[Efficacy and tolerability of coaxil (tianeptine) in the therapy of posttraumatic stress disorder].

The results of a multicenter study of coaxil in the treatment of 90 patients with posttraumatic stress disorder (PTSD) are summarized. Two dosages of the drug, 75 mg daily (44 patients) and 37.5 mg daily (46 patients) have been compared. Coaxil efficacy was estimated with the Clinician Administered PTSD Scale (CAPS) and Hamilton depression scale (HAM-D). High efficacy of coaxil was shown, with 76.7 and 75.6% responders, respectively, for the dosages used. The optimum one proved to be 37.5 mg daily, which is congruent to the standard dose in the treatment of depression and provides not only the efficacy but tolerability of coaxil. The coaxil efficacy depended on a PTSD type: the drug was more effective in chronic PTSD that, in the authors' opinion, might be related to its antidepressant action.

[Psychiatric, psychological, and neurological characteristics of patients with chronic low back pain]. / Psikhiatricheskie, psikhologicheskie i nevrologicheskie kharakteristiki bol'nykh s khronicheskimi boliami v spine.

We examined 143 patients, aged 18-65 years, with chronic low back pain, in 78 of patients diagnosed as chronic somatoform pain disorder (CSPD)--ICD-10 F45.4--and in 65 as chronic pain syndrome (CPS) caused by spine pathology (M48.0, M51.1, M54.4). Depressive symptoms predominated in CSPD patients, who exhibited more pronounced psychopathological disturbances and two-fold higher frequency of personality disorders, comparing to those with CPS. In CSPD patients pain severity and reaction to pain syndrome were significantly higher than in CPS patients. Psychodiagnostic study revealed higher expressed anxiety and depression as well as socio-psychological maladaptation in CSPD patients as compared to CPS ones. After neurological examination, significant between-group differences were found in the frequency of muscular-tonic myofacial, syndrome and iliosacral joint dysfunction.

[Zolpidem (ivadal) treatment of sleep disorders]. / Primenenie zolpidema (ivadala) pri lechenii narushenii sna.

The results of the multicenter study of zolpidem activity, being carried out in inpatient- and out-patient clinics of 20 cities in Russia, are reported. One thousand seventeen patients with transitory, short time and chronic dyssomnia have been included in the trial. Zolpidem (ivadal, "Sanofi-Syntelabo", France) has been prescribed once a day in a dose of 10 mg (one tablet) before going to sleep in a period of two weeks. The efficiency has been assessed by evaluating dyssomnia symptoms according to "Sleep assessment questionnaire" of "Sanofi-Syntelabo" completed by the patients and "Clinical Global Impression Scale" completed by investigators. Safety has been assessed by analyzing a frequency of side effect appearance and changes in vital parameters: blood pressure, heart and breath rate. Zolpidem has been found to reveal high clinical efficiency and safety. By the end of the treatment, 59.5% of the patients experienced no difficulties in falling asleep, in 28.6% of the patients the latter being significantly reduced. On the whole the improvement was in 89.4% patients. No side effects have been observed. Zolpidem is a highly effective and safe medication for different type dyssomnia treatment that can be recommended for application in general clinical practice.

[Clinical and immunological studies in borderline mental disorders: problems and solutions]. / Kliniko-immunologicheskie issledovaniia pri pogranichnykh psikhicheskikh rasstroistvakh: problemy i resheniia.

The study demonstrated that patients having an acute response to stress and those with adaptative disorders with prevailing short-term depressive disorders had certain immunological disorders. Therapy with tranquilizers indicated that they produced an inhibitory effect on T- and B-cell immunity, antibody formation and lymphokine production. Among the immunomodulating peptides myelopid, licopid, and Tactivin, the former was found to be the most effective against anxiety and fear while licopid was the most effective agent in the treatment of psychoasthenic disorders. The findings suggest that therapy with psychotropic peptides will open new vistas in treating mental disorders.

[The methodological characteristics of examining and treating patients with borderline mental disorders]. / Metodologicheskie osobennosti obsledovaniia i lecheniia bol'nykh s pogranichnymi psikhicheskimi rasstroistvami.

Discussed are problems of the methodology of diagnosing neuroses, neurosis-like and other borderline mental disorders. The necessity is emphasized of complex and systemic analysis of general somatic, psychological and psychopathological states. An important place is taken by dynamic analysis of the development of pathological states. The importance of these methodology problems for pathogenetic treatment of patients with borderline mental diseases is discussed.

[Dynamics of mental adaptation disorders in chronic stress among the population after the accident at the Chernobyl nuclear power plant]. / Dinamika psikhicheskoi dezadaptatsii v usloviiakh khronicheskogo stressa u zhitelei raionov, postradavshikh posle avarii na Chernobyl'skoi AES.

A study was made of the formation and dynamics of mental disadaptation in 300 persons living permanently for 4 years in a polluted area of Byelorussia after the Chernobyl accident. The high incidence of chronic somatic diseases was marked, forming the basis for the onset of multiple forms of mental disadaptation. 38% of the examined manifested the preclinical premorbid forms of disadaptation. Description of the structure of the forms of the abnormalities observed permits forecasting their further development and developing differentiated measures of therapy.

[Mental disorders during and after natural disasters and catastrophies]. / Psikhicheskie rasstroistva vo vremia i posle stikhiinykh vedstvii i katastrof.

Analysis is made of mental disorders seen in 3431 victims followed up by psychiatrists in 11 large-scale catastrophies and natural disasters. Three periods of the development of the life-threatening situation were distinguished, during which one can see different states of mental disadaptation and morbid disorders. The clinical picture of such disorders is provided.

[Clinico-pharmacologic analysis of the neurotropic action of tranquilizers]. / Kliniko-farmakologicheskii analiz neirotropnogo deistviia trankvilizatorov.

Clinical aspects of the neurotropic effect of tranquillizers are considered. The systemic differentiated analysis of the influence of these psychopharmacological agents on the functional characteristics of the neurological status and psychophysiological condition of patients with neurotic disturbances is carried out. Two types of the neurotropic effect of tranquillizers and their selective vegetotropic effect are discussed. The presented results indicate that the neurotropic action of the psychopharmacological agents is of induced medical character.

[Mental disadaptation in emergency situations (accident at the Chernobyl nuclear power station)]. / Sostoianie psikhicheskoi dezadaptatsii v ékstrema'lnykh usloviiakh (po materialam avarii na Chernoby'lskoi AES).

Phenomenology and time course of psychic disorders in persons exposed to life-threatening emergency situations provoked by the Chernobyl accident have been analyzed. Three states could be identified according to differences in their psychogenic impact: acute, delayed and long-term. Psychic dysadaptation and disorders might be presented as results of a single process beginning with acute anxiety responses followed by asthenic disorders which backed the relatively steady neurotic and psychopathic states.

[Lipid peroxidation in emotional stress and neurotic disorders]. / Perekisnoe okislenie lipidov pri émotsional'nom napriazhenii i nevroticheskikh rasstroistvakh.

Lipid peroxidation in biological membranes was studied in healthy individuals under emotional stress and in patients with neurosis. The plasma levels of malonic dialdehyde (one of the end products of peroxidation) directly correlated with the severity of emotional stress. Patients with neurotic disturbances showed activation of peroxidation expressed in increase of its initial and end products and decreased levels of alpha-tocopherol. A relationship has been found between clinical characteristics of patients and intensity of the studied biological processes. A conclusion is drawn about the involvement of lipid peroxidation in the pathogenetic chain responsible for the development of neurotic symptom complex.

[Use of the new psychotropic preparation bemitil in treating asthenic disorders (clinico-pharmacological research)]. / Primenenie novogo psikhotropnogo preparata bemitila pri lechenii astenicheskikh narushenii (kliniko-farmakologicheskoe issledovanie).

In a series of 130 patients with asthenic conditions related to borderline forms of neuro-mental disturbances the authors compared clinico-pharmacological action of the actoprotector bemitil with that of nootropic drugs (piracetam and piridotol). The treatment with bemitil was either continuous or intermittent, being conducted according to the scheme elaborated in the course of the study. Bemitil proved to be more effective than piracetam and piriditol in relation to its influence on the manifestations of the asthenic symptom complex in general. Its application was characterized by a faster onset of the therapeutic effect and a peculiar mild psychostimulating action, primarily manifested in the impact on obligate manifestations of the asthenic disorders. The degree of the psychotropic action of the drug was found to be subject to changes depending on the scheme of its use.

[Use of psychophysiologic indices for the prognosis of the clinical action of tranquilizers]. / Ispol'zovanie psikhofiziologicheskikh pokazatelei dlia prognoza klinicheskogo deistviia trankvilizatorov.

A comprehensive comparative approach was used to assess the effectiveness of the psychophysiological indices as predictors of the effect of tranquilizing therapy with benzodiazepine drugs in neurotic patients. The study resulted in selection of several psychophysiological characteristics most relevant to the prognosis of individual responses to the tranquilizers irrespective of the particular neurosis form. The characteristics are recommended for the routine medical use. Indices of the sensorimotor activity and visual analyzer functional lability are among these.