Emoxypine (Mexidol)vsPolygala Tenuifolia

Emoxypine (2-ethyl-6-methyl-3-hydroxypyridine succinate) has a 3-hydroxypyridine structure similar to vitamin B6 (pyridoxine). It is one of the most potent inhibitors of lipid peroxidation in brain tissue — it scavenges hydroxyl radicals and peroxyl radicals, inhibits Fe2+-induced lipid peroxidation, and may chelate transition metals. It modulates the GABA-benzodiazepine receptor complex (GABA-A), enhancing GABAergic transmission through positive allosteric modulation — possibly at a site distinct from the classical benzodiazepine binding site, explaining the lack of sedation and tolerance. It improves mitochondrial function (Complex I protection, membrane stabilization), stabilizes cell membranes (reducing fluidity changes during oxidative stress), and enhances cerebral microcirculation (possibly via nitric oxide or prostaglandin modulation). The anxiolytic mechanism may involve partial agonism or different subunit selectivity.

The saponins (tenuigenin, polygalasaponins, onjisaponins) and oligosaccharide esters (3,6'-disinapoyl sucrose, tenuifolisides) have multiple neurological actions. They inhibit acetylcholinesterase (AChE) at the catalytic site, increasing synaptic acetylcholine and enhancing muscarinic M1/M4 and nicotinic receptor signaling. They promote BDNF and NGF expression via CREB and ERK/MAPK pathways, supporting neuroplasticity and neurogenesis in the hippocampus and subventricular zone. They modulate NMDA receptor function (possibly as positive allosteric modulators at the glycine site) and enhance long-term potentiation (LTP) via CaMKII and PKC. The anti-depressant effects involve monoaminergic modulation — increasing dopamine and norepinephrine via MAO inhibition or reuptake modulation — and HPA axis regulation (reducing CRH and cortisol). Tenuigenin may also activate TrkB receptors directly.