Cerebrolysin

The Cerebrolysin evidence base cited here is 6 sources — 2 clinical, 4 review. Its strongest evidence is human — 2 clinical studies, most recently 2016 ("Cerebrolysin and Recovery After Stroke (CARS): A Randomized, Placebo-Con…"). Regulatory status: Approved in some countries.

• Cerebrolysin is a standardized porcine brain-derived peptide mixture containing low-molecular-weight neuropeptides with BDNF-like and NGF-like activity; it is widely approved and used in Russia, Eastern Europe, China, and parts of Asia for stroke, vascular dementia, and Alzheimer's disease, though it lacks full regulatory approval in the US and Western Europe.
• A 2016 randomized Phase II trial (CARS) in acute ischemic stroke patients found Cerebrolysin produced significantly better upper extremity motor recovery than placebo at 90 days (effect size 0.71, p<0.0001); a 2018 meta-analysis of nine RCTs confirmed statistically significant neurological improvement at 30 days, with a number needed to treat of approximately 8.
• A 2011 randomized double-blind trial in vascular dementia showed 67.5% of Cerebrolysin-treated patients achieved combined cognitive and global improvement vs. 27.0% on placebo (p<0.0001) over 24 weeks; however, the 2020 Cochrane Review found a concerning signal of increased non-fatal serious adverse events at higher doses.

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