Prospekta for ADHD

Prospekta® is an ADHD medication from Russia.

Independent information could not be found. The following information comes from the manufacturer¹ and should therefore be treated with caution.
It is striking that the manufacturer does not envisage continuous use, but rather an 8-week treatment that can be repeated if necessary. There are no reports of a lasting effect of Prospekta®.

According to the manufacturer, Prospekta® contains antibodies against the brain-specific protein S-100.
Prospekta® thereby modifies the functional activity of the brain-specific protein S-100.

S-100 regulates the following in the brain

• Generation and conduction of nerve impulses
• synaptic signal transmission
• Stimulation of neuronal differentiation and proliferation

S-100 influences the balance between activation and inhibition and thus positively influences the integrative activity of the brain. S-100 has nootropic, neuroprotective and neurotrophic effects:

• nootropic activity by improving the formation of a memory trace
• Normalization of the emotional state and behavior of animals (reduction of somatovetegetative manifestations of stress, restoration of motor functions, etc.)
  Activity).
• neuroprotective
• neurorepairing

S-100 exists in a soluble and a membrane-bound form. S-100 interacts with artificial and natural membranes. S-100 has no enzymatic activity. S-100 is involved in, among other things:²³

• Memory processes
• Regulation of the diffusion of monovalent cations through membranes
• Modulation of the physical state of membranes
• Regulation of the phosphorylation of various proteins
• Control of microtubule assembly and disassembly
• Proliferation
• Differentiation
• Apoptosis
• Ca2+ homeostasis
• Energy metabolism
• Inflammation and migration/invasion
• innate and adaptive immune responses
• Cell migration and chemotaxis
• Tissue development and repair
• Invasion of leukocytes and tumor cells

S-100 proteins interact with a variety of target proteins such as³

• Enzymes
• Cytoskeletal subunits
• Receptors
• Transcription factors
• Nucleic acids

Some S100 proteins are secreted/released and regulate cell functions in an autocrine and paracrine manner via the activation of surface receptors, such as³

• the receptor for advanced glycation end products and Toll-like receptor 4
• G protein-coupled receptors
• Scavenger receptors
• Heparan sulphate proteoglycans
• N-glycans.
• epidermal growth factor
• basic fibroblast growth factor

We could not find any described association between S-100 and ADHD in the literature (March 2023).

A Russian RCT study in children aged 7 to 12 years found an improvement in ADHD-RS-V of 25% or more in 55% of subjects, compared to 43.3% with placebo. ADHD symptoms decreased by 10.2 in the Prospekta group and 8.1 in the placebo group⁴
This does not seem a particularly high value to us, especially as a mere 25% improvement is a low threshold.
Side effects were almost equal in the test subjects and the comparison group. No serious side effects were reported.

Further manufacturer information on Prospekta:¹

“Prospekta® increases the resistance of brain tissue to hypoxia and toxic effects and has a membrane-stabilizing and antioxidant effect.
After a stroke or in the post-traumatic phase, it mobilizes intracellular compensatory reserves of damaged and healthy cells that are functionally conjugated with the protein S-100
Neurons and glial cells in the damaged area. It has a moderately strong anxiolytic effect (eliminates anxiety).
By changing the bioelectrical activity of the brain, it can influence the structure of sleep.

Mechanism of action
Studies on cell membranes expressing human GABA, serotonin and dopamine receptors (GABA1A/B2, 5-HT2B, 5-HT2C, 5-HT3 and D3, respectively) show that the drug increases the number of “ligand-receptor” complexes, i.e. can influence both inhibitory and activating neurotransmitter systems. Experimental changes in the spectral power of bioelectrical activity of the cerebral cortex, hippocampus and hypothalamus under the action of Prospekta® have been demonstrated. The nootropic effect of the drug was demonstrated in a clinical trial for the treatment of patients in the early recovery phase of an ischemic stroke. The patients’ cognitive functions improved according to the Montreal Cognitive Assessment Scale (MoCA), which assesses various cognitive areas (attention and concentration, executive functions, memory, language, visual-constructive abilities, abstract thinking, counting and orientation). Improvement in activities of daily living was observed using the Barthel scale, which assesses areas such as ability to eat, self-care including showering and dressing, physiological activities (defecation, urination), ability to move (from bed to chair and back), mobility on a flat surface and climbing stairs. According to the Stroke Quality of Life Scale (SS-QOL), most indicators (speech, vision, thinking, mood, mobility, etc.) improved. The normalization of patients’ behavior and mood was reflected in the decrease in irritability, improvement in self-care, reduction in problems with daily household chores and strengthening of social role in the family. It has been clinically proven that the administration of Prospekta® after a new coronavirus infection reduces asthenia (weakness), the feeling of constant tiredness and fatigue and that in most children with ADHD during the administration of Prospekta® the symptoms of inattention are not pronounced. The average ADHD-RS-V total score is reduced by 10.2 points. The administration of Prospekta® leads to an improvement in concentration when performing tasks or playing games, attention to detail, ability to follow instructions, and complete school and household tasks, chores and errands for adults.

Pharmacokinetics
The sensitivity of modern physico-chemical analytical methods (gas-liquid chromatography, high-performance liquid chromatography, chromatography-mass spectrometry) does not allow the active substance content of Prospekta® in biological fluids, organs and tissues to be estimated on the basis of the specific composition of the preparation (see chapter “Composition”), which makes it technically impossible to investigate the pharmacokinetics.
Indications

Prospekta® is indicated (in Russia) for the treatment of the following disorders:
In adults: Cognitive disorders of various origins, including after acute stroke, asthenic conditions in the post-infection period, including coronavirus infection (COVID-19). In children from 7 years of age for the treatment of attention deficit hyperactivity disorder.
Contraindications
Increased individual sensitivity to the drug components. Lactase deficiency, lactose intolerance, glucose-galactose malabsorption.
Use during pregnancy and breastfeeding
The safety of the use of Prospecta® in pregnant women and during breastfeeding has not been investigated. If administration of the medicinal product is necessary, the risk-benefit ratio should be taken into account.
Instructions for use and dosage
It is not intended to divide the tablet into parts.
Oral intake. Take 1 to 2 lozenges once a day. The medication is taken without meals (between meals or 15 minutes before meals or liquid intake).
For the treatment of cognitive impairment, including after acute disorders of cerebral circulation:
2 tablets 2 times a day. Duration of treatment 6 months; if necessary, treatment can be repeated after 1-2 months.
For the treatment of post-infectious asthenic conditions.
2 times daily 1 tablet. The course of treatment - 1 month, if necessary the treatment can be repeated in 1-2 months.
In the treatment of attention deficit hyperactivity disorder.
2 times daily 1 tablet (approximately at the same time). Duration of treatment 8 weeks; treatment can be repeated if necessary.

Side effects
Individual hypersensitivity reactions to the components of the medicinal product are possible.
In rare cases, the drug may cause drowsiness.

Overdose
Dyspepsia is possible in the event of an overdose caused by excipients contained in the composition of the drug.
Interactions with other medicines
No incompatibilities with other medicinal products have been reported to date.

Precautionary measures
The preparation contains lactose, therefore it is not recommended for patients with congenital galactosemia, glucose or galactose malabsorption syndrome or patients with congenital lactase deficiency.

Influence on the ability to drive
In rare cases, drowsiness may occur; therefore caution is advised when driving.“