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Cognitive Health

Peptides targeting cognitive function, neuroprotection, and neurodegeneration.

Clinical Overview

Cognitive Health

Peptides targeting cognitive function, neuroprotection, and neurodegeneration.

2 peptides0 FDA-approvedintranasal · IV infusion (standard) · IM · slow IV pushLast reviewed · April 22, 2026

Cognitive-health peptides span nootropic, neuroprotective, and synaptogenic mechanisms. Evidence quality ranges from Cochrane-level human data (cerebrolysin) to predominantly preclinical (dihexa).

Mechanism Classes

  • Multi-factor neuropeptide preparations

    Cerebrolysin is a neuropeptide preparation derived from porcine brain with decades of international clinical use in stroke and vascular dementia.

  • Anxiolytic / nootropic peptides

    Selank is a heptapeptide with anxiolytic and cognitive-enhancing effects developed in Russia. Typically administered intranasally to bypass the blood-brain barrier.

  • ACTH-fragment neuroprotective peptides

    Semax is a synthetic ACTH fragment with neuroprotective and cognitive-enhancing properties. Like selank, often administered intranasally.

  • Angiotensin IV synaptogenic analogs

    Dihexa is a small-molecule angiotensin IV analog with potent synaptogenic effects in preclinical models. Human clinical data remains limited.

Regulatory Status

FDA-Approved

None FDA-approved in this category.

Investigational / Off-Label

  • Selank
  • Cerebrolysin
  • Semax
  • Dihexa

Cerebrolysin is approved in 35+ countries (Russia, China, Austria, Germany, and others) for ischemic stroke, traumatic brain injury, and vascular dementia — but is not FDA-approved in the United States.

Evidence Base

Cerebrolysin has Cochrane-reviewed data for acute ischemic stroke and vascular dementia. Selank and semax have primarily Russian human trials with smaller Western follow-up. Dihexa remains predominantly preclinical.

Primary-Literature References

26

Across 2 linked monographs

Prescribing Considerations

  1. 1Rule out reversible contributors first: untreated sleep apnea, thyroid dysfunction, B12 / folate deficiency, depression, medication effects.
  2. 2Validated baseline cognitive assessment (MoCA or similar) before initiating therapy.
  3. 3For established MCI or early dementia, coordinate with neurology and ensure standard-of-care workup including imaging.
  4. 4Intranasal routes (selank, semax) bypass the blood-brain barrier — confirm proper formulation and dosing accuracy.
  5. 5Review concurrent psychotropic medications for interactions.
  6. 6Do not position as disease-modifying for established Alzheimer's — no peptide has demonstrated reversal of Alzheimer's in RCTs.
Peer-reviewed clinical references · last reviewed April 22, 2026PeptidePrescriber · Clinical Reference

Peptides in this category(2)

Clinical monographs for each agent — dosing ranges, safety profile, evidence, and prescribing considerations.

Nootropic & AnxiolyticLimited Evidenceavailableintranasal

Selank

Synthetic tuftsin-analog heptapeptide with anxiolytic, nootropic, and immunomodulatory properties

Primary indication: Generalized anxiety disorder and neurasthenia (approved in Russia as intranasal spray)

Selank (TP-7) is a synthetic heptapeptide analog of the endogenous immunomodulatory peptide tuftsin, developed at the Institute of Molecular Genetics of the Russian Academy of Sciences. Approved in Russia since 2009 as an intranasal anxiolytic and nootropic, Selank provides clinically meaningful anxiety reduction through GABAergic modulation without the sedation, tolerance, or dependence associated with benzodiazepines. Its tuftsin core also confers immunomodulatory properties, creating a unique dual anxiolytic-immunomodulatory pharmacological profile.

Read full guide
NeuromodulationModerate EvidenceIV infusion (standard) · IM · slow IV push

Cerebrolysin

Neurorehabilitation after ischemic stroke and traumatic brain injury (approved in 35+ countries including Austria, Germany, Russia, China; NOT FDA-approved in the United States)

Primary indication: Neurorehabilitation after ischemic stroke and traumatic brain injury (approved in 35+ countries including Austria, Germany, Russia, China; NOT FDA-approved in the United States)

Cerebrolysin is a standardized preparation of low-molecular-weight peptides and free amino acids derived from purified porcine brain tissue by enzymatic hydrolysis. Its proposed mechanisms are pleiotropic and mimic the actions of endogenous neurotrophic factors. Preclinical work demonstrates effects consistent with brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), and glial-derived neurotrophic factor (GDNF) signaling — including upregulation of neuronal survival pathways (PI3K/Akt), inhibition of calcium-dependent proteases (calpains) and caspase-3-mediated apoptosis, attenuation of glutamate excitotoxicity, and enhancement of neurogenesis in subventricular and hippocampal niches. Additional reported actions include anti-inflammatory modulation of microglia, reduction of oxidative stress, and improvement of energy metabolism in neurons. In acute stroke, the presumed benefit is neuroprotection of the ischemic penumbra and enhancement of endogenous recovery mechanisms; in chronic cognitive indications, the hypothesis is sustained neurotrophic support.

Read full guide

2 additional monographs in this category are in clinical review and will be published soon.

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