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Objective: The development of organic brain disorder in opioid addiction is still discussed. Recent studies demonstrated the presence of psychoorganic disorders in patients with opioid addiction. Treatment and rehabilitation measures for correction of neurocognitive disturbances and prevention of degenerative processes in central nervous system (in particular, so called neurometabolic stimulants, nootropics) are required in addition to the specialized substance abuse therapy of opioid addiction. The aim of the study was to evaluate the dynamics of cognitive disturbances and neurotic disorders in patients with asthenic-adynamic variant of post withdrawal disorders in opioid addiction during the treatment with Cerebrolysin.
Methods: Sixty two patients with heroin addiction were studied after the period of detoxication. Group 1 included 36 patients with the manifest stage of the disease (disease duration was since 4 months till 5 years). Group 2 included 26 patients with the disease duration more than 5 years. Organic brain changes were observed in MRT in almost 50% of patients. Though, the data ratio demonstrated significant differences between the groups. Normal brain MRT data prevailed in Group 1 in comparison to Group 2.
Results: Regarding neuropsychological data, the symptoms of mild exhaustion without any significant neuropsychological syndromes were found in Group 1. However, in Group 2 decreased concentration, rapid exhaustion, memory impairment, emotional and behavioral disorders were observed. Average MMSE cognitive function score was 24,3±0,4 which corresponded to cognitive impairment and dementia status. Early diagnostics of brain disturbances is important both from theoretical and practical point of view because treatment and prevention measures are really effective at this stage. The treatment with Cerebrolysin (5ml intramuscularly per day, the course of 20 injections) was started since the 7th-9th day after the last drug use. Affective lability, hypochondriacal, fatigue, inactivity, the inability to do any work persisted after the relief of acute abstinent syndrome. Comparative analysis of the dynamics of cognitive function data demonstrated that in Group 1 the abilities and interest to perform simple intellectual activity appeared and the spectrum of everyday activities significantly enhanced after the treatment with Cerebrolysin. Patients regained the activity and work and reached good well-being and mood which were damaged because of the disease. We suggest that this kind of positive dynamics after treatment confirms the inşuence of organic brain damage on the genesis of patients’ complaints. In Group 2 the positive therapeutic response observed but was limited by the improvement of mood and every day activities.
Conclusions: In our study the craving for drugs was not observed in patients after the treatment with Cerebrolysin as it was already described as a frequent effect of nootropic therapy. Thus, the treatment with Cerebrolysin caused the improvements in cognitive function as well as the decrease of asthenic-adynamic symptoms, such as rapid exhaustion, asthenia, apathy, adynamia. Cerebrolysin is recommended to be included into the therapeutic programme for patients with heroin addiction during early stages of disease.