Objective was to assess the efficacy of treatment of asthenic syndrome in neurotics and patients with stress-associated disorders by means of succinate containing metabolic protectors (mexidol, riboxine/cytoflavine, metaprot/metaprot plus) in comparison with benzodiazepine tranquilizers (phenazepam). Methods. In 142 patients with neurosis or stress-associated disorders, asthenic syndrome was revealed by clinical, psychological and instrumental methods. Asthenic syndrome was performed with somatic complaints preferably: headaches, bowel function disorders, cardialgias, inspiratory dispnoe (60,1%), weakness (52,4%), high psychic and physical tiredness (61,9%), vegetative lability (81,8%). As a rule, neurotic syndrome was connected with psychotraumatic situation. Results. Metabolic protectors containing (mexidol, cytoflavine, metaprot plus) or non-containing (riboxine, metaprot) succinate in their structure were clinically effective in abolition or reduction of asthenic syndrome in such patients, succinate containing drugs being more effective. As an example, in Iowa Fatigue Scale, cypoflavine, metaprot, metaprot plus and phenazapam revealed high antiasthenic activity, mexidol also was active (p<0.05), but in a less degree, and placebo and riboxine had no effect. Antiasthenic action was represented by proper anthiasthenic, antidepressant, anxiolytic, nootropic (cognitive) and positive general somatic effects of the drugs. Conclusion. Special correction of asthenic disorders with succinate-containing metabolic drugs is recommended in patients with neurosis or stress-associated disorders.