopping.
Pharmacoeconomic analysis of the neuroprotective medicines in the treatment of ischemic stroke
Author:
R.I. YAGUDINA1, A.YU. KULIKOV1, V.A. KRYLOV1, E.YU. SOLOVIEVA2, A.I. FEDIN2
1Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia;
2Pirogov Russian National Research Medical University N.I.Pirogov Russian National Research Medical University of the Ministry of Health
of Russia, Moscow, Russia
Summary:
Objective. To perform a pharmacoeconomic analysis of the most frequently prescribed neuroprotective medicines for treating patients with mild ischemic stroke in the acute and early rehabilitation periods in the Russian Federation. Material and methods. Three medical technologies were compared: ethylmethylhydroxypyridine succinate (mexidol), inosine + nicotinamide + riboflavin + succinic acid (cytoflavin) and a deproteinized hemoderivate of the blood of calves (actovegin). Cost minimization analysis, budget impact analysis and sensitivity analysis were performed based on the indirect comparison results. Results. Efficacy analysis shows that mentioned above medicines have the same efficacy: mean difference mexidol is 0,2 (CI min 0,25; max 0,65), cytoflavin — 0,61 (CI min 0,23; max 0,99), actovegin 0,2 (CI min 0,18; max 0,22). The cost minimization analysis for the Russian Federation shows that mexidol therapy is associated with the lowest costs, while savings are observed both in the evaluation of total costs and separate components: intravenous ampoules and tablet forms. The savings in comparison with cytoflavin and actovegin are 231 RUB and 12,872 RUB, respectively. These savings will be enough to treat five patients with ischemic stroke (IS) with mexidol. Moreover, oral mexidol therapy is cheaper than the same dosage forms of cytoflavin and actovegin by 481 RUB and 3,164 RUB, respectively. This is an advantage for the treatment of population at the outpatient stage. Budget impact analysis has shown that the budget for the medicines for treating IS at the current distribution between treatment regimens, is estimated at 1.99 BN RUB. The increase in the proportion of patients receiving mexidol by 10% reduces total costs to 1.75 BN RUB, which is 240 M RUB less than current costs. With these savings 85 thousand patients with IS could be treated. The sensitivity analysis reveals that the result of the cost minimization analysis and the budget impact analysis remain stable when both the amount of the population and the cost of 1 mg of mexidol vary from –10% to + 10%. Conclusions. Mexidol has the same efficacy as alternatives. However mexidol is superior to cytoflavin and actovegin in terms of cost minimization analysis. The savings from one course of alternatives will cover costs of treatment of five patients with IS using mexidol. The increase in the proportion of patients receiving mexidol is associated with savings, which allows us to consider mexidol therapy of mild IS as budget-saving in the Russian Federation. Keywords: pharmacoeconomics, indirect comparison, cost minimization analysis, budget impact analysis, neuroprotectors, ischemic stroke.
Evaluation of blood rheology by patients with acute ischemic stroke with Mexidol administration
Author:
D.M. PLOTNIKOV1, M.N. STEGMEIER1, O.I. ALIEV2
1 Department of Neurology and Neurosurgery, Siberian State Medical University, Tomsk, Russia;
2 Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia
Summary:
Objective. To study rheological properties of blood in patients with acute ischemic stroke treated with mexidol. Material and methods. Sixty patients with acute stroke, including 32 patients who received mexidol (500 mg/IV/20 days) and 28 people who received magnesium sulfate (2000 mg/IV/20 days) were examined. The control group included 20 people without a cardiovascular pathology. Blood rheology (viscosity of whole blood, plasma viscosity, hematocrit, aggregation and deformability of erythrocytes, fibrinogen level) was evaluated in patients three times: for the first 12 hours, 3—5 days and 18—20 days after hospitalization. Results. Hyperviscosity syndrome was observed in all patients with stroke. A significant decrease in blood viscosity was found in patients treated with mexidol: in the 3–5th day at low shear rates and in the 18—20th day at 3—100 s–1 shear rates. Significant differences in hematocrit (p=0.026) and fibrinogen levels (p=0.017) in patients treated with different drugs were found in the 18—20th day of the disease. Higher erythrocyte deformability index was recorded in patients treated with mexidol in the 3—5th day at shear rates of 90 and 890 s–1, in the 18—20th day at shear rates of 90—360 s–1. Conclusion. The study confirms the impact of mexidol on the fluidity of blood during the acute cerebral ischemia and shows its efficacy in reducing blood viscosity, decreasing the level of hematocrit and fibrinogen, increasing the deformability of erythrocytes.
Keywords: acute ischemic stroke, rheological parameters of blood, blood viscosity, erythrocytes deformability, mexidol (ethylmethylhydroxypyridine succinate), treatment of stroke.
Combined administration of mexidol with known medicines
Author:
T.A. VORONINA, E.A. IVANOVA
Research Zakusov Institute of Pharmacology, Moscow, Russia
Summary:
This review summarizes the available data on the combined administration of mexidol with medicines of different pharmacotherapeutic groups. Mexidol has a multifaceted mechanism of action and exhibits a wide range of pharmacological effects. It enhances therapeutic effects of a variety of drugs in research and clinical settings, boosts the effectiveness of therapy prescribed in accordance with the applicable federal standards and contributes to reducing the severity of complications. Effectiveness data and pathogenetic considerations underpinning combination therapy with mexidol and other drugs suggest that this is a viable approach for treating cerebrovascular and cardiovascular diseases, diseases of the nervous system, open-angle glaucoma and alcohol intoxication as well as a number of other diseases.
Keywords: mexidol, combination therapy, free radicals, lipid peroxidation, ischemic stroke, myocardial infarction, ischemic heart disease, epilepsy, alcohol intoxication.
Effect of mexidol on physical working efficiency and level of lactat in blood rats in conditions of light desynhronizes
Author:
T.A. ZAMOSHCHINA, A.A. GOSTYUKHINA, K.V. ZAITSEV, M.V. SVETLIK, O.B. ZHUKOVA
Federal state budgetary institution «Siberian Federal science-clinical center of Federal medicobio-logical agency», Seversk, Russia; Siberian
State Medical University SSMU, Tomsk, Russia
Summary:
Objective. To study an effect of mexidol on the performance of rats after light or dark deprivations in the swimming test with a load and to evaluate the state of glycolytic processes under these conditions. Material and methods. The experiment was carried out in the spring on 70 Wistar male rats. Three groups (30 animals) were in natural light conditions. One of them was not affected. The other two groups were subjected to exercise and 30 minutes before it either saline or mexidol was administered intramuscularly. Four other groups (40 animals) for 10 days were under conditions of dark or light deprivation prior to the presentation of physical activity and received either saline or mexidol before the test after deprivation was canceled. A forced swimming test with an additional load, which was presented to animals every day at 10—11 am for five days in a row, was used as a model of physical activity. The level of lactate was determined by colorimetric method. Results and conclusion. Mexidol increased the performance of rats in the swimming test, both under natural lighting conditions and with light desynchronization, contributed to the formation of cross adaptation to physical activity under natural lighting conditions and prolonged this state under conditions of light deprivation, did not change the content of lactate in the blood of rats after exercise in natural lighting conditions and dark deprivation and prevented its rise after light deprivation.
Keywords: mexidol, light and dark deprivation, working capacity, lactate.