AFOBAZOL

Afobazol was developed in Russia based on a pharmacogenetic concept of anxioselectivity and has been clinically used there since the early 2000s. In vitro studies demonstrate neuroprotective effects against oxidative stress and glutamate toxicity in HT-22 neurons. Animal studies show efficacy in experimental cerebral hemorrhage models, improving survival, learning, and motor activity. Clinical trials in 30 patients confirmed anxiolytic action with an activating component and absence of sedative or myorelaxant effects. However, all published evidence comes from Russian research groups, and no large-scale international randomized controlled trials exist. The compound is not approved by the FDA or EMA, limiting its evidence base relative to mainstream anxiolytics.