Semax , an ACTH(410) analog developed in Russia, has been extensively studied in academic settings for its influence on BDNF, NGF (nerve growth factor), and serotonergic signaling
doi: 10.3389/fimmu.2022.888306 12 DesaiJSteigerSAndersHJ
A prodrug is a biologically inactive or less active compound that is metabolized in the body into a pharmacologically active form
Since the clinical utility of EA was limited both by its diuretic properties, and its lack of isozyme specificity, efforts were made to develop inhibitors with more optimal isozyme specificity and clinical application

The complete side effect frequency breakdown from Phase 2 trials: Very Common (20%+ of patients at 12mg dose) Nausea: 28% Typically mild to moderate, peaks weeks 4-8, usually resolves by week 12 Diarrhea: 24% Usually transient (1-3 weeks), rarely severe Constipation: 21% Paradoxically coexists with diarrhea in different patients Common (10-20% of patients) Vomiting: 17% Decreased appetite: 16% (beyond therapeutic effect) Injection site reactions: 14% Fatigue: 13% Dyspepsia (indigestion): 12% Headache: 11% Uncommon (2-10% of patients) Abdominal pain: 8% Dizziness: 7% Gastroesophageal reflux: 6% Hypoglycemia in diabetics on other medications: 5% Increased heart rate (average 2-4 bpm): 4% Hair thinning/loss: 3% (typically temporary) Rare but Serious (Under 2%) Pancreatitis: 0.3% (3 cases out of 1,032 patients, all resolved with discontinuation) Gallbladder events: 1.4% (expected with rapid weight loss regardless of method) Acute kidney injury: 0.7% (all cases associated with severe dehydration) KEY TAKEAWAY: About 30% experience meaningful nausea in the first 4-8 weeks
