RU2077324C1 - Method of treatment of alcoholism and nicotine addiction - Google Patents

Abstract

FIELD: medicine, narcology, psychiatry. SUBSTANCE: method involves the use of proserin at increasing dose from 0.1 to 3.5 mg and the habitual narcotic agent is administrated at maximum level of response. After negative reflex appearance the developed vegetative response is arrested by atropine administration. EFFECT: prolonged abstinence period, stop smoking. 3 cl

Description

 The invention relates to medicine, namely to addiction.

 Known methods of treating alcoholism and nicotinomania by administering drugs that cause the development of autonomic reactions and introducing at the height of the resulting reaction the usual narcotic substance (In the book "Treatment of chronic alcoholism and tobacco smoking with Carpathian ram". Kiev, 1966, pp. 48-55, 81 )

 Closest to the proposed is a method of treating alcoholism and nicotinomania using apomorphine as a medicine that causes the development of autonomic reactions (In the book of I. V. Strelchuk "Intoxication psychoses. M. Medicine, 1979, S. 289-291).

 The disadvantages of this method are the presence of serious cardiovascular complications, low efficiency, the rapid emergence of addiction to the drug.

 The aim of the present invention is to eliminate the above disadvantages, reduce side effects and complications during therapy and increase its effectiveness.

 This goal is achieved by the fact that as a medicine, proserin is introduced in an increasing dose from 0.1 to 3.5 mg, and after receiving a negative reflex, the resulting vegetative reaction is stopped by the introduction of atropine; proserin on the first day is administered subcutaneously 2.0 3.0 ml of a 0.05% solution; on the second day, 4.0 5.0 ml of a 0.05% solution of proserin is administered and after 35 to 40 minutes at the height of the vegetative reaction, alcohol is orally administered twice and with an interval of 10 minutes and / or smell of alcohol and tobacco in an amount of 6.0 - 7, 0 ml of a 0.05% solution; the vegetative reaction that has arisen is stopped on the first day of treatment 45 minutes after the administration of proserin by the parenteral administration of 1.0 ml of a 0.1% atropine solution, on the second day, 2.0 ml of a 0.1% atropine solution is administered subcutaneously 55 to 60 minutes after the administration of proserin. At 9 10 days of treatment, atropine is administered in a dose of 3.0 ml of a 0.1% solution 70 to 75 minutes after the administration of proserin.

The method is as follows: after the elimination of a hangover with the help of restorative and detoxification therapy, patients receive the following treatment:
1) the first day in the morning 1 hour after breakfast, the patient is injected subcutaneously with 2.0 3.0 ml of a 0.05% solution of proserin (1 1.5 mg) and observe the nature of the reaction, usually expressed in successively occurring moderate hypersalivation, a feeling of heat in the face and neck, etc., a feeling of slight intoxication and then malaise;
2) after 45 minutes, 1.0 ml of a 1% solution of atropine is injected subcutaneously;
3) on the next (second day) in the morning at the same time, taking into account the severity of the reaction to the test administration of the drug, 4.0-5.0 ml of a 0.05% solution of proserin (2-2.5 mg) are administered parenterally;
4) after 35 to 40 minutes from the injection at the height of the development of the reaction, expressed in copious neuro-vegetative manifestations, including discomfort from the esophagus and stomach, the patient is offered to smell cotton wool moistened with alcohol (in the amount of 5.0 to 8.0 g), moisten the patient’s lips with it and ask to taste the alcohol;
5) after 10 minutes, the patient is offered to smell the smell of fumes from cotton wool through which tobacco smoke is passed (in view of the sharp excitation of cholinergic systems in the form of hypersalivation, moderate Mirza, unpleasant taste in the mouth, increased peristalsis, etc., patients usually refuse samples, referring to the fact that the smell and taste of alcohol and tobacco are unpleasant for them and has become alien);
6) after 60 minutes (1 hour), the patient is injected subcutaneously with 2.0 ml of a 0.1% solution of atropine;
7) on the 9-10th day of treatment, a maximum dose of proserin of 6.0-7.0 ml of a 0.1% solution or more is administered, depending on the weight and constitution of the patient (3.0 - 3.5 mg). If there is a reaction at the height of the patients, along with the feeling of nausea, a feeling of a “lump” in the throat, and other pronounced painful sensations: “intercepts” breathing, consider that a shock dose has been reached;
8) after 75 minutes (1 hour 15 minutes), 3.0 ml of a 0.1% atropine solution are subcutaneously administered.

 They do not give special warnings about the need to stop or reduce the number of cigarettes smoked (cigarettes), since it was found that patients during this period do not feel the urge to smoke, and if they smoke “out of habit”, they suffer a number of unpleasant sensations, in particular, dryness in the mouth, unpleasant taste, slight nausea, etc.

 We give examples of specific performance. Example No. 1.

 Patient K., 39 years old. Diagnosis: chronic alcoholism. He entered the clinic MNIIP 18.10.78, left 01.12.79, N medical history 1346. Since the age of 23 he has been abusing alcohol. Alcohol tolerance gradually increased, which by 1970 had reached 1.5 liters of hard liquor per day. By this time, a hangover syndrome had formed. "Spoiled character", became moody, hot-tempered. In recent years, during the period of abstinence, headaches arose, "pressed my heart," troubled by insomnia, "nightmares", sweating. There were no psychotic episodes. Due to a sharp deterioration in his condition, a decrease in his ability to work, he went to a narcological dispensary and in March 1978 was hospitalized in a psychiatric hospital No. 15. Hospital No. 15. He took teturas for a month and a half. After discharge, abstained from alcohol for about one month. He resumed drinking "just like that, did not believe in treatment." Immediately there was an attraction, the need for hangover. He began to drink again for several days in a row. On his own initiative, he requested a second treatment. Physically: heart sounds are muffled, the liver is at the edge of the costal arch. Upon receipt, pain at the point of the gallbladder and in the epigastric region. Laboratory studies: unsharp ECG shifts in the trophic myocardium of the left ventricle, otherwise without deviations. Neurologically: pupil reactions are reduced, convergence failure, a bilateral symptom of Marinescu, in Romberg's position tremor of fingers of outstretched arms, eyelids. Mentally: focused on admission. Complains of poor health, the need to get a hangover. Sluggish, slow. In the course of general strengthening treatment, acute manifestations of alcohol withdrawal softened by 3 days. Subsequently, the state of health gradually improved. 11.16.78 in the morning after breakfast (after 1 hour) he was injected subcutaneously with a 0.05% solution of proserin 2.0 ml. After 20 25 minutes notes "bubbling" in the abdomen, a feeling of cold in the stomach, a slight feeling of nausea, lacrimation, hypersalivation, general malaise. After 45 minutes, a 0.1% solution of atropine 1.0 ml was introduced. In the afternoon, the patient's condition is satisfactory. 17.11.78, at the same time in the morning the patient was injected subcutaneously with 4.0 ml of a 0.05% solution of proserin. Compared to 11/16/78, all changes came sharper and faster. After 10 minutes, there was a sharp increase in peristalsis, which seemed to rise up. Pulse 80 beats per 1 minute. HELL = 120/80 mm RT. Art. Subjectively, the deterioration increased. After 30 minutes from the moment of injection, a test was carried out for the taste and smell of alcohol, after 10 minutes for the smell of tobacco. I felt a “spasm” in my throat, in my throat, “at least do not breathe,” saliva liberated abundantly. Significant anxiety appeared, the patient asked to ease his condition. After 1 hour, atropine 2.0 ml was injected subcutaneously. Gradually, the condition improved, but the “colic” and “cramps” remained throughout the day. He spoke of the course of treatment as follows: "A man seems to come to life again from a binge, nursing himself." He asked me not to do such injections anymore: “This is needed more by the young, after that you will not look at vodka for a month”. Over the next days, a feeling of nausea, heaviness in the head arose. By the time of discharge, the condition is satisfactory. Follow-up: for 8 months, the patient does not drink alcohol, family relations are smooth, working.

 Example N 2. Patient N. 39 years old Dentist. Temporarily not working. He entered the psychiatric hospital N 4 named. Gannushkina 12/13/78, dropped out 01/26/79, N medical history 10532. Diagnosis: chronic alcoholism. Nicotinomania. From the anamnesis: he abuses alcohol from 20-23 years old, smokes 20 years, 20 cigarettes per day from 30 years old, drinks systematically. Since then, a pronounced hangover has been noted. Usually drinks several days in a row at 600.0 800.0 g of vodka per day, adding alcohol, wine, beer. I did not use surrogates. In view of truancy, he often changed jobs. Registered in the PND since 1973. He was treated with teturam, alcohol tests were performed for teturas, but soon (after 2 3 weeks) he began to abuse alcohol again. In December 1973, hail appeared, became anxious, slept poorly. A few days later I saw before falling asleep on the carpet "little gnomes", "ballerinas". He was hospitalized in a psychiatric hospital. Gannushkina. After discharge 3 4 weeks I tried to abstain, but then again began to drink. He worked in a specialty. He drank up to 1.0 liter of vodka daily during this period, often drank alone. When intoxicated, he became vicious, brutal. After another binge, he tried to stab himself with a knife in front of his relatives. He quit his previous job, got a job at school, by profession. At the end of 1978, he began to see "animals" in the apartment: "bears", "arctic foxes", his friends on the "hunt". In the following days I did not remember this. Re-admitted to the psychiatric hospital. Gannushkina. Somatic: according to the conclusion of the therapist, alcoholic hepatitis. Neurologically: without signs of organic damage to the central nervous system. Laboratory studies: no deviations. Mentally: focused on admission. Sparingly reported his alcohol abuse. He said that on the eve of hospitalization in the evening he heard "music", "rolls downhill." He asked to apply the most effective means. With the implementation of general strengthening and detoxification therapy, the state of health improved, the regime was respected, and “alcoholic” humor slipped in separate statements. 01/03/79, the patient was started anti-alcohol treatment and anti-tobacco treatment: in the morning after breakfast, 3.0 ml of a 0.05% solution of proserin were subcutaneously administered to him. In the course of the reactions, the patient noted the similarity of his condition with alcohol intoxication, however, after 30 minutes he began to experience unpleasant sensations in the body, dry mouth, and sweating. After 40 minutes, the patient was administered 1.0 ml of a 0.1% solution of atropine. The next day, at the same time, the patient was administered 5.0 ml of a 0.05% solution of proserin. Soon I already felt a fever in my face and neck, twitching of the muscles of my left hand, contraction of the esophagus, etc. After 20 minutes, a test was made for the smell and taste of alcohol, the patient turned away after a minute, saying that he was unpleasant, nauseous. After 10 minutes, a nicotine odor test was performed. According to the patient, he first felt that this smell was disgusting to him, a stranger. After 1 hour, the subjectively painful state of malaise was stopped by the introduction of 2.0 ml of 0.1 atropine solution subcutaneously. In the next two or three days, he noted that, although he tried to “smoke” out of habit, he immediately threw a cigarette due to unpleasant sensations in his mouth and throat, respiratory throat. 01/11/79, introduced a "shock" dose of proserin 7.0 ml of a 0.05% solution. At the height of the reaction, after 30–40 minutes he noted painful contractions of the stomach and esophagus, the idea of alcohol was painfully disgusting, after 40–50 minutes he complained with fright that there was a lump in his throat and was catching his breath. After 1 hour and 15 minutes, atropine 3.0 ml of 0.1% solution was administered to the patient. A few days later, during a conversation, he said that he was scared to remember about his alcoholic past, since he was a doctor himself. Actively involved in labor processes. Before discharge, tightened, neat, no complaints. Calm Makes real plans for the future. He was discharged home with his wife. Follow-up: (6.5 months). He works by profession in one of the medical institutions. Relations in the family are even. After a month and a half, he was “forced” to sip a glass of wine, but then he felt ill, the next day he came to the department. Subsequently, did not drink (according to the wife and colleagues). Did not smoke.

Using the proposed method for the treatment of alcoholism and nicotinomania provides the following advantages compared to known methods:
Serious cardiovascular complications and the possibility of getting used to the drugs used are excluded;
treatment by the claimed method is a means of choice in cases, in particular, when patients have already undergone anti-alcohol therapy, in view of the fact that it uses drugs that were not used for this purpose;
The claimed method is quite simple, convenient to execute.

 Treatment of 19 patients with the claimed method showed that in 2/3 of the cases they were patients who had already received various anti-alcohol treatment using such means as teturam (antabuse), apomorphine, metronidazole, etc., including, in one case, implantation of the Esperal drug. All of these patients achieved satisfactory results in the short term. At present, the term of abstinence after discharge is 5.4 ± 1.2 months, which exceeds the term of abstinence in these patients after inpatient treatment at previous hospitals and the terms of spontaneous remissions (not more than one month). All patients stopped smoking, 12 of them completely, the rest significantly reduced the number of cigarettes smoked (cigarettes). The method was effective in patients of a young age. All patients returned to work, to study.

Claims (1)

1 1. A method for the treatment of alcoholism and nicotinomania by administering drugs that cause the development of autonomic reactions, and introducing the usual narcotic drug at the height of the reaction, followed by repeating the injections of this combination to create a persistent negative reflex to alcohol and nicotine, characterized in that as Prozerin is injected into the drug in an increasing dose from 1.0 to 3.5 mg, and after receiving a negative reflex, the resulting vegetative reaction is stopped by the administration of atropine .2 2. The method according to claim 1, characterized in that on the first day Neostigmine administered subcutaneously 2.0 3.0 ml 0.05% solution; on the second day, 4.0 5.0 ml of a 0.05% solution of proserin is administered and after 35 to 40 minutes at the height of the vegetative reaction, alcohol is orally administered twice and every 10 minutes and / or it smells of alcohol and tobacco; on 9 10 days of treatment, proserin is administered in an amount of 6.0 7.0 ml of a 0.05% solution. 2 3. The method according to claims. 1 and 2, characterized in that on the first day of treatment, the resulting vegetative reaction is stopped 45 minutes after administration of proserin by parenteral administration of 1.0 ml of 0.1% atropine solution, on the second day, 2.0 ml of 0.1% atropine solution is administered subcutaneously 55 to 60 minutes after administration of proserin, on day 9 10 of treatment, atropine is administered at a dose of 3.0 ml of 0.1% solution 70 to 75 minutes after administration of proserin.