[Risk factors for the development of psychotic disorders associated with synthetic cathinones usage]. / Faktory riska razvitiya psikhoticheskikh rasstroistv, svyazannykh s upotrebleniem sinteticheskikh katinonov.

OBJECTIVE: To identify risk factors and predictors of the development of psychotic disorders in patients who used synthetic cathinones (SKat). MATERIAL AND METHODS: The study included 176 patients who used SKat, which was toxicologically confirmed. One hundred and eleven (63.1%) were male and 65 (36.9%) were female. The median age was 27 years (22-32 (Q1-Q3)). Patients were divided into main and control groups depending on the presence of a psychotic disorder. The main group (those who developed psychosis) consisted of 98 patients, the control groupincluded 78 participants. Clinical-psychopathological, parametric and statistical methods were performed to study predictors and risk factors for the development of psychotic disorders associated with the use of SKat. RESULTS: The study established factors influencing the incidence of psychosis. Older patients were more likely to develop psychosis (p=0.002). Patients who used SKat for more than 21 consecutive days developed psychoses more often (p=0.048). The use of α-pvp (α-pyrrolidinovalerophenone, alpha-pvp) more often led to the development of psychosis (p<0.001). Patients undergoing rehabilitation were less likely to experience the development of psychosis (p=0.009). The resulting regression model is statistically significant (p<0.001). Based on the value of the Nigelkirk coefficient of determination, the model explains 30.9% of the observed group variance. It has been established that the combination of the following factors increases the chances of developing psychosis: female gender, age, duration of daily use, the presence of signs of mental infantilism, fear of the dark in childhood. In turn, the experience of undergoing rehabilitation and any pathology of the mother's pregnancy reduces the risk of psychosis. CONCLUSION: The results are consistent with other studies of substance-induced psychoses. The observed patterns demonstrate that this is a special group of disorders that requires the attention of specialists. The results allow us to outline the field for further study, and may also be useful in the development of therapeutic and preventive recommendations.

[Fluvoxamine in the treatment of depressive disorders in alcohol dependence: results of randomized open-label comparative study]. / Fluvoksamin v terapii depressivnykh rasstroistv pri alkogol'noi zavisimosti: rezul'taty randomizirovannogo otkrytogo sravnitel'nogo issledovaniya.

OBJECTIVE: Assess the efficacy and safety of fluvoxamine, sertraline, citalopram, paroxetine, fluoxetine. MATERIAL AND METHODS: The study included 175 patients with alcohol dependence and depressive disorders. 161 had a diagnosis Alcohol Dependence Syndrome (ADS); 14 patients had a «dual diagnosis¼. All patients were randomized into 5 groups according to the drugs received. To assess the therapeutic efficacy of drugs, the following scales were used: visual analogue scale (VAS), Montgomery-Asberg Depression Rating Scale (MADRS), Hospital Anxiety and Depression Scale (HADS). The safety of drugs was assessed by the incidence of adverse events (AEs) or serious adverse events (SAEs). RESULTS: The drugs relieve depressive disorders: fluvoxamine by the 7th day of treatment, sertraline, paroxetine, citalopram by the 14th day, fluoxetine by the 30th day of therapy. A significant decrease in the level of anxiety when taking fluvoxamine and citalopram occurs by the 7th day, when taking sertraline and paroxetine - by the 14th day, and when taking fluoxetine - by the 30th day. The presence of an anticraving effect in SSRIs is confirmed by the obtained strong and average correlation coefficients between affective disorders and craving for alcohol. The correlation analysis allowed drawing the conclusions about the close connection of presenting features of the affective disorders (depression and anxiety) and craving. The anticraving effect is more expressive in fluvoxamine, sertraline, citalopram and paroxetine. The most common adverse reactions (increased insomnia and anxiety) are observed in: fluoxetine, citalopram, sertraline, paroxetine. Fluvoxamine has the most favorable safety profile. CONCLUSION: SSRIs can be effectively used for the treatment of depressive disorders in alcohol dependence.