15 compounds were read against these 2 conditions; 7 produced a graded row. The other 8 are named further down.

The ranking, and the key it uses

Ordered by the best rung the compound holds anywhere in this goal; then by what that study measured; then by how many graded rows it holds here, as a tie-break only; then by name. There is no blended score — one number mixing the rung and what was measured would invent a third scale nothing was graded against. Every rung links to the rubric that assigned it.

1. 01

   Cerebrolysin

   human RCT · direct outcome · 2 graded rows across 2 of 2 conditions

   Stroke · Traumatic brain injury

   2 graded rows, 2 sources

   1. Stroke

      human RCT Direct outcome Approved for this condition

      Who was studied

      adults with acute ischaemic stroke confirmed on neuroimaging, treated within 48 hours of onset; 7 randomised trials, n=1773 (1689 analysed), mean age approximately 60-69, follow-up 28-90 days; haemorrhagic stroke and the recovery phase were not covered

      Approved and marketed in Russia, China and parts of Eastern Europe, and recommended for acute ischaemic stroke by Russian national clinical practice guidelines; it is not approved by the FDA or the EMA. The 2023 Cochrane review of 7 randomised trials found it probably makes little to no difference to all-cause death (RR 0.96, 95% CI 0.65-1.41, moderate certainty) and probably increases non-fatal serious adverse events (RR 2.39, 95% CI 1.10-5.23, moderate certainty); no included trial reported death-or-dependence, quality of life or return to work. The reviewers judged allocation concealment unclear in 6 of 7 trials, attrition of 16-29% in 4 trials, and two trials at high risk of bias from manufacturer involvement; with fewer than 10 trials they could not test for publication bias by funnel plot.

      Source DOI 1 primary source read for this row

   2. Traumatic brain injury

      human RCT Direct outcome Not approved for this condition

      Who was studied

      adults 18-80 with moderate-to-severe TBI enrolled within 30 days of injury, single centre in Romania, n=93 randomised across three arms (86 in the intention-to-treat analysis), followed 180 days; mild TBI was excluded

      This double-blind three-arm trial gave intravenous cerebrolysin with or without repetitive transcranial magnetic stimulation against saline and measured ten cognitive tests including MoCA, Stroop, Trail Making and CANTAB; no statistically significant difference was found on the primary outcome measures, and the authors list small sample size, single-centre design and short follow-up as limitations. A 2019 systematic review and meta-analysis of cerebrolysin in moderate and severe TBI pooled 5,685 participants across five studies but only one was a randomised trial, the other four being cohorts; it reported improvement on the Glasgow Outcome Scale (SMD 0.30, 95% CI 0.18 to 0.42) and the modified Rankin Scale while grading the body of evidence Level II and citing heterogeneity in dose, timing and injury severity, and the reviewers noted the lack of standard clinical trials as the reason the level of evidence is limited. Cerebrolysin has no FDA or EMA marketing authorisation for any indication; it is marketed under national registrations in Russia, China and other countries, and we did not locate a regulator's own document stating a TBI indication.

      Source PubMed Central 2 primary sources read for this row

2. 02

   Cortexin

   human RCT · direct outcome · 1 graded row across 1 of 2 conditions

   Stroke

   1 graded row, 1 source

   1. Stroke

      human RCT Direct outcome Approved for this condition

      Who was studied

      adults with acute ischaemic stroke in the internal carotid artery territory, intracerebral haemorrhage excluded by CT or MRI, treatment started within 24 hours of onset; n=272, double-blind, placebo-controlled, 70 days

      Approved in Russia and recommended there for acute ischaemic stroke by national clinical practice guidelines; it is not approved by the FDA or the EMA and no EMA or FDA assessment of it exists on file. The single trial, published in Russian, reported benefit from two courses of 10 mg intramuscularly three times daily; the 2023 Cochrane review of Cerebrolysin included this same trial as a Cerebrolysin-like cattle-brain preparation and concluded that adding Cerebrolysin or Cortexin to standard therapy probably does not reduce the risk of dying and increases non-fatal serious adverse events. No trial in haemorrhagic stroke or in the recovery phase is on file.

      Source PubMed 2 primary sources read for this row

3. 03

   Semax

   human observational · direct outcome · 1 graded row across 1 of 2 conditions

   Stroke

   1 graded row, 1 source

   1. Stroke

      human observational Direct outcome Approval not established

      Who was studied

      adults in the recovery phase after ischaemic stroke, n=110 (43 men, 67 women, mean age 58.0 plus or minus 9.7), entering rehabilitation at 89 plus or minus 9 days (early) or 214 plus or minus 22 days (late); acute stroke and haemorrhagic stroke were not studied

      The one located human study measured Barthel index, MRC motor scale and plasma BDNF in post-stroke rehabilitation patients split into semax and no-semax subgroups; the report does not state that allocation was randomised, placebo-controlled or blinded, so it is graded as observational. It is not approved by the FDA or the EMA; a Russian registration for ischaemic stroke is widely asserted but no regulator document was located, so approval status is recorded as unknown rather than guessed. No study of semax in acute or haemorrhagic stroke is on file.

      Source PubMed 1 primary source read for this row

4. 04

   BPC-157

   animal in vivo · direct outcome · 1 graded row across 1 of 2 conditions

   Traumatic brain injury

   1 graded row, 1 source

   1. Traumatic brain injury

      animal in vivo Direct outcome Not approved for this condition

      Who was studied

      mice, weight-drop closed head injury of escalating severity, 24 hour observation; group sizes not reported in the abstract

      Mice given BPC 157 intraperitoneally (10 microgram/kg and 10 nanogram/kg) after weight-drop head injury had less subarachnoid and intraventricular haemorrhage, less brain oedema and lower early mortality over 24 hours than controls. This is a rodent closed head injury model observed for one day, not human TBI, and no human study of BPC-157 in traumatic brain injury is on file.

      Source ScienceDirect 1 primary source read for this row

5. 05

   GHRP-6

   animal in vivo · direct outcome · 1 graded row across 1 of 2 conditions

   Stroke

   1 graded row, 1 source

   1. Stroke

      animal in vivo Direct outcome Not approved for this condition

      Who was studied

      Mongolian gerbils after 15-minute bilateral carotid occlusion with reperfusion, and Wistar rats with focal ischaemia from intracerebral endothelin-1; vehicle, combination therapy and hypothermia groups against a sham-operated control

      Survival, neurological score and infarct volume were measured, and the treated animals matched the hypothermia comparator on neurological score, infarct volume and hippocampal CA1 neuronal density. The intervention was epidermal growth factor plus GHRP-6 given together, so the record does not separate what GHRP-6 contributed on its own; there was no GHRP-6-alone arm. The authors present it as proof of principle needing further support before clinical translation, and no human stroke trial is on file. Rung set from the study's own design wording, "gerbils".

      Source PubMed 1 primary source read for this row

6. 06

   P21

   animal in vivo · direct outcome · 1 graded row across 1 of 2 conditions

   Traumatic brain injury

   1 graded row, 1 source

   1. Traumatic brain injury

      animal in vivo Direct outcome Not approved for this condition

      Who was studied

      adult male C57Bl/6 mice, controlled cortical impact at 1.5 mm penetration (mild to moderate injury), 30 days of treatment; group sizes not reported in the abstract

      Mice given 50 nmol/day of the compound for 30 days after controlled cortical impact performed better on a hippocampus-dependent memory task and showed less neuronal loss in CA1 and parietal cortex than saline controls. The molecule tested was Peptide 6, the ciliary neurotrophic factor fragment from which the shorter tetrapeptide sold as P021 or P21 is derived, so this is evidence about a related but not identical peptide; the model is a mouse model of TBI and no human study of either peptide in traumatic brain injury is on file.

      Source PubMed 1 primary source read for this row

7. 07

   Thymosin Beta-4

   animal in vivo · direct outcome · 1 graded row across 1 of 2 conditions

   Traumatic brain injury

   1 graded row, 1 source

   1. Traumatic brain injury

      animal in vivo Direct outcome Not approved for this condition

      Who was studied

      adult rats, controlled cortical impact over the left parietal cortex; delayed-treatment experiment n=6 sham, 9 saline, 10 thymosin beta-4; outcomes to day 35

      Rats given thymosin beta-4 intraperitoneally after controlled cortical impact showed better spatial learning on the Morris water maze and improved modified neurological severity scores than saline controls, with reduced hippocampal cell loss; early dosing reduced cortical lesion volume while delayed dosing did not. Controlled cortical impact is a rodent model of TBI, not human TBI, and no human trial of thymosin beta-4 in traumatic brain injury is on file.

      Source PubMed Central 1 primary source read for this row

Checked, and nothing on file

8 compounds were read against these conditions and produced no gradeable row. They are named here rather than left off, because a list of 7 reads identically whether 7 survived 15 or 7 were all anyone thought of.

1. Adamax

   No rung — nothing on file to grade

   Checked against stroke. No study meeting the rubric was found for any of them.

2. Angiotensin I on stroke

   No rung — nothing on file to grade Not approved for this condition

   Nothing located administering angiotensin I with a neurological outcome.

3. C-Type Natriuretic Peptide (CNP) on stroke

   No rung — nothing on file to grade Not approved for this condition

   Nothing located with an administered peptide and a neurological outcome.

4. Dihexa

   No rung — nothing on file to grade

   Checked against stroke, traumatic brain injury. No study meeting the rubric was found for any of them.

5. Endothelin-1 on stroke

   No rung — nothing on file to grade Not approved for this condition

   ET-1 is administered intracerebrally in rodents to CAUSE a stroke. The endothelin-1 middle cerebral artery model is one of the standard ways of producing a focal infarct for testing other drugs. That is a model-building use, not a treatment, and it earns no row.

6. Noopept

   No rung — nothing on file to grade

   Checked against stroke. No study meeting the rubric was found for any of them.

7. Pinealon

   No rung — nothing on file to grade

   Checked against stroke. No study meeting the rubric was found for any of them.

8. Vasopressin on stroke

   No rung — nothing on file to grade Not approved for this condition

   Nothing found. Vasopressin appears in the stroke literature as a measured plasma marker and as a suspected contributor to cerebral oedema, not as an administered treatment with a neurological outcome.

Browse by goal

• Weight loss — 29 compounds with a graded row, from 48 checked
• Anti-ageing & metabolic — 16 compounds with a graded row, from 30 checked
• Muscle growth — 9 compounds with a graded row, from 20 checked
• Infection & immunity — 23 compounds with a graded row, from 30 checked
• Cardiovascular — 29 compounds with a graded row, from 33 checked
• Healing & recovery — 16 compounds with a graded row, from 29 checked
• Sexual health & fertility — 13 compounds with a graded row, from 28 checked
• Pain — 8 compounds with a graded row, from 19 checked
• Skin & hair — 9 compounds with a graded row, from 33 checked
• Mood & anxiety — 3 compounds with a graded row, from 12 checked
• Sleep — 9 compounds with a graded row, from 30 checked
• Cognition — 8 compounds with a graded row, from 43 checked
• Inflammation — 5 compounds with a graded row, from 23 checked
• Biological ageing — 8 compounds with a graded row, from 30 checked
• Gut health — 12 compounds with a graded row, from 27 checked