Cortexin ® is a multi-component drug, a composition of polypeptides, vitamins, ribonucleic and amino acids with a Nootropic action.
It was developed in the 1980s in the Soviet Union by the team of scientists of S.M Kirov Military-Medical Academy, and after preclinical and clinical studies successfully used during Afghanistan war.
Cortexin based on a mixture of neuropeptides isolated by acetic acid extraction from the cerebral cortex of young cattle and pigs under 12 months of age. After extraction, this mixture subjected to multi-stage purification process to obtain a fraction of peptides with molecular weights less than ten kilodaltons.
By the method of producing, Cortexin is similar to Cerebrolysin. However, Cerebrolysin, which extracted from pig brains, has a different chemical composition (fewer peptides and more free amino acids). It also contains various micronutrients that support brain health.
Usage of Cortexin in Russian medicine
Cortexin used in the treatment of traumatic brain injury and its neuropsychiatric sequelae, encephalopathy, Organic brain syndrome, withdrawal syndrome, poisoning by psychotropic drugs, migraine, decreased the ability to learn new information, Attention Deficit Hyperactivity Disorder (ADHD), chronic fatigue syndrome, Autism, Cerebral Palsy and in complex therapy of epilepsy.
The therapeutic effect is especially noticeable on the restoration of impaired cognitive functions. It was found that patients with traumatic brain injuries that received treatment with Cortexin improved their memory and attention. They were able to perform attention tests with less number of errors and complete more tasks without the fast onset of fatigue.
In studies on patients with cognitive impairments resulted from cerebral arteriosclerosis, Cortexin has demonstrated positive change in their cognitive functions on the 9th day after beginning of the treatment. Those changes were expressed in an increase of accuracy and capacity of visual short-term memory, concentration, attention, and improvement of logical thinking. In ischemic stroke patients that received treatment with Cortexin, the cognitive impairments such as memory deficits also were less pronounced compared to the patients that received standard treatment.
So, the medical uses are mostly similar to other Nootropics. But there are some specific features of the drug, which makes it more interesting.
Cortexin has no age restriction and can be used for the treatment of kids, even at the age of 1 year or younger. The idea of the treatment of young children with such powerful Nootropic may seem strange. But the most common usage is the treatment of infants. It is prescribed for the treatment of perinatal brain damage and other brain injuries, Cerebral palsy, ADHD and developmental disorders. As clinical studies show, this Nootropic is very efficient in the treatment of ADHD and speech disorders in kids, which is confirmed by the parents’ feedbacks.
The manufacturer also has “Cortexin for kids” version, with 5mg vials instead of 10mg. So, for those who want to try this Nootropic, it is possible to start with the lower dosages. The price for the kid’s version is almost twice lower.
An interesting fact that this Nootropic also utilized in ophthalmology. The reason for that is the Neuroprotective action of the drug. Various eye diseases, such as glaucoma, cause optic atrophy. In this case, it can be included in the complex treatment to restore the functioning of the optic nerve. During my researches, I found several clinical trials in glaucoma patients. If you’d like, I will write about those studies in my next articles.
According to the scientific journal “Herald of the Russian Military-Medical Academy,” Cortexin can be used in healthy individuals affected by stressful work conditions.
Mechanism of action
The pharmacological effects of this Nootropic is a result of changes in the serotoninergic, dopaminergic and GABAergic systems.
The mechanics of action is based on the protection of the nerve cells, stimulating metabolic processes in the brain and the formation of new neural connections. The influence on the central nervous system carried out by modulating the balance between excitatory and inhibitory neurotransmitters.
So the way how Cortexin affects your brain:
- Restoring the balance between inhibitory (Taurine, GABA, Glycine) and excitatory neurotransmitters.
- Increasing the GABA, Serotonin and Dopamine levels.
- Stimulation of neurotrophic activity.
- Antioxidant action.
- Anti-Inflammatory effect.
Cortexin side effects
Although the drug instruction says that there are no side effects besides possible allergic reaction, some users report side effects. They are rare, but they do happen.
Side effects reported by users include:
- Hyperactivity and excitement.
- Irritability and impulsivity.
- Strong allergic reactions with syncope.
- Convulsions, muscle twitches. A couple of users claim that this drug causes convulsion attack to their kids and the worsening of developmental disorder symptoms.
The injections are also painful for most people. It’s not exactly a side effect, but still an unpleasant thing. That’s why manufacturer suggest that Cortexin should be dissolved in Novocaine solution rather than ordinary Water for injections. This will make injections less painful, but the downside is that Novocaine is known to cause allergic reactions and convulsions, especially for kids. That’s may be a reason of some negative feedbacks.
Also, Cortexin is one of the most counterfeited drugs in Russia because of its high demand and price.
The reviews for both adult and kids version are mostly positive. Positive effects reported by users are:
- Increased mental performance and attention.
- Clearing of the brain fog.
- Headaches relief.
- Normalization of sleep.
- Anti-anxiety and antidepressant effect.
This drug most often used in the treatment of developmental disorders. When a child falls behind in development, doctors usually prescribe Cortexin for them, in monotherapy or as a part of complex treatment. And in most cases, according to feedbacks and clinical trials, it is effective.
Here are user ratings on various feedback websites.
Those ratings, however, not really informative. Some people rank it 1/5 and leave positive feedback, and vice versa. 1/5 rating could mean that someone experienced side effects, or no effects at all, which is not the same.
So, I manually analyzed about two hundred Cortexin feedbacks and reviews to gather some more accurate information about it, like side effects frequency. Here is how I sorted them for a better assessment of the effectiveness: users who reported positive results without side effects, positive effects with side effects, adverse effects only, and no effects at all.
In total, 75% of users reported positive effects (143 positive only + 12 with side effects), 13% experienced side effects (14 SE only + 12 with positive effects as well), 17% had no noticeable effects.
Dosages and how to take it
The length of the course is ten days, one ampule via intramuscular injection daily. You can repeat after 3-6 months. To avoid difficulties with falling asleep, it is recommended to make injections at the first half of the day.
Cortexin sold as a lyophilized (freeze-dried) powder in vials. So, to dissolve it before using, you’ll need water for injections or 0.5% procaine solution (1-2 ml per vial).
It also seems possible to take it without injections. Individual studies suggest that you can take it intranasally in lower dosages. Here are some examples:
A study ”Impact of Cortexin on Statokinetic stability of Human” patients received 0.25mg intranasally, twice daily for ten days.
In the study “Evaluation of Meteoadaptogenic properties of peptide drugs in healthy volunteers” subjects received 0.5mg intranasally.
Patent “Method for improving the psycho-emotional state of athletes.” In this patented method, athletes received two drops of Cortexin solution in each nostril, 30 minutes before training for ten days. After that, twice less dosage two hours after training for ten days. To prepare the intranasal solution, they dissolved the content of one vial in 4ml of saline.
Based on this information, I can assume that Cortexin may be taken intranasally at the lower dosages. However, such method of administration not described in official drug instruction, and there are not that much information regarding intranasal efficiency. So, most effective way to take it is intramuscular injections.
Studies and clinical trials
“Modern approaches to treatment and rehabilitation of children with attention deficit hyperactivity disorder.”
Two hundred kids (7-9 years old) diagnosed with ADHD participated in the study. Their level of ADHD was estimated with SNAP-IV scale before treatment and 20 days after cessation of therapy. The kids received monotherapy with Cortexin, 10mg daily for ten days. Here are the results:
Their attention is substantially increased. Hyperactivity symptoms decreased less. Impulsivity level did not change.
“ADHD – clinical typology and the ways of treatment.”
It’s the similar study, but with two groups of kids (5-15 years old).The main group of 163 patients received 10mg daily for ten days. The control group received Piracetam for 30 days. The results are almost the same as in the previous trial. Attention increased, hyperactivity became less pronounced. Impulsivity remains the same and even increased in the six patients from the main group.
“Сlinical and biochemical assessment of dynamics of an acute period of brain injury and combined craniofacial injury.”
This clinical trial was performed on 144 patients with acute traumatic brain injury, 20-45 years old. All patients received standard therapy. They were divided into two groups. The group A included 70 patients, 35 with the TBI of the low severity level and 35 of medium severity level. In addition to the standard treatment, they received 10 or 20(depending on their TBI severity) 2g injections of Piracetam. The group B included 74 people, 37 with mild TBI and 37 with medium TBI. They received 10 or 20 injections of Cortexin in addition to the main therapy.
Besides usual clinical screenings like EEG and MRI to evaluate treatment efficiency, they performed neuropsychological testing:
- Hamilton anxiety scale.
- Hamilton depression scale.
- Visual Analogue Scale for Pain (VAS pain).
- The Multicenter Acute Stroke Trial (MAST).
- Level of Cognitive Functioning Scale.
Here are the results for both groups.
The treatment results were rated as good if a patient had no health complaints or its substantial reduction with the significant regression of neurological disorders. As satisfactory – if patients had fewer complaints than before treatment, with moderately positive dynamics of neurological status. As unsatisfactory – if there was no positive progress. Here are the overall results of treatment with Nootropics:
Analogs and substitutes
There are more similar Nootropics available. Here are examples:
- Cerebrolysin, the main competitor with a longer history of usage. Isolated from pig brains, and contains more amino acids, fewer peptides, and no vitamins. One ml of Cerebrolysin solution contains 215mg of the active component (one ampule of Cortexin contains 10mg). Available in solution form only. Can be administered intravenously.
- Cellex, a nootropic drug made from brains of pig embryos. Available in 0.1 mg/ml solution for subcutaneous injections. Very rare Nootropic with an enormously high price (ten times more expensive than Cortexin).
- Cerebrolysat and Ceregin. A cheap analog of Cerebrolysin manufactured in Belarus by “Belmedpreparaty” and in Russia by “Microgen.” Also isolated from brains, contains neuropeptides and amino acids, but no vitamins, just like Cerebrolysin. Available in solution form with 47-77 mg/ml concentration.
- Cerebrocurin, manufactured and sold in Ukraine, another Cerebrolysin copy.
- Actovegin extracted from calf blood instead of brains. It has little different indications than Cortexin or Cerebrolysin. Actovegin increases glucose absorption and oxygen uptake in tissue and enhances stamina and physical performance. Clinical studies suggest that this drug can reduce cognitive impairments caused by organic brain syndrome.
Cortexin is a powerful Nootropic that is effective for attention and concentration increase. The fact that it is used in kid’s treatment speaks for its safety/efficiency rate. However, it still has side effects, the most frequent of which are irritability and hyperactivity. It may cause an allergic reaction just like any other drug, and to take it you have to deal with injections.
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- Belousova T.V “Therapy of perinatal CNS lesions in newborn infants – Cortexin efficiency.”
- Ryzhak G.A, Malinin V.V, Platonova T.N “Cortexin and regulation of brain functions.”
- Tsygan V.N, Bogoslovsky M.M “The influence of cortexin on memory and attention.”
- Ukhanova T.A, Gorbunov F.E, Ivanova V.V “Reflexotherapy combined with cortexin in the complex treatment of speech disorders in patients with cerebral palsy.”
- Onopriychuk E.I, Treymut U.A, Ivanova N.V “Specific disorders of language development in preschool children. Effectiviness of Cortexin.”
- Golovkin V.I, Bicadze A.N “Restoration of attention after the consequences of traumatic brain injury using the peptide bioregulator cortexin.”
- Gomazkov O.A “Cortexin: molecular mechanisms and targets of neuroprotective activity.”
- Diakonova M.M “Neuroprotection in acute and chronic cerebrovascular insufficiency.”
- Evzelman M.A, Aleksandrova N.A “Cognitive disorders and their correction in patients with ischemic stroke.”
- Chutko L.S, Surushkina S.Y “Modern approaches to treatment and rehabilitation of children with attention deficit hyperactivity disorder.”
- Chutko L.S, Surushkina S.Y, Livinskaya A.M, Nikishena I.S, Yakovenko E.A, Anisimova T.I, Aitbekov K.A, Chernaya J.V, Sergeev A.V “ADHD – clinical typology and the ways of treatment.”
- Sadova V.A, Belskaya G.N, Lvovskaya E.I, Sumnaya D.B, Kuchin D.G, Atmanskiy I.A, Shkarednykh V.U “Сlinical and biochemical assessment of dynamics of an acute period of brain injury and combined craniofacial injury.”