Применение актовегинов, инстенонов, солкосерилов и пр. "ноометаболотропов" не обнаружено у новорожденных, но среди обнаруживаемых публикаций на основании других слоев населения преобладают отечественные.
Пирацетам также нечасто пользуют среди новорожденных:
Pediatr Neurol. 1998 Jan;18(1):41-5.
Clinical efficacy of piracetam in treatment of breath-holding spells.
Donma MM.
Ministry of Health, Bakirkoy State Hospital, Clinics of Paediatrics, Istanbul, Turkey.
To evaluate the efficacy of piracetam therapy, 76 children with breath-holding spells admitted to the Outpatient Clinic of Dicle University Medical Faculty Paediatrics Department and Bakirkoy State Hospital, Paediatrics Department between 1988 and 1990 and 1991 and 1996, respectively, were included in this placebo-controlled trial. Diagnosis of breath-holding spells was made for all cases by medical history, pediatric physical examination, electroencephalogram, and laboratory findings. Placebo or piracetam as suspension was administered to patients on a randomized basis; piracetam was administered to children in suspension 40 mg/kg/day in 2 divided doses for a period of 2 months. Of the 76 children enrolled, 39 received piracetam and 37 received placebo. Overall, control of breath-holding spells was observed in 92.3% of the patients in the group taking piracetam as compared with 29.7% in the group taking placebo (P < .05). No differences between the 2 groups in adverse events or side effects were observed. Complete blood count, biochemical profile, and urine analysis taken before and after treatment revealed no change from beginning to end and no difference between the 2 groups. It is suggested that piracetam is a safe and effective drug, with an incidence of side effects no different from that of placebo, for the treatment of breath-holding spells.
Neuropediatrics. 2002 Feb;33(1):41-2.
Breath holding spells in a 3-day-old neonate: an unusual early presentation in a family with a history of breath holding spells.
Breukels MA, Plotz FB, van Nieuwenhuizen O, van Diemen-Steenvoorde JA.
Department of Pediatrics, St. Antonius Hospital, Nieuwegein, The Netherlands.
Breath holding spells are common in childhood. They peak about 2 years of age and abate by 5 years of age; they are rare before 6 months of age. We report a case of cyanotic breath holding spells starting at the age of 3 days. There was a family history of breath holding spells including a three-year-old brother, patient's father, his sister, and the paternal great grandfather. Pharmacological intervention with iron replacement therapy and piracetam was not successful. We want to draw attention to the fact that breath holding spells should be included in the differential diagnosis of neonatal cyanotic spells. The course of these neonatal breath holding spells is thought to be "benign", but nevertheless, severe breath holding spells can pose problems for parents and clinicians.
Что же касается пирацетама в лечении инсультов, то похоже что кое-кому он может быть полезным:
Stroke. 1997 Dec;28(12):2347-52.
Treatment of acute ischemic stroke with piracetam. Members of the Piracetam in Acute Stroke Study (PASS) Group.
De Deyn PP, Reuck JD, Deberdt W, Vlietinck R, Orgogozo JM.
Department of Neurology, Middelheim Hospital, Antwerp, Belgium.
BACKGROUND AND PURPOSE: Piracetam, a nootropic agent with neuroprotective properties, has been reported in pilot studies to increase compromised regional cerebral blood flow in patients with acute stroke and, given soon after onset, to improve clinical outcome. We performed a multicenter, randomized, double-blind trial to test whether piracetam conferred benefit when given within 12 hours of the onset of acute ischemic stroke to a large group of patients. METHODS: Patients received placebo or 12 g piracetam as an initial intravenous bolus, 12 g daily for 4 weeks and 4.8 g daily for 8 weeks. The primary end point was neurologic outcome after 4 weeks as assessed by the Orgogozo scale. Functional status at 12 weeks as measured by the Barthel Index was the major secondary outcome. CT scan was performed within 24 hours of the onset of stroke but not necessarily before treatment. Analyses based on the intention to treat were performed in all randomized patients (n = 927) and in an "early treatment" population specified in the protocol as treatment within 6 hours of the onset of stroke but subsequently redefined as less than 7 hours after onset (n = 452). RESULTS: In the total population, outcome was similar with both treatments (the mean Orgogozo scale after 4 weeks: piracetam 57.7, placebo 57.6; the mean Barthel Index after 12 weeks: piracetam 55.8, placebo 53.1). Mortality at 12 weeks was 23.9% (111/464) in the piracetam group and 19.2% (89/463) in the placebo group (relative risk 1.24, 95% confidence interval, 0.97 to 1.59; P = .15). Deaths were fewer in the piracetam group in those patients in the intention-to-treat population admitted with primary hemorrhagic stroke. Post hoc analyses in the early treatment subgroup showed differences favoring piracetam relative to placebo in mean Orgogozo scale scores after 4 weeks (piracetam 60.4, placebo 54.9; P = .07) and Barthel Index scores at 12 weeks (piracetam 58.6, placebo 49.4; P = .02). Additional analyses within this subgroup, confined to 360 patients with moderate and severe stroke (initial Orgogozo scale score < 55), showed significant improvement on piracetam in both outcomes (P < .02). CONCLUSIONS: Piracetam did not influence outcome when given within 12 hours of the onset of acute ischemic stroke. Post hoc analyses suggest that piracetam may confer benefit when given within 7 hours of onset, particularly in patients with stroke of moderate and severe degree. A randomized, placebo-controlled, multicenter study, the Piracetam Acute Stroke Study II (PASS II) will soon begin.
Окончательных выводов дождемся из PASS II.