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Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2019, T. 119, No. 7

Summary:
Purpose of the study. Conduct a pharmacoeconomic analysis of the most frequently prescribed drugs of a group of neuroprotectors for the treatment of patients with an ischemic stroke (AI) of a mild and early recovery period in the Russian Federation. Material and methods. Three medical technologies were compared: ethylmethylhydroxypirinate (drug - LP - Mexidol), Inosin + nicotinamide + riboflavin + amber acid (LP cytoflavin) and disordered hemoderivat of blood calves (LP Actovegin). Based on the results of an indirect comparison, a pharmacoeconomic analysis was carried out through the following methods: analysis of cost minimization, analysis of “influence on the budget” and sensitivity analysis. Results. Analysis of effectiveness showed that the LP studied have equal efficiency: the difference of the average LP Aktovegin is 0.2 (di min 0.18; max 0.22), Mexol Mexidol LP (confidence interval - di - min 0.25; Max; 0.65), LP cytoflavin - 0.61 (di min 0.23; max 0.99). Analysis of the minimization of costs showed that the cost of a course of the treatment of one patient of the LP Mexol is accompanied by the lowest costs, while saving is observed when assessing both the total costs and individual components: a solution for injection and tablet forms. The savings in comparison with the LP Cytoflavin and LP Aktovegin is 231 rubles. and 12,872 rubles. respectively. It is possible to additionally treat 5 patients with AI Mexidol on saved only from one course. Moreover, the oral therapy of the Mexol Mexidol LP is more economical by 164 rubles. and 3481 rub. Therapies with similar dosage forms of the Cytoflavin and Actoveginal Public Use, which is an advantage for the population in treatment at the outpatient stage. An analysis of the impact on the budget showed that the total costs of the current distribution of patients according to treatment schemes are 1.99 billion rubles. With an increase in the share of patients receiving Mexidol LP, 10% of the total costs will amount to 1.75 billion rubles, which is 240 million rubles. Less current. On saved products, 85 thousand patients with AI can be additionally treated. A two -factor analysis of sensitivity showed that the result of the analysis of minimization of costs and the impact on the budget remains stable when the number of patients and the cost of 1 mg of Mexidol LP per amount from -10% to +10% changes. Conclusion. In the course of the indirect comparison, it was found that the LP Mexidol, the LP Cytoflavin and LP Actovegin are equal in terms of effectiveness. However, the Mexidol LP has an advantage from the point of view of analyzing the minimization of costs: there are enough funds saved from one course to treat 5 patients with II Mexidol. When considering the consequences of increasing the share of patients receiving Mexol's LP, data were also obtained indicating the savings of funds, which allows us to consider the therapy of the LP Mexoli -preserving budget -storage in the treatment of Easy degree in the Russian Federation. Key words: pharmacoeconomics, indirect comparison, analysis of cost minimization, analysis of “influence on the budget”, neuroprotectors, ischemic stroke.

Place of publication:
Journal of Neurology and Psychiatry, 12, 2018, Issue. 2

Summary:
in the viewing article, a modern concept of mechanisms of antioxidant and antihypoxic effects of the original domestic drug Mexidol (2-ethyl-6-methyl-3-hydroxypirinate) is presented. The direct antioxidant activity of Mexidol is described, which consists in the ability of the drug to inactivate free radicals and increase the activity of antioxidant enzymes of glutathioneperoxidase and in vitro superoxidism. The data on the presence of an indirect antioxidant activity in the Mexidol, manifested in an increase in expression in conditions of ischemia of the transcription factor NRF2, which is responsible for the development of cell stability to oxidative stress. The anti -human action of Mexidol is discussed, due to the presence of amber acid in its molecule, which, on the one hand, maintains the operation of the serpentinexidate link in the Krebs cycle under conditions of oxygen, and on the other hand, is associated with its specific receptors (GPR91) and triggers a cascade of biochemical reactions that increase the resistance of the resistance organism to a lack of oxygen. Keywords: Mexidol, ethylmethylhydroxypirinate, antioxidant, antihypoxant.

Authors:

^LV Stakhovskaya ¹ , Na Shamalov ¹ , DR Khasanova ² , Ev Mel'nikova ³ , AS AGAF'INA ⁴ , KV Golikov ⁵ , AA Yakupova ⁶ , LV Roshkovskaya ⁷ , LV LUKINYKH ⁸ , T. M Lokshtanova ⁹ , Ie Poverennova ¹⁰ , La SHEPANKEVICH ¹¹

¹ Research Institute of Cerebrovascular Pathology and Stroke, Pirogov Russian National Research Medical University, Russian Ministry of Health, Moscow, Russia.
² Interregional Clinical Diagnostic Center, Kazan, Russia.
³ St. Petersburg City Clinical Hospital No. 26, St. Petersburg, Russia.
⁴ St. Petersburg City Clinical Hospital No. 40 of the Resort Administrate District, St. Petersburg, Russia.
⁵ St. Petersburg City General Hospital no. 2, St. Petersburg, Russia.
⁶ Kazan Sate Medical University, Russian Ministry of Health, Kazan, Russia.
⁷ Nikolaevskaya Hospital, St. Petersburg, Russia.
⁸ Vsevolzhsk Clinical Internal Hospital, Leningradskaya Oblast, Russia.
⁹ Pirogov City Clinical Hospital No. 1, Samara, Russia.
¹⁰ SEREDAVIN SAMARA Regional Clinical Hospital, Samara, Russia.
¹¹ Research Institute of Experimental and Clinical Medicine, Novosibirsk, Russia.

Place of publication:
Neuroscience and Behavioral Physiology, Vol. 48, no. 8, October, 2018

Summary:
Objectives. To Assess The Effi Cace and Safety of Prolonged Sequential Therapy with Mexidol in Patients with Hemispheric Ischemic Stroke (IS) In the Acute and Early Racovery Phasses. Materials and Methods. A Randomized, Double-Blind, Multicenter, Placebo Controlled, Parallel-Group Study InCluded 151 PATIENTS (62 MEN and 89 Women) Was Performed in Which 150 Aged 40–79 YEARS WERE RANDOMIZED. Simple Randomization Was Ussed to Defi Ne Two Groups: PATIENTS OF GROUP 1 Receved Mexidol Therapy at AT AT AT AT AT AT AT ATRAVENOS INTREaneUNUS Infusion for 10 Days followed BY INLAL DOSES of 1 tablet (125 Mg) Three Times A Day for Eight Weeks. PATIENTS OF GROUP 2 Receved Placebo by the Same Protocol. The Duration of Involved in the Trial Was 67–71 Days. Results. At the end of Treatment, Mean Scores on the Modifi Ed Rankin Scale (MRS) Were Lower in Group 1 That Group 2 (P = 0.04). Decresses in Mean Mrs Scores (At Visits 1–5) Were More Marked in Group 1 (P = 0.023). The Proportion of Patience Achieving Recovery Corresponding to 0–2 Points on the Mrs (At Visit 5) was Signifi Cantly Greater in Group 1 (P = 0.039). Testing on the National Institutes of Health Stroke Scale at Visit 5 Gave A Signifi Cantly Lower Score in Group 1 (P = 0.035). Decreases in Scores on the National Institutes of Health Stroke Scale at the End of Treatment Relative to the Baseline Level in Patients with Diabetes Were More Marked In Group 1 (P = P = P = 0 .038). In Group 1, The Total Population and the SubpopPulation of Paty Diabetes Mellitus Showed Morked Improvements in Quality of Life, Whis Apparent by Visit 2 Ion of Pathers with the Diffi Culty Mobilizing Was Signifi Cantly Greater in Group 1 (P = 0.022 ). There were no signifi carcasses in the frequencies of advers in patents of the Two Groups. Conclusions. Use of Mexidol in the Acute and Early Recovery Phasses of is IS Recommoded. Keywords: Acute Cerebrovascular Accident, Mexidol, EthylMethylhydroxypyridine Succinate, Effi Cace and Safety, Ischemic Stroke, Acute Phase, Early Reacovery Phase, Epica .

Place of publication:
New therapeutic magazine "Non Nocera", May 2024

Summary:
Cerebrovascular diseases (CVP) retain in the modern world a leading position in the rating of the incidence and disability of the population of most countries. Metabolic disorders, being important risk factors for the development of CVP, are also widespread in populations regardless of gender and age. The frequent combination of CVP and metabolic disorders, including somatic and abdominal obesity, insulin resistance, hyperinosulinemia, hyperglycemia and dyslipidemia, is a bridgehead for the rapid development of complications. One of the early manifestations of such a comorbid union is the formation of vegetative disorders. It is known that vegetative disorders are most often secondary, that is, they arise against the background of existing somatic or mental diseases, but can also develop when exposed to psychogenic factors (stress reaction, adaptation disorders, psychosomatic diseases, anxious and depressive disorders). The most common causes of the development of autonomic dysfunction are organic diseases of the nervous system and somatic diseases, including metabolic and hormonal.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2024, T. 124, No. 4

Summary:
Purpose of the study. Assessment of the effect of the pharmacological modulation of the rehabilitation process with Mexidol with a rehabilitation component of the rehabilitation treatment of cognitive-emotional disorders in patients who have undergone acute cerebral deficiency (scenario) due to acute cerebrovascular impairment or cranial-brain injury. Material and methods. A randomized intervention prospective study was carried out, which consisted of 5 visits. Patients are divided into main groups (OG, N = 30, received standard therapy and Mexidol in/B 500 mg/day 10 days with the subsequent prescription of the drug Mexidol Forter 250, orally, 1 tablet 3 times a day 8 weeks) and comparison (GS, N = 30, received only standard therapy for 66 days). Results. The OG has a comparable to the HS improvement of cognitive functions (p <0.001) (in both groups, improving the results of the Schulte test according to the criteria “Effectiveness of Work” and “The total execution time”, on the Moca scale (for visit 5 - 23.8 ± 2, 6 and 22.9 ± 3.0 points, p = 0.227)). The significant superiority of the OG over the GS is shown in terms of such indicators as a decrease in the severity of anxiety (HADS scale), a visit 4 - 2.6 ± 2.4 versus 4.4 ± 2.4 points (p = 0.004), and depression (Beka scale) , visit 3 - 7.5 ± 4.5 versus 11.4 ± 5.6 points (p = 0.005). The tendency of the superiority of the OG according to muscle power (MRC scale), a visit 4 - 3.3 ± 5.1 versus 2.1 ± 2.2 points (p = 0.051) and the level of vital activity (according to RM), a visit 5 - 2, 9 ± 0.7 versus 3.3 ± 0.6 points (p = 0.053). The statistically significant increase in the mobility of the patients of the OG compared to the GS (the difference in the values ​​of the Rivermid index is 5 - 10.3 ± 2.8 and 8.0 ± 2.8 points, p = 0.006), the average increase in the Rivermide index for visits 5 - 5.4 ± 2.1 versus 3.4 ± 1.6 points (p <0.001). The decrease in the points of the consequences of intensive care (Pets) in both groups was revealed, the statistically significant decrease in the severity of Pits in relation to the previous visit was revealed only in OG (p <0.001). The OG also determined the best, compared to control, indicators of the dynamics of systolic velocity of cerebral blood flow and overshoot coefficient. The study did not record undesirable phenomena (nya). Conclusion. A positive modulating effect of Mexidol was demonstrated with respect to accelerating the restoration of tolerance to cognitive loads, improving the psycho -emotional background by reducing symptoms of anxiety and depression and secondary improvement of motor rehabilitation results in the early recovery period in patients who suffered the scenes, including with Pets manifestations. During the study, Nyu and significant differences in vital functions are not registered, which indicates the comparable safety of therapy in OG and HS. Keywords: acute cerebral failure, Mexidol, ethylmethylhydroxypyridine succinate, Bek scale, modulating effect, Mexidolneuro2023.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2024, T. 124, No. 3, Issue. 2

Summary:
ischemic stroke (AI) is an acute life -burning state, its outcome is determined by the degree of damage to brain tissue, the quality and rate of medical care in the first minutes and hours of the disease. An important mechanism for damage to brain tissue both with ischemia and reperfusion is oxidative stress. The review considers the adverse effect of oxidative stress with ischemia and brain reperfusion of AI. The results of preclinical studies are presented that demonstrate the ability of Mexidol to eliminate the effect of free radicals, to activate antioxidant protection. The data of clinical studies of the use of Mexidol in combination with thrombolytic therapy in patients with AI are considered. Key words: ischemic stroke, revascularization, oxidative stress, Mexidol.

Place of publication:
Medical alphabet, 2023, No. 21

Summary:
Purpose of the study. To study the effect of Mexidol ^® and Mexidol ^® Fort 250 on cognitive status of patients with post -shoe syndrome. Material and methods. 112 patients aged 24–60 years (55 men and 57 women) were examined, which were divided into two groups: the main one - 76 people with a confirmed coronaviral infection with symptoms that served as the basis for the diagnosis of post -icing syndrome (PKS), and control control - 36 people who have not painted coronavirus infection. Patients underwent a neurological and general somatic examination. For the study of cognitive functions, a brief scale for assessing the mental status (Mini Mental State Examination, MMSE) and a battery of tests for evaluating frontal dysfunction (Frontal Assessment Battle) was used. Memory was evaluated by the results of the subtest “memory” of khops, tests “10 words” and visual memory. The level of attention was investigated by the Schulta test and in the test “Verbal associations”, visual-spatial functions were evaluated using the clock test test. To correct the identified disorders, Mexidol ^® according to the scheme 500 mg times a day daily intravenously for 14 days with the subsequent transition to Mexidol Fort ^® 250 to 750 mg per day (one tablet 250 mg three times a day) for 2 months. Results. Patients with post -shoe syndrome were characterized by cognitive heterogeneity: in the structure of cognitive disorders they had lungs (46.0 %) and moderate (36.8 %) cognitive disorders. The course of treatment with Mexidol led to a decrease in the severity of the cognitive symptoms of the PKS. High efficiency and safety of prolonged sequential therapy with Mexidol (injections, then the tablet form Mexidol ^® Forte 250). Keywords: post-shoe syndrome, coronavirus infection SARS-COV-2 New, Cognitive Disorders, Mexidol ^® .

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 5

Summary:
Purpose of the study. To evaluate the effectiveness of consistent therapy with Mexidol and Mexidol Fort 250 in the correction of post -shoe syndrome (PKS) in patients with chronic cerebrovascular diseases (HCVZ). Material and methods. An analysis of the results of the examination and treatment of 110 patients with the CCVZ who suffered Covid-19 was carried out. Patients of the main group (OG, N = 55) received Mexidol (5 ml of iv in a drip for 14 days with the subsequent transition to the tablet form of Mexidol Fort 250, 1 tablet 3 times a day for 2 months); 55 patients of the comparison group (GS) did not receive antioxidants. All included in the study of patients conducted an MRI examination and detailed neuropsychological testing. Results. Patients have a significant improvement in the state of cognitive functions, the regression of asthenia symptoms, and the improvement of night sleep. Differences were statistically significant in comparison with both the initial level and with the GS. Conclusion. The appointment of the drug does not require age -related dose correction and goes well with basic therapy. The recommended scheme for the use of Mexidol: 14 days for 5 ml of iv or/m, then taking the drug Mexol Forter 250 in a dose of 1 tablet 3 times a day for 2 months. Key words: chronic cerebrovascular diseases, post -shoe syndrome, Mexidol, treatment.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 4

Summary:
Purpose of the study. To study the clinical and psychological profile and the quality of life of patients with post-shoe syndrome (PKS). Material and methods. 162 patients aged 24-60 years with a confirmed coronary reerovirus infection caused by the SARS-COV-2 virus, having symptoms that were the basis for the diagnosis of PKS, were examined. Patients underwent a neurological and general somatic examination with the identification of the corresponding neurological syndromes. They evaluated the intensity and nature of the pain (Mc Gill questionnaire), the level of psychosocial stress (Holmes-Road questionnaire), the severity of asthenia (the MFI-20 scale), the level of anxiety (Spielberger-Khanin questionnaire), depression (Bek scale). The quality of life was carried out by applying the Russian version of the SF-36 questionnaire. To correct the identified disorders, Mexidol was used 500 mg once a day every day in/in drip for 14 days, followed by the Mexidol Fort 250, 1 tablet 3 times a day for 2 months. Results . The course of treatment with Mexidol of patients with a PKS led to a decrease in the severity of subjective and objective symptoms of the PKS, asthenic, anxious and depressed disorders, and improved the quality of life of patients. Conclusion. The high efficiency and safety of consistent therapy with Mexidol (V/V, then orally Mexidol Forte 250) in patients with PKS are shown. Key words: post-shoe syndrome, coronavirus infection SARS-COV-2, emotional disorders, anxiety, depression, quality of life, Mexidol.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2023, T. 123, No. 3, Issue. 2

Summary:
Covid-19 development is associated with damage to various organs and systems of the body, including the development of acute ischemic stroke (AI). The article discusses modern ideas about the pathogenesis of AI at the Covid-19. The data on the choice of optimal therapy of patients with COVID-19 and acute AI, as well as the possibility of increasing the efficiency of rehabilitation measures, are analyzed. Information about the effectiveness of the use of the drug Mexidol in patients with COVID-19 and AI is given. Key words: ischemic stroke, Covid-19, treatment, rehabilitation, Mexidol.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2022, T. 122, No. 3

Summary:
the problem of post -shoe syndrome (PKS) attracts great interest due to the widespread prevalence and diversity of clinical manifestations. The main neurological manifestations of the PKS are considered. Information is given about the alleged mechanisms of the formation of PKS. The possibility of using the drug Mexidol for the treatment of patients with PKS is discussed. Key words: Covid -19, post -shoe syndrome, cognitive disorders, chronic brain ischemia, Mexidol, treatment.

Place of publication:
New therapeutic magazine "Non Nocera", November 2021

Summary:
A study of the effectiveness of the use of Mexidol in patients with COVID-19 amid chronic brain ischemia was carried out in St. Petersburg based on St. Petersburg GBUZ “City Hospital No. 38 named after N. A. Semashko. " 304 patients with HIGM and Covid-19 were observed; The 1st group (n = 152) was compiled by patients who received basic therapy and Mexidol, the 2nd group (n = 152) - received only basic therapy. For 14 days, Mexidol was prescribed intravenously with a drop of 500 mg (10 ml) per 400 ml of physiological solution, then Mexol Forte 250 was prescribed 1 tablet (250 mg) 3 times a day for 2 months. They evaluated the state of cognitive functions (Mosa scale), sleep (Spiegel questionnaire), asthenia (MFI-20 scale), quality of life (SIP questionnaire). The examination was carried out before the start of treatment, 30 and 75 days after its beginning. According to the results of the study, in patients in the administration of the drug Mexidol, there were more complete and early restoration of the state of cognitive functions (increase in indicators on the Mosa scale), regression of asthenia, and normalization of sleep. Among the patients of this group, by the end of the study, there were significantly more patients with complete or significant restoration of all indicators of the quality of life.

Place of publication:
New therapeutic journal Non Nocera, June/July 2021

Summary:
neurological complications of the coronavirus infection Covid-19 caused by the SARS-COV-2 virus are extremely diverse and are found in more than 30% of patients. So, with COVID -19, ischemic and hemorrhagic strokes, encephalopathy, meningitis, autoimmune diseases, for example, Guinen - Barre, violations of smell and taste, can develop. However, the fight against the Sarscov -2 virus does not end with screening and treatment of acute conditions. The delayed consequences for the health of people who have experienced Covid -19 are currently being actively studied.

Place of publication:
a journal of neurology and psychiatry named after S.S. Korsakova, 2021, T. 121, No. 3, Issue. 2

Summary:
Purpose of the study. Studying the possibility of increasing the effectiveness of treatment of patients with chronic brain ischemia (HIGM) against the background of COVID-19 using the drug Mexidol. Material and methods. 304 patients with HIGM and Covid-19 were observed; The 1st group (n = 152) was compiled by patients who received basic therapy and Mexidol, the 2nd group (n = 152)-received only basic therapy. For 14 days, Mexidol was prescribed intravenously with a drop of 500 mg (10 ml) per 400 ml of physiological solution, then Mexol Forte 250 was prescribed 250 mg 3 times a day for 2 months. They evaluated the state of cognitive functions (Mosa scale), sleep (Spiegel questionnaire), asthenia (MFI-20 scale), quality of life (SIP questionnaire). The examination was carried out before the start of treatment, 30 and 75 days after its beginning. Results. Patients of the 1st group took place: a more complete and early restoration of the state of cognitive functions (an increase in indicators on the Mosa scale, p <0.01), astress regression (p <0.05), normalization of sleep (p <0.01) . Among patients of the 1st group, the end of the study turned out to be reliably more patients with complete or significant restoration of all indicators of the quality of life. Conclusion. Long-term sequential therapy with Mexidol with the drug provides a more complete restoration of impaired functions in patients with HIGM and Covid-19. Key words: Covid-19, SARS-COV-2 virus, chronic brain ischemia, asthenia, cognitive disorders, dementia, quality of life, Mexidol.

Place of publication:
Infectious diseases, 2021, T. 19, No. 1, P. 159–164

Summary:
the new coronavirus infection Covid-19 is characterized by high mortality and the absence of effective etiotropic therapy. Activation of oxidative stress may be one of the links in the pathogenesis of organ damage against the background of this infection. Target. Assessment of the ability of the drug Mexidol ^® to influence the speed of clinical improvement in pneumonia in hospitalized patients with a new Covid-19 coronaviral infection. The study includes 62 patients over the age of 18 years with a confirmed new coronavirus infection COVID-19 according to computed tomography (CT) of the lungs (stages KT1, KT2, KT3) and studies by the polymerase chain reaction from the nasopharynx and oropharynx on the SARS virus RNA SARS COV-2. After randomization, patients of the 1st group received infusion of Mexidol at a dose of 1000 mg/day for 7 days, patients of the 2nd group-infusion of isotonic sodium chloride solution. Compared to the control group in patients who received therapy with Mexidol, a reliably more pronounced decrease in body temperature, and a tendency to reduce the severity of shortness of breath were noted. In the Mexidol group, the concentration of superoxidsmutase has not changed, while in the control group there was a tendency to reduce it, the C-reactive protein decreased 2.2 times more than in the control group (p = 0.09). The tendency to a more rapid decrease in ferritin in the active intervention group has been identified. Mexidol therapy can have a positive effect on the clinical manifestations and the severity of laboratory-inflammatory syndrome in patients with a new Covid-19 coronaviral infection. Key words: new coronavirus infection Covid-19, oxidative stress, Mexidol.

Place of publication:
therapy No. 5 (39) 2020

Summary:
in the presented review, the pathogenesis of the coronavirus disease 2019 (Covid-19), features of the SARS-COV-2 virus are considered in detail. Given the great importance in the development of this infection of oxidative stress and hypoxia, it is advisable to use antioxidants and antihypoxants in the complex treatment of Covid-19, which may be useful and significantly improve the course of the disease. Key words : Covid-19, coronaviruses, oxidative stress, hypoxia.