Clinical success: In a large-scale, multi-center clinical trial of 728 patients diagnosed with asthenia, bromantane was given for 28 days at a daily dose of 50 mg or 100 mg. The impressiveness were 76.0% on the CGI-S and 90.8% on the CGI-I, indicating broadly-applicable, high effectiveness. The therapeutic benefit against asthenia was notably observed to still be present one-month after discontinuation of the drug, indicating long-lasting positive effects of bromantane. Source.
Atypical mechanisms: Bromantane acts via indirect genomic mechanisms to produce a rapid, pronounced, and long-lasting upregulation in a variety of brain regions of the expression of tyrosine hydroxylase (TH) and aromatic L-amino acid decarboxylase (AAAD), key enzymes in the dopamine biosynthesis pathway.[10][18][19] For instance, a single dose of bromantane produces a 2- to 2.5-fold increase in TH expression in the rat hypothalamus 1.5- to 2-hours post-administration.[20] The biosynthesis and release of dopamine subsequently increase in close correlation with TH and AAAD upregulation.[10][18][19]
No tolerance or addiction: As such, bromantane has few to no side effects (including peripheral sympathomimetic effects and hyperstimulation), does not seem to produce tolerance or dependence, does not show withdrawal symptoms upon discontinuation, and displays an absence of addiction potential, all of which are quite contrary to typical psychostimulants.[1][9] In accordance with human findings, animals exposed to bromantane for extended periods of time do not appear to develop tolerance or dependence either.[22]
Bromantane was also noted to normalize the sleep-wake cycle. The authors concluded that "[Bromantane] in daily dose from 50 to 100 mg is a highly effective, well-tolerated and [safe] drug with a wide spectrum of clinical effects. Therefore, this drug could be recommended for treatment of asthenic disorders in neurological practice." Source.