SU660684A2 - Method of treating phase-going psychosis - Google Patents

Description

one

This invention relates to the field of medicine, namely psychiatry.

The main author's certificate No. 510245 describes a method for the treatment of phase-related psychoses, which consists in the simultaneous cancellation of psychotropic drugs for prolonged saturation of the patient's body with them 1.

However, the lime method does not provide a sufficiently high therapeutic effect in the treatment of patients with intractable subacute resistant conditions.

The aim of the invention is to obtain a therapeutic effect in the treatment of patients with persistent subacute conditions that are resistant to simultaneous withdrawal of psychotropic drugs.

This goal is achieved by the fact that at the same time with the simultaneous cancellation of psychotropic drugs according to ed. swith No. 510245 diuretic substances are administered.

As diuretics, parenteral furosemide or urea OR mannitol is administered daily for 7-10 days in standard doses.

The method is carried out as follows.

On the first day of the withdrawal of psychotropic drugs, one of the diuretics is administered intravenously to the patients in the following doses: lasix 40 mg, mannitol or urea at the rate of 1 g per 1 kg of patient weight. If it is impossible to inject diuretics intravenously (thin, deep veins, patient’s refusal from this procedure, etc.), lasix is injected intramuscularly 20 mg twice a day OR give 40 mg furosemide twice

day. At the same time, patients receive a water load so that the introduction of fluid approximately corresponds to its removal. Said therapy is administered for 10 days.

Example 1. PATIENT P., 1939, R., in5 valid II group. Diagnosis: schizophrenia, intermittent course, depressive state. Hospitalized 15.11.76, discharged 4.3.77, Mentally ill for 3.5 years. He has been hospitalized three times in psychiatric hospitals with paranoid and depressive states. After the first hospitalization in 1974, a disability group was formed. The patient was given the following therapy: 18 mg haloperidol per

per day, melipramine up to 350 mg per day, frenolone up to 15 mg per day, amitriptyline up to 375 mg per day, there was no effect. During the last hospitalization, the patient was treated with Petyl for up to 375 mg intramuscularly per day for 30 days, and subsequently, due to the lack of effect, Triftazin was added to Petilil at a dose of 375 mg at a dose of 60 mg per day for 10 days after which both of these drugs were simultaneously canceled. The patient's condition remained unchanged for 10 days after simultaneous cancellation, and therefore melipramine was prescribed up to 375 mg per day for 30 days, which also proved to be ineffective. Subsequently, triftazin was added to the Meliprami dose of up to 60 mg per day for 10 days, after which the indicated drugs were again discontinued at one time. From the first day, urea was administered to the patient for 10 days at a dose of 65 mg per day at the rate of 1 g of dry urea per 1 kg of the patient's weight intravenously. During the procedure, the patient is given plenty of drink. On the 4th day of the treatment, depressive symptoms disappeared. On the 12th day the patient was discharged Katamnez six months. The patient works, transferred to the third group of disability.

Example 2. Patient M., born in 1951, invalid of group II, diagnosis: schizophrenia, in a lottery, depressive state. He entered the clinic 17.5.1976, Discharged 11.6.1976, Mentally ill with 13 years. The condition was determined by monotonous depression. In a psychiatric clinic, he was repeatedly hospitalized. The patient underwent massive psychopharmacotherapy with anti-depressants in high doses, double-electric therapy, spinal therapy and unloading-diet therapy, four times - the one-time cancellation of psychotropic drugs, all carried out the therapy did not have a positive therapeutic effect. During the month before the last hospitalization, the patient took outpatient amitriptyline up to 225 mg, melipramine up to 325 mg intramuscularly, leponex up to 200 mg, cyclodol up to 25 mg, there was no effect. Upon admission to the hospital, all drugs were discontinued at once. From the first day of withdrawal, lasix 40 mg intravenously per 800 ml of physiological saline was administered to the patient within 10 days. During the procedure, the patient is given plenty of drink. On day 6 of the treatment, depressive symptoms are reduced. After 3 weeks from the day of hospitalization, the patient was discharged. The follow-up year. Psychopathological symptoms are not detected. He is a disability group, the patient is working.

Example 3. Patient P., born in 1951, invalid of group II, diagnosis: schizophrenia, in the lottery, senestopathic-hypochondriacal condition. He was admitted to the hospital on September 16, 1976, and was discharged on December 24, 1976. He was mentally ill since 1971. The state of all subsequent years was determined by depressive senesto-hypochondriacal disorders. Repeatedly hospitalized in psychiatric hospitals. The patient underwent massive psychopharmacotherapy, insulin therapy and unloading diet therapy, which did not produce a positive therapeutic effect. During the last hospitalization, the patient was treated with Pethylyl up to 375 mg intramuscularly, Turelen up to 50 mg per day for 30 days, subsequently, due to the lack of effect, haloperidol up to 30 mg and cyclodol up to 24 mg per day were added for 10 days , after which all drugs were simultaneously canceled. The patient's condition remained unchanged for 10 days after simultaneous cancellation, so psychopharmacotherapy with amitriptyline to 375 mg and triphthazine to 60 mg per day was resumed for 12 days, after which the indicated drugs were again canceled at once. From the first day of cancellation, mannitol is administered to the patient within 10 days.

 at a dose of 60 mg per day at the rate of 1 g of dry mannitol per 1 kg of patient weight intravenously. During the procedure, the patient is given plenty of drink. On

 4-5 days of withdrawal with the use of diuretics, the former symptoms were completely reduced, on the 7th day there was an inversion of affect with an exit to hypomania, the affect was normalized by the 11th day. The follow-up year. Productive psychopathological symptoms cannot be detected, the group

 disability, the patient works by profession, married.

In order to reveal the therapeutic effect in the treatment of patients, a comparison of the known method with the proposed one was made.

0B study selected patients with

prolonged seizure (more than 6 months) and the failure of continuous treatment with psychotropic drugs for more than 2 months, as well as other types of active therapy {insulin-shock, ECT, RTD, a series of cancellations). Only 40 patients with schizophrenia: 37 men and 3 women aged from 21 to 68 years, including 10 people suffering from periodic schizophrenia, 15 people with paranoid with paroxysmal contractility,

0 in the lottery - 15 people. The average duration of the attack was about 2 years. The clinical picture was determined by depressive syndrome in 23 cases, depressive-delusional - in 5 cases and paranoid with circularity - in 12 cases. The study consisted of several stages, patients were transferred to each subsequent stage, for which no therapeutic effect was achieved at the previous stage. Stage 1