ATC Group: N06BX Other psychostimulants and nootropics

Adrafinil is a mild central nervous system stimulating drug typically employed to relieve excessive sleepiness and inattention in geriatric patients. It is also been used off-label to prevent fatigue or falling asleep for extended periods of time. Adrafinil is metabolized to modafinil.

Aniracetam is a member of pyrrolidin-2-ones and a N-acylpyrrolidine. It is a compound with anti-depressive properties used as a mental performance enhancer.

Citicoline stimulates the biosynthesis of structural phospholipids of the neuronal membrane. Citicoline, through this action, improves the function of the membrane mechanisms, such as the functioning of the ionic exchange pumps and receptors inserted in the latter, the modulation of which is indispensable in the neurotransmission.

Idebenone is an anti-oxidant assumed to be capable of transferring electrons directly to complex III of the mitochondrial electron transport chain, thereby restoring cellular energy (ATP) generation under experimental conditions of complex I deficiency. Similarly, in LHON idebenone can transfer electrons directly to complex III of the electron transport chain, thereby bypassing complex I which is affected by all three primary mtDNA mutations causing LHON, and restoring cellular ATP generation.

Meclofenoxate is a cholinergic nootropic with antianoxic effect whether anoxia is provoked by defect or misuse of oxygen. Meclofenoxate improves extraction and utilization of glucose from the brain which allows maintenance of storage of energy for the neuron even in case of O₂ deficiency or aging. In elderly patients, meclofenoxate has been shown to improve performance on certain memory tests. Meclofenoxate also increases cellular membrane phospholipids.

Piracetam’s mode of action in cortical myoclonus is as yet unknown. Piracetam exerts its haemorrheological effects on the platelets, red blood cells, and vessel walls by increasing erythrocyte deformability and by decreasing platelet aggregation, erythrocyte adhesion to vessel walls and capillary vasospasm.

Temgicoluril has an effect on the structure of limbic–reticular activity, particularly on hypothalamus emotional zone, as well as on all several basic neuromediator systems – γ aminobutyric acid (GABA), choline, serotonin, and adrenergic activity. It decreases brain norepinephrine levels and increases brain serotonin levels without modulating dopaminergic systems or cholinergic systems. Temgicoluril purportedly has anti-anxiety (anxiolytic) properties. It is also used to aid smoking cessation. In addition, temgicoluril may be useful in the treatment of adult attention-deficit/hyperactivity disorder (ADHD) symptoms.