A method for the treatment of psychogenic and somatogennye edge of mental disorders

 

(57) Abstract:

The invention relates to medicine, namely to "low-psychiatry". Enter the patient frenolon in the morning and afternoon hours at a dose of 0.00125 grams and glutaral in the morning and afternoon hours at a dose of 1/4 tablets, and at night - in a dose of 1/2 tablet. The method allows successful treatment of borderline disorders involving moderate and pronounced paroxysmal autonomic disorders mixed on an outpatient basis, without discontinuing work, short courses.

The invention relates to the treatment of borderline mental disorders, accompanied vegetative disorders.

Borderline disorders related to "small psychiatry", currently constitute the bulk of mental disorders. They caused considerable trucapture production, and traditional forms of pharmacotherapy in many cases are associated with undesirable side effects or are not effective enough.

It is known that obligate manifestations of borderline mental disorders irrespective of their etiology, are emotional and autonomic disorders. To Peccei only emotional disorders (Svyadosch A. M. Neurosis. - M., 1982. C. 291-297).

It is also known that the treatment of autonomic disorders is based activating or suppressing the influence of the drug on the sympathetic and parasympathetic divisions of the autonomic nervous system (Wayne A. M., Solovieva, A. D. , Kolosov O. A. Vegetative-vascular dystonia. - M.: Medicine, 1981, - S. 285-291). However, the overall effectiveness of the treatment of autonomic disorders accompanying the edge of a mental disorder, reduce the number of the following factors:

traditionally insufficient attention to pharmacotherapy autonomic disorders;

ignoring the importance of evaluation as a structure (the ratio of sympathetic and parasympathetic tone, permanent or paroxysmal in nature), and brightness (weak, rapidly denominated denominated) autonomic disorders;

the lack of reliable objective methods of quantitative and qualitative evaluation of disorders of autonomic tone.

For pharmacotherapy of borderline mental disorders traditional is the use of minor tranquilizers. However, the use of pharmacological agents in this group is associated with the risk of tolerance to drugs, drug dependence is a s in the treatment of borderline mental disorders is the use of small doses of neuroleptics and anticonvulsants, that avoids the development of a number of side effects while increasing the effectiveness of treatment.

For example, the famous (Samples E. C. prognosis of the effectiveness of metavanadate and glutaral in the treatment of borderline mental disorders: Dis. Kida.the honey.Sciences. - Kupavna, 1994. S. 124) a method of treatment of borderline mental disorders, based on the use of low doses of neuroleptic frenolona (metavanadate) - 2.5 g in the morning and afternoon hours. The combination of activating and sedative properties of the drug makes it quite effective in the treatment of a number of asthenic options psychogenic and somatogennye edge of mental disorders. The use of the drug can improve reduced sympathetic tone in patients with introversive personality traits, which tend to asthenic forms of borderline mental disorders. However, the treatment can have side effects such as irritability, disturbances of sleep, increasing signs of empathie and increased autonomic seizures.

Eliminating some of these shortcomings by using an integrated psychotropic drugs, combining a mild stimulant and expressed sedation baroterapii for physicians. In 2 volumes. So 1. 1993. S. 28) a method for the treatment of borderline mental disorders and psychogenic somatogennye nature of the comprehensive drug gloverall dose of 1/2 tablet at night. The composition of the tablets glutaral includes:

Phenobarbital - 0,025 g

Bromizoval - 0.07 g

Caffeine sodium benzoate - 0,005 grams

Calcium gluconate - 0.2 g

This method allows you to avoid sleep disturbances and emotional excitability, reduces excessive activation of the sympathetic division of the autonomic nervous system.

However, in some cases, its use causes an increase in parasympathetic tonus of the vegetative nervous system, increased lethargy in the daytime, manifestations of anxiety.

Also known (Samples E. C. prognosis of the effectiveness of metavanadate and glutaral in the treatment of borderline mental disorders: Dis. Kida.the honey. Sciences. - Kupavna, 1994. C. 132-135) a method of treatment of borderline mental disorders sharing and frenolona, and glutaral. This phrenolon administered in the morning and afternoon hours at a dose of 0.0025 g, and glutaral - 1/2 pill at night. This method can be achieved positive clinical effect in cases where there have been violations of autonomic tone mixed what about this method of treatment is possible only in those cases when manifestations of vegetative empathie accompanying borderline mental disorder, expressed in a moderate way and are permanent. In those cases where the clinical picture of the disease autonomic disorders mixed character expressed quite clearly and have paroxysmal nature, to achieve a positive clinical effect is not possible.

Thus, known methods of treatment can not achieve a positive therapeutic effect in the treatment of borderline mental disorders and psychogenic somatogennye nature, accompanied by moderate to pronounced paroxysmal autonomic disorders mixed character.

Inventive task consisted in finding a treatment for borderline mental disorders and psychogenic somatogennye nature, accompanied by moderate to pronounced paroxysmal autonomic disorders mixed, allowing pharmacotherapy in the outpatient setting, without discontinuing work, short courses, creating a patient, positive attitudes to treatment and extending the possibility of psychotherapeutic influence.

On the ay application frenolona in the morning and afternoon hours and glutaral - 1/2 pill at night, in which glutaral used additionally in the morning and afternoon frequent dose of 1/4 tablets, and phrenolon used at a dose of 0,00125,

Distinctive features of the invention are the additional use of glutaral in the morning and afternoon hours in the 1/4 dose pills and use frenolona dose 0,00125,

This method allows effective treatment of borderline mental disorders and psychogenic somatogennye nature, accompanied by moderate to pronounced vegetative disorders of mixed type, as a permanent and paroxysmal character, short courses and without separation of the sick from work. The method creates favorable conditions for subsequent psychotherapeutic influence.

Information confirming the possibility of carrying out the invention

The invention is illustrated by the following examples.

Example 1. Patient K., 35 years. Diagnosis: chronic tonsillitis in the phase of therapeutic remission. Vegetative-vascular dystonia, due to the effects of low-intensity neyroinfektsionnyh process, permanent-paroxysmal form with frequent autonomic crises of a mixed nature. In childhood he suffered poyavilas signs of emotional and autonomic lability. With 25 years of suffering autonomic crises violation of cardiac rhythm (palpitations, "fading" of the heart), redness or pallor of the face, sweating, feeling of fear, weakness. Sometimes there are flashes of irritability and anger. Disturbed sleep. Dreams are often unpleasant or intimidating nature. Psychological research has revealed the predominance of the emotional properties of excitability and anxiety damn conceited. The level of neurotic - 16 units, extroversion - 17 units (test Eysenck). When monopolar EEG study after functional loading (hyperventilation) fixed high-frequency flash electrical activity with an amplitude of 60 mV, a frequency of 40 Hz with a duration of 2.5 seconds in the right temporal region. At the same time in the left temporal region are recorded similar to flash the beta frequency range 30 Hz with a duration of 0.3 sec with an amplitude of 20 mV.

On the basis of clinical manifestations of borderline mental disorders, psychological testing, and conducted research tools the patient was assigned to a ten-day course of treatment with phrenolon dose 0.00125 grams in the morning and afternoon hours and gloverall in said reducing emotional tension. On the 6th day of treatment, normalization of cardiac rhythm, no bad dreams, improved health, reduced temper. With 7-day treatment vegetative crises were not registered. After 10 days of treatment of complaints on health is not present, noted a good mood and health. The treatment was performed in an outpatient setting without discontinuing work. Observation during the month showed normalization of emotional and autonomic tone. Electroencephalographic study in the dynamics (10-day follow-up) showed the norm. The follow-up period of 6 months. Violations of health and health no.

Example 2. Patient M, 40, carpenter. Was admitted for treatment with a diagnosis of neurotic personality development in hypochondriacal type with autonomic crises of a mixed nature. At a young age, suffered mental trauma in the presence of friends was forced not to respond to abusive behavior of a stranger. Soon developed state, accompanied by apathy, a sense of violation of cardiac rhythm ("interruptions" and "fading"). Was hospitalized in the intensive care unit, where the bypass assistant is p" . After examination in the clinic organic lesion of the myocardium was excluded, was discharged with a diagnosis of vegetative-vascular dystonia". In the future, under additional emotional stress have become easy to occur autonomic seizures are of a mixed nature, accompanied by the fear of death. Was called the ambulance through, went to doctors of different specialties, but the treatment effect was not given. The frequency of attacks is from 1 to 4 per month. Psychotherapeutic correction did not give sufficient effect due to the frequent recurrence of autonomic disorders.

Before treatment a comprehensive survey. A tendency towards the formation of a conversion-hypochondriacal worries, anxiety and doubtful traits, increased emotional lability. In the test Eysenck measure of extroversion - 9 unit, neuroticism - 17 units In Minesotta personality questionnaire "peaks" on the 3rd (75 points) and 7th (85 points) the scales. When electroencephalographic study on the background of hyperventilation outbreaks of electroactivity gamma-band in the left temporal region of 50 Hz, an amplitude of 80 mV, pulse duration of 1.5 seconds. At the same time in the right temporal region recorded the electrical activity h is ia the patient was prescribed treatment under the scheme, specified in example 1.

After administration of drugs by the described method on the 3rd day of treatment the patient reported feeling of self-confidence, easing emotional stress. On the 7th day of treatment disappeared a sense of inner excitement was reduced emotional lability. During the 10-day course of treatment autonomic seizures are not fixed. Actively involved in the psychotherapeutic process. The treatment was performed without discontinuing work. Upon completion of the course of treatment, the patient noted increased productivity, improvement of the situation in the family and in the production team. The physical condition of the patient remained good.

Thus, the task of eliminating emotional and autonomic disorders accompanying psychogenic edge mental illness, was solved by applying the above-described pharmacological schema.

To eliminate the possibility of a psychogenic disease recurrence without discontinuing work was conducted two months psychotherapeutic course. Re-study the electrical brain activity of the patient showed complete normalization of the EEG. Follow-up is SS="ptx2">

The proposed method of treatment was used for the correction of the emotional-autonomic disorders with borderline mental disorders and psychogenic somatogennye of nature 368 patients. Of them women - 256 people, men and 112 persons, patients with somatogennye edge of mental disorders - 230 people with psychogenic borderline mental disorders - 138 people.

Analysis of the effectiveness of therapy using frenolona and glutaral in patients with moderate and distinct violations of paroxysmal and permanent-paroxysmal character when somatogennye and psychogenic borderline mental disorders under the proposed method and the method prototype showed a number of benefits of treatment by the proposed method. Thus, in male patients, the effectiveness of treatment for these disorders, the method of the prototype was 30% (partial response - 22%, full - 8%), and the proposed way - 84% (partial response and 11% of full - 73%). In women, respectively 32% (22% and 10%) for the prototype, 87% (13% and 74%) for the proposed method.

In the treatment of psychogenic edge disorders the effectiveness of the treatment by the method of the prototype was 25% (partial response and 16%, full - 9%), and the proposed way - 69 the program has increased from 39% (partial effect - 25% of full - 14%) to 91% (partial response and 17%, full -74%). After the treatment by the proposed method also registered an increase in the proportion of persistent therapeutic effect (over 6 months) with 25% prototype to 57% according to the invention.

Thus, the proposed method is an effective method of treatment of borderline mental disorders of various etiologies associated with autonomic disorders. In addition to the normalization of the emotional state of the patient, it helps to normalize the functioning of newsegments autonomic centers of the brain, which leads to reduction of permanent and paroxysmal autonomic disorders. The conduct of pharmacotherapy in this way does not cause disruption of the sick, creates favorable conditions for psychotherapeutic work, reduces the overall treatment time. All this allows to widely apply the proposed method of treatment in medical practice.

A method for the treatment of psychogenic and somatogennye edge of mental disorders by applying frenolona in the morning and afternoon hours and glutaral 1/2 pill at night, characterized in that it further in the morning and afternoon hours of the Sabbath.

 

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