No 4s (2012)

The main direction in the treatment of Alzheimer's disease (AD) is a replacement therapy aimed at overcoming neurotransmitter deficiency in different neuronal systems. Deficiency of acetylcholine is the basis of cognitive impairment and the subsequent development of total dementia. For the overcoming of cholinergic deficiency acetylcholinesterase inhibitors, such as rivastigmine, donepezil and galantamine, are widely used; their efficacy and safety in patients with AD were convincingly demonstrated in numerous domestic and foreign clinical trials. The number of glutamate receptors in the hippocampus is significantly reduced in AD., and the degree of reduction correlates with the severity of dementia. The basic glutamatergic strategy for the treatment of AD includes memantine, which has neuroprotective and positive symptomatic effects on the level of preserved glutamatergic synapses.

The current assessment of the effectiveness of pharmacotherapy is based on application of clinicodiagnostic scales. This is especially true for classification of emotional state of patients whose assessment is often based on a subjective basis. This directly relates to the manifestation of emotional excitability, often observed in the clinical picture of borderline mental disorders (BPD); the importance of their adequate evaluation during pharmacotherapy is above exception. Phenomenological number of conditions with emotional excitability is adjacent to the boundaries of non-criminal and criminal aggression that determines the application of methods of measurement of various manifestations of aggression for evaluation. Comparative analysis of the most recognized of them allowed to see a number of shortcomings. For the purpose of assessment of emotional excitability during pharmacotherapy in patients with BPD in clinical practice, as well as for research, brief questionnaire to identify the emotional excitability (BQEE), which was developed and tested in the present study, can be effectively applied, in particular, for the selection of patients with the most common and severe manifestations of emotional excitability at the screening stage of research and for assessment of the dynamics of the manifestations of emotional excitability during drug therapy at later stages of the study.

Treatment of patients with alcohol dependence syndrome is a complex, time-consuming, and involves several consecutive stages, differing in content: the treatment of urgent conditions - detoxification; treatment of withdrawal syndrome; correction of the psycho-pathological and somatic disorders in postabstinent period (initial period of remission); pharmaco- and psychotherapy designed to overcoming, suppression, and deactualization of morbid tendency for alcohol and (or) other psychotropic poisons consumption; and various types of maintenance therapy and psychotherapy in the rehabilitation stage.

The article presents the results of evaluation of the effectiveness of antiepileptic therapy in the treatment of epileptic syndromes associated with atypical absences (AA), involving 129 patients with various forms of epilepsy and onset of seizures from the first day of life to 18 years with AA in course of the disease reported. The study has shown the high efficiency of valproates (Convulex) and succinimides (ethosuximide) in respect of relief of pseudogeneralized attacks and blocking of frequent diffuse discharges in patients with symptomatic/cryptogenic focal forms of epilepsy and secondary bilateral synchronization phenomenon of the electroencephalogram.

Hyperprolactinemia (HP) is “latent” side effect of some antipsychotic drugs. To date, many aspects of the HP against the background of antipsychotic therapy are unclear and controversial in some cases. The currently available literature data for corrective measures in children and adolescents with mental illnesses and developed drug-induced HP are rare. Clarification of several issues related to the occurrence of HP, which is characteristic to some extent for each of the currently used antipsychotic drugs, will allow to develop more balanced therapy and minimize side effects in children and adolescents.