Sex, drugs, haloperidol. How the Old Testament led to pre-trial detention centers and mental hospitals

In the early 2000s, a young graduate of the Faculty of Philosophy of the Novosibirsk State University, Pavel Lobarev, the son of the Novosibirsk oppositionist, and later an official of the regional administration, Igor Lobarev, was himself interested in politics: he was a member of the National Bolshevik Party of Eduard Limonov, in 2003, in protest against the war in Iraq, with his comrades, he threw tomatoes at the director of the NATO information bureau in Moscow, Rolf Welberts, and in the same year he ran for the State Duma. In 2005, Lobarev was expelled from the NBP for criticizing the leadership; he soon withdrew from politics, and then left with his wife for St. Petersburg, continuing to actively speak out on his VKontakte page and attend all kinds of rallies. In St. Petersburg, Lobarev took up cryptocurrencies - that’s what he lived on.

Indications for use

The medication is prescribed for the treatment of certain diseases, and among them the following pathological processes can be distinguished:

• Tourette's disease;
• Various psychoses;
• Psychomotor disturbances;
• Hallucinations;
• An agitated depressive state, which is characterized by sadness and anxiety along with motor and speech overexcitation;
• Vomiting caused by a course of chemotherapy;
• Psychosomatic disorders
• Stuttering;
• Hiccups;
• Oligophrenia;
• Age-related behavioral changes;
• Children's behavioral disorders, such as hyperreactivity and autism.

Contraindications

In some situations, treatment with Haloperidol has a negative effect on the body, so its use is prohibited in the following cases:

• Intolerance to the composition of the medication;
• Various types of coma;
• Parkinson's disease;
• Serious central nervous system disruptions caused by xenobiotics;
• Depression;
• Children under 3 years old;
• Pregnancy and lactation period.

The use of Haloperidol is permissible with extreme caution in the following cases:

• Diseases of the cardiovascular system;
• Epilepsy;
• Renal, hepatic, as well as pulmonary-cardiac and respiratory failure;
• Thyrotoxicosis;
• Alcoholism;
• Prostate adenoma.

Pros and cons based on reviews and practical experience

One can highlight the advantages of the drug, such as reasonable price and high quality , but a large list of restrictions on use and side effects significantly spoils the whole picture.

Forms of release and cost

The price of Haloperidol (Biocom) tablets is 15 rubles . Haloperidol (Ozone) – 20 rubles . Haloperidol-acri costs 25 rubles, and haloperidol-forte costs 57 rubles . The price of Haloperidol in drops fluctuates around 50 rubles.

Use of the medication

In order for the drug to have the necessary effect on the body, it comes with instructions for use. The tablets should be taken orally 1-2 times a day with plenty of liquid, such as milk or drinking water. The dose for each specific case is individual, but you can drink no more than 100 mg per day, otherwise an overdose of Haloperidol is possible.

Initially, the doctor will prescribe the minimum concentration of the drug and gradually increase it until the desired result is obtained. The medication should also be discontinued gradually. For older people and in acute cases of the disease, the dosage is selected significantly lower than usual, and then gradually rises. The duration of therapy for adults is usually 10-12 weeks.

For Haloperidol, the instructions also describe the features of the course of use of the medication in children. The drug is mainly used 2-3 times a day. The dosage is gradually increased, but not more than once a week. If there is no result from therapy, after 4-5 weeks the drug is discontinued.

The medication is used intramuscularly and intravenously in severe cases when a person cannot take the tablet orally. It will have to be administered every 5-8 hours. For severe psychosis, you can use the medicine 2 times with an interval of 1 hour. No more than 100 mg per day is allowed. If psychosis is the result of alcohol intoxication or chronic alcoholism, then the drug is administered intravenously. The dosage taken is mainly the same as for a common mental disorder.

When the injection solution contains haloperidol ester and decanoic acid (haloperidol decanoate), the injection is given into the muscle 1-2 times a month. The dose may be increased no more than once every 30 days.

Treatment cannot be prescribed

Already in August, it became clear that Lobarev would not be imprisoned for terrorism: linguistic examination did not find anything like that in his posts. The drug case also didn’t go well: one of Lobarev’s acquaintances, also in jail, testified that it was he who hid ketamine on his balcony, however, most likely, his confession was a fiction.

Pavel Lobarev at a picket in response to the actions of Orthodox activists who disrupted concerts of rock musicians. Novosibirsk, summer 2014

Even during his first conviction in 2007, Lobarev was diagnosed with schizotypal personality disorder due to the use of psychoactive substances, which, however, did not prevent him from being sent to prison (this term combines a whole range of mental conditions that are characterized by abnormal thinking and eccentric behavior, but are not accompanied by serious changes in personality, as in schizophrenia. Most patients with schizotypal personality disorder do not require treatment. - Note RS). Examinations carried out in September and December 2017 confirmed the diagnosis. The doctors could not say whether the patient was sane at the time of the crimes, and recommended that he be treated first.

Then begins a leapfrog of court decisions and appeals. In January, the judge of the Sovetsky District Court of Novosibirsk, Evgeny Duzenko, decided to send Lobarev to the hospital, but did not prescribe compulsory treatment, and in February he completely returned the case about prescribing treatment to the prosecutor's office. The prosecutor's office does not agree with this and is filing an appeal, but while the trial is pending, Pavel's term of arrest is coming to an end, and the Novosibirsk regional specialized psychiatric hospital No. 6 does not want to accept him: the medical institution, they say, is only for patients who are prescribed compulsory treatment . On February 27, 2018, the prosecutor of the Sovetsky district writes to Judge Duzenko: the hospital won’t take Lobarev, he should be released from custody on the 28th, what to do? The judge laconically replies that Lobarev should be placed in a hospital. Lobarev should have gone home, but on February 28, the head doctor of the hospital, Irina Korolkova, suddenly changed her mind, and Pavel ended up in the ward, although still without treatment. This was to his advantage: he felt normal and did not want to be treated with neuroleptics at all. “They kind of took me on a tour there,” he says.

On April 4, the Novosibirsk Regional Court upheld the appeal of the prosecutor's office and sent the case of prescribing treatment to Lobarev for a new trial, and on June 14, the judge of the same Sovetsky District Court, Svetlana Egorova, prescribed this treatment to him. Lobarev, already in the hospital, files an appeal against Egorova’s decision, but loses. The decision to prescribe compulsory treatment comes into force on August 21, 2021.

It would seem that the case was lost, but... on July 9, a commission of doctors de jure discharged Lobarev, admitting that he had been cured - the court decision was a little late. Only the court can release him from the hospital, which on September 13 decided to return Lobarev to the pre-trial detention center. He did not agree with this either, filed an appeal, which he lost again, but almost immediately after this, on November 12, investigator Masalova replaced his preventive measure with a written undertaking not to leave the place, and the next court sent him to a general hospital for a month for a new examination, which recognized his sanity Lobarev incl. at the time of the commission of the crimes. He was released on December 11 - exactly one year and five months after his arrest.

Features of the effect on the body

Haloperidol shows impressive results in the treatment of mental disorders by blocking postsynaptic dopamine receptors (a neurotransmitter) in brain tissue (mesolimbic and mesocortical).

The drug combines antipsychotic, sedative and antiemetic effects. Due to them, the medication provokes extrapyramidal disruptions, but does not have a blocking effect on choline. The effects appear due to the following actions:

• Calming effect. This action becomes possible due to the blocking of α-adrenergic receptors in the reticular formation of the brain;
• Antiemetic effect. It turns out that this effect is due to the blocking of dopamine receptors in the vomiting center;
• Decreased body temperature. The effect occurs due to the blockade of dopamine receptors located in the hypothalamus.

People usually do not take Haloperidol tablets for a long time, since due to the constant effect of the drug on the body, the hormonal balance is disrupted. The synthesis of prolactin increases and the production of gonadotropic hormones decreases.

The ester of haloperidol and decanoic acid affects the body much longer and has the following effect:

• Removes pathological personality changes, and also eliminates various manias and hallucinations;
• Stimulates the patient's interest in the outside world;
• Achieves positive results even in the case of patients who are resistant to other types of antipsychotics;
• Stops behavioral disturbances in children and reduces the degree of their hyperactivity.

After the injection, the duration of the effect is usually 4-5 weeks, but in more severe cases the injection is given every 14 days.

Development of a terrorist

Pavel Lobarev at the rally “For Fair Elections”, Novosibirsk, February 26, 2012.
As follows from the case materials, operational work on Pavel Lobarev began 15 months before his arrest: on March 1, 2021, Novosibirsk police officer Major Roman Dolgov investigated his page “ VKontakte”, revealing a “negative assessment of religion”, “hatred of the current political authorities and the Russian Orthodox Church.” Some posts from 2015, according to the major, justified terrorism. Lobarev then read the Old Testament, was amazed at the amount of violence prescribed by Yahweh and began to reason that all religions, including Christianity, are bloodthirsty, and if you are a true believer and want to follow the word of God, you must act the same way as militants banned in many countries of the world “Islamic State”, which are trying to literally fulfill what is written in the Koran. It was the ironic phrase “Today only the Islamic State acts as the power of God on earth” (as opposed to “conformists” from other religions) that became the basis for initiating a case under Art. 205.2 (public justification of terrorism).

Police Lieutenant Colonel Roman Dolgov, detective officer for the Department of Internal Affairs of the Main Directorate of the Ministry of Internal Affairs of Russia for the Novosibirsk Region, receives a memorial badge “For hard work” from the hands of the rector of the Novosibirsk Alexander Nevsky Cathedral, Archpriest Alexander Novopashin

Only in May 2017, the investigation materials were transferred to the Novosibirsk Investigative Committee, which opened the case on June 29. Unsuspecting Lobarev came from St. Petersburg to Novosibirsk to sell an apartment, and at the same time to the Psyland electronic music festival - he lived in a tent on an island in the Ob Sea. On July 10, he went to the city for housing issues and decided to spend the night with his parents (they themselves had gone on vacation; only Pavel’s 94-year-old grandmother was at home). On the same day, Novosibirsk Investigative Committee investigator Natalya Masalova decides to urgently search the apartment of Lobarev’s parents and detain him: they decided not to apply to the court for permission to search, they were afraid that the suspect would suddenly decide to destroy evidence in the case.

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The apartment was searched for forty minutes, a mobile phone, laptop and mouse were confiscated, but the police did not leave immediately: they decided to call a sniffer dog because someone thought that Pavel had thrown drugs out the window, however, based on the case materials, it is unclear who. Only an attesting witness speaks about this, who herself did not see anything like this, but heard it from someone. The dog arrived two hours later (all this time the police officers were in the apartment without any reason), but found nothing under the windows. But Lobarev voluntarily gave out a small amount of hashish, and the dog found a bag with 8 grams of ketamine on the balcony (an anesthetic drug, the circulation of which is limited in the Russian Federation. - Note). However, according to Lobarev, he only owned hashish, the origin of ketamine is unknown to him: he is a long-time user of a variety of drugs, including ketamine, and has been repeatedly brought to justice under various parts of Article 228, but, according to him, he always bought a little, so that, if anything happens, he can get off with an administrative penalty: “8 grams is, as they say, not my handwriting,” he assures. Hashish was not enough for criminal prosecution, but possession of ketamine was added to terrorism. Lobarev was placed in a pre-trial detention center.

Side effects

Various adverse reactions often occur when taking Haloperidol. They are mainly associated with intolerance to the composition or improper use. Side effects include the following:

• Symptoms of a nervous system disorder are as follows: Sleep disorders and headache (observed mainly at the beginning of therapy);
• Anxiety mixed with fear and worry;
• Feelings of euphoria and deep depression;
• State of lethargy (lethargy, slowness);
• Epilepsy;
• Exacerbation of mental disorders and hallucinations.

• Occasionally, disruptions in the functioning of the hematopoietic organs are observed: Leukocytosis;
• Erythropenia;
• Leukopenia;
• Agranulocytosis.

The patient often experiences low or high blood pressure, as well as hair loss and the appearance of extra pounds. Side effects from taking Haloperidol are treated by gradually withdrawing the drug and relieving symptoms.

Dosage forms of the drug

Haloperidol is available in several forms, depending on the manufacturer and composition.

The most popular types are the following drugs: haloperidol-decanoate, haloperidol-Richter in tablets and ampoules, haloperidol-ratiopharm, haloperidol-acri in the form of tablets and solution, haloperidol-forte.

Haloperidol decanoate

Haloperidol decanate is clear, fatty, oily solution It can also be yellow or light green. The drug is placed in dark glass ampoules, which should be stored in contour packs and tightly closed cardboard packages.

The product, in fact, does not consist of pure haloperidol, but of its ester diluted with decanoic acid. The medicine can also relieve chronic pain. The composition contains benzyl alcohol, which has an antiseptic effect, and sesame oil as excipients.

Haloperidol-Richter

Haloperidol-Richter is a German solution for administration , which has the appearance of an almost colorless liquid. A slightly yellowish tint is also acceptable.

Available in clear glass ampoules and placed in packs. In addition to the main substance, haloperidol, auxiliary functions are performed by water and lactic acid, which has an antimicrobial effect.

Haloperidol-Richter is also available in tablet form. They are usually white, completely flat, odorless and have an engraving on one side. The composition includes potato starch, which is used as a drug filler.

Also colloidal silicon dioxide, which is an excellent adsorbent and regenerating agent, magnesium stearate, which acts as an emulsifier, and lactose monohydrate as a food additive.

The amount of haloperidol in tablets from this company may also vary. Both 1.5 milligrams and 5 milligrams. The visual difference will be the lack of labeling on the five milligram tablets.

Haloperidol-ratiopharm

Haloperidol-ratiopharm is drops for internal use . They are contained in bottles with special droppers, and the composition of haloperidol does not exceed two milligrams.

In addition to water, the composition includes methyl parahydroxybenzoate and propyl parahydroxybenzoate, which act as preservatives, and lactic acid.

Haloperidol-acri

Haloperidol-acri is also available in two forms. Both solution and tablets have a similar composition to haloperidol-Richter.

Haloperidol-forte

Haloperidol forte comes in tablet form and includes anhydrous colloidal silicon oxide for regeneration, white gelatin, talc, starch and lactose.

Overdose

When using Haloperidol more than the required amount, overdose symptoms may occur:

• Muscle stiffness (rigidity);
• Low blood pressure (in rare cases high);
• Tremor;
• Coma;
• Breathing problems;
• Drowsiness;
• Shock.

If signs of overdose occur, the patient should know what to do:

• After taking the tablets, rinse your stomach and drink activated charcoal;
• If you have breathing problems, you will need mechanical ventilation (artificial ventilation);
• To stimulate blood circulation, an albumin solution or plasma is administered.

special instructions

When prescribing a course of Haloperidol, the doctor usually advises regular examinations, as you will need to monitor your heart rate, blood composition and liver enzymes. Injections of the drug will have to be done under the strict supervision of a specialist, especially when it comes to children and the elderly.

It is necessary to gradually switch from injections to tablets, and if side effects develop, gradually reduce the dose of the medication to a minimum and stop using it completely.

Separately, the following instructions should be highlighted:

• People involved in heavy physical labor and bath lovers need to take care of themselves. In such situations, a person may suffer heatstroke due to the medication's effect on thermoregulation in the hypothalamus. The same applies to taking cold medications together with Haloperidol;
• Due to the risk of developing photosensitivity, it is recommended to cover the skin from excess exposure to sunlight. It is advisable to discontinue Haloperidol therapy gradually even if side effects occur, since withdrawal syndrome often occurs;
• The drug has a strong antiemetic effect and can mask its toxicity and other pathologies that are characterized by this symptom. Diagnosis becomes extremely difficult;
• A drug with a prolonged effect can be prescribed only after using the regular version of Haloperidol. This must be done to find out whether there is intolerance to the composition of the medication or not;
• The medicine can affect a person’s psychomotor functions, so it is not recommended for people who need concentration and reaction speed at work.

What happens in the body during an overdose of psychotropic substances?

Ethanol and psychotropic substances in combination with Haloperidol can cause serious side effects that addicts mistake for drug intoxication.
Such complications include a feeling of euphoria, psychomotor agitation, involuntary muscle activity, hallucinations, increased libido, prolonged erection, and autonomic disorders. In case of an overdose of butyrophenone, Haloperidol itself can cause the listed side effects. Any psychotropic drug consists of chemical components that can cause the following reactions in the body:

• delay of physiological processes in the body
• inhibition of various reflexes and responses
• CNS inhibition
• suppression of a person’s brain centers and nervous activity, against the background of which he becomes indifferent to the realities happening around him

The formation of indifference and artificial mood against the background of changes in muscle tone can be provoked by incompletely studied processes in the body at the level of higher nervous activity. Moreover, all side effects are explained by the result of chemical processes in the body.

Unfortunately, a true overdose of Haloperidol is not limited to just the reactions listed. Intoxication of the body affects not only a person’s consciousness, but also creates a real threat to his life. Following euphoria, a person may experience respiratory depression, a sharp decrease in blood pressure, and progressive cerebral edema leading to coma. If the antipsychotic was supplemented with ethyl alcohol or other psychotropic substances, the listed symptoms increase rapidly.

Interaction

When prescribing Haloperidol, the following nuances must be taken into account:

• Under the influence of the drug, the metabolism of MAO inhibitors and antidepressants slows down, and their effect, as well as toxicity, is significantly enhanced;
• When combined with Bupropion, the effect of the latter drug noticeably decreases and epilepsy attacks occur more often. The same applies to other anticonvulsants;
• The simultaneous use of Haloperidol and vasoconstrictor medications is not recommended due to the weakening of their effect;
• The drug interferes with medications prescribed for Parkinson's disease and significantly reduces their effectiveness;
• The medication can distort the effect of anticoagulants;
• Exposure to Haloperidol may significantly reduce the effect of Bromocriptine and the dosage will need to be adjusted;
• Combining the drug with Methyldopa is unacceptable, as mental disorders may develop or worsen;
• Amphetamine-based medications reduce the effect of Haloperidol, and it can reduce their psychostimulant effects;
• Antihistamines and anticholenergic medications belonging to the 1st generation stimulate the m-anticholinergic effect of Haloperidol and significantly reduce its antipsychotic effect;
• If you use drugs like Carbamazepine for a long time, the concentration of Haloperidol in the blood will decrease significantly;
• The medicine can improve the effects of medications to lower blood pressure, as well as m-anticholinergic drugs;
• Using the drug with lithium-based medications may cause the development of encephalopathy and aggravation of extrapyramidal symptoms;
• Concomitant use with Fluoxetine is contraindicated, as the chance of side effects increases;
• The drug increases the negative effects of alcohol, opioid analgesics, sleeping pills, antidepressants and anesthesia on the nervous system;
• When prescribing Haloperidol, it is not recommended to constantly drink coffee and strong tea, as the effectiveness of the drug deteriorates.

Banker without dividends

“After assessing the situation [with cigarettes], I thought: who do I want to be here? “I want to be a person who has a lot of cigarettes, I don’t want to humiliate myself, wash the floors for a cigarette,” Lobarev philosophizes. – People fall into credit slavery because their needs are too high. Instead of limiting their needs, they want more now, and he doesn’t think about what will happen later. On the contrary, I understand that if I cut myself now, I can get some surplus, and this surplus can be invested in something.” At first, Pavel pulled out a pack for four days, saved up the initial capital in a month and began lending money to his neighbors - at interest. “There were no conflicts,” says Pavel. “The market was created; it regulated everything with its invisible hand.”

The conflict arose only with the administration, which tried to prohibit usurious activities. During the searches, the staff confiscated Lobarev's accumulated tobacco wealth; he tried to complain to the head doctor, threatening him with the prosecutor's office, but he was invariably explained that the doctor was always right, although there were no negative consequences for him: he never received treatment, and he could not be intimidated with injections. To secure the business, Pavel began saving not cigarettes, but debt obligations, however, most of the debts had to be written off when he was discharged.