Phenibut is a drug for improving memory and increasing performance.

Sleep disorder, restlessness, increased anxiety, irritability, emotional instability, high fatigue - familiar phrases for a modern person who often faces psycho-emotional stress and stress. When these and similar conditions affect the quality of life, the attending physician may prescribe Phenibut, a nootropic medicine that improves cognitive abilities and has a mild tranquilizing effect. This combination allows you to simultaneously maintain performance and eliminate anxiety.

Phenibut is good for people who often experience anxiety and restlessness.

Indications

Phenibut can be used once to prevent motion sickness and for the purpose of premedication for anesthesia.

The active ingredient of the drug, aminophenylbutyric acid, is a derivative of phenylethylamine and gamma-aminobutyric acid (GABA). Moreover, GABA is an organic compound, a brain metabolite, that is, a substance that is used by the structures of the central nervous system to ensure metabolism and maintain the effective functioning of brain cells.

Phenibut is prescribed by your doctor to treat the following conditions or diseases:

• asthenic state (lethargy, apathy, feeling of exhaustion, fatigue, etc.);
• anxiety-neurotic conditions;
• constant incessant anxiety for various reasons;
• feeling of fear;
• feeling of anxiety;
• insomnia, nighttime restlessness and nightmares in older people;
• obsessive-compulsive neurosis;
• psychopathy;
• with strong anxiety before surgery or any other invasive diagnostic procedure;
• Meniere's disease and other pathologies of the vestibular apparatus caused by injuries, vascular and other disorders;
• otogenic labyrinthitis;
• dizziness caused by dysfunction of the vestibular apparatus;
• prevention of motion sickness;
• stuttering in children;
• tics of various origins in children;
• enuresis in children;
• alcohol withdrawal syndrome (in combination with other drugs);
• preliminary state in alcoholism;
• to enhance the effect of antiparkinsonian drugs.

Nootropics

Nootropics (from the Greek noos - thinking, mind, tropos - direction, desire, affinity) are neurometabolic drugs that have a direct activating effect on the integrative mechanisms of the brain, optimize cognition (processes of memory, thinking, intelligence) and increase the level of wakefulness (vigilance). ), increase the brain’s resistance to harmful influences, and also improve cortico-subcortical connections.

Due to the ability of nootropics to improve mentality in healthy and sick people, they are called cognitive enhancers. Nootropics stimulate the transmission of excitation in central neurons, accelerating interneuron contacts and the exchange of neurotransmitters; activate the synthesis of protein and RNA in neurons, stabilize the membranes of nerve cells, improve energy processes, microcirculation and blood supply to the brain (without vasodilation), increase the latter’s resistance to hypoxia, have pronounced antihypoxic, neurotrophic and cerebroprotective activity, etc.

At the same time, nootropics do not affect the course of neurovegetative processes, do not have significant psychostimulating, hypnotic, sedative and analgesic effects, do not cause specific changes in the EEG, do not have significant toxicity, and do not impair blood circulation. In general, the mechanism of the therapeutic effect of nootropics has not been studied enough.

1. Piracetam. Synonyms: Lucetam, Memotropil, Nootobril, Nootropil, Noocetam, Pyrabene, Piramem, Apagon, Centilan, Euvifor, Gabazet, Norotrop, Stimubral and many others. etc. Indicated for the treatment of various psychiatric, neurological and somatic diseases.

In psychiatric practice, these are asthenic disorders of various origins, mental retardation, learning difficulties, post-stress disorders, depressive states with asthenia, apathy, adynamia, lethargy and senesto-hypochondriacal symptoms, deficiency disorders in schizophrenia with a deficit of activity, attention and communication, organic processes of various etiologies , including atrophic, traumatic, vascular and intoxication. Piracetam improves the tolerability and effectiveness of antidepressants and antipsychotics, and the severity of side effects during treatment with them. Prescribed for the treatment of abstinence, relief of exogenous-organic psychoses.

In neurology and somatic practice, it is used in the treatment of a number of organic diseases of the brain (vascular processes, comatose and subcomatose states, intoxication, trauma, inflammatory processes and their consequences, birth trauma, asphyxia, the period of convalescence after meningitis, encephalitis, etc.), heart attack myocardium, cortical myoclonus, sickle cell anemia, viral neuroinfection, etc. It is prescribed orally, intramuscularly, intravenously or by infusion. In the treatment of chronic conditions, it is usually prescribed orally, regardless of food intake, 3-4 times a day in doses of up to 2.4 g, sometimes up to 3.2 g. Treatment begins with 1.2 g / day, the dose is then increased gradually, by 0 .4 g per day. The therapeutic effect occurs after 2–3 weeks of treatment; subsequently, the dose is gradually reduced to a maintenance dose of 1.2–1.6 mg/day. For stroke, up to 12 g per day is prescribed for 2 weeks. For children, the drug is prescribed in smaller doses: under 5 years of age - 200 mg 3 times a day, from 5 to 16 years - 400 mg 3 times a day.

The course of treatment with piracetam lasts from 2–3 weeks to 2–6 months.

In acute painful conditions (coma, poisoning with morphine and barbiturates, withdrawal symptoms, pre-delirious states, acute complications during psychopharmacotherapy), piracetam is prescribed intramuscularly or intravenously. Therapy begins with the introduction of 2–4 g/day and quickly increases the dose to 4–7 g/day or more. After the condition improves, they switch to taking the drug orally.

Side effects: possible agitation, irritability, anxiety, arousal (including sexual), weakness, sleep disturbance, dyspeptic disorders, abdominal pain, tremor, dizziness, allergic reactions; Elderly patients may experience an increased frequency of attacks of coronary insufficiency. Side effects occur especially often in patients with psychiatric pathology. In such cases, the dose of the drug should be reduced or stopped taking it for a while.

Contraindications for use: hypersensitivity, acute renal failure, hemorrhagic stroke, pregnancy, breastfeeding, diabetes, age under 1 year.

Release form: capsules of 400 mg in a package of 60 pieces; tablets of 200 mg in packs of 60 and 120 pieces; 20% solution in ampoules of 5 ml (1 g of substance per ampoule) in a package of 10 pieces; piracetam granules for children in a package of 56 g (2 g piracetam, 50 g sugar and fillers) in glass jars. Combination drugs are available: Fezam - contains piracetam with cinnarizine; Procetam (Orozetam) - piracetam with orotic acid; Diapiram - piracetam with diazepam, etc.

2. Aminalonum, gamma-aminobutyric acid (GABA). Synonyms: Gammalon, Ganevrin, Apogamma, GABA, Gaballon, Mielogen, etc. It is known that GABA is the main mediator involved in the processes of central inhibition through interaction with GABAergic receptors of type A and type B. A close connection of the latter with benzodiazepine receptors has been established: benzodiazepines potentiate the effect of GABA, which, in turn, is the effect of benzodiazepines, many hypnotics and anticonvulsants. Under the influence of GABA, the energy processes of the brain are activated, the respiratory activity of tissues increases, and the brain's utilization of glucose and hemodynamics improve. The nature of the action of GABA is close to nootropics. It is used mainly in geriatric practice and in the treatment of children with mental retardation, as well as for vascular disorders of the brain. There is information about the effectiveness of the use of aminalon in the treatment of depression with asthenohypochondriacal symptoms, alcoholic encephalopathy, alcoholic polyneuritis and dementia.

It is prescribed orally before meals 3-4 times a day. Adults are prescribed up to 3.75 g/day, the average dose is 1.5–3 g/day. Children, depending on age, are prescribed from 0.5 to 3 g/day. The course of treatment is up to 2–6 months. For motion sickness, adults are prescribed 0.5 g, children - 0.25 g 3 times a day for 3-4 days.

Side effects are rare; in some cases, in the first days of treatment, dyspeptic symptoms, sleep disturbances, a feeling of heat, and blood pressure fluctuations are observed. When the dose is reduced, these effects usually disappear quickly.

Contraindications for use: hypersensitivity. Release form: tablets of 0.25 g in a package of 100 pieces.

3. Sodium oxybutyrate (Natrii oxybutiratas) . Synonyms: Sodium oxybate, Sodium salt of hydroxybutyric acid, Natrium oxybutiricum, Oxybate sodium. A nootropic with pronounced antihypoxic, sedative, general anesthetic and central muscle relaxant activity, in large doses induces sleep and a state of anesthesia. Enhances the effect of analgesics, narcotic drugs, and has an anti-shock effect. In psychiatric practice, it is used to treat neurotic and neurosis-like conditions, intoxication and brain injuries, and night sleep disorders (including narcolepsy). In somatic medicine it is used as a means of anesthesia, in the treatment of hypoxic cerebral edema, hypoxic condition of the retina, and glaucoma.

Prescribed orally, intramuscularly and intravenously. Orally for the treatment of neurotic conditions, take 0.75 g (1 tablespoon of 5% solution 2-3 times a day), insomnia - 1.5-2.25 g at night once (2-3 tablespoons of 5% solution) .

Release form: 66.7% solution in 37.5 ml bottles (before use, prepare a 5% aqueous solution by diluting the contents of the bottle in 0.5 liters of freshly boiled chilled water); 20% solution in ampoules of 10 ml in a package of 10 ampoules.

Side effects: with rapid intravenous administration, there may be motor agitation, convulsive twitching of the limbs and tongue, and in case of overdose, respiratory arrest. Upon recovery from anesthesia, motor and speech agitation sometimes occur. The antidote is bemegride. With prolonged use of the drug, hypokalemia is possible.

Contraindications for use: hypokalemia, myasthenia gravis, hypersensitivity, late toxicosis of pregnancy with arterial hypertension.

4. Phenibut - see "Antidepressants."

5. Pantogamum. Synonyms: Calcium homopantothenat, Hopaten, Hopa, etc. Nootropic with anticonvulsant, moderate and short-term hypotensive effects. Prolongs the effect of barbiturates, reduces reactions to painful stimuli. It is used to treat residual organic brain failure, decreased activity and disability, mental retardation in children, and is also effective for hyperkinesis, Jacksonian epilepsy, parkinsonism, neuroleptic syndrome, clonic stuttering in children, delayed speech development, epilepsy with petit mal and polymorphic seizures (in combination with specific antiepileptic drugs).

It is prescribed orally 15–30 minutes after meals. The daily dose for adults is 1.5-3 g, for children - 0.75-3 g in three divided doses. The course of treatment is from 1 to 4 (sometimes up to 6) months. Courses of treatment are repeated if necessary.

Release forms: tablets of 0.25 g and 0.5 g in a package of 50 pieces.

6. Picamilon (Picamilonum). Nootropic with tranquilizing and vegetotropic effects. It is prescribed orally regardless of food intake. For cerebrovascular diseases and vegetative dystonia, adults are prescribed from 0.02 to 0.05 g 2-3 times a day, the course of treatment is 1-2 months, with the course repeated after 5-6 months. In the complex of antidepressant therapy in old age, 0.04–0.2 g (in 2–3 doses) is recommended for 1.5–3 months. During the period of alcohol withdrawal, 0.1–0.15 g/day is prescribed, the course of treatment is 6–7 days, the duration of treatment can be increased to 4–5 weeks in doses of 0.04–0.06 g/day. To restore working capacity, 0.06–0.08 g/day is prescribed for 1–1.5 months.

Side effects: increased irritability, agitation, anxiety, headache, dizziness, mild nausea, itching, allergic rash.

Contraindications for use: hypersensitivity, acute and chronic kidney diseases.

Release form: tablets of 0.01 g, 0.02 g and 0.05 g in a package of 30 pieces.

7. Pyriditol (Piriditolum). Synonyms: Pyritinol, Cerebol, Enerbol, Encephabol, Biocephalin, Cogitan, Enbol, Enerbol, Pyritinol, etc. A nootropic with pronounced antidepressant activity. Enhances the effects of phenamine, the anticonvulsant effect of phenobarbital, and prolongs the effect of barbiturates. Indicated for the treatment of minor depression of various origins and neurosis-like conditions with symptoms of asthenia, apathy, adynamia, as well as residual organic conditions with a predominance of anergy phenomena, in children - mental retardation, cerebrasthenic syndrome, encephalopathy, mental retardation.

It is prescribed orally 15–30 minutes after meals 2–3 times a day (it is not recommended to take the drug in the evening). The daily dose for adults is from 0.2 to 0.6 g, for children - 0.05-0.3 g. The course of treatment is from 1 to 3 months, repeated courses - after 1-6 months.

Side effects: headache, nausea, insomnia, irritability, in children - psychomotor agitation, sleep disturbance.

Contraindications for use: psychomotor agitation, epilepsy, increased convulsive readiness, hypersensitivity.

Release forms: tablets of 0.05 g, 0.1 g and 0.2 g in a package of 60 pieces. Encephabol is available in tablets of 0.1 g and in the form of syrup of 0.1 g in 5 ml.

8. Acephenum. Synonyms: Analux, Meclofenoxate, Centrophenoxine, Cerutin, Claretil, Lucidril, Meclofenoxate hydrochloride, Ropoxil, etc. Metabolic products of acephen are free radical inhibitors, have the properties of nootropics and mild stimulants and are marketed under the name Deanol (Dinetal, Etanamin, etc.). Nootropic with a moderate stimulating effect. Indicated for the treatment of asthenia, memory loss in old and senile age, obsessions and other neurotic disorders.

It is prescribed orally at 0.1–0.3 g 3–5 times a day, the course of treatment is 1–3 months. Side effects are rare. Sometimes there is an exacerbation of psychotics, fear and anxiety. Contraindications for use: infectious diseases of the central nervous system, hypersensitivity.

Release form: tablets of 0.1 g in a package of 50 pieces.

9. Memantine. Synonym: Akatinol Memantine, Akatinol Memantin. Neuroprotective, antispastic, antiparkinsonian agent. A non-competitive antagonist of N-methyl-D-aspartate (NMDA) receptors, it inhibits glutamatergic neurotransmission and the progression of neurodegenerative processes, and has a neuromodulatory effect. Indicated for the treatment of mild to moderate dysfunctions of the central nervous system (weakening of memory, attention, interests, fatigue, psychoorganic decline in personality), muscle spasticity and motor disorders due to damage to nervous structures (brain injuries, multiple sclerosis, Parkinson's disease, etc.). The drug enhances the effect of barbiturates, neuroleptics, anticholinergics, levodopa, dopamine receptor agonists, amantadine, and may change the effect of dantrolene and baclofen.

It is prescribed orally during meals, without chewing and with liquid. Adults - starting from 3 mg/day, if necessary, with a weekly increase in dose by 5–10 mg/day to 30–60 mg/day, and then reducing it to maintenance (10–20 mg/day). Children - 0.5 mg/kg/day or 1 drop per 1 kg of weight.

Side effects: dizziness, internal or motor restlessness, fatigue, increased intracranial pressure. Prescribe with caution to persons whose work requires high concentration of attention.

Contraindications for use: hypersensitivity, confusion, severe dysfunction of the liver and kidneys. Restricted for use in epilepsy, thyrotoxicosis, pregnancy, breastfeeding.

10. Cerebrolyzin. Synonym: Cebrilisin. It is a mixture of metabolically active neuropeptides with pronounced neurotrophic activity. Indicated for the treatment of organic brain damage with cognitive deficits, mental retardation

chemical development in children, dementia syndromes of various origins (Pick's disease, Alzheimer's disease, vascular dementia, etc.), as well as endogenous depression resistant to antidepressants. The drug enhances the effect of antidepressants.

Prescribed daily intravenously or intramuscularly. In acute conditions in adults (ischemic stroke, head injury, complications after brain surgery), it is administered intravenously over 60–90 minutes in an amount of 10–60 ml in 100–250 ml of saline. The course of treatment is 10–25 days. In the residual period - 5-10 ml IV for 20-30 days. For dementia syndromes - 10-20 ml IV for 3 weeks, for psychoorganic syndrome and depression - 5-10 ml IV for 20-25 days. In neuropediatric practice - 1–2 ml (up to 1 ml per 10 kg of weight) intramuscularly for 1 month, repeating the course 2–3 times a year.

Side effects: hyperthermia with rapid intravenous infusion.

Contraindications for use: hypersensitivity, acute renal failure, status epilepticus. Use with caution during pregnancy, especially in the first 3 months.

Release forms: solution of 215.2 mg in ampoules of 1 ml; 215.2 mg in ampoules of 5 ml and 10 ml; 215.2 mg in 30 ml bottles.

11. Pantogam. Nootropic with anticonvulsant and antidysuric effects. Helps normalize GABAergic transmission in chronic alcoholism, has analgesic properties, prolongs the effect of novocaine and sulfonamides, inhibits the increased bladder reflex and detrusor tone. Indicated for the treatment of disorders of higher cerebral functions of various origins in adults and children (vascular, traumatic encephalopathy, atrophic processes, etc.), treatment of epilepsy, trigeminal neuralgia, chronic neuroleptic syndrome, hyperkinesis, PTSD, urination disorders (pollakiuria, urgency , enuresis). The effects of the drug are enhanced by glycine and xidifon. Pantogam, in turn, prolongs the effect of barbiturates, potentiates the effects of anticonvulsants, nootropics, local anesthetics, and prevents the side effects of phenobarbital, finlepsin, and neuroleptics.

It is prescribed orally 15–30 minutes after meals in the morning and afternoon. Adults - 0.25–1 g per dose, 1.5–3 g/day; course of treatment - 1-6 months, repeated course - after 3-6 months. For schizophrenia (in combination with psychotropic drugs) - 0.5-3 g/day, course of treatment - 1-3 months. For epilepsy (in combination with anticonvulsants) - 0.75–1 g/day, course - up to 1 year or more. For extrapyramidal hyperkinesis (as part of complex therapy) - 0.5-3 g/day, course - 4 months or more. For the consequences of neuroinfection and head injury - 0.25 g 3-4 times a day. For asthenic conditions - 0.25 g 3 times a day. For dysuria - 0.5–1 g 2–3 times a day.

Children single dose - 0.25-0.5 g, daily dose up to 1 year - 0.5-1 g, from 1 to 3 years - 1.5-2 g, from 3 to 15 years - 2.5- 3 g. The daily dose is increased over 7–12 days, the maximum dose lasts 15–40 days, after which it is reduced until discontinued within 7–8 days. Breaks between courses of therapy are 2 months. For dysuria in children - 25–50 mg/kg, course 1–3 months.

Side effects: allergic reactions.

Contraindications for use: hypersensitivity, acute severe kidney disease, first trimester of pregnancy.

Release forms: tablets of 250 mg and 500 mg in cans of 50 pieces; 10% syrup, 50 ml and 100 ml.

12. Glycine. Nonessential amino acid. Nootropic with antiepileptic, antistress and sedative effects. Indicated for the treatment of asthenia, PTSD, neuroses and neurosis-like conditions, vegetative dystonia, acute ischemic stroke, consequences of exogenous-organic and intoxication diseases. Glycine reduces the toxicity of anticonvulsants, neuroleptics, antidepressants, and can enhance the effect of hypnotics, tranquilizers and antipsychotics.

Prescribed orally sublingually 0.1 g 2-3 times a day for 2-4 weeks. Children under 3 years old - 0.05 g 2-3 times a day, over 3 years old - 0.1 g 2-3 times a day. For sleep disorders - 0.05–0.1 g 20 minutes before bedtime. For ischemic stroke, during the first 3-6 hours - 1 g (buccal or sublingual with 1 teaspoon of water), then - 1 g / day for 1-5 days, over the next 30 days - 0.1-0 .2 g 3 times a day.

Side effects: allergic reactions are possible. Contraindications for use: hypersensitivity. Release form: tablets of 0.1 g in a package of 50 pieces.

13. Idebenone. Nootropic. Indicated for the treatment of asthenia, asthenodepressive, asthenovegetative conditions, PTSD, psychoorganic syndrome of vascular and other origins, as well as hereditary mitochondrial diseases (MELAS syndrome, Leber optic atrophy, Leigh's disease) and Friedreich's ataxia.

Prescribed orally after meals, 30 mg 2-3 times a day (last dose no later than 17:00). The course of treatment is 1.5–2 months, repeated 2–3 times a year.

Side effects: mental agitation, difficulty falling asleep, headache, dyspepsia, allergic reactions.

Contraindications for use: hypersensitivity. Use with caution during pregnancy and breastfeeding. Use with caution for persons whose work requires high concentration of attention.

Release form: tablets of 30 mg in a package of 10 pieces.

14. Gliattilin. Synonym: Choline alfoscerate. Neuroprotector, centrally acting cholinomimetic. Indicated for the treatment of exogenous-organic, atrophic diseases (cerebrovascular insufficiency, acute and recovery periods of TBI, ischemic stroke, dementia, senile pseudomelancholia).

Prescribed orally, intramuscularly and intravenously. Take 400 mg orally 2-3 times a day. IM and IV (administer slowly!) - 1000 mg/day in the morning for 15–20 days, and then orally 800 mg in the morning and 400 mg in the afternoon for 6 months.

Side effects: nausea.

Contraindications for use: hypersensitivity. It is not recommended to prescribe during pregnancy and breastfeeding.

Release form: capsules of 400 mg in a package of 14 pieces; solution of 1000 mg in ampoules of 4 ml in a package of 3 pieces.

15. Ethylthiobenzymidazol hydrochloride. Antihypoxic, psychostimulant, anxiolytic, antiasthenic agent. Indicated for the treatment of asthenic and asthenodepressive conditions of various origins.

Prescribed orally after meals and no later than 16 hours, 0.25–0.5 g 2–3 times a day (no more than 2 g/day) for 1–4 weeks or 3–5 days in a row with breaks of 2– 5 days (2–3 courses). Treatment can be repeated after 1 month. To improve performance, take 0.25 g 1–2 times a day in cycles of 5 days with 2-day breaks, a total of 4–6 courses. During treatment, you should adhere to a diet rich in carbohydrates.

Side effects: irritability, anxiety, headache, sleep disturbance, nausea, rarely - vomiting, discomfort in the epigastrium.

Contraindications for use: hypersensitivity, severe psychomotor agitation, hyperglycemia. Restricted for use during pregnancy.

Release form: tablets of 0.25 g.

16. Semax solution 0.1% (Solucio Semaxi 0.1%). Gentapeptide in preservative (nipagin). Nootropic, adaptogen. Indicated for the treatment of asthenic conditions of various origins, to increase adaptation in extreme conditions, to prevent mental fatigue during intense and monotonous work.

Prescribed intranasally, 2-3 drops in each nasal passage 2-3 times a day for 3-14 days (single dose - 200-2000 mcg, daily dose - 500-5000 mcg). It is also administered by electrophoresis (the optimal daily dose is 400–600 mcg/day).

There are no side effects observed. Contraindications for use: acute psychosis, severe anxiety, endocrine diseases, pregnancy, breastfeeding.

Release form: 0.1% drops in 3 ml bottles.

17. Deanol aceglumate. Synonym: Nooclerin. Nootropic with cerebroprotective, antiasthenic, antidepressant and hepatoprotective effects. Indicated for the treatment of asthenic, asthenodepressive conditions of various origins, withdrawal symptoms, psychoorganic, neuroleptic syndromes, mnestic-intellectual decline, neurotic, psychosomatic and neurosis-like disorders.

Prescribed orally, 1 teaspoon (1 g of the drug) 2-3 times a day (no later than 18 hours), the course of treatment is 1.5-2 months.

Side effects: allergic reactions. Contraindications for use: hypersensitivity.

18. Biotredinum. Ingredients: L-threonine (100 mg) and pyridoxine hydrochloride (5 mg). Nootropic with anti-alcohol, anti-withdrawal effects. Indicated for the treatment of reduced mental performance and concentration, pathological craving for alcohol and alcohol withdrawal. The drug reduces the side effects of neuroleptics, antidepressants, tranquilizers, and barbiturates.

Prescribed orally sublingually: children - 2 mg/kg; adolescents and adults - 1 tablet 2-3 times a day for 3-10 days. Courses of treatment are repeated 3–4 times a year or more. For chronic alcoholism, 1-3 tablets are prescribed 2-3 times a day for 4-5 days. Courses are repeated 5–10 times a year or more. For alcohol withdrawal, 1-4 tablets 3-4 times a day are prescribed on the first day, then 1-2 tablets 2-3 times a day for 3-4 weeks (the best effect is achieved when combined with 0.1 g of glycine sublingually, glycine is taken 10–15 minutes before biotredin).

No side effects were identified. Contraindications for use: alcohol intoxication. Release form: tablets of 105 mg in packages of 30 and 50 pieces.

19. Tenoten. It has anxiolytic, antidepressant, nootropic, stress-protective, antiasthenic, antihypoxic, neuroprotective effects. Indicated for the treatment of asthenic, neurotic and neurosis-like disorders with manifestations of anxiety, depression, apathy, adynamia, affective lability of various origins, especially with moderately severe organic lesions of the central nervous system.

It is prescribed orally on an empty stomach (keep the tablet in your mouth until completely dissolved). Depending on the severity of the condition, give from 1 to 12 tablets per day, the last dose is no later than 2-3 hours before bedtime. The course of treatment is up to 3 months, if necessary – up to 6 months. Courses of treatment may be repeated.

Side effects: dry mouth, heartburn, flatulence, hyperhidrosis, allergic reactions.

Contraindications for use: hypersensitivity. Release form: tablets in a package of 20 pieces.

20. Tanakan. Synonyms: Bilobin, Ginkgo Biloba, Ginkgo Biloba (BP). A nootropic with antihypoxic, angio-, cerebroprotective and antiaggregation effects, improves cerebral circulation, reduces capillary permeability, and activates intracellular metabolism. It also has an antidepressant effect and slows down the progression of degenerative processes in atrophic diseases of the central nervous system. Indicated in the treatment of the consequences of stroke, TBI, memory impairment, senile dementia, neurosensory disorders, Raynaud's syndrome, pathology of peripheral circulation, diabetic angioia and retinopathy.

Prescribed orally during meals, 3 tablets or 3 doses of solution per day. Side effects: headache, dyspepsia, allergic reactions.

Contraindications for use: hypersensitivity.

Release forms: tablets of 40 mg in packages of 30 and 90 pieces; drinking solution 30 ml in a bottle.

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Contraindications

Phenibut is contraindicated during pregnancy

Despite the positive effect on the body and an impressive list of indications, the use of Phenibut may be limited. So, it is contraindicated in the following cases:

• individual sensitivity or intolerance to the components of the drug;
• pregnancy and breastfeeding;
• liver failure;
• erosions and ulcers of the gastrointestinal tract.

How to take Phenibut

Phenibut is prescribed in therapeutic courses lasting from 2-3 to 4-6 weeks, depending on the disease and the speed of normalization of the condition. Therapy can be repeated after 2-4 weeks. This time interval is necessary so as not to cause addiction to the drug, which supplies the brain with the necessary metabolites, and it (the brain) stops producing these substances on its own in the required quantities.

Phenibut is started at full therapeutic dosage. But they stop the course of treatment gradually, reducing the dosage over 1-2 weeks.

With long-term use of Phenibut, it is recommended to take a general blood test once a week to identify possible eosinophilia and a blood test for the activity of AST and ALT.

When using Phenibut with other psychotropic drugs, it is necessary to reduce the dosage of both medications taken.

If a person gets motion sickness in transport, then Phenibut should be taken 20-30 minutes before the trip in a single dose of 250-500 mg (1-2 tablets). Only in this case will it be effective.

Take Phenibut tablets with plenty of water.

Phenibut should only be taken after meals, as severe irritation of the stomach lining may occur. The tablet must be swallowed whole, without biting or chewing, or crushing in any other way. The tablets should be taken with plenty of water.

Standard dosage of Phenibut for adults: 250 – 500 mg (1-2 tablets) 3 times a day. If necessary, the dosage is increased to 750 mg (3 tablets) 3 times a day.

For children under 8 years of age, Phenibut is prescribed 20–150 mg 3 times/day, and for children aged 8–14 years—250 mg 3 times/day.

The maximum permissible dosage of Phenibut is: 750 mg (3 tablets) for adults, 500 mg (2 tablets) for elderly people over 65 years of age, 300 mg for children 8 – 14 years of age and 150 mg for children under 8 years of age.

The duration of use of Phenibut is determined by the attending physician.

Correction of agitation in dementia

We are publishing an article about one of the common symptoms of dementia—excitement, or agitation. The article was first published in the Canadian medical journal Family Health Online. We thank our colleagues for the opportunity to translate it into Russian and make it accessible to a Russian-speaking audience.

In dementia, the patient's mental abilities and behavior change due to damage to the brain. Dementia can be caused by various diseases ,

including Alzheimer's disease. About half of patients with dementia experience agitation, or agitation, at certain points in their illness. It affects the quality of life of both patients and those caring for them, especially if they are primarily family members. Because this situation often means that a loved one needs constant supervision, caregivers can live in a constant state of high stress, which undermines their own physical and mental health. Proper management of behavioral disorders can improve the well-being of both the patient and the caregiver.

Forms of agitation in dementia: what are they?

A state of excitement or agitation is called pathological physical or verbal activity.
The behavior it causes can be either aggressive or non-aggressive. Examples of non-aggressive behavior include pacing, wandering, repeating actions or statements, complaining, interrupting. Aggressive behavior includes yelling or hitting. A man with dementia rips off his diaper. What to do? Experts caring for seriously ill people talk about options for solving a common problem Valeria MikhailovaElena KonyaevaKristina OsotovaOlga Vygovskaya
Psychological and psychiatric problems

Possible causes of agitation

Diseases

Behavioral disturbances are sometimes the only sign of medical problems in people with dementia. Patients may become agitated due to constipation, dehydration, pain, or infection. Deterioration of a person’s condition due to any existing disease can also cause such behavior.

Delirium

Delirium is an acute state of clouding of consciousness, leading to pathological activity and a narrowing of attention span. It is often caused by medical problems, such as thyroid deficiency, infection, and medications. If a person with dementia becomes agitated, delirium must always be ruled out.

Environmental stress

People with dementia prefer stable and predictable environments. Any changes in the environment can serve as a trigger for agitation: for example, changes in daily routine, diet, noise level, visual stimuli, or even the arrival of a new caregiver.

Medicines

Agitation in some patients is caused by both over-the-counter and prescription medications. This condition can be caused by medications such as steroids, antispasmodics and antidepressants. Alcohol withdrawal syndrome, narcotic painkillers and sedatives can also lead to agitation in dementia.

Mental disorders

Depression, mania, anxiety, psychosis are some of the conditions that underlie the state of agitation in patients with dementia. With mania, behavioral disturbances such as “gushing” with ideas and rapid, assertive speech may occur. In psychosis, a person may see or hear something that does not exist: for example, patients may worry about allegedly stolen things (in fact, of course, no one stole anything from them).

Dementia

Dementia itself can cause serious behavioral problems. However, before concluding that it is what causes behavioral disorders, it is necessary to consider and eliminate the factors listed above.

Alzheimer's disease is like a road: support during the “long goodbye” How can you tell whether changes occurring in a loved one signal a problem or are they just part of the aging process? Family Health Online

Symptomatic treatment

How is agitation treated in dementia?

Non-drug methods

Behavioral symptoms of dementia can be controlled by adjusting the behavior of caregivers, as well as changing the environment.

Change the behavior of caregivers

Therapeutic touch

Simple touch (such as holding someone's hand) shows care, but it can also provoke arousal if a person wants to be alone. An individual approach is required, you need to focus on the patient’s response.

Switching attention

Attention switching techniques distract patients from a state of excitement, redirecting them to perform some task. Effective and simple examples include trying to engage the person in a conversation or getting them to participate in a social event.

Confession

This is a method in which we focus on the emotional component of the statement to a greater extent than on the actual content of the conversation. In other words, you need to pay attention to the emotion that the person is expressing and recognize that it exists. For example: “You seem to be enjoying this” or “You seem sad right now.”

Communication

It is very important to establish simple verbal communication with people with dementia. Speak in a low voice, clearly and slowly. Short, clear phrases best help a person understand what is being said. Questions should be formulated in such a way that they can be answered with a simple answer, such as “yes” or “no.” It is worth paying attention to the nonverbal component of communication. A tense posture, furrowed brows, and rapid movements are perceived as unfriendly. Conversely, a calm manner, eye contact and a relaxed posture are optimal. Try to match your verbal and nonverbal cues.

Change the environment

Removing irritants

Too much visual and auditory information at the same time can be detrimental to a person with dementia. Excessively loud sound from a TV or radio, bright lighting, and fuss can be very distressing for patients. They are positively influenced by being in a quiet, calm and familiar environment.

Setting up a daily routine

Patients with dementia need a daily routine in which certain activities and events take place at regular times with the participation of people they know well. A stable schedule helps patients retain events in memory and reduces anxiety.

No physical restraint

Restraining a person does not reduce the number of falls or injuries. On the contrary, the use of restraint measures can cause them. In addition, problems associated with lack of movement (bedsores and muscle weakness) cannot be ruled out. Physical restraint should be avoided as much as possible, and the need for it should first be discussed with your doctor.

By the way, wearing diapers can be considered physical constraint. It is unusual for a person to wear absorbent underwear, they feel constrained, get irritated and rip off the diaper. In the article “Absorbent Underwear for Adults,” we wrote about what type of diapers are optimal for older adults with dementia.

Selecting music

Music can calm people with dementia who are agitated – especially if it is familiar to them.

Laura Wayman about the problem of dementia: a letter from a gerontologist from the USA About how they cope with the problem of dementia in America, why it is important for everyone to know the symptoms of the disease and how to behave in difficult situations with a person with dementia Laura Wayman

Care

"Three P Method"

Cause

(what preceded the event) –
behavior
–
consequences
. The “Three P Method” is aimed at identifying the “triggers” of the state of excitation. Those caring for someone with dementia should keep a diary of the patient's behavior. Try to identify the event that preceded the onset of arousal. Describe exactly how the ensuing arousal manifested itself and everything that contributed to the change in this behavior. By adjusting the environment in accordance with the conclusions you have made, you can reduce the agitation of the dementia patient.

Let's look at an example. P (cause) - the patient watches a hockey match on TV, P (behavior) - becomes restless and speaks loudly, P (consequences) - this behavior stops as soon as the TV is turned off. In this case, the problem lies in watching a hockey match. If it tends to excite a person, perhaps watching matches should be avoided.

Use of Medicines

Some types of destructive behavior can be corrected with medication. Drug therapy is used if adjustments in the behavior of caregivers and changes in the environment do not produce results: the patient’s state of agitation does not go away. Or - in cases where his behavior becomes dangerous. In this case, it is possible to use a wide range of drugs.

The type of drug chosen depends on the cause of the agitation. During treatment, the patient's condition must be monitored to monitor the effectiveness of the drug and its side effects.

Agitation in dementia can be a serious problem. Any patient with recent or progressive changes in behavior needs the help of a doctor to understand why he began to behave this way. At the first stage, it is best to try non-drug methods. But, as we said above, they alone may not be enough. If [the patient's] behavior cannot be controlled, the next step is to consider drug therapy.

Remember that you are not alone! When you are caring for a loved one with dementia at home, it can be helpful to have a trusting relationship with your healthcare provider.

We thank Anna Borisova, a volunteer of the Vera Foundation, for the translation.

The material was prepared using a grant from the President of the Russian Federation provided by the Presidential Grants Foundation.

How to take Phenibut for children

Phenibut has proven to be a drug with low toxicity and good tolerability, so it is prescribed for the treatment of neurotic and anxiety disorders in children and the elderly.

Phenibut for children (from 8 years old) is used in a dosage of 20 – 100 mg/day for a course of 2-4 weeks. This duration of therapy is associated with the child’s possible psychological adaptation to the medicine. The drug is prescribed to young children (less than 8 years old) by a doctor in exceptional cases. Only the doctor can decide on this. Phenibut is not recommended for infants, since the medication can have multidirectional effects on the child, which cannot be predicted in advance. Doctors advise refraining from using Phenibut for at least two years.

Children aged 8 to 14 years should take no more than 250 mg per day

Also, if necessary, it is better to give the powder, which is prepared by a pharmacist in a pharmacy, since dividing Phenibut 250 or 100 mg into correct, “children’s” doses is difficult.

VSD, Panic attacks

Anonymous user

December 7, 2020

Good afternoon.
I really ask for your help. In August I got sick with Covid. 10 days in the hospital. TYPE against the background of coronavirus. After discharge, my legs began to go numb below the knees. Now 4 months have passed since the illness. And I still feel bad. Numbness in legs does not go away. I feel dizzy at times. Sometimes it hurts. Periodically, the arms go numb from the shoulder to the hand. Not completely, but in places. Slight weakness. Tachycardia in motion. There were strong PAs. But I was able to drown them out. And so on December 5 (2 days ago) I went for an MRI. They told me to check my head + arteries + veins. Let me say in advance that I am wildly afraid of confined spaces. But it had to be done. At the end of the study I felt sick. I felt very dizzy, I had the feeling that I was falling somewhere, and my right hand began to go numb. I called the doctor. He said that we need to wait 3 minutes. Somehow I suffered. They pulled me out of the device, and I could barely stand, I was shaking so much. At home I continued to shake, my blood pressure rose a little. At 12 am I fell asleep. And I woke up with a sore throat (I had a cold) and a headache. I took a pill. After about 30 minutes she helped and I decided to go to bed. But as soon as I lay down, my right arm began to go numb and then it hit me. Wild fear. Panic. The pulse jumped to 136. It became difficult to breathe. My head started to spin. My blood pressure jumped from 143 to 93. I drank kapoten and glycine under my tongue. Let go. But after 10 minutes it came again. I called an ambulance. While I was waiting, they let me go again. Blood pressure and pulse returned to normal. But then it covered me again. The ambulance has arrived. With them, I was once again covered and released. They said that the ECG was normal, the pulse pressure was normal. That I’m having a panic attack due to fear and stress experienced during the MRI. They told me to go to a neurologist. Treat nerves and neck. Since I was lying in the MRI machine, I was very uncomfortable and all the tension was on my neck and head. She held the waistband of her trousers with her hands. And when she let go, my fingers were burgundy. The ambulance left and told me to go to bed. Somehow by 6:30 am I fell asleep. Yesterday I walked around broken all day. I wanted to go to bed. But as soon as I closed my eyes, I immediately felt unwell. It felt like I was lying in this MRI machine. I opened my eyes and everything passed. I slept last night. Fine. Everything is more or less good. And then, out of the blue, I sat and my head suddenly seemed to feel hot, it became somehow unpleasant and a wild fear appeared in it. But I pulled myself together and in less than a minute it passed. About an hour later it happened again. I went to play on the phone. And again the heat in the head. Unexplained sensations in the head. And wild fear. Again, I tried to calm myself down. In a minute it was all over. At the same time, my hands and feet are icy (even under the blanket). Blood pressure is 124 over 84. Before going to the MRI it was usually 108/115 over 77/82. I also noticed that if I now read something bad, I immediately feel unwell. The questions are: 1. What’s wrong with me? Was it after the intense stress from the MRI that these panic attacks appeared? And it’s these sensations that frighten me, like heat and it’s unclear what’s in my head (this had never happened before the MRI procedure). 2. Can PA occur several times a day out of nowhere or from the slightest stress or anxiety? 3. Is my MRI result very bad? 4. How can I cope with fear? I sit and now I’m afraid every minute that this terrible feeling in my head might come over me again. ((( PS I am adding examinations: MRI photo Ophthalmologist photo ENMG of the legs - normal Ultrasound of the arms and legs - arteries are normal. The veins in both the arms and legs are dilated. I take: Eliquis 2.5 mg - 2 times, enalapril 5 mg - in the morning, vitamin D, Picamilon 50 mg - morning and evening Chronic diseases:
Hypertension, stage 2 obesity, hay fever, gastritis, irritable bowel syndrome, tonsillitis, laryngitis

The question is closed

VSD

panic attacks

Phenibut during pregnancy and lactation

As for taking Phenibut during pregnancy and breastfeeding, doctors come to a consensus - the drug is strictly prohibited in the first trimester, since the formation of all major organs and systems occurs in the fetus. There have been no clinically reliable studies on exactly how GABA derivatives affect the unborn baby. It is also unknown whether the active ingredient passes into breast milk. Therefore, if Phenibut is indicated for use, it is recommended to switch to artificial feeding.

As for later stages of pregnancy, experts allow use with caution when the likely benefit to the mother significantly outweighs the possible risk to the fetus.

Why does panic disorder develop?

Many experts believe that at least once in their life everyone experiences symptoms similar to a panic attack. But the majority do not focus on them; a pathological reaction is not triggered.

Panic attacks can also occur against the background of various somatic and functional disorders and psychopathologies.

The causes vary as much as the severity of the symptoms. If we summarize all the available data, we can identify several main triggers:

1. A long stay in a psychotraumatic situation is stress at work or study, which the body expresses with the help of psychosomatics.
2. Secondary benefit - often a panic attack carries some benefit: by feeling unwell, the patient avoids any tasks or responsibilities. Sometimes the presence of such a benefit is itself the cause of the disorder.
3. Somatic diseases. Often the symptoms of the disorder are caused by diseases of the endocrine system.

Treatment is aimed at both relieving symptoms and eliminating the underlying cause. Therefore, first of all, the specialist will try to find out what led to the unpleasant symptoms.

Interaction

The interaction of Phenibut with other medications is limited to joint use with any other tranquilizers, antipsychotics, sleeping pills, narcotic (opiates) and anticonvulsants, as the effects of both drugs are enhanced. In this case, it is necessary to reduce the dosage of both Phenibut and medications belonging to one of the listed groups. Also, it is necessary to take with caution drugs that have a toxic effect on the liver and blood system.

Phenibut and alcohol

As follows from the instructions, Phenibut is used in the complex treatment of alcohol withdrawal syndrome to relieve anxiety, restlessness and other unpleasant psychological experiences and symptoms. But this does not mean that simultaneous use of the drug and alcoholic beverages is possible.

The fact is that it is impossible to predict the body’s reaction to such a combination. Phenibut in combination with alcohol can cause rapid and severe intoxication or, on the contrary, help not to get drunk and maintain clarity of mind.

Panic disorder. Part 1. A disease that doesn’t exist?

All people who suffer from panic attacks have that very first time where it all begins. One fine, or perhaps not so good, day, filled with anxieties and worries, they experience a sharp change in their condition. They experience heart palpitations, trembling throughout the body, rapid breathing, and dry mouth. And most importantly, the horror of death rolls over them...

This horror paralyzes some, while others want to rush around in search of immediate help. And then the ambulance arrives, the doctors take an ECG, examine the patient and issue a conclusion: “Everything is fine with you. It's just nerves." It would seem that you can breathe out and live your old life. But it was not there. The story is just beginning...

What happened?

Usually this condition occurs because the person is very frightened by something. In this case, he was afraid of a sudden change in the functioning of his body. It began to seem to him that he was sick with something, he had a heart attack or stroke. But the cause of this condition is not related to diseases of the internal organs, but is of a mental nature. It is the nervous system that changes the nature of its work and causes all this terrible storm inside. This state takes a person by surprise. For this reason, in this case they talk about a panic attack.

Manifestations of attacks can be varied. They can be divided into two large groups: symptoms from internal organs (somatic) and mental manifestations.

Somatic symptoms

Most often, during an attack, a person experiences a feeling of compression in the heart area and palpitations. This can be the most frightening thing, because in the understanding of many people, these symptoms are signs of a heart attack.

But during a panic attack, the feeling of increased heartbeat is subjective. The patient feels as if the heart is beating at an accelerated pace. In fact, the pulse may remain within normal limits.

In addition to unpleasant heart sensations, a person in a state of panic attack experiences a feeling of constriction in the chest. It seems to him that he is suffocating and does not have enough air. He trembles, experiences hot or cold flashes, and feels dizzy.

Sometimes this can be accompanied by abdominal pain, nausea and even vomiting.

Mental symptoms

In such a state it is difficult to remain calm. If your body does this, how can you not worry? A person develops a sharp fear of death. He is worried that he will not be able to cope with his condition and that he will not be able to receive timely help.

People start rushing around, trying to find someone who could help, or, on the contrary, they huddle in a corner and are afraid to move. After all, any movement can cause a subjective feeling of worsening of the condition.

How the disorder is formed

For some people, this condition occurs once or twice in their lives and never happens again. They occasionally recall what happened with hostility, but this does not have much impact on them.

Others, after the first time, are constantly faced with panic. The threat of an unexpected change of state hangs over them like a sword of Damocles. People begin to fear that the attack may recur. As a result, panic attacks begin to “overgrow” with fears.

People try to change their behavior and lifestyle to reduce the risk of an attack. Their condition is already determined not only by the attacks, but also by the fears associated with them, and by various behavioral tricks that are designed to deceive the disease. Gradually, a person's personality and character change. Based on panic attacks, a more severe condition develops, which is called “panic disorder”.

Physiology of the disease

What causes this disorder? The nervous system, weakened by stress, is “to blame” for everything.

The first time symptoms appear is most often due to fatigue, overheating or lack of sleep. All this is superimposed on some long-standing stress. Stress hormones are released into the blood, primarily adrenaline. But this is not enough for the development of the disorder.

But when this storm falls on a person in an inappropriate situation, where he feels helpless (he was riding in an elevator, was in an unfamiliar place where he didn’t know anyone, found himself locked in a room), then he can become truly scared. The patient is overcome by fear not only because of the unpleasant symptoms, but also by the horror that he will die here alone and no one will be able to help him.

This fear remains forever in the memory. And when a person finds himself in a similar situation, riding alone in the same elevator or finding himself in a stuffy room, his brain can automatically remember everything and trigger panic again. Adrenaline is again released into the blood, which again causes heart palpitations, rapid breathing, trembling, and a feeling of fear. Neither the heart, nor the blood vessels, nor the lungs are damaged, it’s just that adrenaline makes them work at the limit of their strength.

Who's at risk

Not everyone is affected by the disorder in the same way. Women suffer from panic disorders more often than men. Moreover, the risk of getting sick depends not only on gender, but also on age. Most often, the disorder develops in so-called “young adults”—20–25 year olds.

The characteristics of the nervous system also influence. Those who have a tendency to easily change the “mode” of the autonomic nervous system are more susceptible to panic attacks. Such people quickly blush, sweat, they often feel dizzy from excitement, stuffiness, overwork, and their heart rate easily increases during physical and emotional stress.

Personality characteristics of a person also play a significant role. Thus, in anxious people, panic disorder is more common than the average population. However, it is worth noting that anxiety is not a direct path to panic attacks. It's just a matter of predisposition.

There is also a certain “nepotism” here. If there are those in the family who suffer from panic attacks, then the risk of getting sick in other family members is higher. Is this disorder hereditary? It has not yet been reliably established. Genetic characteristics may be to blame here, or perhaps the “infectious example” of one of the family members plays a role. Children can observe their parents' behavior and unconsciously copy it.

Panic attacks can recur for many months or even years. Patients feel tied hand and foot by their problem. Is there a way out of this “vicious circle”? I will tell you in my next article.

Natalia Stilson

Photo thinkstockphotos.com