Рецепт. 2021; : 625-633
Медикаментозная коррекция нарушений сна и зависимости от снотворных и седативных препаратов
https://doi.org/10.34883/PI.2021.24.5.002Аннотация
Нарушение сна – распространенная проблема, с которой сталкиваются люди любых возрастных категорий. Лечение расстройств сна проводится комплексно, включает назначение медикаментов разных групп, в том числе снотворных. Однако их самостоятельный бесконтрольный прием, неправильный выбор препарата, его доз, кратности и продолжительности применения провоцируют другую проблему – зависимость, которая развивается постепенно, от нескольких недель, месяцев до нескольких лет. Избавиться от зависимости самостоятельно очень сложно. Лечение, которое применяется при зависимости от седативных и снотворных средств, направлено на снятие абстинентного синдрома, постепенное сокращение дозы препарата, на фоне которого развилась зависимость; замещение лекарства на препарат, не вызывающий привыкания, например, противосудорожные препараты из группы габапентиноидов, которые положительно влияют на уменьшение тяжести расстройств сна и соматических симптомов. Прегабалин может быть рекомендован в качестве медикаментозной коррекции нарушений сна и зависимости от седативных и снотворных препаратов у пациентов в условиях первичной медицинской практики.
Список литературы
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14. Grossman P., Niemann L., Schmidt S., Walach H. (2004) Mindfulness-based stress reduction and health benefits: a meta-analysis. J. Psychosom. Res., 57 (1), pp. 35–43.
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16. Jacobi F., Hofler M., Strehle J. (2014) Mental disorders in the general population: study on the health of adults in Germany and the additional module mental health (DEGS1-MH). Nervenarzt, 85 (1), pp. 77–87.
17. Kessler R.C., Demler O., Frank R.G. (2005) Prevalence and treatment of mental disorders, 1990 to 2003. N. Engl. J. Med., 352 (24), pp. 2515–2523.
18. Lee H.B., Song M.L., Koo B.B., Cho Y.W. (2017) Mood symptoms and restless legs syndrome without periodic limb movements during sleep: is it a clinical subtype? J. Neuropsychiatry Clin. Neurosci., 29 (1), pp. 52–59.
19. Lichstein K.L., Taylor D.J., McCrae C.S. (2016) Insomnia: epidemiology and risk factors. Principles and practice of sleep medicine. 6th ed. Elsevier, Philadelphia, pp. 761–768.
20. Lydiard R.B., Rickels K., Herman B., Feltner D.E. (2010) Comparative efficacy of pregabalin and benzodiazepines in treating the psychic and somatic symptoms of generalized anxiety disorder. Int. J. Neuropsychopharmacol., 13 (2), pp. 229–241.
21. Mason E.C., Harvey A.G. (2014) Insomnia before and after treatment for anxiety and depression. J. Affect. Disord., 168, pp. 415–421.
22. Montgomery S.A., Baldwin D.S., Blier P. (2007) Which antidepressants have demonstrated superior efficacy? A review of the evidence. Int .Clin. Psychopharmacol., 22 (6), pp. 323–329.
23. Pande A.C., Crockatt J.G., Feltner D.E. (2013) Pregabalin in generalized anxiety disorder: a placebo-controlled trial. Am. J. Psychiatry, 160, pp. 533–540.
24. Pélissolo A., André C., Chignon J.M. (2002) Anxiety disorders in private practice psychiatric out-patients: prevalence, comorbidity and burden (DELTA study). Encephale, 28 (6 Pt. 1), pp. 510–519.
25. Taguchi T., Igarashi A., Watt S. (2015) Effectiveness of pregabalin for the treatment of chronic low back pain with accompanying lower limb pain (neuropathic component): a non-interventional study in Japan. J. Pain Res., 8, pp. 487–497.
26. Taylor D.J., Mallory L.J., Lichstein K.L. (2007) Comorbidity of chronic insomnia with medical problems. Sleep, 30 (2), pp. 213–218.
Recipe. 2021; : 625-633
Medical Correction of Sleep Disorders and Dependence on Sleeping Pills and Sedatives
https://doi.org/10.34883/PI.2021.24.5.002Abstract
Sleep disorder is a common problem faced by people of all age categories. Treatment of sleep disorders is carried out comprehensively, including the prescription of medications of different groups, including sleeping pills. However, their independent uncontrolled intake, wrong choice of the drug, its doses, frequency and duration of use provoke other problems – dependence, which develops gradually, from several weeks, months to several years. Getting rid of addiction on one’s own is very difficult. The treatment, which is used for dependence on sedatives and hypnotics, is aimed at relieving withdrawal syndrome by gradually reducing the dose of the drug, on the background of which the dependence has developed; replacing the drug with another one that is not addictive, for example, anticonvulsants from the gabapentinoid group, which positively affects the reduction of the severity of sleep disorders and somatic symptoms. Pregabalin can be recommended for medical correction of sleep disorders and dependence on sedatives and hypnotics in patients in primary medical practice.
References
1. Alexandrovsky Yu. (1996) Social stress disorders. RMJ, pp. 117–126.
2. Ancyborov A. (2018) Novye psihoaktivnye veshchestva: kratom, DMT, serotoninergichskie gallyucinogeny, dissociativnye narkotiki. Mekhanizm dejstviya, psihoaktivnye effekty [New psychoactive substances: cratom, DMT, serotonergic hallucinogens, dissociative drugs. Mechanism of action, psychoactive effects]. Nevrologicheskij vestnik, vol. L, no 1, pp. 37–43.
3. (2018) Respublikanskij perechen’ narkoticheskih sredstv, psihotropnyh veshchestv i ih prekursorov, podlezhashchih gosudarstvennomu kontrolyu v Respublike Belarus’ [Republican list of narcotic substances, psychomotor substances and their precursors subject to state control in the Republic of Belarus]. Minsk.
4. Tvorogova N. (2017) Klinicheskaya psihologiya [Clinical psychology]. PER SE, Moscow, pp. 416–420.
5. Abler B., Hofer C., Walter H. (2019) Habitual emotion regulation strategies and depressive symptoms in healthy subjects predict fMRI brain activation patterns related to major depression. Psychiatry Res., 183 (2), pp. 105–113.
6. Baldwin D., Woods R., Lawson R., Taylor D. (2011) Efficacy of drug treatments for generalised anxiety disorder: systematic review and metaanalysis. BMJ, 342, pp. 11–99.
7. Baldwin D.S., Loft H., Dragheim M. (2012) A randomised, double-blind, placebo controlled, duloxetine-referenced, fixed-dose study of three dosages of Lu AA21004 in acute treatment of major depressive disorder (MDD). Eur. Neuropsychopharmacology, 22 (7), pp. 482–489.
8. Bandelow B., Michaelis S. (2015) Epidemiology of anxiety disorders in the 21st century. Dialog. Clin. Neurosis, 17 (3), pp. 327–335.
9. Bech P. (2007) Dose-response relationship of pregabalin in patients with generalized anxiety disorder. A pooled analysis of four placebocontrolled trials. Pharmacopsychiatry, 40, pp. 163–168.
10. Cape J., Whittington C., Buszewicz M. (2010) Brief psychological therapies for anxiety and depression in primary care: meta-analysis and metaregression. BMC Med., 8, p. 38.
11. Etkin A., Wager T.D. (2007) Functional neuroimaging of anxiety: a meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia. Am. J. Psychiatry, 164 (10), pp. 1476–1488.
12. Feltner D., Wittchen H.U., Kavoussi R. (2008) Long-term efficacy of pregabalin in generalized anxiety disorder. Int. Clin. Psychopharmacol., 23, pp. 18–28.
13. Gorman J.M. (2002) Treatment of Generalized Anxiety Disorder. J. Clin. Psychiatry, 63 (suppl 8), pp. 17–23.
14. Grossman P., Niemann L., Schmidt S., Walach H. (2004) Mindfulness-based stress reduction and health benefits: a meta-analysis. J. Psychosom. Res., 57 (1), pp. 35–43.
15. Guaiana G., Barbui C., Cipriani A. (2010) Hydroxyzine for generalised anxiety disorder. Cochrane Database Syst. Rev., 8 (12), pp. 23–32.
16. Jacobi F., Hofler M., Strehle J. (2014) Mental disorders in the general population: study on the health of adults in Germany and the additional module mental health (DEGS1-MH). Nervenarzt, 85 (1), pp. 77–87.
17. Kessler R.C., Demler O., Frank R.G. (2005) Prevalence and treatment of mental disorders, 1990 to 2003. N. Engl. J. Med., 352 (24), pp. 2515–2523.
18. Lee H.B., Song M.L., Koo B.B., Cho Y.W. (2017) Mood symptoms and restless legs syndrome without periodic limb movements during sleep: is it a clinical subtype? J. Neuropsychiatry Clin. Neurosci., 29 (1), pp. 52–59.
19. Lichstein K.L., Taylor D.J., McCrae C.S. (2016) Insomnia: epidemiology and risk factors. Principles and practice of sleep medicine. 6th ed. Elsevier, Philadelphia, pp. 761–768.
20. Lydiard R.B., Rickels K., Herman B., Feltner D.E. (2010) Comparative efficacy of pregabalin and benzodiazepines in treating the psychic and somatic symptoms of generalized anxiety disorder. Int. J. Neuropsychopharmacol., 13 (2), pp. 229–241.
21. Mason E.C., Harvey A.G. (2014) Insomnia before and after treatment for anxiety and depression. J. Affect. Disord., 168, pp. 415–421.
22. Montgomery S.A., Baldwin D.S., Blier P. (2007) Which antidepressants have demonstrated superior efficacy? A review of the evidence. Int .Clin. Psychopharmacol., 22 (6), pp. 323–329.
23. Pande A.C., Crockatt J.G., Feltner D.E. (2013) Pregabalin in generalized anxiety disorder: a placebo-controlled trial. Am. J. Psychiatry, 160, pp. 533–540.
24. Pélissolo A., André C., Chignon J.M. (2002) Anxiety disorders in private practice psychiatric out-patients: prevalence, comorbidity and burden (DELTA study). Encephale, 28 (6 Pt. 1), pp. 510–519.
25. Taguchi T., Igarashi A., Watt S. (2015) Effectiveness of pregabalin for the treatment of chronic low back pain with accompanying lower limb pain (neuropathic component): a non-interventional study in Japan. J. Pain Res., 8, pp. 487–497.
26. Taylor D.J., Mallory L.J., Lichstein K.L. (2007) Comorbidity of chronic insomnia with medical problems. Sleep, 30 (2), pp. 213–218.
