Лекарственно-индуцированные ночные кошмары


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Аннотация

По современным представлениям, ночные кошмары относят к группе парасомний. Одним из важных факторов, индуцирующих их появление, является прием различных лекарственных средств, в таком случае ночные кошмары называют лекарственно-индуцированными. Частота лекарственно-индуцированных ночных кошмаров точно не установлена, но при приеме некоторых препаратов (например, мефлохина) она может достигать 59%. Механизм развития ночных кошмаров при применении лекарственных средств чаще всего обусловлен их влиянием на различные рецепторы и нейротрансмиттерные системы: адренергическую, дофаминергическую и холинергическую. Среди классов лекарственных препаратов, прием которых чаще ассоциируется с развитием ночных кошмаров, рассматриваются антидепрессанты, противопаркинсонические средства, анальгетики, препараты, применяющиеся для лечения заболеваний сердечно-сосудистой системы, и некоторые другие. Тактика ведения пациентов с развитием лекарственно-индуцированных ночных кошмаров предполагает выявление и отмену лекарственного средства, индуцировавшего ночной кошмар или снижение его дозировки, а также при возможности назначение данного препарата в утреннее время. Профилактика лекарственно-индуцированных ночных кошмаров заключается в соблюдении принципов рациональной фармакотерапии, прежде всего в избегании превышения допустимой дозировки лекарственных средств.

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Т. М Остроумова

Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет)

О. Д Остроумова

Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский Университет); Российский национальный исследовательский медицинский университет им. Н.И. Пирогова, Российский геронтологический научно-клинический центр

Email: ostroumova.olga@mail.ru
д.м.н., профессор кафедры клинической фармакологии и пропедевтики внутренних болезней; зав. лабораторией клинической фармакологии и фармакотерапии

А. И Кочетков

Российский национальный исследовательский медицинский университет им. Н.И. Пирогова, Российский геронтологический научно-клинический центр

А. П Переверзев

Российский национальный исследовательский медицинский университет им. Н.И. Пирогова, Российский геронтологический научно-клинический центр

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