History of psychiatry. History of psychiatry. Disorders of sensations Disorders of sensations

and perception.and perception.

Lyudmyla T. SnovydaLyudmyla T. Snovyda

"A psychiatrist is a fellow who asks you a "A psychiatrist is a fellow who asks you a lot of expensive questions your wife asks lot of expensive questions your wife asks

for nothing" - Joey Adamsfor nothing" - Joey Adams

Psychiatry -Psychiatry - The term psychiatry, coined by Johann Christian Reil in 1808, The term psychiatry, coined by Johann Christian Reil in 1808,

comes from the Greek “psyche” (soul or mind) and “iatros" comes from the Greek “psyche” (soul or mind) and “iatros" (healer or doctor)(healer or doctor)

Psychiatry is a medical specialty which exists to study, Psychiatry is a medical specialty which exists to study, prevent, and treat mental disorders in humans. Psychiatric prevent, and treat mental disorders in humans. Psychiatric assessment typically involves a mental status examination assessment typically involves a mental status examination and taking a case history, and psychological tests may be and taking a case history, and psychological tests may be administered. Physical examinations may be conducted and administered. Physical examinations may be conducted and occasionally neuroimages or other neurophysiological occasionally neuroimages or other neurophysiological measurements taken. Diagnostic procedures vary but official measurements taken. Diagnostic procedures vary but official criteria are listed in manuals, the most common being the criteria are listed in manuals, the most common being the ICD from the World Health Organization and the DSM from ICD from the World Health Organization and the DSM from the American Psychiatric Association.the American Psychiatric Association.

Connection with other Connection with other specialities -specialities -

Those who practice psychiatry are different than most Those who practice psychiatry are different than most other mental health professionals and physicians in that other mental health professionals and physicians in that they must be familiar with both the social and biological they must be familiar with both the social and biological sciences. The discipline is interested in the operations of sciences. The discipline is interested in the operations of different organs and body systems as classified by the different organs and body systems as classified by the patient's subjective experiences and the objective patient's subjective experiences and the objective physiology of the patient. While the focus of psychiatry physiology of the patient. While the focus of psychiatry has changed little throughout time, the diagnostic and has changed little throughout time, the diagnostic and treatment processes have evolved dramatically and treatment processes have evolved dramatically and continue to do so. Since the late 20th century, the field of continue to do so. Since the late 20th century, the field of psychiatry has continued to become more biological and psychiatry has continued to become more biological and less conceptually isolated from the field of medicine.less conceptually isolated from the field of medicine.

Connection with other Connection with other specialities -specialities -

While the medical specialty of psychiatry utilizes While the medical specialty of psychiatry utilizes research in the field of neuroscience, psychology, research in the field of neuroscience, psychology, medicine, biology, biochemistry, and pharmacology, medicine, biology, biochemistry, and pharmacology, it has generally been considered a middle ground it has generally been considered a middle ground between neurology and psychology. Unlike other between neurology and psychology. Unlike other physicians and neurologists, psychiatrists specialize physicians and neurologists, psychiatrists specialize in the doctor-patient relationship and are trained in in the doctor-patient relationship and are trained in the use of psychotherapy and other therepautic the use of psychotherapy and other therepautic communication techniques. Psychiatrists can communication techniques. Psychiatrists can therefore prescribe medication, order laboratory therefore prescribe medication, order laboratory tests, utilize neuroimaging in a clinical setting, and tests, utilize neuroimaging in a clinical setting, and conduct physical examinations.conduct physical examinations.

Ancient timesAncient times

Starting in the 5th century BC, mental disorders, Starting in the 5th century BC, mental disorders, especially those with psychotic traits, were considered especially those with psychotic traits, were considered supernatural in origin. This view existed throughout supernatural in origin. This view existed throughout ancient Greece and Rome. Early manuals written about ancient Greece and Rome. Early manuals written about mental disorders were created by the Greeks. In 4th mental disorders were created by the Greeks. In 4th century BC, Hippocrates theorized that physiological century BC, Hippocrates theorized that physiological abnormalities may be the root of mental disorders. abnormalities may be the root of mental disorders. Religious leaders and others returned to using early Religious leaders and others returned to using early versions of exorcisms to treat mental disorders which versions of exorcisms to treat mental disorders which often utilized cruel, harsh, and other barbarous methods.often utilized cruel, harsh, and other barbarous methods.

Ancient timesAncient times

Middle AgesMiddle Ages The first psychiatric hospitals were built in the medieval Islamic The first psychiatric hospitals were built in the medieval Islamic

world from the 8th century. The first was built in Baghdad in 705, world from the 8th century. The first was built in Baghdad in 705, followed by Fes in the early 8th century, and Cairo in 800. Unlike followed by Fes in the early 8th century, and Cairo in 800. Unlike medieval Christian physicians who relied on demonological medieval Christian physicians who relied on demonological explanations for mental illness, medieval Muslim physicians relied explanations for mental illness, medieval Muslim physicians relied mostly on clinical observations. They made significant advances to mostly on clinical observations. They made significant advances to psychiatry and were the first to provide psychotherapy and moral psychiatry and were the first to provide psychotherapy and moral treatment for mentally ill patients, in addition to other forms of treatment for mentally ill patients, in addition to other forms of treatment such as baths, drug medication, music therapy and treatment such as baths, drug medication, music therapy and occupational therapy. In the 10th century, the Persian physician occupational therapy. In the 10th century, the Persian physician Muhammad ibn Zakariya Razi (Rhazes) combined psychological Muhammad ibn Zakariya Razi (Rhazes) combined psychological methods and physiological explanations to provide treatment to methods and physiological explanations to provide treatment to mentally ill patients. His contemporary, the Arab physician Najab mentally ill patients. His contemporary, the Arab physician Najab ud-din Muhammad, first described a number of mental illnesses ud-din Muhammad, first described a number of mental illnesses such as agitated depression, neurosis, and sexual impotence such as agitated depression, neurosis, and sexual impotence (Nafkhae Malikholia), psychosis (Kutrib), and mania (Dual-Kulb).(Nafkhae Malikholia), psychosis (Kutrib), and mania (Dual-Kulb).

Middle AgesMiddle Ages In the 11th century, another Persian physician Avicenna In the 11th century, another Persian physician Avicenna

recognized 'physiological psychology' in the treatment of recognized 'physiological psychology' in the treatment of illnesses involving emotions, and developed a system for illnesses involving emotions, and developed a system for associating changes in the pulse rate with inner feelings, associating changes in the pulse rate with inner feelings, which is seen as a precursor to the word association test which is seen as a precursor to the word association test developed by Carl Jung in the 19th century.Avicenna was developed by Carl Jung in the 19th century.Avicenna was also an early pioneer of neuropsychiatry, and first also an early pioneer of neuropsychiatry, and first described a number of neuropsychiatric conditions such as described a number of neuropsychiatric conditions such as

hallucination, hallucination, insomnia, mania, nightmare, melancholia, insomnia, mania, nightmare, melancholia, dementia, epilepsy, paralysis, stroke, dementia, epilepsy, paralysis, stroke, vertigo and tremor.vertigo and tremor.

Middle AgesMiddle Ages Psychiatric hospitals were built in medieval Europe from Psychiatric hospitals were built in medieval Europe from

the 13th century to treat mental disorders but were the 13th century to treat mental disorders but were utilized only as custodial institutions and did not provide utilized only as custodial institutions and did not provide any type of treatment.Founded in the 13th century, any type of treatment.Founded in the 13th century, Bethlem Royal Hospital in London is one of the oldest Bethlem Royal Hospital in London is one of the oldest psychiatric hospitals. By 1547 the City of London psychiatric hospitals. By 1547 the City of London acquired the hospital and continued its function until acquired the hospital and continued its function until 1948.1948.

Early modern periodEarly modern period In 1656, Louis XIV of France created a public system of In 1656, Louis XIV of France created a public system of

hospitals for those suffering from mental disorders, but hospitals for those suffering from mental disorders, but as in England, no real treatment was being applied. as in England, no real treatment was being applied. Thirty years later the new ruling monarch in England, Thirty years later the new ruling monarch in England, George III, was known to be suffering from a mental George III, was known to be suffering from a mental disorder. Following the King's remission in 1789, mental disorder. Following the King's remission in 1789, mental illness was seen as something which could be treated illness was seen as something which could be treated and cured. and cured.

Early modern periodEarly modern period By 1792 French physician Philippe Pinel introduced By 1792 French physician Philippe Pinel introduced

humane treatment approaches to those suffering from humane treatment approaches to those suffering from mental disorders. William Tuke adopted the methods mental disorders. William Tuke adopted the methods outlined by Pinel and that same year Tuke opened the outlined by Pinel and that same year Tuke opened the York Retreat in England. That institution became known York Retreat in England. That institution became known as a model throughout the world for humane and moral as a model throughout the world for humane and moral treatment of patients suffering from mental disorders. It treatment of patients suffering from mental disorders. It inspired similar institutions in the United States, most inspired similar institutions in the United States, most notably the Brattleboro Retreat and the Hartford Retreat notably the Brattleboro Retreat and the Hartford Retreat (now the Institute of Living).(now the Institute of Living).

19th century19th century Universities often played a part in the administration of the Universities often played a part in the administration of the

asylums. Due to the relationship between the universities asylums. Due to the relationship between the universities and asylums, scores of competitive psychiatrists were and asylums, scores of competitive psychiatrists were being molded in Germany. Germany became known as the being molded in Germany. Germany became known as the world leader in psychiatry during the nineteenth century. world leader in psychiatry during the nineteenth century. The country possessed more than 20 separate universities The country possessed more than 20 separate universities all competing with each other for scientific advancement. all competing with each other for scientific advancement. However, because of Germany's individual states and the However, because of Germany's individual states and the lack of national regulation of asylums, the country had no lack of national regulation of asylums, the country had no organized centralization of asylums organized centralization of asylums ffor psychiatry.Britain, or psychiatry.Britain, like Germany, also lacked a centralized organization for like Germany, also lacked a centralized organization for the administration of asylums. This deficit hindered the the administration of asylums. This deficit hindered the diffusion of new ideas in medicine and psychiatry.diffusion of new ideas in medicine and psychiatry.

19th century19th century In the United States in 1834, Anna Marsh, a physician's In the United States in 1834, Anna Marsh, a physician's

widow, deeded the funds to build her country's first widow, deeded the funds to build her country's first financially-stable private asylum. The Brattleboro Retreat financially-stable private asylum. The Brattleboro Retreat marked the beginning of America's private psychiatric marked the beginning of America's private psychiatric hospitals challenging state institutions for patients, hospitals challenging state institutions for patients, funding, and influence. Although based on England's York funding, and influence. Although based on England's York Retreat, it would be followed by speciality institutions of Retreat, it would be followed by speciality institutions of every treatment philosophy.every treatment philosophy.

In 1838, France enacted a law to regulate both the In 1838, France enacted a law to regulate both the admissions into asylums and asylum services across the admissions into asylums and asylum services across the country. By 1840, asylums as therapeutic institutions country. By 1840, asylums as therapeutic institutions existed throughout Europe and the United States.existed throughout Europe and the United States.

19th century19th century However, the new and dominating ideas that mental However, the new and dominating ideas that mental

illness could be "conquered" during the mid-nineteenth illness could be "conquered" during the mid-nineteenth century all came crashing down. Psychiatrists and century all came crashing down. Psychiatrists and asylums were being pressured by an ever increasing asylums were being pressured by an ever increasing patient population. Overcrowding was rampant in patient population. Overcrowding was rampant in France where asylums would commonly take in double France where asylums would commonly take in double their maximum capacity. Increases in asylum their maximum capacity. Increases in asylum populations may have been a result of the transfer of populations may have been a result of the transfer of care from families and poorhouses, .care from families and poorhouses, .

19th century19th century but the specific reasons as to why the increase occurred but the specific reasons as to why the increase occurred

is still debated today. No matter the cause, the pressure is still debated today. No matter the cause, the pressure on asylums from the increase was taking its toll on the on asylums from the increase was taking its toll on the asylums and psychiatry as a specialty. Asylums were asylums and psychiatry as a specialty. Asylums were once again turning into custodial institutions and the once again turning into custodial institutions and the reputation of psychiatry in the medical world had hit an reputation of psychiatry in the medical world had hit an extreme low.extreme low.

20th century20th century The 20th century introduced a new psychiatry into the The 20th century introduced a new psychiatry into the

world. The different perspectives of looking at mental world. The different perspectives of looking at mental disorders began to be introduced. The career of Emil disorders began to be introduced. The career of Emil Kraepelin somewhat model this hiatus of psychiatry Kraepelin somewhat model this hiatus of psychiatry between the different disciplines. between the different disciplines.

20th century20th century Kraepelin initially was very attracted to psychology and Kraepelin initially was very attracted to psychology and

ignored the ideas of anatomical psychiatry. Following ignored the ideas of anatomical psychiatry. Following his acceptance for a professorship of psychiatry, and his acceptance for a professorship of psychiatry, and later his work in a university psychiatric clinic, later his work in a university psychiatric clinic, Kraepelin's interest in pure psychology began to fade Kraepelin's interest in pure psychology began to fade and he introduced a plan of a more comprehensive and he introduced a plan of a more comprehensive psychiatry.Kraepelin also began to study and promote psychiatry.Kraepelin also began to study and promote the ideas of disease classification for mental disorders, the ideas of disease classification for mental disorders, an idea introduced by Karl Ludwig Kahlbaum.an idea introduced by Karl Ludwig Kahlbaum.

20th century20th century The initial ideas behind biological psychiatry, stating The initial ideas behind biological psychiatry, stating

that these different disorders were all biological in that these different disorders were all biological in nature, evolved into a new idea of "nerves" and nature, evolved into a new idea of "nerves" and psychiatry became a sort of rough neurology or psychiatry became a sort of rough neurology or neuropsychiatry. Following Sigmund Freud's death, neuropsychiatry. Following Sigmund Freud's death, ideas stemming from psychoanalytic theory also began ideas stemming from psychoanalytic theory also began to take root. The psychoanalytic theory became popular to take root. The psychoanalytic theory became popular among psychiatrists because it allowed the patients to among psychiatrists because it allowed the patients to be treated in private practices instead of asylums. be treated in private practices instead of asylums. However the progress of psychiatry by the 1970s turned However the progress of psychiatry by the 1970s turned psychoanalytic theory into a marginal school of thought psychoanalytic theory into a marginal school of thought within the field.within the field.

20th century20th century ECT was "discovered" when Ugo Cerletti, psychiatrist, ECT was "discovered" when Ugo Cerletti, psychiatrist,

visited a Rome slaughterhouse to see what could be visited a Rome slaughterhouse to see what could be learned from the method that was employed to butcher learned from the method that was employed to butcher hogs. In Cerletti's own words, "As soon as the hogs were hogs. In Cerletti's own words, "As soon as the hogs were clamped by the [electric] tongs, they fell unconscious, clamped by the [electric] tongs, they fell unconscious, stiffened, then after a few seconds they were shaken by stiffened, then after a few seconds they were shaken by convulsions.... During this period of unconsciousness convulsions.... During this period of unconsciousness (epileptic coma), the butcher stabbed and bled the (epileptic coma), the butcher stabbed and bled the animals without difficulty....animals without difficulty....

20th century20th century "At this point I felt we could venture to experiment on man, and I "At this point I felt we could venture to experiment on man, and I

instructed my assistants to be on the alert for the selection of a instructed my assistants to be on the alert for the selection of a suitable subject."suitable subject."

Cerletti's first victim was provided by the local police - a man Cerletti's first victim was provided by the local police - a man described by Cerletti as "lucid and well-oriented." After surviving described by Cerletti as "lucid and well-oriented." After surviving the first blast without losing consciousness, the victim overheard the first blast without losing consciousness, the victim overheard Cerletti discussing a second application with a higher voltage. He Cerletti discussing a second application with a higher voltage. He begged Cerletti, "Non una seconda! Mortifierel" ("Not another begged Cerletti, "Non una seconda! Mortifierel" ("Not another one! It will kill me!")one! It will kill me!")

Ignoring the objections of his assistants, Cerletti increased the Ignoring the objections of his assistants, Cerletti increased the voltage and duration and fired again. With the "successful" voltage and duration and fired again. With the "successful" electrically induced convulsion of his victim, Ugo Cerletti brought electrically induced convulsion of his victim, Ugo Cerletti brought about the application of hog-slaughtering skills to humans, about the application of hog-slaughtering skills to humans, creating one of the most brutal techniques of psychiatrycreating one of the most brutal techniques of psychiatry..

20th century20th century LobotomyLobotomy

Lobotomy is a surgical practice where parts of the Lobotomy is a surgical practice where parts of the frontal lobes are intentionally destroyed. Violent frontal lobes are intentionally destroyed. Violent criminals calm down, highly depressed people don't criminals calm down, highly depressed people don't seem so depressed any longer, and manics finally seem so depressed any longer, and manics finally mellow out. But they wander aimlessly, drool mellow out. But they wander aimlessly, drool uncontrollably, and have very little left of whatever uncontrollably, and have very little left of whatever "personality" they once had. If the goal is calm, quiet, "personality" they once had. If the goal is calm, quiet, and "nice" people, then it's a roaring success. and "nice" people, then it's a roaring success.

20th century20th century This period of time saw the reemergence of biological psychiatry. This period of time saw the reemergence of biological psychiatry.

Psychopharmacology became an integral part of psychiatry Psychopharmacology became an integral part of psychiatry starting with Otto Loewi's discovery of the first neurotransmitter, starting with Otto Loewi's discovery of the first neurotransmitter, acetylcholine. Neuroimaging was first utilized as a tool for acetylcholine. Neuroimaging was first utilized as a tool for psychiatry in the 1980s. The discovery of chlorpromazine's psychiatry in the 1980s. The discovery of chlorpromazine's effectiveness in treating schizophrenia in 1952 revolutionized effectiveness in treating schizophrenia in 1952 revolutionized treatment of the disease, as did lithium carbonate's ability to treatment of the disease, as did lithium carbonate's ability to stabilize mood highs and lows in bipolar disorder in 1948. While stabilize mood highs and lows in bipolar disorder in 1948. While psychosocial issues were still seen as valid, psychotherapy was psychosocial issues were still seen as valid, psychotherapy was seen to be their "cure." Genetics were once again thought to play seen to be their "cure." Genetics were once again thought to play a role in mental illness. Molecular biology opened the door for a role in mental illness. Molecular biology opened the door for specific genes contributing mental disorders to be identified. By specific genes contributing mental disorders to be identified. By 1995 genes contributing to schizophrenia had been identified on 1995 genes contributing to schizophrenia had been identified on chromosome 6 and genes contributing to bipolar disorder on chromosome 6 and genes contributing to bipolar disorder on chromosomes 18 and 21chromosomes 18 and 21

SensationSensation – – the most the most elementary stage, elementary stage, which reflects which reflects separate separate

quality of subject, which is acting in right moment to sensory quality of subject, which is acting in right moment to sensory organs.organs.

ClassificationClassification : : According to modality:According to modality: InteroceptiveInteroceptive – give signal about condition of our inner – give signal about condition of our inner

world: warm, cold, hunger, uncomfortability. These world: warm, cold, hunger, uncomfortability. These sensastions don’t have localisation, outside proection, sensastions don’t have localisation, outside proection, closely connected with emotional processes. closely connected with emotional processes.

ExteroceptiveExteroceptive – 5 sensation organs: smell, taste, sight, – 5 sensation organs: smell, taste, sight, hearing, tactile.hearing, tactile.

ProprioceptiveProprioceptive – information about body position, – information about body position, movement in space, everything which makes body scheme.movement in space, everything which makes body scheme.

SensationSensation – – AnesthesiaAnesthesia – absence of 1 or more type of – absence of 1 or more type of

sensation. sensation. AnalgesiaAnalgesia – loss of pain sensation ( at – loss of pain sensation ( at acute psychopathological diseases.) Patients, who acute psychopathological diseases.) Patients, who commit suicides: they cut their organs – at such commit suicides: they cut their organs – at such moment they don’t feel anything. After some time moment they don’t feel anything. After some time everything comes back with recreation of psyche. everything comes back with recreation of psyche. ( At deep depression, progressive paralysis, brain ( At deep depression, progressive paralysis, brain syphillis, convulsive disorders(hysteria), syphillis, convulsive disorders(hysteria), anaestesia anaestesia dolorosa depresia – absense of sensationdolorosa depresia – absense of sensation).).

HyperesthesiaHyperesthesia – subjective increasing of sensation. – subjective increasing of sensation. HyperalgesiaHyperalgesia – increasing of pain sensastion – increasing of pain sensastion (depression,espessially light).(depression,espessially light).

SensationSensation – – Optical hyperesthesiaOptical hyperesthesia – daily light blind a man. – daily light blind a man. Acustical h-siaAcustical h-sia – changes of – changes of perceptionperception threshold. Light sound threshold. Light sound

percept as strong one even to pain. This is sign of expercept as strong one even to pain. This is sign of exhhaustionaustion, , asthenic conditions.asthenic conditions.

Taste, smellTaste, smell – complains on increasing of these sensations. It – complains on increasing of these sensations. It could be at normal conditions. could be at normal conditions.

Skin sensationsSkin sensations – tactile and temperature. Touch to a body is – tactile and temperature. Touch to a body is unpleasantunpleasant..

ParesthesiaParesthesia – – distortion sensations.distortion sensations.

SenestopathySenestopathy – – psychosomatic sensation. It has such psychosomatic sensation. It has such signs:signs:

..Polymorphism of sensations (pain, Polymorphism of sensations (pain, heartburn, electrisationheartburn, electrisation).). ..Sign which differentiates it from general somatic signs – Sign which differentiates it from general somatic signs –

there are complains, but they don’t have any localization, there are complains, but they don’t have any localization, intensity, patients cannot explain them.intensity, patients cannot explain them.

It has matter during mask depression diagnostic: sen.-as cardio-It has matter during mask depression diagnostic: sen.-as cardio-vascular, central – neurotic, abdominal, skin- underskin, bone – vascular, central – neurotic, abdominal, skin- underskin, bone – muscle.muscle.

They could be: They could be: permanent, episodical, as attack (sen.- crisis). permanent, episodical, as attack (sen.- crisis). Accompanied with panic, vegetative disorders. They begin with Accompanied with panic, vegetative disorders. They begin with simple sen., after that they become very hard.simple sen., after that they become very hard.

Elementary senElementary sen.- those, which doesn’t have sensor modality .- those, which doesn’t have sensor modality (“my sole is trembling”).(“my sole is trembling”).Simple sen. – Simple sen. – concrete modalityconcrete modality – – pain, pain, parasthesias.parasthesias.

Senesthesia – Senesthesia – various disorders of various disorders of movement, which has subjective character, movement, which has subjective character, which are not confirm with objective which are not confirm with objective investigations (“my legs and arms are not investigations (“my legs and arms are not listening to me”).listening to me”).

Sinesthesia – Sinesthesia – appear as a result of action of appear as a result of action of different sensation organs “colored music”. different sensation organs “colored music”. Smell calls some other sensation. Name of Smell calls some other sensation. Name of the person- some color etc.the person- some color etc.

PERCEPTION - PERCEPTION - - - reflection of object in general.reflection of object in general. Classification: splitting, illusions, pseudohallucinations, Classification: splitting, illusions, pseudohallucinations,

hallucinations, eydetysm, disorder of sensor synthesis, hallucinations, eydetysm, disorder of sensor synthesis, hallucinoids.hallucinoids.

DoubleDouble - loss of capacity of whole object formulation. He percept - loss of capacity of whole object formulation. He percept normally object, but couldn’t join it together. Ex.- tree – it’s normally object, but couldn’t join it together. Ex.- tree – it’s separately leaves, trunk etc. At infectious diseases.separately leaves, trunk etc. At infectious diseases.

IllusionsIllusions – false perception of real existent object. – false perception of real existent object. Affective ill.- affect of fear, anxious, horror, connected with special Affective ill.- affect of fear, anxious, horror, connected with special

emotional condition.emotional condition. Verbal ill.- words, phrases are percept Verbal ill.- words, phrases are percept in place of real. in place of real. Pareydolia Pareydolia – optical illusions with fantastic content. Various – optical illusions with fantastic content. Various

objects which don’t have forms are seen in various pictures.objects which don’t have forms are seen in various pictures.

PERCEPTION - PERCEPTION - --

PERCEPTION - PERCEPTION - - - HallucinationHallucination – perception without object,which acts – perception without object,which acts

on sense organs.on sense organs. Visual.Visual. Simple – Simple – photopsiasphotopsias. Complex – have subject content – . Complex – have subject content –

zoological, demanomanic, antropomorphic(close people, zoological, demanomanic, antropomorphic(close people, dead people, body pieces, inner organs), panoramic- dead people, body pieces, inner organs), panoramic- ground, atomic explosure).etcground, atomic explosure).etc

Acustical.Acustical. Simple – sounds. Simple – sounds. Complex – comment, imperative, stereotypical – during Complex – comment, imperative, stereotypical – during

some time they hear same words or phrases.some time they hear same words or phrases.

Optical illusion Optical illusion

Optical illusion Optical illusion

Optical illusion Optical illusion

PERCEPTION - PERCEPTION - - - Smell, tasteSmell, taste – when they don’t take food. – when they don’t take food. SkinSkin – tactile(touching,pressure, insects under skin, hair in the – tactile(touching,pressure, insects under skin, hair in the

mouth)etc.mouth)etc. Interoceptive, visceralInteroceptive, visceral – inside of the body animals, different – inside of the body animals, different

objects.objects. KinesteticalKinestetical – feel, like fingers are compressed in a fist, run – feel, like fingers are compressed in a fist, run

somewhere.somewhere. VestibularVestibular – feeling of falling, lifting. – feeling of falling, lifting. Symptom of twinSymptom of twin – feeling of body splitting. – feeling of body splitting. HypnogogicHypnogogic – in condition of falling asleep. – in condition of falling asleep. HypnopompicHypnopompic –in condition of getting up. –in condition of getting up. Affectogenic hAffectogenic h.- in condition of strss, affect..- in condition of strss, affect. InductiveInductive – they have collective character. There is inductor and the – they have collective character. There is inductor and the

person to whom induct. If we separate them we understand who is ill.person to whom induct. If we separate them we understand who is ill.

PERCEPTION - PERCEPTION - S-m Lippman, s-m Ashaphenburg, s-m Reyhardt.S-m Lippman, s-m Ashaphenburg, s-m Reyhardt.

PERCEPTION - PERCEPTION - PSEUDOHALLUCINATIONS.PSEUDOHALLUCINATIONS. At first was described by At first was described by

Candinskyy in 1890.Candinskyy in 1890. Pequliarities :Pequliarities :

..False objects, which are experience, such as False objects, which are experience, such as going in space ”see by mind, by inner eye, i can going in space ”see by mind, by inner eye, i can see by brain, hear by inner ear”.see by brain, hear by inner ear”.

..They have obusive character, appear suddenly, They have obusive character, appear suddenly, agains patients will. Feeling of self activity agains patients will. Feeling of self activity accompanied by someones action.accompanied by someones action.

..They don’t have objective reality, don’t mix with They don’t have objective reality, don’t mix with reality.reality.

..Difference between real and pseudohallucination.Difference between real and pseudohallucination.

PERCEPTION - PERCEPTION - As a rule, at pseudoh. We can see changes in behavior – As a rule, at pseudoh. We can see changes in behavior –

apsence of signs on outside world.apsence of signs on outside world. There are some objective signs: they watching or There are some objective signs: they watching or

listening to smth, close ears, nose, touch smth. They listening to smth, close ears, nose, touch smth. They hide somewhere, looking for smth, catching smth, run hide somewhere, looking for smth, catching smth, run somewhere- real.somewhere- real.

In pseudoh. – absence of attention on In pseudoh. – absence of attention on surrounding.surrounding.

PERCEPTION - PERCEPTION -

PERCEPTION - PERCEPTION - Hallucinoids Hallucinoids – – rudimentary display of rudimentary display of

visual h. Prestage of real h. Patients have visual h. Prestage of real h. Patients have some critics to them. It’s not h.-on, but it’s some critics to them. It’s not h.-on, but it’s not normal.not normal.

Eydetysm(Eydetysm(eidetic memoryeidetic memory)) – Man capacity to – Man capacity to hold for a long time some object, pictures. hold for a long time some object, pictures. As a rule visual, but could be auditorial and As a rule visual, but could be auditorial and tactile. Phenomenal visual memory.tactile. Phenomenal visual memory.

PERCEPTION - PERCEPTION - Depersonalization – is a nonspecific feeling that a

person has lost his or her identity, that the self is different or unreal. People may be concerned that body parts do not belong to them. People may have an acute sensation that their body has drastically changed.

Derealization – is the false perception by a person that the environment has changed. For example, everything seems bigger or smaller, or familiar surroundings have become somehow strange and familiar.

PERCEPTION - PERCEPTION - – DISORDER OF SENSORIAL SYNTHESISDISORDER OF SENSORIAL SYNTHESIS (psychosensorial (psychosensorial

disorders) – perception disorder of form, size, objects, oneself. disorders) – perception disorder of form, size, objects, oneself. On abolition from illusion there is no disorder of identity of On abolition from illusion there is no disorder of identity of subject.subject.

Metamorphosias Metamorphosias – perception disorder of form and size. They – perception disorder of form and size. They are bigger – are bigger – macropsiamacropsia or smaller – or smaller – micropsia.micropsia.

Dysmehalopsia – Dysmehalopsia – twisted.twisted. PaliopsiaPaliopsia – on abolition of 1 object – there a lot of them. – on abolition of 1 object – there a lot of them. Disorders of body scheme – Disorders of body scheme – autometamorphopsia. Macropsia autometamorphopsia. Macropsia

– – increasing (Huliver), increasing (Huliver), micropsiamicropsia –decreasing (lilliputian). –decreasing (lilliputian). Disorders of time perception – increasing of time speedDisorders of time perception – increasing of time speed((at manic at manic

patientspatients)), decreasing of time speed(at depressive patients)., decreasing of time speed(at depressive patients).

PERCEPTION - PERCEPTION -

–Thank you for your Thank you for your attention!attention!

PsychopharmacologyPsychopharmacology

Lyudmyla T. Snovyda Lyudmyla T. Snovyda

PsychotropicsPsychotropics

First psychotropic drug – First psychotropic drug – chlorpromazine(aminazine) was chlorpromazine(aminazine) was offered in 1952. by French scientists offered in 1952. by French scientists Delay Delay and and DenikerDeniker. It was beginning . It was beginning of psychopharmacotherapy era, of psychopharmacotherapy era, which took first place and leave other which took first place and leave other methods behind. methods behind.

CLASSIFICATION OF CLASSIFICATION OF PSYCHOTROPICS.PSYCHOTROPICS.

There are 3 classes: There are 3 classes: 1. Neuroleptics:1. Neuroleptics:1а) N.mainly with sedative action: 1а) N.mainly with sedative action:

aminazine,thizercine, sonapax, neuleptil, aminazine,thizercine, sonapax, neuleptil, chlorptotyxen, leponex;chlorptotyxen, leponex;

1 b) N. Mainly with antipsychotic action : 1 b) N. Mainly with antipsychotic action : triphtazine, mazheptil, phrenolon, triphtazine, mazheptil, phrenolon, haloperidol, eglonil, rispolept, clopixol, haloperidol, eglonil, rispolept, clopixol, fluonxol, ziprexa (olanzapine), solian fluonxol, ziprexa (olanzapine), solian (amisulpirid) ;(amisulpirid) ;

1c) N.with long action :phtorphenazyn-1c) N.with long action :phtorphenazyn-dekanoat (moditen-depoe), semap, orap, dekanoat (moditen-depoe), semap, orap, haloperidol-dekanoat.haloperidol-dekanoat.

2.Tranquilizers:2.Tranquilizers:2а) T.mainly with sedative action: elenium, 2а) T.mainly with sedative action: elenium,

nozepam, nitrazepam, phenazepam, nozepam, nitrazepam, phenazepam, amizil, meprotan, tranqsen;amizil, meprotan, tranqsen;

2b) T. with stimulate 2b) T. with stimulate actionaction : trioxazine, : trioxazine, rudotel, seduxen, gydazepam, grandaxynrudotel, seduxen, gydazepam, grandaxyn

3. Antidepressants:3. Antidepressants:3а) a. With mainly sedative action : 3а) a. With mainly sedative action :

amitriptyline, phtoracezine, pirazidol, amitriptyline, phtoracezine, pirazidol, azaphen, oxydiline, cypramil, cypralex, azaphen, oxydiline, cypramil, cypralex, zoloft;zoloft;

33b) a.with mainly stimulate action: b) a.with mainly stimulate action: melipramine, nuredal, transamine, melipramine, nuredal, transamine, indopan, prozac.indopan, prozac.

1. Neuroleptics1. Neuroleptics (first generation (first generation antipsychotics)antipsychotics)

Useful for the treatment of Useful for the treatment of schizophrenia;schizoaffective disorder;delusional schizophrenia;schizoaffective disorder;delusional disorder,alcohol hallucinosis and disorder,alcohol hallucinosis and alc.paranoia;mania;postpartum alc.paranoia;mania;postpartum psychosis;dementia and delirium;psychosis psychosis;dementia and delirium;psychosis occuring secondary to intoxication with occuring secondary to intoxication with cocaine,stimulants,cannabis or anabolic cocaine,stimulants,cannabis or anabolic steroids,autism;mental retardation when steroids,autism;mental retardation when complicated by stereotypies or aggression.complicated by stereotypies or aggression.

Side effects:sedation,hypotension,and Side effects:sedation,hypotension,and anticholinergic effects,acute extrapyramidal side anticholinergic effects,acute extrapyramidal side effects:parkinsonism,bradykinesia,bradyphrenia,aeffects:parkinsonism,bradykinesia,bradyphrenia,akathisia,dystonia,oculogyric crisis,dysphoria.kathisia,dystonia,oculogyric crisis,dysphoria.

1а.1а.Neuroleptics with sedative Neuroleptics with sedative actionaction::

Aminazine : sedative action, decreasing of motion activity and some weakening of scelet muscles,strong central adreno- and cholinolitic action,peripheral adrenolitic action, potention of drug action, somnolent,analgetics,anticonvulsive preparations; decreasing of systolic and dyastolic arterial pressure, deppressive action.

This is one of the strongest sedatives for remove of psychomotor excitement.

Indications:different types of psychomotor excitement(schizophrenia,chronic paranoid and hallucinative-paranoid conditions,MDP,agitation during deppression,fear, insomnia during psychosis).

Side effects and complications: collapse (at first two hours after use), weakness, dryness in a mouth,extrapyramidal disorders (parkinsonism,akathisia,dyskinesia), alergic reactions, токсичний toxic hepatitis,trombophlebitis,neuroleptic depression.

Average dose – 600-800 mg.– dragee) 0,025–0,05–0,1. Amp. 2,5% - 1-2-5 ml.

ThizercineThizercine – close to aminazine. – close to aminazine. Pequliarities:for ability to potentiate action Pequliarities:for ability to potentiate action of drugs and analgetics and for of drugs and analgetics and for hypotensive action - in 3-4 times stronger hypotensive action - in 3-4 times stronger from aminazine. Antivomiting and from aminazine. Antivomiting and cholinolitic action less than at cholinolitic action less than at aminazin.Deppressive effect - minimal.This aminazin.Deppressive effect - minimal.This is one of most minimal toxic neuroleptics. is one of most minimal toxic neuroleptics.

Indications and antiindications -same as Indications and antiindications -same as aminazine.aminazine.AD – 600-800 mg.AD – 600-800 mg.dragee 0,025; Amp. 2,5%-1ml.dragee 0,025; Amp. 2,5%-1ml.

Sonapax (Sonapax (thioridazine). thioridazine). Has calming action with moderate Has calming action with moderate

stimulative and soft tymoleptic effect.stimulative and soft tymoleptic effect.Choosing antipsychotic action mainly at Choosing antipsychotic action mainly at alarm, fear, intensity, which are connected alarm, fear, intensity, which are connected with with ipochondria,obsessives,phobias,senestopaipochondria,obsessives,phobias,senestopathies.thies.Indications:neurosolike conditions.Indications:neurosolike conditions.Ad – 200-600 mgAd – 200-600 mgDragee - 0,01; 0,025 і 0,1.Dragee - 0,01; 0,025 і 0,1.

NeuleprilNeulepril. . More typical neuroleptic than sonapax,cause its More typical neuroleptic than sonapax,cause its

psychotropic action is close to aminazine and is psychotropic action is close to aminazine and is characterized with slowing action without characterized with slowing action without stimulative componentstimulative component.Indications:first of all -different psychopatic conditions,disorders of behavior.In literature this preparation is known as “behavior corrector”.At the same time its not helpfull for psychomotor excitement ,but good for removing anger,tension, irritability,explosivity.AD– 30-50 mg.

capsules по 0,01. Drops inside 4% solution, 1 drop.=1mg.

ChlorprotyxenChlorprotyxen (truxal) (truxal) Most typic neurolepric and for psychotropic Most typic neurolepric and for psychotropic

activity is close to tysercin.Its therapeutic activity is close to tysercin.Its therapeutic effect consist of slow action without effect consist of slow action without deppession,moderate antipsychotic and deppession,moderate antipsychotic and choose sedative influence on psychomotor choose sedative influence on psychomotor excitation.excitation.Its direct action on hallucinations and Its direct action on hallucinations and delusions is very close to aminazine,but it delusions is very close to aminazine,but it is less toxic.is less toxic.AD– 200 – 400 mg.AD– 200 – 400 mg.tab. 0,015; 0,025 і 0,05;tab. 0,015; 0,025 і 0,05;amp. 2,5 % - 1 ml.amp. 2,5 % - 1 ml.

LeponexLeponex (clozapine, azaleptine) (clozapine, azaleptine) One of the last neuroleptics.One of the last neuroleptics.

Indication - same as Indication - same as aminazine,tizercine,chlorprotyxen - all types of aminazine,tizercine,chlorprotyxen - all types of excitement.excitement.Pequliarity - practically full absence of Pequliarity - practically full absence of extrapyramide side effects.extrapyramide side effects.

AD – 200-600 mg.AD – 200-600 mg.tab. 0,025 і 0,1; amp. 2,5%-2 ml.tab. 0,025 і 0,1; amp. 2,5%-2 ml.

1b.Neuroleptics of antipsychotic 1b.Neuroleptics of antipsychotic action.action.

Tryphtasine(stelasineTryphtasine(stelasine) – it has:) – it has: neuroleptic effect + moderate stimulate componentneuroleptic effect + moderate stimulate component strong general antipsychotic influencestrong general antipsychotic influence choosing antipsychotic action on productive choosing antipsychotic action on productive

psychosymptomacy:delusions,hallucinations,syndropsychosymptomacy:delusions,hallucinations,syndrome of psychic automatism.me of psychic automatism. Comparing to aminazine,tryphtazine has bigger Comparing to aminazine,tryphtazine has bigger influence on productive psychosymptomacy(in 10 influence on productive psychosymptomacy(in 10 times).times).Ad – 30-100 mg.Ad – 30-100 mg.tab. 0,005 і 0,01; amp – 0,2% - 1 ml.tab. 0,005 і 0,01; amp – 0,2% - 1 ml.

MazheptilMazheptilOne of the most strong antipsychotic preparations. One of the most strong antipsychotic preparations.

Especcially is used at catatonic-hebephrenic Especcially is used at catatonic-hebephrenic disorders.disorders.

For strenght of antipsychotic action we can For strenght of antipsychotic action we can compare it only with insuline-shock therapy.compare it only with insuline-shock therapy.But it has strong extrapyramide disorders.But it has strong extrapyramide disorders.Ad – 20-150 mg.Ad – 20-150 mg.Tab. 0,001 і 0,01; Tab. 0,001 і 0,01;

amp. 1% - 1 ml.amp. 1% - 1 ml.

EtaperazineEtaperazine Pequliarities:Pequliarities: for antivommitin action in 10 times stronger for antivommitin action in 10 times stronger

tahn aminazine(is included in soldier apothek;tahn aminazine(is included in soldier apothek; has stimulative effect,thats why is indicated has stimulative effect,thats why is indicated

at stupor and substupor,apatho-abulic at stupor and substupor,apatho-abulic conditions,autism,negativism;conditions,autism,negativism;

choosing action on hallucinative0delusional choosing action on hallucinative0delusional disorders and especcially verbal hallucinosis.disorders and especcially verbal hallucinosis.

Ad–30-80 mgAd–30-80 mgtab. 0,004; 0,006; 0,01.tab. 0,004; 0,006; 0,01.

HaloperidolHaloperidol One of the most active One of the most active

neuroleptics,lowtoxic.neuroleptics,lowtoxic.Choosing action on Choosing action on hallucinations,delusions.hallucinations,delusions.Indications:all psychopathological Indications:all psychopathological conditions which have hallucinative-conditions which have hallucinative-delusional signs.delusional signs.Side effects: often extrapyramide Side effects: often extrapyramide disorders.disorders.

Ad– 10-60 mgAd– 10-60 mgtab. 0,0015; 0,003; 0,005.tab. 0,0015; 0,003; 0,005. amp. 0,5 % - 1 ml.amp. 0,5 % - 1 ml.

RispoleptRispolept– atypical antipsychotic preparation of – atypical antipsychotic preparation of new generation.Is indicated at acute and chronic new generation.Is indicated at acute and chronic psychosis with positive psychosis with positive symptomacy(delusions,hallucination,psychosensosymptomacy(delusions,hallucination,psychosensorial disorders) and anxious-deppressive disorders. rial disorders) and anxious-deppressive disorders. Is effective in deficit symptomacy during Is effective in deficit symptomacy during schizophrenia.schizophrenia.Ad - 2-6 mg;Ad - 2-6 mg;Tab 0,001; 0,002; 0,003; 0,004.Tab 0,001; 0,002; 0,003; 0,004.

ZiprexaZiprexa (olanzapine) – new atypical antipsychotic (olanzapine) – new atypical antipsychotic pr. Has active influence not only on positive pr. Has active influence not only on positive psychopathological psychopathological symptoms(delusions,hallucinations)but also symptoms(delusions,hallucinations)but also negative(decreasing of negative(decreasing of emotions,will,language)and also on depressive emotions,will,language)and also on depressive symptoms.Rarely has side neurologiceffects.symptoms.Rarely has side neurologiceffects.Tab. 0,005 і 0,01.Tab. 0,005 і 0,01.Ad– 15-20 mgAd– 15-20 mg

SolianSolian (amisulpirid) – new atypical (amisulpirid) – new atypical preparation of antipsychotic action;is preparation of antipsychotic action;is indicated at acute and chronic indicated at acute and chronic schizophrenic disorders,which has positive schizophrenic disorders,which has positive and negative symptoms.and negative symptoms.Tab. 0,1; 0,2; 0,4.Tab. 0,1; 0,2; 0,4.Ad – 50 – 300 mg.Ad – 50 – 300 mg.

..Positive sides of atypical neuroleptics: Positive sides of atypical neuroleptics: 1) Has influence on positive and negative 1) Has influence on positive and negative

signs of psychic disorders.signs of psychic disorders.2) Comparing with typical n.-has less 2) Comparing with typical n.-has less

extrapyramide and other disorders.extrapyramide and other disorders.Negative side:Negative side:1)Expansive.1)Expansive.2)Don’t have depot variants. 2)Don’t have depot variants.

1c.Depot-preparations1c.Depot-preparations.. Moditen-depot:Moditen-depot:

connection of strong choosing action on connection of strong choosing action on hallucinative-delusional symptomacy with hallucinative-delusional symptomacy with good antipsychotic action;good antipsychotic action;

restrains progression of process;restrains progression of process; light activisation action;light activisation action; some general - sedative action.some general - sedative action.Indications - same as triphtazineIndications - same as triphtazine

Amp. 2,5% - 1 ml on oil.Amp. 2,5% - 1 ml on oil.Dose – 12,5 – 75 mg intramuscle 1 time in Dose – 12,5 – 75 mg intramuscle 1 time in 1-3 weeks.1-3 weeks.

2. 2. TranquilizersTranquilizers

Dont have antipsychotic properties, only Dont have antipsychotic properties, only decrease fear,obsessions,tension,anxiety and decrease fear,obsessions,tension,anxiety and other neurotic symptomacy.Dont have other neurotic symptomacy.Dont have extrapyramide side effects.extrapyramide side effects.Name”Name”tranguilare” means to make calm.tranguilare” means to make calm.

2 а. Tranquilizers of sedative 2 а. Tranquilizers of sedative action:action:

Mostly have slow, calming influences. It appears as Mostly have slow, calming influences. It appears as regression of neurotic,neuroticlike and regression of neurotic,neuroticlike and psychopatholike disorders which run with psychopatholike disorders which run with irritability,explosivity,anger,fear and anxiety.irritability,explosivity,anger,fear and anxiety.

Meprotan. Meprotan. Has calming ,light tranguilize,moderate Has calming ,light tranguilize,moderate hypnotic and antiphobic action.hypnotic and antiphobic action.

Be carefull to indicate for drivers,cause it can call muscle Be carefull to indicate for drivers,cause it can call muscle relaxation,slow of reaction.relaxation,slow of reaction.

Tab. 0,2; 0,4.Tab. 0,2; 0,4.

EleniumElenium has: has:а) strong slow effect ;а) strong slow effect ;б) strong generaltranquilize action.б) strong generaltranquilize action.Indications: all types of hypersthenic type of Indications: all types of hypersthenic type of

neurotic,neuroticlike,psychopathies with neurotic,neuroticlike,psychopathies with increased excitement;increased excitement;

obsessive-phobic and ipochondric conditionsobsessive-phobic and ipochondric conditions convulsive conditions.convulsive conditions.Side effects: disturbance of mensis, decrease of Side effects: disturbance of mensis, decrease of

libido and potention.libido and potention.tab. 0,005; dragee 0,005; 0,01 і 0,025.tab. 0,005; dragee 0,005; 0,01 і 0,025.

PhenazepamPhenazepam–newest preparation of –newest preparation of benzodiazepines. One of the strongest benzodiazepines. One of the strongest tranquilizators.Has strong action to tranquilizators.Has strong action to obsessions,phobias,ipochondric syndroms whic obsessions,phobias,ipochondric syndroms whic are resistant to other tr-s.Has strong sedative are resistant to other tr-s.Has strong sedative action,sleep effect.Serious anticonvulsive and action,sleep effect.Serious anticonvulsive and vegetostabilisative action.vegetostabilisative action.Tab.- 0,0005; 0,001 і 0,0025.Tab.- 0,0005; 0,001 і 0,0025.

2 b. Tranquilizers with 2 b. Tranquilizers with stimulative actionstimulative action

DiazepamDiazepam. Slow influence of d.shows up only in . Slow influence of d.shows up only in first days,then it changes of cheerfulness first days,then it changes of cheerfulness feeling,some increase of mood,activity,good work.feeling,some increase of mood,activity,good work.

Has good regulative action on disturbed vegetative Has good regulative action on disturbed vegetative functions.Has good anticonvulsive action(in 10 functions.Has good anticonvulsive action(in 10 times more than elenium).times more than elenium).

Has good effect at Has good effect at asthenodepressive,asthenoipochondric and other asthenodepressive,asthenoipochondric and other neurotic syndroms(at hyposthenic episodes).neurotic syndroms(at hyposthenic episodes).

Irreplaceable at status epilepticus,white fever,alcohol Irreplaceable at status epilepticus,white fever,alcohol abstinence. abstinence.

Possible psychological dependance(after 2 months - Possible psychological dependance(after 2 months - brake for 3 weeks). brake for 3 weeks).

Tab. 0,005; amp. 0,5% - 2 ml.Tab. 0,005; amp. 0,5% - 2 ml.Ad – 15-45 mg.Ad – 15-45 mg.

HidazepamHidazepam – “daily” tranquilizater, has – “daily” tranquilizater, has strong t-tive and anticonvulsive strong t-tive and anticonvulsive action,effective for therapy in period action,effective for therapy in period of remission at alcoholic patients.of remission at alcoholic patients.Tab. 0,02 і 0,05.Tab. 0,02 і 0,05.Ad - 60 -100 mg.Ad - 60 -100 mg.

3.Antidepressants.3.Antidepressants.main action:main action:antidepressive – main antipsychotic effect and antidepressive – main antipsychotic effect and

additional action:sedative or stimulative.additional action:sedative or stimulative.Mechanism of action:Mechanism of action:

А) tymoleptics(tricyclic a.)remove depression at А) tymoleptics(tricyclic a.)remove depression at patients,make mood better.Dont influence on patients,make mood better.Dont influence on emotional sphere of normal emotional sphere of normal people:melipramin,amitryptilin,azaphen,pirazidol,opeople:melipramin,amitryptilin,azaphen,pirazidol,oxylidin etc.xylidin etc.

B) tymoanalepticsтимоаналептики (monoamine B) tymoanalepticsтимоаналептики (monoamine oxidase inhibitors(MAO):increase mood not only at oxidase inhibitors(MAO):increase mood not only at sick,but also at normal sick,but also at normal people:nuredal,transamin,indopan,iprazid etc.people:nuredal,transamin,indopan,iprazid etc.

Note:Note:1) you cant prescribe simultaneous preparations of 1) you cant prescribe simultaneous preparations of

these two groups(possible hypertonic these two groups(possible hypertonic crisis,psychomotor excitation,even death);crisis,psychomotor excitation,even death);

2)after usage of MAOi TA you can use only after 14 2)after usage of MAOi TA you can use only after 14 days,and MAOi after TA - after 2-3 days.days,and MAOi after TA - after 2-3 days.

Clinically there are 2 groups:Clinically there are 2 groups:а) with sedative action (amipryptilin etc).а) with sedative action (amipryptilin etc).в) with stimulative action(melipramin etc)в) with stimulative action(melipramin etc)

For last years in practic we use 2 new For last years in practic we use 2 new groups:groups:

selective serotonin reuptake selective serotonin reuptake inhibitors(SSRI):fluoxetin(prodep,prosac)),zinhibitors(SSRI):fluoxetin(prodep,prosac)),zoloft(sertralin), cypramil.oloft(sertralin), cypramil.

Selective noradrenalin reuptake Selective noradrenalin reuptake inhibitirs(SNRI) inhibitirs(SNRI) doxepin(synekvan),ludiomil(maprolitin).doxepin(synekvan),ludiomil(maprolitin).

4. Psychostimulators4. PsychostimulatorsPsychostimulatorsPsychostimulators–medicalpreparations,under influence of which psychic –medicalpreparations,under influence of which psychic

activity is stimulates,mind and psychic work increase,mood becomes activity is stimulates,mind and psychic work increase,mood becomes better,decrease feeling of fatique,hunger and thirst, decreasing of sleepy.better,decrease feeling of fatique,hunger and thirst, decreasing of sleepy.

Sidnocarb Sidnocarb – original preparation,one of the most effective and dangerous – original preparation,one of the most effective and dangerous ps-s.Calls stimulation of CNS,which exepts by patient as natural feeling of ps-s.Calls stimulation of CNS,which exepts by patient as natural feeling of cheerfulness,energy,increase of work ability. cheerfulness,energy,increase of work ability. Indications: ascthenic conditions,which run with Indications: ascthenic conditions,which run with apathy,ipochondria,decrease of workability,stupor,substupor,and apatho-apathy,ipochondria,decrease of workability,stupor,substupor,and apatho-abulic conditions. abulic conditions. Tab. 0,005; 0,01; 0,025.Tab. 0,005; 0,01; 0,025.Ad – 20-30 mg.Ad – 20-30 mg.

5. Nootrops5. NootropsN. Stimulate protein synthesis and N. Stimulate protein synthesis and nuclein acids, has antihypoxia nuclein acids, has antihypoxia action,normalise bioenergy in nerve action,normalise bioenergy in nerve cells at organic injuiries of CNS or cells at organic injuiries of CNS or residual organic insufficiency.residual organic insufficiency.

PiriditoPiridito (encephabol) – on basic (encephabol) – on basic of vit. В6.of vit. В6.Has stimulate and antidepressive Has stimulate and antidepressive actionaction..Tab. 0,05; 0,1; 0,2.Tab. 0,05; 0,1; 0,2.

Ad – 0,2-0,6Ad – 0,2-0,6

PantogamPantogamExcept metabolic - has anticonvulsive Except metabolic - has anticonvulsive action,increase mind activity.action,increase mind activity. Little toxic. Little toxic.Indications: Jacksons Indications: Jacksons epylepsy,parkinsonism,tremor,neuroleptic syndrom, epylepsy,parkinsonism,tremor,neuroleptic syndrom, stammer at children,polymorphic and small attacs stammer at children,polymorphic and small attacs of epylepsy.of epylepsy.Tab. 0,25 і 0,5Tab. 0,25 і 0,5

Ad. – 1,5-3.0Ad. – 1,5-3.0

PyracetamPyracetam – makes better memory,facilitate – makes better memory,facilitate study process.Very little toxic.Widely use in study process.Very little toxic.Widely use in herontology,pediatrics..herontology,pediatrics..

capsuls – 0,4; tab. – 0,2; amp. – 20 % - 5 mlcapsuls – 0,4; tab. – 0,2; amp. – 20 % - 5 mlAd – 2,0-3,0Ad – 2,0-3,0

Thanks for Thanks for attention!attention!