Cerebrolysin and its emerging clinical applications in psychiatry

To the Editor

I read with great interest the recent article by Xiao et al. (2012). Cerebrolysin may have a number of clinical benefits in the treatment of psychiatric disorders.

Cerebrolysin, when administered in conjunction with neuroleptics, can attenuate cognitive dysfunction in patients with mild moderate autism. The combination can also help to ameliorate behavioural disorders in patients with mild moderate autism to a certain extent. Fine motor function is improved by about 0.10 years while attention during performance of tasks is improved by about 0.34 years (Radzivil and Bashina, 2006). Cerebrolysin seems to be more effective in patients with Asperger’s syndrome in comparison to patients with childhood autism. For instance, Krasnoperova et al. (2003) reported positive benefit from cerebrolysin therapy in nearly all patients with Asperger’s syndrome in contrast to clinical benefit in 89% of patients with autism.

Similarly, in patients with Alzheimer’s disease cerebrolysin administration results in significant improvements in the global function as well as the ‘Change with Caregiver Input’ scale. Similarly, significant improvement is seen in the ‘Alzheimer’s disease Assessment Scale-Cognitive subscale’ (Panisset et al., 2002). Patients with underlying Alzheimer’s disease also show improvement in the ‘Cornell Depression Scale’ (Bae et al., 2000). For instance, Panisset et al. (2002) showed that following 3 months of cerebrolysin therapy the response rate was 76% (CIBIC + responders) in the cerebrolysin group compared to 57% in the placebo group (Panisset et al., 2002). Clinical benefit has been observed as long as 24 weeks after cessation of cerebrolysin therapy (Ruether et al., 2002; Ruther et al., 2000).

Side effects of psychotropic drugs such as dysuria can be ameliorated by concurrent cerebrolysin administration (Panteleeva et al., 1999). In fact, nearly 74 % of patients with psychotropic-induced extrapyramidal side effects benefit from cerebrolysin therapy. Dysomnia also can be reduced by simultaneous cerebrolysin administration. Cardiac side effects are also decreased.

Common side effects of cerebrolysin therapy include weight loss and headaches; anxiety exacerbation may also occur. Despite these side effects, the clinical benefit of cerebrolysin makes it a remarkable agent with significant potency in psychiatric disorders. Clearly, there is a need for further large-scale studies to fully assess the full potential and efficacy of cerebrolysin.