How long can you take Afobazol? How long can you drink Afobazol without a break?

"Afobazol": general information

Anti-anxiety drugs are the general name for a group of medications that affect the central nervous system. Based on their origin, they are divided into plant and synthetic.

The ranks of selective anxiolytics have been supplemented by the drug Afobazol. The instructions indicate that there are no side effects characteristic of the group of benzodeazipine tranquilizers in this drug. It has an anti-anxiety, activating effect and has a positive effect on the general condition. By taking the drug, you don’t have to worry about the body’s addiction, memory impairment, or the occurrence of “withdrawal syndrome” after completing the course of treatment.

"Afobazol" is a medicinal (psychotropic) product produced in Russia. The anxiolytic has a number of advantages compared to some antidepressants and benzodiazepine tranquilizers. The scientists who developed the drug claim that there are no negative consequences that usually accompany treatment with sedatives. "Afobazole", the composition of which does not cause an inhibitory, muscle relaxant effect, does not form drug dependence.

Clinical studies of Afobazole have confirmed its effectiveness. Both women and men aged 18 to 60 years with neurotic disorders took part in the trial. The first results of improving the emotional state and reducing anxiety were recorded already 3–10 days after starting to take the drug.

After 6 weeks of therapy, almost all patients experienced partial or complete remission. The product is recognized as absolutely safe for use in any field of medicine. Despite the free sale in pharmacies, before use you should consult a doctor to establish a diagnosis and prescribe a suitable treatment regimen.

Can pregnant women drink?

Afobazole is prescribed to expectant mothers only in extreme cases : if the psycho-emotional state of a pregnant woman is in a state that threatens the normal course of pregnancy and threatens miscarriage or premature birth, then taking the drug in order to normalize her emotional background would be quite appropriate. However, a woman should take it only as prescribed by a doctor and under his supervision.

In the early stages

In the early stages of pregnancy, the formation of the internal organs of the fetus and its life support systems occurs. In addition, at this time the placental barrier is just forming, which makes the embryo practically defenseless: all toxic or chemical substances easily enter the baby’s body through the mother’s blood, increasing the risk of developing congenital pathologies and gene mutations.

Taking any medications by the mother in the 1st trimester is extremely undesirable, and Afobazole is no exception in this case. Despite all the hormonal storms occurring in a woman’s body, the drug should not be taken under any circumstances.

If a woman did not know about pregnancy and was treated with Afobazole, then after the secret became obvious, treatment must be stopped. In case of serious mental health problems, it is advisable for her to ask the doctor to prescribe a herbal medicine consisting of natural ingredients.

In the 2nd trimester

At 4–6 months of pregnancy, taking the drug is acceptable . But a doctor can prescribe it only if the benefits to the mother’s health outweigh the potential risk to the fetus. In addition, by the fourth month, the baby is already reliably protected in the womb by the formed placenta, so the risk of harmful substances reaching the fetus directly is reduced.

In the 3rd trimester

It has been clinically proven that the drug does not affect muscle tone, that is, taking Afobazole cannot provoke premature birth. However, again, this drug should be taken only in extreme cases, since the effect (or lack thereof) on the embryo has not been established in the laboratory.

How does the drug work?

The selective axolytic in the composition of the product allows you to prevent changes in membrane-dependent receptors. This, in turn, helps reduce the level of irritability, discomfort, anxiety, and fear. Thanks to the drug, sleep is normalized, a surge of vital energy appears, and physical condition is restored.

Symptoms of somatic disorders associated with the respiratory, cardiovascular, sensory, and digestive systems eventually cease to appear and bother the patient. The result of therapy should be assessed in the 4th week of treatment, when the maximum effect of the drug "Afobazol" is achieved. Reviews from doctors indicate stabilization of blood pressure levels (stress often causes hypertension) after taking the drug. Symptoms of autonomic disorder (increased heart rate, tremors, shortness of breath, chest pain) are also reduced.

The effect of the drug lasts for 2 weeks after the end of administration. The patient ceases to feel constant fear and concern. Attacks of muscle twitching and dizziness are blocked, and attention is improved. Compared to benzodiazepines, the therapeutic effect is less pronounced.

Features of the drug use

After stress or excessive emotional stress, nerve cells, also called neurons, become depleted. Receptors respond less well to signals sent by the body. This condition leads to the appearance of such unpleasant symptoms as increased anxiety, irritability, restlessness, delayed reactions, increased fatigue, and poor sleep.

Afobazole restores nerve cells, restoring their functionality, and protects them from the negative effects of stress in the future. Systematic use of the drug will relieve:

• excessive anxiety;
• drowsiness or, conversely, insomnia;
• increased nervousness;
• irritability;
• dizziness and other manifestations of stress.

The effect of therapy occurs already by the fifth day from the start of taking the drug.

When is Afobazol prescribed?

The use of a sedative is especially important for people suffering from a constant feeling of uncertainty, suspiciousness, and violent emotional manifestations in response to negative life situations. As part of complex therapy, it is prescribed to patients with bronchial asthma, hypertension, chronic insomnia, and oncological pathologies.

Taking Afobazole is mandatory for the following problems:

• neurasthenia and neuroses;
• systemic lupus erythematosus (autoimmune disease);
• cardiac ischemia;
• dermatological diseases (psoriasis, eczema, lichen);
• coding for alcohol addiction and smoking;
• premenstrual syndrome;
• irritable bowel syndrome;
• oncological pathologies;
• anxiety;
• cardiopsychoneurosis.

The drug can be used during periods of increased anxiety, for example before taking exams or when changing jobs. For each patient, an individual treatment regimen and dosage of the drug “Afobazol” are prescribed. Analogues of the drug contain other active ingredients, but have the most similar therapeutic effect. Only a specialist can select the optimal drug for therapy after first examining the patient.

How to take Afobazol?

The instructions for the medication are an important document that every patient should read before starting to use the drug. According to the annotation, the tablets are taken after meals. The optimal single dose is 10 mg. If necessary, the attending physician can adjust this value. Depending on the diagnosis, it varies both less and more. Drink a sedative 3 times a day at approximately the same interval of time. The maximum duration of use is 3 months, after which you need to take a break.

For a short course of treatment, you can purchase the drug in a cardboard package of 10 or 20 tablets. It is also available in cans of 50 and 100. This volume is best used if long-term therapy with Afobazol is necessary. The price starts from 280 rubles. and depends on the dosage of the active substance.

The results of using the product appear at different times. In some patients, an improvement in their emotional state is observed already on the third day of treatment, in others - a little later. The drug is well absorbed from the intestinal walls and is quickly eliminated from the body.

pharmachologic effect

The active substance of the drug is a derivative of 2-mercaptobenzimidazole, a selective anxiolytic that is not a benzodiazepine receptor antagonist. This means that the drug does not act on benzodiazepine receptors in the brain.

The drug prevents the development of membrane-dependent changes in the GABA receptor. It has an anxiolytic and mild activating effect, while eliminating the development of a hypnosedative effect. In addition, there are no negative effects such as a depressing effect on attention, memory, or muscle relaxation. After discontinuation of Afobazole, there is no drug dependence and no withdrawal syndrome, characteristic of many tranquilizers, is formed.

The therapeutic effect is realized as a combination of two effects: anti-anxiety and mild stimulating effects. Approximately on the 5-7th day of continuous treatment the following are noted:

• reducing the severity of anxiety, which manifests itself as concern, apprehension, bad feelings, irritability;
• elimination of tension, namely, getting rid of timidity, anxiety, insomnia, fear, tearfulness;
• relief from somatic (muscular, cardiovascular, respiratory, sensory, gastrointestinal symptoms), autonomic (sweating, chills, dry mouth, dizziness) and cognitive (weakened memory, difficulties in perceiving information) disorders.

The drug eliminates anxiety well and improves mood, but does not inhibit the activity of the central nervous system (there is no lethargy, drowsiness, lethargy).

The maximum effect is realized after 4 weeks of treatment. The effect continues for 1-2 weeks after finishing taking Afobazole.

Pharmacokinetics

The instructions for use of Afobazole indicate that the drug is non-toxic. It is quickly and well absorbed from the gastrointestinal tract and enters the bloodstream.

Cmax - 0.13±0.073 μg/ml. On average, it lingers in the body for 1.6-0.88 hours and is most actively distributed among organs with good blood supply. The half-life is 0.82 hours (excreted in feces and urine).

"Afobazol": contraindications

Despite the relative safety and non-toxicity of the components, the drug is still prohibited to be taken during pregnancy and lactation. Children under 18 years of age should not take it without a doctor's prescription. Persons who have an individual intolerance to the substances contained in it should avoid using the drug.

Some patients note the appearance of drowsiness after taking the sedative Afobazol. Reviews from doctors confirm the appearance of such symptoms only in the case of an independent increase in the recommended daily dose. If you follow the specialist's instructions, the drug helps improve concentration. Therefore, it is approved for use when it is necessary to control mechanisms.

Side effects

The development of an allergic reaction is possible if the body is intolerant to lactose, which is part of the drug "Afobazol". Overdose is rare and manifests itself in the form of significant sedation. Due to the fact that the drug is quickly eliminated from the body, this condition usually goes away on its own. Sometimes caffeine (sodium benzoate) may need to be given subcutaneously.

At the beginning of therapy, an undesirable reaction to Afobazole may occur. Side effects such as nausea and vomiting disappear after discontinuation of the drug. If symptoms persist, you should seek medical help.

Is the drug compatible with alcohol?

This question interests almost everyone who takes a sedative. The light tranquilizer Afobazol and alcohol are quite compatible. The components of the drug do not enhance the narcotic effect of ethanol, but rather, on the contrary, suppress it. Therefore, you may not feel intoxicated from a small amount of high-proof drinks. In turn, alcohol does not have the best effect on the healing process and will reduce its effectiveness.

It is not advisable to take the anxiolytic Afobazol and alcohol at the same time. The drug is often used in the treatment of withdrawal symptoms, when it is difficult for the patient to tolerate quitting alcohol or nicotine. This remedy makes it easier to endure this period. It also helps relieve hangover syndrome by “launching” the work of the central nervous system.

What to replace it with?

Today, pharmaceutical companies offer a wide selection of sedative drugs of both natural and synthetic origin. If necessary, you can choose a substitute for the drug “Afobazol”. Analogues will have other active ingredients in their composition, but the therapeutic effect will be identical. Medications that can relieve anxiety and confusion syndromes include:

• "Diazepam";
• "Adaptol"
• "Phenazepam";
• "Elinium";
• "Amizil";
• "Atarax";
• "Tenoten";
• "Persen";
• "Mebix";
• "Phenibut";
• "Tranquesipam";
• "Neurofazol" (synonym for the drug "Afobazol").

Substitutes have a similar therapeutic effect, but they cannot be compared with the original remedy. The optimal remedy should be selected by the attending physician, taking into account the patient’s diagnosis and the presence of individual intolerance to the components. It is quite difficult to cope with the manifestation of neurosis on your own, because drugs can only remove the symptoms of the disease, but not solve the cause of the problem.

What do patients and doctors say?

Various life circumstances always hit the nerves and provoke panic attacks, depression, and fear of the future. Not everyone can cope with depression and hysterics. For help in such situations, you should contact a neurologist. Many specialists prefer to prescribe the “mild” tranquilizer “Afobazol” to their patients. The drug received mostly positive reviews from doctors, although some consider this to be a placebo effect, despite the huge number of people for whom the anxiolytic returned good health and a stable emotional state. Patients suffering from a constant feeling of anxiety and prone to worry say that the remedy really helps and suppresses unpleasant symptoms if the case is not advanced.

Most patients who have used the drug note a rapid therapeutic effect literally from the first day of use. Panic attacks, which are often accompanied by tachycardia and spasms in the chest and throat, stop. A calm state allows you to correctly assess the situation and find ways to resolve problems.

Negative reviews are quite rare and are mainly associated with side effects. Some patients did not feel any changes in their psychological state for the better after taking Afobazol. An overdose of an anxiolytic is practically excluded if you fully comply with the neurologist’s instructions and do not exceed the dosage.

Folk remedies and methods of prevention

• Doctors say that nervous tension in a pregnant woman may be due to a lack of B vitamins in her body. Therefore, before taking pills, you can try to get rid of anxiety and nervous swings by increasing the amount of foods containing them in your diet: liver, cheese, peas, eggs, walnuts, peanuts, potatoes, green vegetables and brown rice.
• Good results are obtained by taking infusions and herbal teas, the components of which are plants such as lemon balm, mint, chamomile, linden blossom, hawthorn, and motherwort. But they should be taken regularly and only after consultation with your doctor.
• Essential oils can also create a calming state for the expectant mother. Sandalwood, lavender, mint, pine needles - these are the oils that can undoubtedly be placed in an aroma lamp.
• Moderate physical activity can cope with attacks of apathy, depression, and nervous tension: walks in the fresh air, light exercise. Yoga classes have an undoubted positive effect on stabilizing the mental health of the mother.

Despite the fact that Afobazol is a fairly effective drug, it is still not worth purposefully resorting to its services during the period of bearing a child. If you have mental health problems, you must first try all possible safe remedies and only then, after the doctor’s permission, resort to his help. Under no circumstances should you take the drug on your own initiative.

Should I take Persen instead of Afobazole?

"Persen" is a plant-based sedative. It contains mint leaves, lemon balm, and medicinal valerian root extract. Natural origin has a positive effect on symptoms of anxiety, irritability, and promotes normal sleep without attacks of daytime sleepiness. When choosing “Afobazol” or “Persen” for treatment, it should be taken into account that the effect of the first is milder compared to a synthetic anxiolytic.

A plant-based sedative can be used in pediatrics under the strict supervision of a physician. "Persen" improves attention, calms and helps cope with insomnia. Can be prescribed in complex therapy for vegetative-vascular dystonia, withdrawal syndrome of potent medications. As a preventative measure, it is recommended during periods of constant stressful situations.

A specialist must choose between two sedatives. In milder cases, it is sometimes sufficient to take a herbal sedative. If the situation requires “serious” medications, the patient is prescribed Afobazol. Contraindications to the use of “Persen” are high blood pressure, pregnancy, children under 3 years of age and individual intolerance to the components.

Pregnancy VS Afobazole

During a wonderful period of pregnancy, many medications are contraindicated for a woman. This is due to the fact that their composition can adversely affect the child. Therefore, even under severe stress, a pregnant woman should think a hundred times before taking this or that drug.

Is Afobazole included in the list of prohibited substances? Alas, yes. Although experimental studies on animals have shown that it does not have harmful effects on the fetus. However, what happens to people is not yet fully understood.

It is known that feelings of anxiety and worry are typical for expectant mothers. Hormonal changes in the body do not pass without leaving a trace.

But it is precisely in the first trimester in the early stages that a woman should under no circumstances take strong medications, including Afobazole during pregnancy. After all, during this period the baby’s organs are formed and developed. It’s the same with nursing mothers. They are also prohibited from taking this medicine during lactation.

In the last stages, you should also not use the drug. It is rare, but it does happen that a doctor may prescribe this drug in the second trimester. But these are isolated cases. Most doctors will not take the responsibility of prescribing this medicine to a pregnant woman. It is better to consult your doctor.

"Afobazol" or "Adaptol"?

The sedative "Adaptol" belongs to the group of anxiolytics and has the same therapeutic effect as "Afobazol". Use is indicated for neuroses, emotional instability, stress of various etiologies. Helps reduce cravings for nicotine and improves tolerability of antipsychotics.

Clinical trials have confirmed the positive effect of the drug on mental activity. "Adaptol" also improves reaction speed when controlling various mechanisms and does not cause drowsiness during the day. The active ingredient of the drug is mebicar (one capsule contains 300 mg). Does not cause dependence or addiction.

The product is prohibited for use by children under 10 years of age, pregnant and lactating women. Side effects (dizziness, weakness) develop only when the recommended dose of Adaptol is significantly exceeded.

Many patients who first took Afobazol and then Adaptol noted that the sedative effect of the latter was weaker. Afobazole really has a pronounced anti-anxiety effect. He is able to cope with the symptoms of a panic attack, overcome feelings of fear and eliminate autonomic disorders (dry mouth, sudden dizziness). It makes sense to take the Latvian analogue only in mild cases, with minor neurological disorders.

Afobazole in therapeutic practice

Solovyova I.K.

In the practice of a therapist, one often has to deal with disorders that are not amenable to the usual, usual for a therapist, treatment - psychosomatic diseases: psychosomatic diseases (Greek psyche - soul, consciousness, so-matos body) - psychogenically or predominantly psychogenically caused dysfunctions of internal organs or physiological systems (circulation, respiration, digestion, urination, etc.). Another definition of this difficult concept. Psychosomatic disorders (PD) are painful conditions manifested by exacerbation of somatic pathology, the formation of general symptom complexes arising from the interaction of somatic and mental factors - somatized mental disorders, mental disorders reflecting the body's response to a somatic disease.

A patient often presents with cardiological and other seemingly therapeutic pathologies, but it turns out that the cause is psychosomatics.

In modern medicine, psychosomatic disorders are the subject of research into the role of stress in the pathogenesis of somatic diseases; connections between a person’s character and behavior and sensitivity or resistance to the development of certain somatic diseases; reactions to illness (“behavior” in illness) depending on the type of personality; the effect of certain treatment methods on the mental state. The frequency of detection of psychosomatic disorders is quite high and ranges from 30–57% [Smulevich A.B., 2000].

Etiology

Emotional stress occupies a central place in the clinical concept of psychosomatic disorders. The functions of emotions ultimately come down to modification (usually increasing) the body’s energy resources, the formation of a tendency to maintain (increase) or, conversely, eliminate (decrease) contact with a factor that has one or another effect on the individual (this determines the positive or negative sign of emotion), and the organization of specific forms of behavior corresponding to the quantitative characteristics of the influencing factor.

In addition to subjective experiences (internal restlessness, anxiety, depression, fear, etc.), any emotional arousal inevitably contains two components: nonspecific, the clinical manifestation of which is a vegetative reaction, and specific - the individual’s corresponding interpretation of his well-being and the current situation in in general. The combination of a specific experience, a vegetative reaction and the subsequent individual assessment of all occurring phenomena forms the characteristics of an individual’s behavior. This relationship was developed in the process of evolution and is aimed at preparing the body to actively counteract danger. The detection of vegetative symptoms does not necessarily indicate the presence of any organic changes in the internal organs or the central nervous system. The physiological reflection of negative emotions is an increase in blood pressure and increased respiration, a change in the tone of the bladder or the activity of the digestive tract, tension in the skeletal muscles and an increase in blood coagulation activity, which phylogenetically protects against excessive blood loss in case of injury, and other reactions. By the severity of autonomic dysfunction, one can indirectly judge the degree of emotional tension (especially in situations where the patient categorically denies the presence of fear, anxiety or depression). The more intense or prolonged the impact of negative emotions, the more significant and persistent the vegetative disorders, the more grounds for their chronicity and morphological tissue damage.

Types of psychosomatic disorders in therapist practice

Disorders that are classified as psychosomatic include not only psychosomatic diseases in the traditional sense of the term, but also a much wider range of disorders: somatization disorders, pathological psychogenic reactions to a somatic disease. This series also includes mental disorders, often complicated by somatic pathology (anorexia nervosa, bulimia, alcoholism, etc.), disorders that arise as a result of certain types of treatment, for example, depression and memory disorders that develop after coronary artery bypass surgery [Zaitsev V.P. et al., 1990; Skachkova N.I., 1996; Prokhorova S.V., 1996], affective anxiety and asthenic states in patients on hemodialysis [Korkina M.V., Marilov V.V., 1995]. In a number of studies [Smulevich A.B., 2000; Tuk B. et al., 1997] within the framework of psychosomatic disorders, conditions such as premenstrual syndrome and premenstrual dysphoric disorder are considered; depression during pregnancy and postpartum depression, including the “sadness of women in labor” syndrome; involutional hysteria, etc. Psychosomatic disorders also include somatogenic (symptomatic) psychoses - delirium, amentia, hallucinosis, etc.

And since such patients often see a general practitioner, first of all it is the general practitioner who needs to provide the patient with medication correction. Often a more serious pathology, say, cardiological, is also hidden under the guise of a psychosomatic disorder. Cardioneurosis, coronary artery disease, arterial hypertension, even peptic ulcer disease and bronchial asthma of the patient with an adequate impact on the main etiological factor of the disease - the mental sphere.

For P.r. the most typical manifestations of autonomic dysfunction are: local or general hyperhidrosis; periodic chills and contractions of the hair muscles (a symptom of goose bumps) at normal body temperature or even hypothermia; symptom of a wound spring (shuddering, palpitations, cold sweat with an unexpected call, ringing, knocking, clap of thunder); signs of hyperthyroidism in the absence of organic thyroid disease: various vasomotor disorders, sometimes imitating Raynaud's syndrome; so-called hot flashes during menopause; vascular dystonia, occurring predominantly as labile arterial hypertension. Significant diagnostic difficulties arise when there is incoordination of smooth muscle contractions due to autonomic dysfunction. In these situations, it is possible to develop partial bronchospasm, psychogenic dysuria, or the most common functional disorders of the tone and motility of the digestive organs in medical practice: duodenogastric or duodenogastroesophageal reflux, biliary dyskinesia, cardiospasm, irritable stomach or irritable colon syndromes.

The occurrence of dissynchronization of biological rhythms is characteristic. This is manifested primarily by daily and seasonal fluctuations in mood and well-being, alternating periods of asthenia and preserved performance (such as periodic fatigue, “laziness,” apathy). Within the framework of this phenomenon, disturbances in the rhythm of sleep and wakefulness should also be considered (including shortening of night sleep, dyssomnia with irresistible daytime sleepiness, insomnia); psychogenic heart rhythm disorders (most often in the form of extrasystole and sinus tachycardia); paroxysms of functional dysrhythmia of breathing (psychogenic dyspnea); functional non-inflammatory disorders of thermoregulation with hypothermia in the morning and persistent low-grade fever in the afternoon (“thermometer fever”), functional disorders of ovulation, causing relative, psychosomatic infertility, and other pathological changes in individual biological rhythms.

Psychosomatic disorders are formed, as a rule, against the background of asthenic syndrome with complaints of fatigue, lethargy, malaise, decreased physical and mental performance, irritable weakness, followed by emotional indifference; migraine-like or constant dull headache and occasional dizziness are possible. The feeling of extreme fatigue, weakness (even exhaustion) can be localized only in the limbs, back, head, lumbar or precordial region and does not go away after rest and a night's sleep.

In a targeted analysis of the patients’ condition, mood disorders such as dysphoria, subdepressive or depressive syndrome, hypochondriacal concerns and fears are identified, reaching in some cases the degree of cancerophobia, cardiophobia, syphilophobia, etc.

Emotional disorders and autonomic dysfunction against the background of asthenia and desynchronization of biological rhythms cause pathologically increased sensitivity with a painful affective connotation, when the most insignificant, nonspecific and usually not perceived intero- and exteroceptive stimuli acquire the character of extremely intense or even extreme. General mental hyperesthesia with obvious or erased, masked depression gives rise to a clinical discrepancy between the abundance of unpleasant sensations and the paucity (or absence) of objective changes. The object of hypochondriacal fixation in patients may be hyperesthesia of the sensory organs with a complaint of intolerance to bright light, sharp sounds, all kinds of foods or various odors. Visual hyperesthesia is often combined with dizziness and hemicrania, auditory hyperesthesia with sleep disturbances, gustatory hyperesthesia with glossodynia and stomatalgia, olfactory hyperesthesia with psychogenic shortness of breath and so-called hydrorhea, simulating vasomotor rhinitis or hay fever. Hyperosmia can also manifest itself as an aversion to previously indifferent or even pleasant aromas (tobacco, incense, etc.) along with an addiction to odors (for example, gasoline or oil paint), which normally do not evoke positive emotions.

Cutaneous hyperesthesia with extremely heightened sensitivity to any touch, line irritation or injection, thermal and meteorological influences is especially common. At the clinic P.r. In addition, there is skin hyperesthesia with a decrease in pain and tactile (less often temperature) sensitivity, as well as a combination of local hyperesthesia of some areas of the skin with relative or even complete anesthesia of others. The central nature of these disorders is most pronounced with anasthesia doloresa - a feeling of severe pain in areas of the skin that have lost sensitivity to external irritations. The most typical sign of skin hyperesthesia is diffuse or local (mainly of the scalp, armpits or anogenital area) thymogenic skin itching with the formation of excoriations and trophic changes up to lichenification. Itching acts as a constant component of pseudoallergic reactions, occurring in the form of generalized erythema, skin rashes (urticarial, papular, bullous, sometimes petechial) and Quincke's edema.

The phenomena of mental hyperesthesia are often combined with algic syndromes, which makes it necessary to carefully distinguish between P.r. and organic diseases of internal organs and the nervous system. Most often it is necessary to differentiate cardialgia with coronary heart disease, arthralgia and myalgia with diffuse connective tissue diseases, gastralgia with gastric or duodenal ulcer, pseudoradicular syndrome with discogenic radiculopathy, atypical trigeminal syndrome with an acute attack of glaucoma, disease of the teeth or paranasal sinuses, migraine neuralgia, etc.

Algic syndromes may be associated with incoordination of smooth muscle contractions due to autonomic dysfunction. In some cases, they arise in connection with a heightened perception of painful sensations against the background of somatogenic or psychogenic asthenia and general mental hyperesthesia (usually during the recovery period after a variety of pathological processes or injuries). Of no less important practical importance is the reproduction, in the cliché type, of previous complaints, as if borrowed by an emotionally unstable patient from the symptoms of a pathological process that was once suffered; a certain affect is transformed in such situations into a painful somatic sensation, similar to that experienced in the past, but more painful in terms of the intensity of the subjective experience of pain. The pinnacle of algic states against the background of general mental hyperesthesia becomes synesthesialgia, when not only painful and thermal, but also visual, auditory, tactile and even taste irritations are accompanied by a feeling of oppressive pain. At the same time, there are very unique and painful conditions that are, in fact, on the verge of actual pain and feelings of physical and mental suffering, and occur in the form of restless legs syndrome or some types of professional autonomic polyneuralgia.

Treatment

Long-term pharmacotherapy is recommended as the most justified strategy for treating psychosomatic disorders in patients. Among the drugs of first choice in psychosomatic situations, anxiolytics are increasingly used.

Anxiolytics of the benzodiazepine structure (BDZ) are currently widely used to treat such conditions. One of the distinctive properties of this class of drugs is the rapid development of the therapeutic effect. However, the downside of this phenomenon is the high risk of abuse. And this is a big problem. In this regard, the most common BDZs are limited in terms of use of 2–4 weeks, which is undoubtedly not enough for effective therapy. This means that the choice should fall on drugs that do not have this negative component of treatment. As data accumulated on the addictive properties of BDZ, as well as on other adverse events accompanying treatment with them, this group of drugs turned out to be largely discredited. By the mid-80s of the 20th century, attempts to synthesize new drugs from this group had virtually ceased. Let us recall that in our country the last BDZ registered was alprazolam in 1986. At the same time, doctors, for lack of anything better, continued to use benzodiazepine drugs, increasing the course of therapy to 12 months.

A fundamentally new approach to the development of an anxiolytic drug is the creation of the domestic drug Afobazol. Afobazole's chemical structure is a mercaptobenzimidazole derivative and is not a benzodiazepine receptor agonist. The action of the drug is based on the inhibition of membrane-dependent changes in the GABA receptor, and therefore its availability for the corresponding ligand is reduced.

Afobazole is a short-lived drug, the half-life of which is 0.82±0.54 hours, the time to reach maximum concentration is 0.85±0.13 hours, and the retention of the drug in the body is on average 1.6±0.86 hours. Preclinical studies of Afobazole on animals have proven its anxiolytic effect and the absence of a sedative effect. The drug does not have muscle relaxant properties or a negative effect on memory and attention. With its use, drug dependence does not form and withdrawal syndrome does not develop. The effect of the drug is realized primarily as a combination of anxiolytic (anti-anxiety) and mild stimulating (activating) effect. Afobazole, when prescribed to patients with psychosomatic disorders, reduces or eliminates anxiety (preoccupation, apprehension, apprehension, irritability), tension (fearfulness, tearfulness, anxiety, inability to relax, insomnia, fear), and therefore somatic (muscular, sensory, cardiac -vascular, respiratory, gastrointestinal symptoms), autonomic (dry mouth, sweating, dizziness), cognitive (difficulty concentrating, weakened memory) disorders, which is observed on days 5-7 of treatment with Afobazole. The maximum effect is achieved by the end of 4 weeks of treatment and persists in the post-therapeutic period (on average 1–2 weeks). The use of the drug is especially indicated in patients with predominantly asthenic personality traits in the form of anxious suspiciousness, uncertainty, increased vulnerability and emotional lability, and a tendency to emotional stress reactions.

Clinical researches

Afobazole

In the Department of Borderline Psychiatry of the State Scientific Center for Social and Forensic Psychiatry named after. V.P. Serbsky, on the basis of the clinical department of PKB-12 in Moscow, a study was conducted on Afobazole, which gave very good results. The study included hospitalized and outpatient patients aged 18 to 60 years with a main diagnosis of generalized anxiety disorder, which also included cardiac complaints of patients (according to DSM-IV-TR) with a Hamilton Anxiety Scale score of at least 20, which gave informed consent to participate in the study.

The exclusion criteria were: the complex structure of the anxiety syndrome, including phobic, hypochondriacal and depersonalization disorders; anxiety disorders within diseases of endogenous and organic nature; history of epilepsy and convulsive conditions; alcoholism and substance abuse; schizophrenia; current somatic and neurological diseases in the acute stage, requiring drug therapy; severe night sleep disturbances requiring drug correction; pregnancy; breastfeeding period; individual intolerance to the drug; reduction of anxiety on the Hamilton scale when taking placebo by more than 30%. The duration of patient participation in the study was 66 days. The stages of the study included: screening with mandatory discontinuation of previous therapy - 7 days; use of placebo for 7 days; use of Afobazol or diazepam – 42 days; study of the development of withdrawal syndrome – 10 days. In the latter case, a return to taking the drug was envisaged with a gradual reduction in its dose.

At the end of the placebo period, patients were prescribed: in the main group - Afobazole in a daily dose of 30 mg, divided into three doses; in the comparison group - diazepam in a daily dose of 30 mg, divided into three doses.

Afobazole and diazepam were used as monotherapy. If night sleep disturbances occurred or worsened, short-term (several days) prescription of hypnotics (zopiclone up to 7.5 mg per day or zolpidem up to 5 mg per day) was prescribed. For the treatment of somatic diseases, drugs that do not have psychotropic activity were used.

A comparative study of Afobazole with the standard anxiolytic diazepam, often used in psychoacardiology, revealed pronounced anxiolytic activity of the drug under study in relation to generalized anxiety. The peculiarities of Afobazole's action are the gradual development of an anxiolytic effect with a predominant effect on the cognitive component of anxiety, good tolerability, and the absence of withdrawal syndrome when abruptly stopping the drug. The emergence of a new anxiolytic with such a spectrum of psychopharmacological activity favorable for clinical practice indicates the prospects for its use for generalized anxiety in a wide outpatient practice (including neurological, cardiological and general somatic), in geriatric patients, and in people in stressful situations.

conclusions

Thus, high efficiency, an acceptable efficacy/safety ratio, absence or low incidence of serious adverse reactions, good tolerability - all this determines the widespread use of Afobazole in psychosomatic conditions and opens up new opportunities for the general practitioner in the management of patients with a clear predominance of mental dominants over somatic ones. .

Is it possible to replace Afobazol with Phenibut?

The drug "Phenibut" refers to nootropic medications derived from gamma-aminobutyric acid. Able to cope with tension, worry, anxiety. Promotes the activation of mental abilities and helps to concentrate. This occurs due to improved blood supply to brain tissue. The product is non-toxic and completely safe. It is eliminated from the body within 3 hours after administration. Despite some positive aspects of the drug, it is less well tolerated by patients and often causes undesirable consequences and addiction to the system, unlike Afobazole.

Experts do not recommend using a nootropic drug for more than 6 weeks, so as not to cause addiction. The medicine has a stronger anti-anxiety effect (according to patient reviews) than Afobazol.

Price is of no small importance when choosing a drug, and Phenibut can easily be called an affordable medicine compared to the latest generation anxiolytic (cost is about 120 rubles). It is worth considering that during treatment with this sedative, it is prohibited to drink alcoholic beverages. Phenibut and ethanol have the same effect and inhibit the functioning of the central nervous system. Quite often, the drugs Afobazol and Phenibut are prescribed for the treatment of chronic alcoholism, when the patient suffers from memory impairment, loses interest in life, and experiences withdrawal symptoms.

Compared to Afobazol, the contraindications to the use of Phenibut are somewhat expanded. The drug, according to the instructions, is taken with caution for peptic ulcers and liver pathologies. Under strict medical supervision, a sedative is used in the treatment of children under 8 years of age. During pregnancy, the manufacturer advises against using the product, since there is no data on such studies. If there are symptoms of an overdose (drowsiness, vomiting, low blood pressure), it is necessary to urgently rinse the stomach.