Neuroprotective and nootropic drug Semax in the treatment of patients with cerebrovascular disease

This clinical study evaluated the efficacy of Semax, a synthetic analog of the ACTH(4-10) fragment, in treating patients with cerebrovascular disease. Semax is administered intranasally and was developed as a neuroprotective and nootropic drug at the Institute of Molecular Genetics of the Russian Academy of Sciences.

Patients with cerebrovascular disease received intranasal Semax in a therapeutic regimen and were assessed for neurological and cognitive parameters. Results demonstrated that Semax produced:

• Significant cognitive improvement, including attention, memory, and executive functions
• Neuroprotective effects assessed by standardized neurological scales
• Good tolerability and favorable safety profile
• No significant side effects related to the hypothalamic-pituitary-adrenal axis

The mechanism of action of Semax involves multiple pathways: increased expression of BDNF (brain-derived neurotrophic factor) and other neurotrophic factors, modulation of the central monoaminergic system, and anti-inflammatory effects in ischemic brain tissue.

A particularly relevant aspect is that Semax, unlike complete ACTH, does not have significant corticotropic activity — meaning it does not stimulate cortisol release. This allows its use as a neuroprotector without the undesirable endocrine effects of corticosteroids. The study helped consolidate Semax as a therapeutic option in Russian neurology, where it is approved for the treatment of stroke, encephalopathy, and cognitive impairment.