Cerebrolysin
Not FDA-approved
Cerebrolysin is a mixture of small peptide fragments and amino acids from pig brain, so it has no single structure.
Cerebrolysin is a mixture of small peptide fragments and amino acids made from pig brain, given into a vein or muscle. It is widely used for stroke in Russia, Eastern Europe and parts of Asia, and is also given for brain injury and dementia. In acute stroke it did not reduce deaths; reported benefits in rehabilitation, brain injury and dementia are small or uncertain.
How it works
- It is a mixture, not a single molecule: low-molecular-weight peptide fragments and free amino acids taken from pig brain protein.
- It is thought to protect nerve cells and support their repair, somewhat like the brain's own growth factors.
- Those effects come from animal and lab studies, which describe actions on several pathways rather than one target.
Evidence
Acute stroke
A 2023 Cochrane review of randomized trials found little or no effect on deaths. Non-fatal serious adverse events were more common with Cerebrolysin.
Rehabilitation after stroke
Two identical manufacturer-supported trials, 442 patients pooled, reported better arm function. A third trial of 70 patients, E-COMPASS, found no overall difference in motor recovery.
Moderate to severe brain injury
Two small randomized trials, 185 patients pooled, showed a small-to-medium benefit on combined recovery scores at 30 and 90 days. The smaller trial missed its main goal on its own.
Caveats
- In acute-stroke trials, non-fatal serious adverse events were more common with Cerebrolysin than with placebo.
- No large independent trial has confirmed the stroke-rehabilitation results.
- For vascular dementia, a 2019 Cochrane review rated the evidence very low quality. Its authors said any benefit may be too small to matter.
- The manufacturer supported several of the trials.
- Its studied uses are recovery after stroke or brain injury and dementia, not sharper thinking in healthy people.
References
- Ziganshina LE, et al. Cochrane Database Syst Rev. 2023;10:CD007026.
- Guekht A, et al. Neurol Sci. 2017;38:1761-1769 (CARS-1 and CARS-2 pooled).
- Chang WH, et al. BMC Neurol. 2016;16:31 (E-COMPASS).
- Vester JC, et al. Neurol Sci. 2021;42:4531-4541 (CAPTAIN).
- Cui S, et al. Cochrane Database Syst Rev. 2019;11:CD008900.
This page is for education only. It is not medical advice. Decisions about any treatment belong with a physician who knows your history.