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, which 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.
Thus, Prospekta® modifies the functional activity of the brain-specific protein S-100.

S-100 thereby regulates in the brain

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

S-100 influences the balance between activation and inhibition and thus positively affects 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
  Activity).
• neuroprotective
• neuroreparative

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 the assembly and disassembly of microtubules
• 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 including³

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

Some S100 proteins are secreted/released and regulate cellular functions in an autocrine and paracrine manner via 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 sulfate 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 of children 7 to 12 years of age found improvement in ADHD-RS-V of 25% or more in 55% of subjects, compared with 43.3% on 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 since a mere 25% improvement is a low threshold.
Side effects were almost equal in subjects and comparison group. Serious side effects were not reported.

More manufacturer information about Prospekta:¹

“Prospekta® increases the resistance of brain tissue to hypoxia and toxic effects and has a membrane stabilizing and antioxidant effect,” he said.
After stroke or in the post-traumatic phase, it mobilizes intracellular compensatory reserves functionally conjugated to protein S-100 from damaged and healthy
Neurons as well as the glial cells in the damaged area. It has moderately strong anxiolytic effect (eliminates anxiety).
By changing the bioelectric activity of the brain, it can affect 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 affect both inhibitory and activating neurotransmitter systems. Experimental changes in the spectral power of bioelectrical activity of the cerebral cortex, hippocampus and hypothalamus under the effect of Prospect® were demonstrated.The nootropic effect of the drug was demonstrated in a clinical trial for the treatment of patients in the early stage of recovery from ischemic stroke. Patients’ cognitive functions improved according to the Montreal Cognitive Assessment Scale (MoCA), which assesses various cognitive domains (attention and concentration, executive functions, memory, language, visual-constructive skills, 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 of irritability, improvement of self-care, decrease of problems with daily household chores, and strengthening of social role in the family. It has been clinically proven that administration of Prospekta® after a new coronavirus infection reduces asthenia (weakness), feelings of constant tiredness and fatigue, and that symptoms of inattention are not pronounced in most children with ADHD during administration of Prospekta®. The average ADHD RS-V total score is reduced by 10.2 points. Administration of Prospekta® results in improvement in concentration while performing tasks or playing games, attention to detail, ability to follow instructions, and complete school and household tasks, chores, and adult errands.

Pharmacokinetics
The sensitivity of modern physicochemical analytical methods (gas-liquid chromatography, high-performance liquid chromatography, chromatography-mass spectrometry) does not allow estimating the active ingredient content of Prospekta® in biological fluids, organs and tissues based on the specific composition of the preparation (see chapter “Composition”), which makes it technically impossible to study 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 states in the period after infection, including coronavirus infection (COVID-19). In children 7 years and older for the treatment of attention deficit hyperactivity disorder.
Contraindications
Increased individual sensitivity to the drug components. Lactase deficiency, lactose intolerance, glucose-galactose malabsorption.
Taking during pregnancy and lactation
The safety of the use of the drug Prospecta® in pregnant women and during lactation has not been studied. If administration of the drug is necessary, the benefit-risk ratio should be considered.
Directions for use and dosage
It is not intended to divide the tablet into parts.
Oral intake. Daily single intake of 1-2 lozenges. The drug 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 blood flow :
2 tablets 2 times a day. Duration of treatment 6 months; if necessary, the treatment can be repeated after 1-2 months.
For the treatment of postinfectious asthenic conditions.
2 times a day 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; if necessary, the treatment can be repeated.

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

Overdose
Dyspepsia is possible in case of overdose, caused by excipients contained in the composition of the drug.
Interactions with other medicines
Incompatibilities with other drugs have not been reported so far.

Precautions
The preparation contains lactose, therefore prescription is not recommended in patients with congenital galactosemia, glucose or galactose malabsorption syndrome or in patients with congenital lactase deficiency.

Influence on driving ability
In rare cases, drowsiness may occur; therefore, caution should be exercised when driving.“