Psychostimulants
These drugs increase working capacity and intellectual productivity and activate the central nervous system. They reduce the need for sleep and food, and improve mood.
However, the effect is achieved through the inefficient use of the body's internal reserves. After a short period of high activity, severe fatigue inevitably sets in. In the presence of mental disorders, they can provoke anxiety, insomnia, delusions, and hallucinations.
Limitations and risks:
- Extremely high risk of developing dependence. Many substances in this group (cocaine, amphetamine) are classified as narcotics.
- Clinically, mainly caffeine and herbal preparations (ginseng, schisandra, Rhodiola rosea) are permitted.
- They are used very restrictively: for narcolepsy, mild depression in schizophrenia (with mandatory subsequent rest), ADHD in children, and occasionally for obesity.
Nootropics and neurometabolic stimulants
Nootropic agents have a positive effect on intelligence and memory, help eliminate the consequences of organic central nervous system damage, and increase the brain's resistance to stress.
Main groups:
- GABA derivatives: piracetam, nicotinoyl-GABA, phenibut, pantogam. GABA itself crosses the blood-brain barrier poorly and is used only in acute vascular catastrophes.
- Drugs similar to GABA and glutamic acid: deanole aceglumate and meclofenoxate (combining nootropic and mild stimulating effects).
- Amino acid complexes: cortexin, cerebrolysin (derived from animal tissues).
- Vitamins and their derivatives: folic acid, vitamin E, pyritinol.
Groups of drugs affecting brain functions
According to their mechanism of action, several areas of pharmacological correction are distinguished:
- Stimulation of memory and learning: NMDA receptor blockers (memantine), anticholinesterase agents (galantamine, donepezil), peptide hormones (semax), and melatonin.
- Increasing general tone (psychostimulants): phosphodiesterase inhibitors (caffeine), indirect adrenomimetics (amphetamine, mezocarb), as well as general tonic herbal remedies (ginseng, eleutherococcus) and antidepressants with a tonic component.
- Optimization of emotional status: tranquilizers, $\beta$-blockers (propranolol), and sedative antidepressants.
Indications for nootropics
Unlike psychostimulants, nootropics have broad indications because they act physiologically and rarely cause serious side effects at therapeutic doses.
They are indicated for:
- Mental retardation;
- Intelligence and memory disorders;
- Cerebrovascular pathology;
- Asthenia;
- Intoxications and alcohol withdrawal.
Sometimes healthy people use them to adapt to excessive mental or physical stress.
Briefly: answers to topical questions
What is the complete mechanism of action of caffeine on the central nervous system?
The mechanism of action of caffeine on the central nervous system is realized through three main biochemical processes.
- Effect on intracellular calcium — altering the content of $Ca^{2+}$ ions in cells.
- Adenosine receptor antagonism — competitive blockade of receptors eliminates the inhibitory effect of adenosine, leading to cell activation.
- Phosphodiesterase inhibition — slowing down the breakdown of cyclic adenosine monophosphate, causing cAMP accumulation in brain tissues.
What are the clinical symptoms of acute psychostimulant overdose?
Clinical symptoms of acute psychostimulant overdose include pronounced neurological and psychotic disorders.
- Neurological disorders — tremor, convergence insufficiency, and blurring during coordination tests.
- Affective disorders — irritability, touchiness, labile mood, anxiety, and suspiciousness.
- Hallucinatory-paranoid psychosis — includes persecutory delusions, auditory illusions, and hallucinations.
- Tactile hallucinosis (Magnan's symptom) — the sensation of worms and insects crawling under the skin, causing the patient to scratch the skin.
Also characteristic of poisoning are psychomotor agitation and acute paranoid syndrome.
Class and exam questions
Due to the high risk of developing dependence and severe bodily exhaustion following their use, as these drugs deplete physiological reserves without replenishing them.
Due to the high risk of developing dependence and severe bodily exhaustion following their use, as these drugs deplete physiological reserves without replenishing them.
What is the paradox of psychostimulant action in ADHD?
In children with attention deficit disorder, they do not cause hyperactivity; on the contrary, they improve concentration and help control behavior.
How fast does the effect of nootropics appear?
The action of nootropic drugs develops slowly; achieving a pronounced effect requires a prolonged course of treatment, usually at least one month.
What else to study on this topic
- The mechanism of GABA derivative penetration across the blood-brain barrier
- Specifics of tranquilizer use and withdrawal syndrome
- Differences between anticholinesterase drugs
- Biogenic stimulants of plant and animal origin
- Endogenous brain protective substances (endorphins, melatonin)
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Other topics in "Chapter 17. Therapy of Mental Disorders. Basic Principles of Prevention and Rehabilitation"
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