Psychiatry and Clinical Psychopharmacology

Correction of astenoadinamic option of post abstinence disorders

Psychiatry and Clinical Psychopharmacology 2013; 23: Supplement S9-S10
Keywords : cerebrolysin, abstinence
Read: 497 Published: 21 March 2021

For opiate (heroin) addiction literature data are ambiguous. There have been reports about the possibility of forming psychoorganic disorders in opiate addiction. Currently, the main number of drugs used opioid is heroin, which combines a variety of highly toxic ingredients: strychnine, quinine, chlorine derivatives. The use of opium treated with acetic anhydride, promotes the formation of toxic encephalopathy with intellectual disabilities. Some authors deny the decline of intelligence in these patients and suggest that intelligence remains intact for a long time from the start of anesthesia. Because of narcotic destruction of the cerebral hemispheres are largely violated mental disorders, attention, psychomotor coordination, speech, gnosis, praxis, the bill, thinking, orientation, planning and control of mental activity. With long-term substance abuse appears fatigue, exhaustion of attention, lack of ability to concentrate, inability to intense mental activity. The patient becomes irritable, dysphoric, and evil. Develops overall emotional brutalization, deceit, lack of a sense of shame, they become indifferent; they do not care about losing a job or a family, and even their own health. Cerebrolysin - peptidergicnootropic drug has low molecular weight, biologically active neuropeptides, which overcome the blood-brain barrier and enter directly to the nerve cells. In particular, it reduces the concentration of lipid peroxidation products, which increased in heroin addiction. A very important aspect of the action cerebrolysin is that it shows a positive effect on cognitive function, improves concentration, the processes of memorizing and reproducing information associated with short-term memory, increases the ability to maintain skills that will intensify the process of mental activity, improves mood, promotes the formation of positive emotions, i.e. has a neuroprotective effect, acting as proof of cognitive impairment. Furthermore, it has such important characteristics as antiastenic, antidepressant and psychostimulant. Very important is the brain-specific adaptogenic effect Cerebrolysin associated with increased stability of the nerve cells to the damaging effects of different nature. Due to its properties Cerebrolysin found extremely wide application in the treatment of various cognitive disorders, including mnemonic arising from hypoxia, intoxication, and various degenerative diseases of the brain. The aim of the study was evaluation of cognitive disorders and neurotic disorders in Cerebrolysin therapy in patients with heroin addiction. The study involved 26 patients with heroin dependence during inpatient treatment, mean age 31.5 years, disease duration of 3.5 years, the daily dose of drugs used intravenously 0.5 g Patients were divided into study and control groups are not statistically different. Cerebrolysin treatment was started on day 7-9 after the last use of the drug. Cerebrolysin dose was 5 mL intramuscularly - 1 time a day. In the control group, patients received placebo 5.0 ml physiological solution. Total per patient was 20 injections. Clinical follow-up procedure was performed “Short-term memory”, “correction test” and the syndrome of anhedonia on Krupitsky E.M. et al. The duration of clinical follow-up was 20 days. The positive results of the subjective assessment of the treatment given 8 - (57.1%) patients. In the 4 - (28.6%) of the effect of treatment, patients rated as minor, and 2 - (14.3%) reported no effect. Analysis of the results of cognitive tests showed a statistically significant improvement in cognitive function compared to baseline by the end of Cerebrolysin therapy was observed in all tests treatment. When testing the ability to repeat the words, patients in the 1-day treatment called on average 4-5 words, to the 20th day of therapy Cerebrolysin - repeated 8-9 words. Volume attention was assessed by the number of scanned characters, the concentration by number of errors made. After treatment with Cerebrolysin significantly improved the quality of attention Neurosis-like disorders were expressed in postabstinence period and characterized by dysphoric, dreary or apathetic depression and other ipohondric disorders. Long retained affective lability, hypochondriacal, fatigue, inactivity, the inability to do any work. Patients were inactive, carefree, careless, and cheeky. On the 20th day of treatment Cerebrolysin was an increase in total physical activity, the revival of interest. Significantly decreased dysphoria, irritability, anxiety, and to a lesser extent - the lability of affect, hypochondriacal, inherent to many patients during the deprivation of the drug. Anxiety levels also declined. Clearly reduce the appearance of asthenic disorders with 2.15 points before treatment cerebrolysin to 1.0 points on the 10 th day and 0.63 points on the 20-day treatment. The same applies to apatico-abulic disorders. Patients become much more active, decreased fatigue, weakness, apathy, indifference. Patients become less distracted, they have decreased confusion and aspontaneous, purposeful activity and increased productivity in the work. The behavior of patients became more orderly and organized, improved mood, much less irritation reactions occurred with negativity and violence. Patients improved further opportunities and interest in simple intellectual activity expanded scope performs everyday activities. Many patients return to the lost work due to illness, they have improved activity, health and mood. In the control group, was set a positive therapeutic effect (usually minimal), it was limited to improved mood and increased activity in some daily activities. The most noticeable effect of Cerebrolysin recorded for asthenia, interest in the environment, emotional liveliness, a sense of comfort, sleep disorders. A distinct positive dynamics of these complaints under the inşuence of drugs suggests that their genesis in the main role played by organic brain damage. It is important that the treatment of patients with Cerebrolysin not marked deterioration craving for drugs, which often occurs when using nootropics. Components of the syndrome of anhedonia decreased during treatment equally in primary and in the control group, which was also due to the ongoing psychotherapy in both groups. The majority of patients treated with Cerebrolysin, noted during treatment no side effects. Thus, ?erebrolysin provided a positive effect on cognitive function, as well as disorders such as rapid exhaustion, fatigue, apatic-abulistic syndrome, anxiety. All the above points to the desirability of placing on Cerebrolysin a therapeutic treatment program for heroin addicts. Thus, the exchange rate Cerebrolysin therapy reduced the severity of disorders of attention and memory, improving overall cognitive status of patients. Cerebrolysin therapy did not increase the craving for the drug. Application of Cerebrolysin along with improvements in cognitivefunction accompanied by a reduction of concomitant psychiatric symptoms - depression and other disorders.

EISSN 2475-0581