Treatment of alcohol withdrawal syndrome
Author:
Y.P. SIVOLAP
Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
Summary:
Alcohol withdrawal arises in result of long-lasting or short, but massive, alcohol abuse, manifests itself with oppressive symptoms and in some cases is complicated by seizures, hallucinosis and delirium tremens that may be life-threatening for patients. The leading neurochemical factors underlying alcohol withdrawal syndrome and its complications are lack of GABA and excessive glutamate activity, which is important for therapy choice. The first-line drugs in the treatment of alcohol withdrawal syndrome and alcoholic delirium are benzodiazepines, which have the maximum pharmacological similarity with ethanol. Other medications, including barbiturates, anticonvulsants, propofol, dexmedetomidine, and antipsychotics, may be used as alternatives to and in addition to benzodiazepines, especially in the case of protracted delirium with therapeutic resistance. Certain prospects in the treatment of alcohol withdrawal syndrome are associated with ethylmethylhydroxypyridine succinate, which is a bit similar to benzodiazepines in its pharmacology.
Keywords: alcohol use disorders, alcohol withdrawal syndrome, alcohol seizures, alcohol hallucinosis, delirium tremens, benzodiazepines.
Possibilities of using Mexidol in the complex therapy of mental disorders
Author:
V.K. SHAMREY, E.S. KURASOV, V.V. NECHIPORENKO, A.I. KOLCHEV, N.V. TSYGAN
Kirov military medical Academy, St Petersburg, Russia
Summary:
A review of the current literature on the possible use of mexidol (ethylmethylhydroxypyridine succinate) in the treatment of mental (including addictive) disorders is conducted. The possibility of its use to reduce negative psychopathological symptoms, neurocognitive deficit, manifestations of the antipsychotic syndrome (including its extrapyramidal disorders) in antipsychotic treatment of patients with schizophrenia spectrum disorders and insomnia disorders in the complex therapy of borderline mental disorders has been shown. The potential of mexidol in the treatment of addictive pathology, as well as the effects of intoxication caused by alcohol and other psychoactive (including narcotic) substances, deserves special attention.
Keywords: mental disorders, addictive pathology, Mexidol, treatment, complex therapy.
The effect of mexidol in the combination with antidepressants on sleep disturbance in young patients with panic disorder
Author:
E.S. KURASOV, R.S. REMIZEVICH
Kirov Academy of Military Medicine, St.-Petersburg
Summary:
We studied 70 patients with panic disorder, 30 men and 40 women, mean age 34,5±1,8 years. All patients had insomnia. Patients were classified into the main and control groups. Patients of the control group received antidepressants only (fevarin in dosage 150 mg daily). Patients of the main group were additionally treated with mexidol (375 mg daily). The treatment duration was two weeks. A clinical and instrumental (polysomnography) examination revealed that the use of mexidol enhanced the decrease in anxiety disorders, autonomic disturbances and insomnia and improved quality of life of the patients.
Keywords: panic disorder, antidepressant, mexidol.
The use of mexidol in urgent treatment of alcoholic delirium
Author:
O.I. KLINDUKHOVA, O.E. NOVGORODOV, N.N. SERGIENKO, P.V. DANILYUK, O.V. BELOTSERKOVICH
Summary:
Results of the clinical study of efficacy and tolerability of mexidol administered in intravenous drop-by-drop introduction during 5—7 days in the therapy of 50 cases of complicated alcoholic delirium are presented. The patient condition and changes in device test data were assessed in comparison with those of a control group of patients receiving a basic therapy without mexidol. It is shown that mexidol has stopped psychosis in shortest terms thus decreasing secondary complications and lethality.
Keywords: mexidol, antioxidant, antihypoxant, alcoholic delirium, stopping.
Dynamics of eeg and psychophysiological indicators of acute poisoning neurotoxicants on the stage of rehabilitation on the background of different methods of treatment
Author:
I.YU. BEREZINA, A.V. BADALYAN, L.I. SUMSKY, YU.S. GOLDFARB
Sklifosovsky Research Institute for Emergency Medicine, Public Healthcare Institution of Moscow Healthcare Department, Moscow, Russia;
Russian Medical Academy of Postgraduate Education, Federal Public Educational Institution of Additional Professional Postgraduate Education of Russian Federation Healthcare Ministry, Moscow, Russia
Summary:
Objective: To evaluate the dynamics of functional activity of brain structures underlying cognitive functions in patients with encephalopathy due to poisoning with neurotoxicants on the stage of rehabilitation. Material and methods: Fifty-six patients were examined. The main group consisted of 40 patients treated with intravenous injections with mexidol (n=10), combination of mexidol with non-pharmacological methods – mesodiencephalic modulation (MDM) (n=10), hyperbaric oxygenation (HBO) (n=10) and the combination of MDM and HBO (n=10). The comparison group included 16 people. All patients underwent neurophysiological (EEG, auditory event-related potentials) and neuropsychological examinations. Results: Marked EEG changes were noted in all patients. The domination of disturbances of functional activity on the diencephalic or mesodiencephalic levels was observed. After treatment, positive changes were found in 60% of patients. The positive dynamics was observed in 80% patients when the combination of mexidol, MDM and HBO was used. The negative dynamics was noted in 5 (12,5%) of patients of the main group, in particular when mexidol only was used. The results of the primary neuropsychological study revealed that cognitive impairment of different severity was found in 97,5% of patients of the main group and 100% of patients of the comparison group. After treatment, performance on neuropsychological tests improved by 62,5%, N200 and P300 latencies reduced, while the amplitudes increased, in the patients of the main group. Conclusion: The use of mexidol, MDM and HBO in the treatment of patients with encephalopathy due to poisoning with neurotoxicants on the stage of rehabilitation improved the indicators of functional brain activity and cognitive functions.
Keywords: encephalopathy, acute poisoning with neurotoxicants, electroencephalography, auditory event-related potential (P300), psychophysiological testing, mexidol, mesodiencephalic modulation, hyperbaric oxygenation.