Репозиторий Университета

The tendency to anxiety is a characteristic feature of alcohol abusers, and anxiety can be a symptom of alcohol withdrawal as well as comorbid disorder. The frequent comorbidity of alcohol use disorders and anxiety is due to a number of reasons including general hereditary predisposition, mutual conditioning and similar pathogenesis. Pharmacological therapy of anxiety disorders in alcohol-dependent patients is carried out on the basis of general principles of anxiety treatment and involves the use of benzodiazepines, antidepressants and, in some cases, antipsychotics as second-line medicines.

© 2018, Media Sphera Publishing Group. All rights reserved. A number of frequently discussed issues of clinical psychiatry include comparing the advantages and disadvantages of typical and atypical antipsychotics. It is believed that atypical antipsychotics are less likely to cause extrapyramidal disorders and have a more significant effect on the negative symptoms of schizophrenia compared to typical drugs. However, many randomized controlled and cohort studies, as well as systematic reviews and meta-analyses carried out on their basis, allow questioning the superiority of second-generation antipsychotics over their predecessors, in particular in terms of tolerability. Current scientific evidence provides sufficient evidence for the clinical use of chlorpromazine and other traditional antipsychotics, along with more recent medicines.

© 2018, Media Sphera Publishing Group. All Rights Reserved. Objective. To develop therapeutic programs for treatment of depression with panic attacks on the basis of their clinical and psychopathological features. Material and methods. A total of 100 in-and outpatients, aged from 18 to 60 years, with depression of mild and moderate severity with panic attacks were studied. The investigation was carried out using clinical, psychopathological and psychometric (the Atypical Depression Diagnostic Scale (ADDS), the Montgomery—Asberg Depression Rating Scales (MADRS), and the Sheehan Anxiety Rating Scale (ShARS)) methods. The patients were assessed on admission, on the 1st, 2nd, 4th and 8th weeks with subsequent processing and defining standard indicators. Three therapeutic groups were formed: the 1st group received therapy combining an antidepressant and a tranquilizer; the 2nd group an antidepressant, a tranquilizer and a mood stabilizer; and the 3rd group an antidepressant, a tranquilizer and an antipsychotic agent. The time course of expression of the signs of depression, anxiety and frequency of panic attacks was analyzed. Results. The highest efficacy in the form of reduced signs of depression and anxiety was observed in the 3rd group on the 1st week of therapy. No significant differences in reduction of depression and anxiety were found between the 1st and 2nd groups. In the 1st therapeutic group, there was an increase in the frequency of panic attacks together with the reduction in their expression and decrease in the severity of depression as compared to the 2nd and 3rd groups. At the same time the 3rd therapeutic group was characterized by a maximally expressed decrease in the frequency of panic attacks already on the 1st week of therapy. Conclusion. The study has shown that the use of antipsychotic drugs in addition to therapy with antidepressants and tranquilizers is the most effective way to stop depression.