Neuropathobiology of senile dementia and mechanism of action of nootropic drugs

Nootropics as Cognitive Enhancers: Types, Dosage and Side Effects of Smart Drugs

Nootropics, also known as "smart drugs" are a diverse group of medicinal substances whose action improves human thinking, learning, and memory, especially in cases where these functions are impaired. This review provides an up-to-date overview of the potential effectiveness and importance of nootropics. Based on their nature and their effects, this heterogeneous group of drugs has been divided into four subgroups: classical nootropic compounds, substances increasing brain metabolism, cholinergic, and plants and their extracts with nootropic effects. Each subgroup of nootropics contains several main representatives, and for each one, its uses, indications, experimental treatments, dosage, and possible side effects and contraindications are discussed. For the nootropic plant extracts, there is also a brief description of each plant representative, its occurrence, history, and chemical composition of the medicinal part. Lastly, specific recommendations regarding the use of nootropics by both ill and healthy individuals are summarized.

Establishing Natural Nootropics: Recent Molecular Enhancement Influenced by Natural Nootropic

Nootropics or smart drugs are well-known compounds or supplements that enhance the cognitive performance. They work by increasing the mental function such as memory, creativity, motivation, and attention. Recent researches were focused on establishing a new potential nootropic derived from synthetic and natural products. The influence of nootropic in the brain has been studied widely. The nootropic affects the brain performances through number of mechanisms or pathways, for example, dopaminergic pathway. Previous researches have reported the influence of nootropics on treating memory disorders, such as Alzheimer's, Parkinson's, and Huntington's diseases. Those disorders are observed to impair the same pathways of the nootropics. Thus, recent established nootropics are designed sensitively and effectively towards the pathways. Natural nootropics such as Ginkgo biloba have been widely studied to support the beneficial effects of the compounds. Present review is concentrated on the main pathways, namely, dopaminergic and cholinergic system, and the involvement of amyloid precursor protein and secondary messenger in improving the cognitive performance.

Effects of Panax ginseng, Turnera diffusa and Heteropterys tomentosa extracts on hippocampal apoptosis of aged rats

Objective:

To verify if the medicinal plants Panax ginseng C.A. Mey, Turnera diffusa Willd. ex Schult., and Heteropterys tomentosa O. Mach., which are amply used by the population as tonics and cognition enhancers, could have a protective effect on cell death by apoptosis, since this could be one of the mechanisms of action of these substances.

Methods:

Aged male Wistar rats (n=24) were divided into four groups. Over 30 days, three groups received treatments with hydroalcoholic extracts of the plants, and one group received saline solution. A fifth group with young adult male Wistar rats (n=4) received saline solution during the same period. Using the TUNEL technique, the percentage of apoptosis in the hippocampus of these animals was evaluated.

Results:

No differences were observed between the percentage of apoptotic cells in the hippocampus of aged animals and of young control animals. The percentage of apoptosis in the hippocampus of aged animals treated chronically with the extracts from the three plants also did not differ from the percentage of apoptosis in the hippocampus of the control group of aged animals.

Conclusion:

Treatment with the hydroalcoholic extracts of Panax ginseng, Turnera diffusa, and Heteropterys tomentosa did not influence the apoptosis of the hippocampal cells of aged rats.

Investigation into stereoselective pharmacological activity of phenotropil

Phenotropil [N-carbamoylmethyl-4-aryl-2-pyrrolidone (2-(2-oxo-4-phenyl-pyrrolidin-1-yl) acetamide; carphedon)] is clinically used in its racemic form as a nootropic drug that improves physical condition and cognition. The aim of this study was to compare the stereoselective pharmacological activity of R- and S-enantiomers of phenotropil in different behavioural tests. Racemic phenotropil and its enantiomers were tested for locomotor, antidepressant and memory-improving activity and influence on the central nervous system (CNS) using general pharmacological tests in mice. After a single administration, the amount of compound in brain tissue extracts was determined using an ultra performance liquid chromatography-tandem mass spectrometry (UPLC/MS/MS) method in a positive ion electrospray mode. In the open-field test, a significant increase in locomotor activity was observed after a single administration of R-phenotropil at doses of 10 and 50 mg/kg and S-phenotropil at a dose of 50 mg/kg. In the forced swim test, R-phenotropil induced an antidepressant effect at doses of 100 and 50 mg/kg, and S-phenotropil was active at a dose of 100 mg/kg. R-phenotropil significantly enhanced memory function in a passive avoidance response test at a dose of 1 mg/kg; the S-enantiomer did not show any activity in this test. However, the concentrations of R- and S-phenotropils in brain tissue were similar. In conclusion, the antidepressant and increased locomotor activity relies on both R- and S-phenotropils, but the memory-improving activity is only characteristic of R-phenotropil. These results may be important for the clinical use of optically pure isomers of phenotropil.

Donepezil: a review of its use in Alzheimer's disease

Donepezil (E-2020) is a reversible, noncompetitive, piperidine-type cholinesterase inhibitor. It is selective for acetylcholinesterase rather than butyrylcholinesterase. Donepezil 5 and 10 mg/day significantly improved cognition and global clinical function compared with placebo in well designed short term trials (14 to 30 weeks) in 161 to 818 patients with mild to moderate Alzheimer's disease. Beneficial effects on cognition were observed from week 3 of treatment. Donepezil 10 mg/day significantly delayed the deterioration in activities of daily living (ADL) [by 55 weeks] compared with placebo in a retrospective analysis of 1 trial, and in the largest trial significantly improved patients' abilities to perform complex tasks. However, no significant improvement in function was observed with donepezil 5 mg/day in another trial. In the 2 trials of longest duration donepezil (5 and 10 mg) significantly delayed symptomatic progression of the disease. While there was no evidence for a positive effect of donepezil on patients' quality of life, there are no validated measures of this parameter specific to patients with Alzheimer's disease. Donepezil (5 and 10 mg) significantly reduced caregiver burden. Long term efficacy data suggest that improvements in cognition, global function or ADL are maintained for about 21 to 81 weeks with donepezil (10 mg/day in most patients). Donepezil is generally well tolerated with the majority of adverse events being mild and transient. Predictably, most events were cholinergic in nature and generally related to the gastrointestinal and nervous systems. The incidence of these events was significantly higher with donepezil 10 mg than with placebo in short term clinical trials; however, this may have been due to the 7-day dose increase schedule used in these studies and can be minimised by increasing the dose after a longer (6-week) period. The incidence of serious adverse events was generally similar between donepezil 5 and 10 mg (4 to 10%) and placebo (5 to 9%) in short term trials. 26% of patients receiving donepezil (5 and 10 mg) reported serious events over a 98-week period in a long term trial. Importantly, there was no evidence of hepatotoxicity with this drug. Conclusions. Donepezil (5 and 10 mg) is an agent with a simple once-daily dosage schedule which improves cognition and global clinical function in the short (up to 24 weeks) and long term (up to about 1 year) in patients with mild to moderate Alzheimer's disease. Improvements in ADL were also observed with donepezil 10 mg/day. Adverse events associated with donepezil are mainly cholinergic. Donepezil has been extensively studied and should be considered as a first-line treatment in patients with mild to moderate Alzheimer's disease.

Cyclic GTP imitates the potentiating effect of the nootrope vinpocetine on the high-threshold A-current in mollusk neurons

Isolated common snail neurons were studied using two-microelectrode potential clamping to record high-threshold (threshold = 10 mV) rapidly-inactivating potassium current (I(Aht)); the effects of the nootrope vinpocetine on this current were studied and were compared with the effects of cyclic nucleotides. Intracellular application of dibutyryl derivatives of cyclic adenosine monophosphate (dcAMP) and guanosine monophosphate (dcGMP) was used. The results showed that vinpocetine potentiates or fails to alter I(Aht) in different cells, while dcGMP imitates the effect of vinpocetine. Simultaneous application of vinpocetine and dcGMP did not result in additive effects. Unlike dcGMP, dcAMP did not imitate the effects of vinpocetine, and decreased I(Aht) in most cells. These data suggest that cGMP mediates the potentiating effect of vinpocetine on I(Aht).

Learning and memory in the SAMP8 mouse

The SAMP8 (P8) mouse strain develops deficits in learning and memory relatively early in its lifespan. This review provides an overview of the age-related changes that occur in P8 mice. Behavioral studies with P8 mice show impaired acquisition and retention as early as 4 months of age. Deficits in acquisition and retention occur with both aversive and appetitive training tasks. Anatomical studies have detected a number of age-related changes that occur in the central nervous system of P8 mice. The age-related increase in amyloid beta protein is well correlated with the age-related decline in learning and memory. Antibody to amyloid beta protein injected prior to training alleviated impaired acquisition and retention, whereas post-training injections alleviated retention deficits in older P8 mice. Biochemical studies have detected numerous age-related changes with reduced NMDA receptor activity most closely related to impaired learning and memory in P8 mice. Pharmacological studies have found age-related functional changes in the ability of drugs to improve memory processing in P8 mice in the septum and the hippocampus. The specific pattern of pharmacological changes and the inferred change in neurotransmitter activity suggest that age-related impairment in memory processing may be due to impaired septohippocampal interactions. The proposal that P8 mice may be a useful model for studying the early phases of age-related dementia of the Alzheimer type, while still requiring considerable study, seems reasonable.

The effects of piracetam and its novel peptide analogue GVS-111 on neuronal voltage-gated calcium and potassium channels

1. With the use of the two-microelectrode voltage-clamp method, three types of voltage-activated ionic currents were examined in isolated neurons of the snail Helix pomatia: high-threshold Ca2+ current (ICa), high-threshold Ca(2+)-dependent K+ current (IK(Ca)) and high-threshold K+ current independent of Ca2+ (IK(V)). 2. The effect of bath application of the nootropics piracetam and a novel piracetam peptide analog, ethyl ester of N-phenyl-acetyl-L-prolyl-glycine (GVS-111), on these three types of voltage-activated ionic currents was studied. 3. In more than half of the tested cells, ICa was resistant to both piracetam and GVS-111. In the rest of the cells, ICa decreased 19 +/- 7% with 2 mM of piracetam and 39 +/- 14% with 2 microM of GVS-111. 4. IK(V) in almost all cells tested was resistant to piracetam at concentrations up to 2 mM. However, IK(V) in two-thirds of the cells was sensitive to GVS-111, being suppressed 49 +/- 18% with 1 microM GVS-111. 5. IK(Ca) appeared to be the most sensitive current of those studied to both piracetam and GVS-111. Piracetam at 1 mM and GVS-111 at 0.1 microM decreased the amplitude of IK(Ca) in most of the cells examined by 49 +/- 19% and 69 +/- 24%, respectively. 6. The results suggest that piracetam and GVS-111 suppression of voltage-activated calcium and potassium currents of the neuronal membrane may regulate (both up and down) Ca2+ influx into neurons.

Piracetam promotes mossy fiber synaptic reorganization in rats withdrawn from alcohol

Prolonged alcohol intake affects the morphology of the hippocampal formation of the rat and the resulting alterations do not reverse after withdrawal. Actually, an increase of the degenerative activity might occur in this condition. This unexpected observation prompted us to test the efficacy of neuronoprotective drugs during withdrawal. Because in a previous study we found that piracetam, a cyclic derivative of GABA, once added during withdrawal impedes hippocampal cell loss, we decided to evaluate the effect of this compound at the synaptic level. Using unbiased stereological techniques, we estimated the total number of contacts between mossy fibers and CA3 pyramids, as well as the volume and the surface area of the respective pre- and postsynaptic compartments. We found that in piracetam-treated withdrawn rats the number of synapses was higher than that observed in nonpiracetam-treated and alcohol-fed animals. The mechanisms leading to the synaptic reorganization took place at the mossy fiber level. The postsynaptic compartment does not seem to participate in the reorganization. It is suggested that the role of piracetam in this process might depend on the protective effect that this compound has upon glutamatergic receptors.