Method of treating neurotic personality development

FIELD: medicine.

SUBSTANCE: method involves a drug therapy with the antidepressant paroxetine in a daily dose of 40-50 mg a day in two stages daily for 30 days, the benzodiazepine anxiolytic diazepam 10-12 mg a day intramuscularly for 20 days, the antioxidant mexidol for the first 20 days intravenously drop-be-drop in a daily dose of 200-250 mg, and for the following 10 days in a dose of 375-400 mg orally in tablets, the immunocorrector Thymogen 0.01% in a dose of 1.2-1.3 ml intramuscularly once a day for 10 days followed by administering 1.2-1.3 ml intramuscularly every second day five times in a combination with hyperbaric oxygenation at excessive pressure 0.8-1.0 atm at compression and decompression rate 0.1 atm a minute with 40-minute isopressure from the first day of treatment for 21 days.

EFFECT: higher clinical effectiveness.

1 ex

 

The invention relates to medicine, namely to psychiatry, and can be used in the treatment of patients with persistent forms of neurotic disorders - neurotic personality development, when the disease duration is five years or more.

A method of treating neurotic personality development using anxiolytics in combination with antidepressants, normotimicheskoe drugs and antipsychotic drugs, with mainly neuroleptic activity, - of thioxanthene derivatives, substituted benzamido, etc. For medicinal products traditionally used in the treatment of severe forms of neurotic disorders described many undesirable effects, such as side, manifested in the development of hematologic, endocrine, autonomic disorders, neurotic disorders, and toxic (Manual on psychiatry. In 2 volumes. Vol. 1/A. S. Tiganov, A. V. snezhnevsky, D. D. Orlovskaya, etc.; Under. Ed. A. S. Tiganov. - M.: Medicine, 1999. - S. 527-558).

With this method of treatment the risk of developing complications from therapy exceeds the clinical effect of drug combinations anxiolytics, normotimicheskoe drugs, antidepressants and neuroleptics. In addition, there is typically incomplete relief of symptoms, causes frequent� relapse, patients need long-term hospital treatment, which is associated with significant economic costs.

The technical result consists in the rapid and complete relief of leading with neurotic personality development of psychopathological symptoms and syndromes: deep stress due to neurotic disorders, combined with hypochondriacal fixation, depressive, conversion, obsessive - phobic manifestations in the case of the formation of obsessive - phobic and hysterical neurotic personality development, is due to the integrated effects of drug combinations cytoprotector, immunocorrector, anxiolytic, antidepressant, hyperbaric oxygen therapy on mental function, neuro-endocrine and immune homeostasis.

Said technical result is achieved in that in the method of treating neurotic personality development conducted pharmacotherapy simultaneously antidepressant paroxetine in a daily dose of 40-50 mg per day in two divided doses daily for 30 days, the benzodiazepine anxiolytic diazepam - 10-12 mg per day intramuscularly for 20 days, the antioxidant Mexidol initially intravenously in a daily dose of 200-250 mg the first 20 days and then in the next 10 days about 375-400 mg orally in tablets immunocorrector the timogen 0,01% a solution of 1.2-1.3 ml �nutramigen 1 time a day for 10 days followed by administration of 1.2-1.3 ml intramuscularly every other day, No. 5, in combination with hyperbaric oxygenation with a gauge pressure of 0.8-1.0 atmosphere, at a speed of compression and decompression of 0.1 atmospheres per minute, the period of isopress 40 minutes, 1 times a day for 21 days of treatment.

The method is carried out as follows. From the first day of treatment, patients are administered within 30 days: the antidepressant paroxetine inside 40-50 mg in two divided doses per day, benzodiazepine anxiolytic diazepam intramuscularly at 10-12 mg 1 time a day for 20 days, the antioxidant Mexidol initially intravenously in a daily dose of 200-250 mg in the first 20 days, then in the next 10 days the drug is given in pill in a daily dose of about 375-400 mg; immunocorrector timogen 0.01% solution administered by a 1.2-1.3 ml intramuscularly daily, 10 injections, then every other day for a 1.2-1.3 ml intramuscularly, 5 injections. At the same time during the first 21 days patients underwent hyperbaric oxygenation in single pressure chambers got 3-01 (NPF "LAD", Russia) with a gauge pressure of 0.8-1.0 atmosphere, at a speed of compression and decompression of 0.1 atmospheres per minute, the period of isopress is 40 minutes, 1 time per day.

Clinical example. Patient B., 42 years old, (case No. 2682), was treated in the Mordovian Republican psychiatric hospital (Saransk) with 08.12.2012, with a diagnosis of Neurotic personality development.

Did Sheikh�of psychiatrist city psychoneurological clinic with complaints of weakness, malaise, depressed mood, lack of desire to perform any activity, decreased appetite, sleep disturbances in the form of difficulty falling asleep and sleepiness during the day, decreased performance, unpleasant sensations in the body, changing from one section to another, in the form of tingling, twisting, burning.

From the anamnesis: the patient by nature anxious and insecure. At the end of 2005 on the background of long-term heavy stress situations, significant for the patient, there were complaints of weakness, malaise, depressed mood, lack of desire to perform any activity. Was repeatedly treated by a neurologist and psychiatrist as an outpatient. In 2012 joined hypochondriacal symptoms. The patient sought medical assistance in the city mental hospital, where he was sent for inpatient treatment in a psychiatric hospital.

Mental state at admission to hospital: Consciousness clear. Oriented to place, time, self correct. Her expression dull. Joined to the conversation on the issues. During the conversation often sighs, speech tempo is slow. Fixed on his painful condition, hard to switch to another topic of conversation. Expresses that after the experience of stressful situations (conflicts with her husband, infertility, divorce, Odie�the middle) appeared fatigue, weakness, malaise, lost the desire to perform any activity. Notes that the circle narrowed sharply ceased to meet and communicate with friends, to visit theatre and cinema. Notes reduced efficiency, there was a sense that not all meaning can understand, resulting in he quit his job. When the conversation periodically to eyes well up with tears, expressed complaints of painful unpleasant sensations in the body in the form of burning and tingling in different groups of muscles in different parts of the body moving from one place to another. Background mood is unstable with a predominance of anxious affect. Deception of perception is not revealed. Delusional ideas are not expressed. Criticism is reduced to a state.

The results of additional methods of research:

1. General analysis of blood from 08.12.2012, Hemoglobin 135 g/l, ESR - 8 mm/h, the total number of cells is 6.5×109/l: eosinophils - 2, stab neutrophils - 3, segmented - 67, lymphocytes - 26, monocytes - 2%. The General analysis of urine from 08.12.2012, without pathology.

2. The immunity from 08.12.2012, T-lymphocytes - 65%, lymphocytes 6%, and immunoglobulin M - 98 mg%, immunoglobulin G - 1150 mg%, immunoglobulin A - 118 mg%, phagocytosis activity of neutrophils is 69%, T-helpers - 39%, T-suppressor - 21%, circulating immune complexes: large - 0.e., medium - $ 15.e., small 104.e., adhesion of neutrophils to 16%, nst-test - 2%, an index of neutrophil activation is 0.01, the load index of 4.1.e., complementary activity of blood serum is 4.2. Conclusion: immunopathological condition - reducing the tension of the immune system functioning, weakening of humoral defense factors - hypoinsulinemia class A, lower total serum complement activity of blood, increasing small fraction of circulating immune complexes, decreased metabolic activity of neutrophils.

3. Hormonal status from 08.12.2012, Thyroid-stimulating hormone - 1.38 nmol/l, free thyroxine - 16,97 nmol/l, antibodies to thyroglobulin have been identified, the cortisol - 609,4 nmol/l increase in the concentration of cortisol in the blood serum.

For biochemical analysis of blood from 08.12.2012, pathological changes were found.

The diagnosis: Neurotic personality development.

Prescribed treatment:

1. Tab. Paroxetini 0,02

Orally 1 tablet 2 times a day for 30 days.

2. Sol. Diazepami 0,5% - 2 ml (10 mg)

Intramuscular injection of 10 mg 1 time per day, 20 days.

3. Sol. Mexidoli 5% - 4 ml (200 mg)

Sol. Natrii chloridi 0,9% - 400 ml

Intravenous drip, 1 times a day for 20 days.

Tab. Mexidoli 0,125

Inside: 1 tablet 3 times a day from 21 to 30 day.

4. Sol Thymogeni 0.01% to 1.2 ml

Intramuscularly 1 time a day, every day the first 10 days, with 11 days intramuscularly every other day 5 injek�rd.

5. Hyperbaric oxygen therapy, positive pressure of 0.8-1.0 atmosphere, at a speed of compression and decompression of 0.1 atmospheres per minute, the period of isopress - 40 minutes, 1 time per day during the first 21 days.

In the ongoing treatment: positive dynamics was observed, ranging from 10 days of treatment, quiet, questions answered after a pause, specified in the plan. In the Department of the research Institute became sociable, is actively involved in psychotherapeutic group sessions. Deception of perception, delusions are not identified. The orderly behavior. Thinking consistent, somewhat slowed the pace. Emotionally labile.

Mental status at the 20-day treatment: the patient calm, in the Department of communicative, engaged in a circle of patients. In touch takes on issues, responding on the merits. Correctly oriented in all types. Delusions, illusions of perception is not revealed. Notes an improvement in their condition in the form of normalization of sleep, appetite. Thinking consistent, somewhat slowed the pace. Background mood is closer to equal.

At the time of discharge (30-day): Consciousness clear. Oriented to place, time, self correct. Outwardly tidy. Contact for questions, answers specified in the plan. It consistent. Deception of perception, delusions are not revealed. Attention sustainable. The processes of remembering, FOTS�of otvedeniya not broken. Began to note that there is still interest in communication. Actively involved in rehabilitation activities. Makes plans about the need for job search and employment.

At discharge, the General blood and urine analysis, biochemical blood analysis - without pathological changes.

The immunity from 09.01.2013 G. T-lymphocytes - 65%, lymphocytes 6%, and immunoglobulin M - 112 mg%, immunoglobulin G - 1180 mg%, immunoglobulin A - 114 mg%, phagocytosis activity of neutrophils - 76%, T-helpers - 39%, T-suppressor - 9%, circulating immune complexes: large - 0.e., medium - 7 in.e., small - 35.e., adhesion of neutrophils to 18%, nst-test - 9%, an index of neutrophil activation - 0,09, the load index is 3.7.e., complementary activity of blood serum of 4.9. Conclusion: in comparison with immunological from 08.12.2012, there is a positive trend: to restore the functional activity of segmented neutrophils - increased NBT - test, an index of neutrophil activation, phagocytosis activity of neutrophils, normalized number of circulating immune complexes of the fine fraction recovered complementary activity of blood serum, the load index. Persists hypoinsulinemia class A.

Thus, in this clinical example, through the use of regimens with the use of Srednyaya�efticiency doses of antidepressant and anxiolytic on the background of the appointment of an antioxidant, immunocorrector, oxygen under high pressure were able to achieve significant clinical effect.

A method of treating neurotic personality development, consisting in the fact that conduct pharmacotherapy antidepressant paroxetine - 40-50 mg orally in two divided doses for 30 days, the benzodiazepine anxiolytic diazepam - 10-12 mg intramuscularly 1 time per day, 20 days, antioxidant Mexidol initially at a daily dose of 200-250 mg intravenously in the first 20 days, and then about 375-400 mg orally in tablets in the next 10 days, immunocorrector the timogen 0.01% solution of 1.2-1.3 ml intramuscularly daily in the amount of 10 injections, then 1.2-1.3 ml intramuscularly every other day in the amount of 5 injections, simultaneously with pharmacotherapy conduct hyperbaric oxygenation with a gauge pressure of 0.8-1.0 ATM at a speed of compression and decompression of 0.1 atmospheres per minute, the period of isopress is 40 minutes, in the first days of treatment 1 time per day for 21 days.



 

Same patents:

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39 cl, 13 ex, 2 tbl, 77 dwg

FIELD: medicine, pharmaceutics.

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20 cl, 3 tbl

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18 cl, 11 ex, 11 tbl, 9 dwg

FIELD: medicine, pharmaceutics.

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35 cl, 2 tbl, 105 ex

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9 cl, 4 tbl, 9 ex

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22 cl, 1 tbl, 128 ex

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6 cl, 81 ex

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1 ex

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2 cl, 1 ex

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1 tbl, 2 ex

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EFFECT: improved and valuable medicinal effect.

8 cl, 2 tbl, 2 dwg, 2 ex

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FIELD: chemistry.

SUBSTANCE: invention relates to compound of formula:

double line between N and C represents double bond, X is absent, a Y stands for H; W stands for C=O; each of R1, R2, R3, R4 stands for H; R5 is selected from groups OR15, where R15 has the same determination as R; optionally R5 stands for binding group or is selected from groups: polypyrrole, polyindolyl, polyimidazolyle, polypyrrole-imidazolyle, polypyrrole-indolyl or polyimidazole-indolyl unit, optionally bound to binding groups; R6 stands for OR or optionally, R6 stands for binding group; Z is selected from groups (CH2)n, where n stands for 1, 2 or 3, CR15R16, where each of R15 and R16 independently stands for H or linear alkyl, having from 1 to 10 carbon atoms; R stands for H or linear or branched alkyl, having from 1 to 3 carbon atoms, optionally substituted with group -COR11; R11 stands for H or -OR14; and R14 stands for H or linear or branched alkyl, having from 1 to 3 carbon atoms; each of R1, R2, R3, R4, R1', R2', R3' and R4' stands for H, optionally any of R1, R2, R3, R4, R1', R2', R3' or R4' stands for binding group, Z is selected from groups (CH2)n, where n stands for 1, 2 or 3; R6 stands for OR, or optionally R6 stands for binding group; A and A′ stand for O, D and D', similar or different, and independently represent linear or branched alkyls, having from 1 to 10 carbon atoms; L is absent or stands for phenyl group, where said phenyl group representing L, is optionally substituted, where substituent is represented by binding group or is selected from OR7, NR8R9, NRCOR' or OCOR11; R and R' independently represent H or linear or branched alkyl, having from 1 to 10 carbon atoms, optionally substituted with halogen or group -COR7; R7, R8, R9 and R11 independently represent H or linear or branched alkyl, having from 1 to 10 carbon atoms, or polyethylene glycol unit (-OCH2CH2)n, where n stands for integer number from 1 to 10; on condition that said compound has not more than one binding group, which provides bond with cell-binding agent due to covalent bond, which possess anti-proliferative activity.

EFFECT: obtaining novel compounds.

24 cl, 59 dwg, 9 tbl, 40 ex

FIELD: medicine.

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EFFECT: method enables providing the more effective pre-surgical preparation by reducing an intraocular pressure in a combination with preventing systemic complications and postoperative inflammations.

2 ex

FIELD: medicine, pharmaceutics.

SUBSTANCE: invention relates to the chemical-pharmaceutical industry and represents an orally disintegrating tablet composition, which includes particles of a therapeutic preparation, containing: a therapeutically effective quantity of, at least, one therapeutic preparation; 0.5-3% ODT binding polymer; sugar alcohol and/or saccharide; and a disintegrant, with particles of the therapeutic preparation being prepared by granulation of, at least, one therapeutic preparation, sugar alcohol and/or saccharide and the disintegrant in the presence of the ODT binding polymer, where the composition mainly disintegrates within approximately 30 seconds after contact with saliva in the oral cavity or in testing by a disintegration test <USP 701>.

EFFECT: drug form can be applied in elderly patients and patients with swallowing disorders.

28 cl, 8 dwg, 13 tbl, 5 ex

FIELD: medicine.

SUBSTANCE: what is involved is infusion therapy with crystalloid solutions at 15 ml/kg of a patient's body weight. That is followed by puncturing and catheterising an epidural space at the level of ThVII-ThVIII according to the standard practice and introducing a test dose of 2% lidocaine 3 ml. If observing no signs of intrathecal introduction of local anaesthetics 10 minutes later, a basic dose containing 0.75-1% naropin 10 ml or 0.25-0.5% marcaine 10 ml and clofelin 3-5 mcg/kg is introduced. Total intravenous anaesthesia follows 20 minutes after pre-medication with atropine 0.01 mg/kg, 1% diphenylhydramine 1 ml and relanium 10 mg and urethral catheterisation. A narcosis is induced with propofol in a dose of 2 mg/kg. Anaesthesia is maintained with propofol 2-4 mg/kg·h. After that, within the first hour following the detoxification, naloxone 12 mg is introduced intravenously; a naloxone measurement rate is supposed to make 0.8 mg/h for 4-5 following hours of general anaesthesia. The repeated introduction of 0.75-1% naropin 6 ml or 0.25-0.5% marcaine 6 ml and clofelin 2-3 mcg/kg into the epidural space is performed 90 minutes later. After the procedure is terminated, and the patient recovers, prolonged epidural analgesia is conducted by introducing 0.2% naropin 10 ml and clofelin 1 mcg/kg into the epidural space every 4 hours for 24-48 hours.

EFFECT: method provides safety of ultrafast opioid detoxification and prolongs the remission in the given category of patients.

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FIELD: medicine.

SUBSTANCE: thoracic epidural analgesia is conducted by puncturing and catheterisation of an epidural space at ThVIII - ThIX before the expiry of 24 hours from the onset of a disease after a moderate intravenous infusion therapy in the amount of 15-20 mg/kg of crystalloid solutions. 20 minutes before an expected endoscopic papillosphincterotomy, a catheter is moved 4-5 cm in a cranial direction. At ThV-ThX, 0.4% naropin 10-12 ml or 0.2% Marcaine 10-12 ml and clonidine 100 mcg are administered through a catheter. That is followed by a pre-medication by administering 0.1% atropine 0.5-1 ml and 0.5% relanium 1-2 ml. Thereafter, the patient is taken to an X-ray operation room to conduct the endoscopic papillosphincterotomy without an endoscopic retrograde cholangiopancreatography with general pancreatic duct stenting. After the operation has been completed, the patient is taken to an intensive care unit wherein an extended epidural analgesia is conducted by administering 0.2% naropin 10-12 ml or 0.15% marcaine 10-12 ml into the epidural space every 4 hours until the patient is taken to a department of surgery.

EFFECT: early intestinal motility recovery, increased pancreatic secretion, prevented spasm of the gastrointestinal sphincter ensured by a pathological complete blockade of sympathetic impulsing.

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