The translational potential of experimental pharmacology for cerebrovascular disorders

The efficacy of reperfusion therapy to restore cerebral blood supply in patients with ischaemic cerebrovascular disorders is well recognized. Medications with proven cerebrovascular activity, such as oxymethylethylpyridine succinate (Mexidol), nicotinoyl-gamma-aminobutyric acid (Picamilon), and nimodipine, are successfully used in neurological practice with the first two having antiplatelet activity. This review analyses the vascular and antiplatelet effects of those medications, their effect on cerebral blood circulation, blood pressure and the central nervous system, and their neuroprotective activity. Potential compounds are also reviewed: S-amlodipine nicotinate and succinic acid ester of 5-hydroxyadamantan-2-one, which have significant cerebrovascular anti-ischaemic activity but a diametrically opposite effect on blood pressure. S-amlodipine nicotinate lowers blood pressure, while the succinic acid ester of 5-hydroxyadamantan-2-one elevates it. A GABA-positive component is present in the mechanism of action of all the studied drugs except for nimodipine. Experimental data on the effect of substances on cerebral circulation, blood pressure and platelet aggregation, as well as the interaction with GABA A receptors, significantly increase the translational potential of cerebrovascular medications.