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Research information only. Not medical advice. 18+ only. Not FDA-approved for human therapeutic use.

Cortexin

Also known as: Korteksin, Cortexin polypeptide complex, cerebral cortex polypeptide complex

Polypeptide neuroprotective complex (lyophilized extraction of animal cerebral cortex containing neuropeptides, amino acids, and trace elements)

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What it is

Cortexin is a lyophilized polypeptide extraction of animal cerebral cortex (calves) comprising neuropeptides, amino acids, and trace elements; nucleoprotein complexes with DNA fragments may also be present (PMID 46356623; PMID 36099784). Proposed molecular mechanisms include: normalization of glutamatergic (NMDAR) transmission, antioxidant and anti-inflammatory action, and restoration of blood-brain barrier integrity. Cortexin derivatives (short peptides EDR and DS) are proposed to bind histone H1.3, thereby modulating chromatin structure at the Fkbp1b gene locus encoding peptidyl-prolyl cis-trans isomerase, which regulates calcium ion release from neuronal organelles. Additional mechanisms discussed include stimulation of neuroprotection, neuroplasticity, and neuropreparation processes, as well as epigenetic peptide-driven regulation. Biomarkers associated with its effect include reduction of NR2-peptide concentration (neurotoxicity marker), enhancement of antioxidant activity (SH-groups, superoxide dismutase), and modulation of cytokine profile (PMID 40879235; PMID 30335070). Cortexin also demonstrated normalization of blood cortisol, dehydroepiandrosterone sulphate, and thyroid hormones in patients with asthenic disorders. The CTXN3 gene (Cortexin 3), distinct from the drug Cortexin, encodes a brain-enriched membrane protein whose polymorphism has been associated with schizophrenia risk and APP/Aβ metabolism (PMID 25889058; PMID 24535457) — these are genetic findings for the CTXN3 protein and not direct evidence of the drug's mechanism.

Class: Polypeptide neuroprotective complex (lyophilized extraction of animal cerebral cortex containing neuropeptides, amino acids, and trace elements)

What it's studied for

  • Ischemic stroke (acute and recovery periods) — neurological and cognitive recovery Human RCT
    • Multicenter RCT (n=490): IV and IM forms of Cortexin 10 mg both therapeutically equivalent; 93.64% (IV) vs 86.50% (IM) achieved mRS 0–2 at day 90; NIHSS improved by ~3.8–3.9 points; comparable safety profiles. PMID 41524350 Fedin et al., Zhurnal nevrologii 2025
    • Multicenter double-blind RCT (n=272): two courses of Cortexin 10 mg IM three times daily showed high efficacy and safety; best outcomes with two 10-day courses. PMID 24874316 Aliferova et al., Zhurnal nevrologii 2014
    • 90 patients with hemispheric IS: repeated course of Cortexin 20 mg IM led to more complete regression of neurological deficit vs single course or basic therapy alone. PMID 27845314 Belova et al., Zhurnal nevrologii 2016
    • 122 patients: Cortexin 30 mg/day IM (10+10+10) for two courses showed most complete regression of neurological deficit. PMID 30132453 Belova et al., Zhurnal nevrologii 2018
    • RCT (n=40): Cellex showed more pronounced improvement in NIHSS and MMSE vs Cortexin 10 mg IM in early recovery period of IS. PMID 33449527 Khabirov et al., Zhurnal nevrologii 2020
    • Systematic review including one Cortexin RCT (n=272): moderate-certainty evidence that Cerebrolysin-like agents probably have no beneficial effect on preventing all-cause death in acute IS; Cortexin study judged low risk for incomplete outcome data. PMID 37818733 Cochrane review, 2023
  • Chronic cerebral ischemia (CCI) — cognitive and neurological impairment Human RCT
    • Multicenter RCT (n=189): dose-dependent effect on neurological disorders, asthenia, sleep disturbance; antioxidant effect confirmed regardless of dose; good tolerability. PMID 30335070 Fedin et al., Zhurnal nevrologii 2018
    • Observational multicenter study (n=801): Cortexin 10 mg/day + Neuromexol reduced cognitive impairment, depressive symptoms, and NSE biomarker by 2-fold; VEGFA decreased only in main group. PMID 38147380 Mashin et al., Zhurnal nevrologii 2023 (CORNELia)
    • Multicenter study (n=309): Cortexin 10 mg/day + citicoline showed high efficacy for vascular cognitive disorders. PMID 30874524 Belova et al., Zhurnal nevrologii 2019
    • Multicenter program (n=495): significant positive cognitive effects with Cortexin alone and Cortexin + memantine; memantine addition improved severe cognitive impairment. PMID 29460902 Fedin, Zhurnal nevrologii 2018
    • All-Russian screening (n=500 analyzed from 50,000): Cortexin 10 mg/day for 10 days reduced focal neurological symptoms, improved cognitive and emotional status. PMID 25403301 Mashin et al., Zhurnal nevrologii 2014
    • Review supporting Cortexin's multitarget neuroprotective mechanism in CCI including biomarker evidence (NR2-peptide, antioxidant activity, cytokine modulation). PMID 40879235 Zakharov & Zakharova, Zhurnal nevrologii 2025 (review)
  • Post-COVID cognitive impairment and neurological disorders Human observational
    • 109 patients: Cortexin 10 mg IM for 20 days (repeated at 3 and 6 months) significantly improved concentration, executive functions, auditory-verbal memory; no adverse events. PMID 39113450 Melnik, Zhurnal nevrologii 2024
    • Multicenter program (n=979): Cortexin 10–20 mg IM for 10 days effective for cognitive and asthenic disorders; anti-anxiety and antidepressant effects more pronounced at 20 mg. PMID 35175707 Putilina et al., Zhurnal nevrologii 2022 (CORTEX program)
    • Review discussing role of Cortexin in post-COVID syndrome management. PMID 37490677 Cherdak & Mkhitaryan, Zhurnal nevrologii 2023 (review)
  • Neurological complications of type 2 diabetes mellitus (cognitive impairment, anxiety-depression, diabetic polyneuropathy) Human RCT
    • Multicenter RCT (n=110): Cortexin 10 mg IM x10 doses + comprehensive treatment: MoCA improved 1.2-fold; HADS anxiety decreased 1.6x, depression 1.7x; NTSS-9 decreased 2.8x; HbA1c more reduced (7.3% vs 7.8%); 5 AEs total, none treatment-related. PMID 42133422 DIACORT trial, Zhurnal nevrologii 2026
  • Alcoholic encephalopathy — cognitive recovery Human observational
    • 40 patients: Cortexin 10 or 20 mg IM for 10 days improved MMSE (27.3→28.9), FAB (15.5→17.1), Schulte tables (97.5→84.5 sec) significantly; no dose difference reported. PMID 42360215 Masaleva & Ivenkov, Zhurnal nevrologii 2026
    • RCT: Cortexin 10 mg/day IM for 10 days in chronic alcohol encephalopathy/polyneuropathy improved clinical symptoms, EEG, ENMG; well-tolerated with no side effects. PMID 20517210 Solov'ev & Elistratova, Zhurnal nevrologii 2010
  • Depressive disorder (adjunctive therapy) Human observational
    • 98 patients: Cortexin 10 mg IM once daily for 10 days added to antidepressants significantly reduced MADRS scores, improved SASS, improved safety profile vs antidepressant monotherapy (p=0.001). PMID 41782536 Schastnyy, Zhurnal nevrologii 2026
  • Post-stroke cognitive impairment and speech disorders (including young adults) Human observational
    • 30 young patients (18–45y): Cortexin improved MoCA from 25.1 to 28.4 after two courses; quality of life improved significantly at visit 4. PMID 39269301 Shchepankevich et al., Zhurnal nevrologii 2024
    • 71 stroke patients: Cortexin 10 mg IM twice daily + Aphasia.No app significantly improved speech, writing, reading vs comparison group. PMID 39690562 Kuznetsova et al., Zhurnal nevrologii 2024
    • 90 patients: Cortexin 10 mg IM twice daily with repeated course accelerated quality of life normalization after hemispheric IS. PMID 27459764 Belova et al., Klinicheskaia meditsina 2016
    • 90 patients: repeated course of Cortexin 20 mg IM led to more rapid and complete regression of cognitive disorders vs single course or basic therapy. PMID 27905386 Belova et al., Zhurnal nevrologii 2016
  • Traumatic brain injury (TBI) — consequences and rehabilitation Human observational
    • Review: high efficiency of Cortexin in correction of asthenic, vegetative, cognitive and emotional consequences of TBI, including in childhood. PMID 36946393 Solovieva et al., Zhurnal nevrologii 2023 (review)
  • Cerebral palsy (CP) — motor, cognitive and speech disorders in children Human observational
    • Review: Cortexin showed high efficacy due to multimodal action (neuroprotection, neuroplasticity, neuropreparation) in motor, cognitive, and autonomic disorders in CP and perinatal CNS lesions. PMID 38261281 Nemkova & Boldyrev, Zhurnal nevrologii 2024 (review)
    • 78 children with CP (age 2–7): combined microcurrent reflexotherapy + Cortexin (10 injections per course) significantly improved speech functions vs reflexotherapy alone. PMID 21946134 Ukhanova et al., Zhurnal nevrologii 2011
  • Neuropsychiatric pathology in children and infants (hypoxic-ischemic CNS damage) Human RCT
    • RCT: 323 children (7 days – 1 year): 2 courses of Cortexin with 3-month interval significantly reduced frequency and severity of myotonic and hypertensive-hydrocephalic syndromes; 73.4% of subgroup 1A showed increased EEG bioelectric activity. PMID 39731376 Degtyareva et al., Zhurnal nevrologii 2024
  • Epilepsy — cognitive and behavioral comorbidities in children; post-stroke epilepsy Human observational
    • 86 children (3–17y) with epilepsy: Cortexin + antiepileptics improved electrophysiological parameters; no seizure aggravation in 95%; cognitive improvement in 65%. PMID 33834730 Kalmykova et al., Zhurnal nevrologii 2021
    • 46 patients with post-stroke epilepsy: Cortexin 10 mg IM for 15 days added to basic therapy significantly enhanced clinical effects and positive EEG changes. PMID 20873481 Gafurov & Gafurov, Zhurnal nevrologii 2010
  • ADHD and cognitive dysfunction in children (attention, memory, learning) Human observational
    • Multicenter study (n=635, age 3–7y): Cortexin (10 IM injections) effective for cognitive dysfunction across ADHD, speech delay, perinatal CNS lesions, asthenic syndrome; best response in ADHD aged 3–4. PMID 29652302 Zykov et al., Zhurnal nevrologii 2018
    • 60 children with dyslexia: Cortexin more effective than encephabol (73.3% vs 60.0%) in reading, attention, working memory; significant EEG neurophysiological changes. PMID 33728849 Chutko et al., Zhurnal nevrologii 2021
    • 30 children with memory disorders: Cortexin more effective than encephabol (86.7% vs 63.3% improvement) on neuropsychological and neurophysiological measures. PMID 22027605 Chutko et al., Zhurnal nevrologii 2011
  • Delayed speech development / developmental dysphasia in children Human observational
    • 54 children (3–4y) with developmental dysphasia: Cortexin once daily IM for 10 days increased active vocabulary 2.3x, articulated phrases 3.6x; improved social adaptation and cerebrasthenic problems. PMID 31851172 Zavadenko et al., Zhurnal nevrologii 2019
    • 266 children with delayed speech development: Cortexin monotherapy effective for isolated speech disorder and psychomotor delay; also improved behavior and self-control. PMID 34037354 Balakireva et al., Zhurnal nevrologii 2021
  • Obstructive sleep apnea — associated cognitive impairment Human observational
    • Review: Cortexin with multimodal mechanism may minimize negative impact of OSA on cognitive health. PMID 37655408 Khoreva et al., Zhurnal nevrologii 2023 (review)
  • Organic emotionally labile (asthenic) disorders — neuroendocrine effects Human RCT
    • RCT: Cortexin added to standard therapy normalized blood cortisol, DHEA-S, and thyroid hormones; clinical improvement associated with recovery of homeostatic systems. PMID 23667876 Levchuk et al., Bull Exp Biol Med 2013
  • Working capacity in elderly — combined with breathing exercises Human observational
    • Clinical trial: 2-week breathing exercises + Cortexin optimized functional state and professional performance in older teachers more than Cortexin alone; effect lasted 2 months. PMID 32593245 Lysenko et al., Advances in Gerontology 2020
  • Rosacea-associated psychological sequelae (anxiety, depression) Human observational
    • Systematic review: Cortexin mentioned as a treatment option that may target inflammatory mediators and neurotropic factors to alleviate anxiety and depression in rosacea patients. PMID 39954108 Sharifi et al., Arch Dermatol Res 2025 (systematic review)
  • Perinatal hypoxic-ischemic brain injury (animal model) Animal studies only
    • Rat model: Cortexin 1 mg/kg IP daily for 10 days showed transient improvement of EMG spectral structure on day 10; positive effect on vagosympathetic balance on day 30. Administration to intact infant rats caused disturbances of vagosympathetic balance and heart rhythm. PMID 30695499 Kuznetsov & Kuznetsova, Zhurnal evoliutsionnoi biokhimii 2016

Community-reported dosing

RouteDoseFrequency / DurationPopulation / contextSource tier
intramuscular10 mg or 20 mg10 dayshumanResearch PMID 42360215
intramuscular10 mg10 doses (days 1–10)humanResearch PMID 42133422
intramuscular10 mg once daily (in the morning)10 dayshumanResearch PMID 41782536
intravenous (course 1, group 1); intramuscular (course 1, group 2; course 2, both groups)10 mg IV and placebo IM 2 times a day (course 1); then 10 mg IM 2 times a day (course 2)2 courses of 10 days eachhumanResearch PMID 41524350
intramuscular10 mg20 days continuously; repeated at 3 and 6 monthshumanResearch PMID 39113450
intramuscular10 mg 2 times a dayacute hospital stayhumanResearch PMID 39690562
intramuscular10 mg or 20 mg10 dayshumanResearch PMID 35175707
intramuscular10 mg per 2 ml of 0.9% NaCl solution daily10 dayshumanResearch PMID 33449527
not specified (described as part of combined regimen)10 mg/day10 dayshumanResearch PMID 38147380
not specified10 mg/day10 dayshumanResearch PMID 30874524
intramuscular20 mg (group 1) or 10 mg (group 2)10 days; repeated after 6 monthshumanResearch PMID 30335070
not specifiednot explicitly stated per dose; part of multicenter programnot explicitly statedhumanResearch PMID 29460902
intramuscularonce daily10 dayshumanResearch PMID 31851172
intramuscular10 mg and 20 mg IM10 dayshumanResearch PMID 35175707
not specified10 mg/day10 dayshumanResearch PMID 25403301
intramuscular10 mg three times a daytwo 10-day courses (70-day treatment period)humanResearch PMID 24874316
intramuscular20 mg (10+10) or 30 mg (10+10+10) per daytwo 10-day courses with 10-day breakhumanResearch PMID 30132453
intramuscular20 mg (10+10)one or two 10-day courses with 10-day intervalhumanResearch PMID 27845314
intramuscular20 mg (10+10)one or two 10-day courses with 10-day breakhumanResearch PMID 27905386
intramuscular10 mg IM twice daily (morning and afternoon)two 10-day courseshumanResearch PMID 27459764
intramuscular20 mg per day10 dayshumanResearch PMID 31626220
intramuscular10 mg15 dayshumanResearch PMID 20873481
intramuscular10 mg/day10 dayshumanResearch PMID 20517210
not specifiednot explicitly statednot explicitly statedhumanResearch PMID 23667876
intraperitoneal1 mg/kg10 daysanimalResearch PMID 30695499

Tier key: Research = PMID-cited study · [C] = scraped community source · [S] = model-synthesized from aggregate community reports (softer evidence). How we source.

References

  1. [1] PMID 41524350 — Multicenter RCT (n=490): IV and IM forms of Cortexin 10 mg both therapeutically equivalent; 93.64% (IV) vs 86.50% (IM) achieved mRS 0–2 at day 90; NIHSS improve
  2. [2] PMID 24874316 — Multicenter double-blind RCT (n=272): two courses of Cortexin 10 mg IM three times daily showed high efficacy and safety; best outcomes with two 10-day courses.
  3. [3] PMID 27845314 — 90 patients with hemispheric IS: repeated course of Cortexin 20 mg IM led to more complete regression of neurological deficit vs single course or basic therapy
  4. [4] PMID 30132453 — 122 patients: Cortexin 30 mg/day IM (10+10+10) for two courses showed most complete regression of neurological deficit.
  5. [5] PMID 33449527 — RCT (n=40): Cellex showed more pronounced improvement in NIHSS and MMSE vs Cortexin 10 mg IM in early recovery period of IS.
  6. [6] PMID 37818733 — Systematic review including one Cortexin RCT (n=272): moderate-certainty evidence that Cerebrolysin-like agents probably have no beneficial effect on preventing
  7. [7] PMID 30335070 — Multicenter RCT (n=189): dose-dependent effect on neurological disorders, asthenia, sleep disturbance; antioxidant effect confirmed regardless of dose; good tol
  8. [8] PMID 38147380 — Observational multicenter study (n=801): Cortexin 10 mg/day + Neuromexol reduced cognitive impairment, depressive symptoms, and NSE biomarker by 2-fold; VEGFA d
  9. [9] PMID 30874524 — Multicenter study (n=309): Cortexin 10 mg/day + citicoline showed high efficacy for vascular cognitive disorders.
  10. [10] PMID 29460902 — Multicenter program (n=495): significant positive cognitive effects with Cortexin alone and Cortexin + memantine; memantine addition improved severe cognitive i
  11. [11] PMID 25403301 — All-Russian screening (n=500 analyzed from 50,000): Cortexin 10 mg/day for 10 days reduced focal neurological symptoms, improved cognitive and emotional status.
  12. [12] PMID 40879235 — Review supporting Cortexin's multitarget neuroprotective mechanism in CCI including biomarker evidence (NR2-peptide, antioxidant activity, cytokine modulation).
  13. [13] PMID 39113450 — 109 patients: Cortexin 10 mg IM for 20 days (repeated at 3 and 6 months) significantly improved concentration, executive functions, auditory-verbal memory; no a
  14. [14] PMID 35175707 — Multicenter program (n=979): Cortexin 10–20 mg IM for 10 days effective for cognitive and asthenic disorders; anti-anxiety and antidepressant effects more prono
  15. [15] PMID 37490677 — Review discussing role of Cortexin in post-COVID syndrome management.
  16. [16] PMID 42133422 — Multicenter RCT (n=110): Cortexin 10 mg IM x10 doses + comprehensive treatment: MoCA improved 1.2-fold; HADS anxiety decreased 1.6x, depression 1.7x; NTSS-9 dec
  17. [17] PMID 42360215 — 40 patients: Cortexin 10 or 20 mg IM for 10 days improved MMSE (27.3→28.9), FAB (15.5→17.1), Schulte tables (97.5→84.5 sec) significantly; no dose difference re
  18. [18] PMID 20517210 — RCT: Cortexin 10 mg/day IM for 10 days in chronic alcohol encephalopathy/polyneuropathy improved clinical symptoms, EEG, ENMG; well-tolerated with no side effec
  19. [19] PMID 41782536 — 98 patients: Cortexin 10 mg IM once daily for 10 days added to antidepressants significantly reduced MADRS scores, improved SASS, improved safety profile vs ant
  20. [20] PMID 39269301 — 30 young patients (18–45y): Cortexin improved MoCA from 25.1 to 28.4 after two courses; quality of life improved significantly at visit 4.
  21. [21] PMID 39690562 — 71 stroke patients: Cortexin 10 mg IM twice daily + Aphasia.No app significantly improved speech, writing, reading vs comparison group.
  22. [22] PMID 27459764 — 90 patients: Cortexin 10 mg IM twice daily with repeated course accelerated quality of life normalization after hemispheric IS.
  23. [23] PMID 27905386 — 90 patients: repeated course of Cortexin 20 mg IM led to more rapid and complete regression of cognitive disorders vs single course or basic therapy.
  24. [24] PMID 36946393 — Review: high efficiency of Cortexin in correction of asthenic, vegetative, cognitive and emotional consequences of TBI, including in childhood.
  25. [25] PMID 38261281 — Review: Cortexin showed high efficacy due to multimodal action (neuroprotection, neuroplasticity, neuropreparation) in motor, cognitive, and autonomic disorders
  26. [26] PMID 21946134 — 78 children with CP (age 2–7): combined microcurrent reflexotherapy + Cortexin (10 injections per course) significantly improved speech functions vs reflexother
  27. [27] PMID 39731376 — RCT: 323 children (7 days – 1 year): 2 courses of Cortexin with 3-month interval significantly reduced frequency and severity of myotonic and hypertensive-hydro
  28. [28] PMID 33834730 — 86 children (3–17y) with epilepsy: Cortexin + antiepileptics improved electrophysiological parameters; no seizure aggravation in 95%; cognitive improvement in 6
  29. [29] PMID 20873481 — 46 patients with post-stroke epilepsy: Cortexin 10 mg IM for 15 days added to basic therapy significantly enhanced clinical effects and positive EEG changes.
  30. [30] PMID 29652302 — Multicenter study (n=635, age 3–7y): Cortexin (10 IM injections) effective for cognitive dysfunction across ADHD, speech delay, perinatal CNS lesions, asthenic
  31. [31] PMID 33728849 — 60 children with dyslexia: Cortexin more effective than encephabol (73.3% vs 60.0%) in reading, attention, working memory; significant EEG neurophysiological ch
  32. [32] PMID 22027605 — 30 children with memory disorders: Cortexin more effective than encephabol (86.7% vs 63.3% improvement) on neuropsychological and neurophysiological measures.
  33. [33] PMID 31851172 — 54 children (3–4y) with developmental dysphasia: Cortexin once daily IM for 10 days increased active vocabulary 2.3x, articulated phrases 3.6x; improved social
  34. [34] PMID 34037354 — 266 children with delayed speech development: Cortexin monotherapy effective for isolated speech disorder and psychomotor delay; also improved behavior and self
  35. [35] PMID 37655408 — Review: Cortexin with multimodal mechanism may minimize negative impact of OSA on cognitive health.
  36. [36] PMID 23667876 — RCT: Cortexin added to standard therapy normalized blood cortisol, DHEA-S, and thyroid hormones; clinical improvement associated with recovery of homeostatic sy
  37. [37] PMID 32593245 — Clinical trial: 2-week breathing exercises + Cortexin optimized functional state and professional performance in older teachers more than Cortexin alone; effect
  38. [38] PMID 39954108 — Systematic review: Cortexin mentioned as a treatment option that may target inflammatory mediators and neurotropic factors to alleviate anxiety and depression i
  39. [39] PMID 30695499 — Rat model: Cortexin 1 mg/kg IP daily for 10 days showed transient improvement of EMG spectral structure on day 10; positive effect on vagosympathetic balance on
  40. [40] PMID 31626220 — 20 mg per day intramuscular (human)
  41. [41] PMID 46356623 — in-prose reference
  42. [42] PMID 36099784 — in-prose reference
  43. [43] PMID 31099784 — in-prose reference
  44. [44] PMID 25889058 — in-prose reference
  45. [45] PMID 24535457 — in-prose reference
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