[Therapy of asthenic disorders after psychotic conditions in patients with cognitive impairment: results of an observational non-interventional program]. / Terapiya astenicheskikh rasstroistv posle perenesennykh psikhoticheskikh sostoyanii u patsientov s kognitivnymi narusheniyami: rezul'taty nablyudatel'noi neinterventsionnoi programmy.

OBJECTIVE: An observational non-interventional study was conducted to obtain data on the efficacy and safety of Prospekta in the treatment of postpsychotic asthenia in patients with cognitive impairment (CI). MATERIAL AND METHODS: We selected 69 patients aged 18-75 years with asthenic disorders that developed after suffering psychotic conditions and CI, who were prescribed Prospekta. At four visits (at baseline, after 2, 4 and 8 weeks), the doctor collected complaints, anamnesis, examined the patient, assessed the severity of asthenia on the MFI-20 (The Multidimensional Fatigue Inventory-20) scale, CI - on the MMSE (The Mini-mental state examination). Concomitant diseases and maintenance therapy of the underlying disease were recorded, and the safety of treatment with Prospect was evaluated. At the last visit, the doctor's clinical impression was assessed using the CGI-I (Clinical Global Impression - Global Improvement Scale). RESULTS: The analysis included data from 69 patients (mean age 45.7 years), of which 27 (33.4%) were women. Prospekta reduced the severity of asthenia on the MFI-20 scale from 85.7±6.6 to 51.6±7.1 points, including general asthenia, mental and physical asthenia, and contributed to an increase in activity and motivation (p<0.001). 8-week treatment with Prospekta improved cognitive function on the MMSE scale from 25.7±3.7 to 28.8±1.5 points (p<0.001). There was no effect of the drug on blood pressure, heart rate. 76 adverse events (AEs) were detected in 22 patients, of which 62 AEs (82%) were of mild severity, 14 AEs (18%) were of moderate severity. A causal relationship of AEs with taking Prospekta, according to doctors, was absent in 48 (63%) cases. CONCLUSION: Prospekta is an effective and safe drug for the treatment of asthenic disorders that have developed after suffering psychotic conditions in patients with CI.

[Cardiac rhythm disorders and arterial hypertension in treatment-compliant patients with alcoholic dependence: features of the clinical course and therapy].

Features of dynamics of arterial hypertension and rhythm disorders within 3 years after the termination of alcohol intake were studied. The study included 260 patients with alcoholic dependence at the age from 22 to 74 years (mean age 46±6.6 years). The functional state of the cardiovascular system was evaluated. It has been shown that within 1 month after the termination of alcohol intake, 73.1% of patients develop arterial hypertension that needs treatment. Cardiac rhythm disorders were registered in 23.1% of cases. Antiarrhythmic drugs are recommended, in at least 83.1% cases, to patients having the combination of arterial hypertension and paroxismal ventricular rhythm disorders in the endpoint of the study. Efficacy of hypotensive and antiarrhytmic drugs is analyzed.

[Mental disorders following delirium tremens].

Twenty-four patients, aged between 29-62 years (average age - 44+/-11 years), at the post-psychosis period of delirium tremens were observed. In 19 patients, this period was characterized by a triad of mental disorders including cognitive dysfunction, affective disturbances and alcohol anosognosia. Memantine was recommended for all patients with mental disorders. These disorders are reduced during 11-28 (in average - 18+/-4) days after the recovery of psychosis. The hypothesis on the close relationship of three types of described disorsers with mild forms of Korsakoff disease and the expediency of memantine therapy after the delirium tremens was expressed.

[The risk of sudden cardiac death in patients with alcohol addiction: how urgent is a problem?].

Features and variants of cardiovascular pathology among patients with alcohol addiction were analyzed in 251 patients with II-III degrees of alcohol addiction during 3 years. Treatment and compliancy of patients were taken into account. Based on the results of the primary clinical and instrumental examination, patients were divided into two groups depending on the presence (181 patients) or the absence (70 patients) of cardiovascular pathology. Mortality rates, including sudden death, and cardiac complications were significantly higher in patients with cardiovascular pathology. The impact of patient's compliance on these indices has been revealed.

[Detoxification in withdrawal state in methadone maintenance patients]. / Kupirovanie sindroma otmeny metadona u aktseptorov metadonovykh programm.

A comparative study of withdrawal states of 7 methadone maintenance patients and 21 heroin addicts was carried out. The protracted and low predictable course of methadone withdrawal states, along with relatively high resistance to clonidine and other medications, was demonstrated. Similarity of mental disorders, including addictive personality disorders, was found in both groups of patients.

[The use of neuroleptics in treating opiate dependence]. / Ispol'zovanie neiroleptikov v lechenii opiinoi narkomanii.

The aim of the study was to determine indications and contraindications for prescription of neuroleptics in opium addiction and to study their influence on the state of the patients at different stages of the treatment. 197 patients were treated: 185 men aged 15-62 years and 12 women aged 16-35 years. The duration of the addiction was from 6 months to 18 years. It was found that therapy with neuroleptics is a necessary component of a combined treatment in the acute phase of the withdrawal syndrome and at the first stages of the following therapy. At the late stages the necessity of their administration decreased. An administration of sulpiride, alimemazine, periciazine, and thioridazine was more preferable; withdrawal psychoses were relieved with droperidol and haloperidol most effectively. In a period of antirelapse maintenance therapy administration of sulpiride, periciazine and thioridazine is indicated. Application of the preparations of prolonged action in contraindicated because of the possibility of neurolepsy development. It is emphasized that neuroleptics fail to stop a drive to narcotics and are not suitable to correct sleep.

[Preventive therapy of opiate addiction with naltrexone]. / Preventivnaia terapiia opiinoi narkomanii naltreksonom]

The trial included 120 patients with opiates addiction: the study group (60 patients) and a control one (60 individuals) which were similar in sex, age and clinical peculiarities of the disease. Naltrexon was administered prophylactically to the patients of the study group during 6 months and longer, while the patients of the control group didn't receive naltrexon. Simultaneously, a program of common therapy and rehabilitation concerning both groups was performed during 6 months. It was established that application of naltrexon decreased probability of relapse of drug abuse, facilitated an inclusion of a patient into a program of therapy and rehabilitation, increased a number and quality of remissions as well as it also decreased a tendency to alcohol and sedative drugs administration. Naltrexon had no side effects and was well tolerated by the patients. 8 follow-up cases of treatment with metadone in some foreign clinics are presented. These observations and literary data show that prophylactic properties of metadone are less pronounced as compared with naltrexon.

[Experience in using ketamine preparations in the psychotherapy of alcoholism]. / Opyt primeneniia preparatov ketamina v psikhoterapii alkogolizma.

After careful clinical examination 64 alcoholics (48 males and 16 females) aged 21-52 were assigned to ketamin aversive psychotherapeutic procedure supposed to make the patients emotionally concerned with their disease and suggestible of alcohol intolerance. Ketamin caused in 55 patients (85.5%) oneiroid clouding of consciousness with occasional catatonic inclusions, 9 patients (14.5%) became delirious. Ketamin-induced high suggestibility created beneficial conditions for psychotherapy. A 2-year follow-up of 42 patients registered complete abstinence in 15 patients. The results obtained with ketamin are comparable to those achieved with conventional methods. This alternative approach needs further research, especially as analytical opportunities are concerned.