ვიტალი კაშიას სტატია "საქართველოს ფსიქიატრიის მოამბის" მე-6 ნომრიდან

rispoleptis efeqturobis Sefaseba SizofreniiT daavadebul avadmyofTa mkurnalobaSi

(preparatis gamoyenebis Teoria da praqtika)

v. S. kaSia

m. asaTianis saxelobis fsiqiatriis

s/k instituti

Tbilisi, saqarTvelo

tipiuri neiroleptikis gamoyenebiT Sizofreniis xangrZliv mkurnalobas garkveuli SezRudvebi gaaCnia: pacinetTa 25%-33% Catarebuli Terapiis mimarT rezistentulia (1,9). klasikuri neiroleptikebi iCenen SezRudul zemoqmedebas negatiur simptomatikaze: azrovneba Raribdeba, iqmneba socialuri gariyuloba, ikargeba emociuri gamomsaxveloba. es medikamentebi iwveven gamoxatul gverdiT movlenebs. iTvleba, rom atipiuri neiroleptikebi H. Meltzez (n) mier mowodebuli ganmartebis Tanaxmad, warmoadgenen preparatebs antifsiqozuri efeqtiT ise, rom ar iwveven gverdiT eqstrapiramidul movlenebs da aqveiTeben Sizofreniis negatiur gamovlinebebs. dReisaTvis atipiuri antifsiqozuri medikamentebi warmoadgenen pirveli rigis samkurnalwamlo preparatebs im pacientebisaTvis, romlebic cudad itanen tipiur neiroleptikebs, aseve pacientebisTvis, romlebic rezistentulebi arian klasikuri neiroleptikebiT mkurnalobis mimarT.

erT-erT cnobil atipiur neiroleptiks warmoadgens ristolepti. bolo ramdenime wlis ganmavlobaSi rispoleptma ara marto aRiareba miiRo  praqtikul fsiqiatriaSi, aramed moxda misi daniSvnis Cvenebis mniSvnelovani gafarToeba.

gamoiyeneboda ra Tavdapirvelad rogorc preparati SemanarCunebeli TerapiisaTvis, rispoleptma miiRo farTo gamoyeneba rogorc mwvave da qvemwvave endegonuri fsiqozebis mkurnalobisaTvis, aseve gaxangrZlivebuli dunedmavali mdgomareobisas, rogorc mozrdil pacientebSi, aseve bavSvTa,.mozardTa da moxucebulobis asakSi. dRevandel dRes rispolepti warmoadgens yvelaze xSirad daniSvnad axal Taobis neiroleptiks, ase magaliTad: aSS-Si receptebiT daniSnuli rispolepti Seadgens TiTqmis 25%-s yvela antifsiqozuli preparatis receptebisa. pacientTa gadayvana tipuri neiroleptikebidan rispoleptze Cveulebrivi Terapiuli praqtika gaxda. neiroleptikis cvlilebis mizezi klinicistisTvis SeiZleba gaxdes tradaciuli neiroleptikebis efeqturobiTa da usafrTxebiT daukmayofilebloba, rac ukavSirdeba pozitiuri simptomebis arasakmaris reduqcias da narCen negatiur aSlilobebs (apaTia, motivaciis daqveiTeba da kognituri darRvevebi da sxva).

avadmyofebic aseve xSirad arian motivirebuli neiroleptikebis Secvlis mimarT. tradiciuli neiroleptikebis mtanjveli gverdiTi efeqtebis, maTi arasakmarisi efeqturobis, aseve piradi arCevanis gamo. avadmyofTa tipiuri neiroleptikebi da rispoleptze gadayvanis mecnierul dasabuTebas warmoadgens mravalricxovani gamokvlevebi, romelSic ganxilulia preparatis sxvadasxva fsiqofarmakologiuri Tviseba, misi efeqturoba da usafrTxoeba tradicul antifsiqotikebTan SedarebiT. am monacemebiT, romlebic Cven eqimebs gvexmareba  miviRoT swori gadawyvetileba mtikcebiTi medicinis mocemulobaze dayrdnobiT, anu sworad mravalcentruli gamocdis rezultatebiT, Cven gavakeTeT mcire mimoxilva. Yyvela Catarebul gamokvlevaSi rispoleptma aCvena mniSvnelovani upiratesoba placebo TerapiasTan SedarebiT, xolo maT umravlesobaSi upiratesoba Sizofreniis pozitiuri aSlilobebis mkurnalobisas, tradiciul neiroleptikebTan SedarebiT.

R. Bozison gamoavlina simptomTa 60%-is reduqcia im pacintebSi, romlebic iRebdnen rispoleptis 10,0 mg.-s saSualo dReramuri doziT da mxolod 25% im pacintebSi, romlebic iRebdenen haloperidols (saSualo 20,0 mg. dR. doziT) gamokvleva tardeboda 6 kviris ganmavlobaSi.

8 kviriani gamokvlevisas Hoybez adarebda rispolepts (8,5 saSualo dRis doziT) perfenazins(saSualo dR. doza 28,0 mg) da armoaCina bodviTi da halucinatoruli aSlilobis sando reduqcia pacinetTa 78%-Si. 59% im pacientebTan SedarebiT, romlebic iRebdenen perferazins.

haloporidolis 10,0 mg dR. doziT miRebis Sedareba ripoleptis 1.0-4.0-8.0-12. an 16.0 mg dR. dozasTan, gamovlinda preparatis sakmarisi efeqturoba 4.0-8.0-12.0 mg. dRiur dozebze da ufro cxadi reduqcia pizitiuri sindromebisa haloperidolis gamoeynebasTan SedarebiT.

Davis da Jnikak Caatares ra meta analizi 5 ormagi brma kontolirebadi gamokvlevisas, daadastures, rom risolepti 6.0mg/ 12.0 mg dR. doziT mniSvnelovnad ufro efeqturia, vidre tipuri antifsiqotipebis standartuli dozebi, magaliTad: haloperidoli 10,-20,0md dR. doziT.

rispoleptma iseve rogorc sxva tipiurma medikamentebma, aCvena efeqturoba refraqteruli SizofreniiT daavadebul avadmyofTa mkurnalobisas. ormagi brma meTodiT gamokvlevisas rispoleptiT da klozapiliT im avadmyofebSi, romlebic iyvnen rezistentuli tradiciuli neiroleptikebisadmi, orive preparatma gamoavlina sarwmuno efeqturoba, amastan rispolepti avlenda moqmedebis ufro swraf dawyebas, vidre klozapini. rispoleptis (12,0 mg. dR doziT) da haoperidolis (10,0 mg. dR. doziT). 12-kviriani SedarebiTi gamokvlevisas refraqteruli Sizofreniis dros c. claus aRmoaCina Pa NSS–is SkaliT im avadmyofTa meti ricxvis gaumjobeseba, romlebic itarebdnen Terapias rispoleptiT im avadmyofTan SedarebiT, romlebic mkurnaloben Sedarebis preparatiT (24%).

Sizofreniis pozitiuri simptomebisagan gansxvavebiT, romlebic upiratesad iwveven avadmyofTa da maTi garemocvis daZabulobas, negatiuri simptomebi, iseve, rogorc kognituri funqciebi, dReisTvis ganixileba, rogorc daavadebis gamosavlis ZiriTadi prediqtorebi, ganapirobeben ojaxur da profesionalur prognozs, aseve, pacientTa socialuri adaptaciis xarisxs. praqtikulad Catarebul yevla kontrolirebad da gaxsnil gamokvlevebSi xazgasmuli iyo rispoleptis upiratesoba sxva tradiciul neiroleptikebTan: haloperiodlTa, qlorpomazilTan da perfenazimTan SedarebiT negatiur simptomebze gavlenis TvalsazrisiT. gamokvlevaTa metanalizis rezultatebiT, romlebic eZRvneboda rispleftiis (saSualo 4,0 mg. dR. doziT) gavlenas negatiur simptomatikaze (J. Carman), is didi albaTobiT (1,43-jer) amcirebs negatiur simptomebs, vidre konvencionaluri neiroleptikebi. atipiuri neiroleptikebi zogadad, ukeTesad gadaitaneba avadmyofebis mier, vidre tradiciuli anti fsiqotipebi, rac dadebiTad aisaxeba pacientTa mier preparatis miRebis reJimis dacvaze.

im pacientTa Soris romelbic iReben rispolefts 4,0-8.0 mg dR. doziT. EPC-is sixSire iyo naklebi, vidre im pacientebSi, romlebic imyofebodnen haloperidoliT Terapiaze da Seesabameboda am simptomatikis gavrcelebadobas placebo mkurnalobis dros.

gamokvlevis rezultatebma, romlebSic gamoiyeneboda rispoleptis mravaljeradi dozebi, cxadyo, rom preparati iwvevs dozadamokidebul efeqtebs, romlebic iwyeben momatebas 12.0 mg. dR. dozidan. atipiur neiroleptikTa ukeTesi  amtanoba ukavSirdeba antiqolinerguli Terapiis nakleb saWiroebas. Aamerikul-kanadur gamokvlevebSi avadmyofebi, romlebic iReben 6,0 mg. rispolepts (yvelaze efeqturi dR. doza) saWiroeben antiqolinergul Terapias SemTxevvaTa imave procentebSi, rogoric placebo Terapiisas.

rispoleptiT mkurnalobisas somatovegetatiuri gverdiTi efeqtebidan yvelaze xSirad SeiniSneboda umniSvnelo Zilianoba da orTostatiuli hipotenzia. orTostatiuli Tavbru amave gamokvlevebSi aRiniSneboda rispoleptiT mkurnalobaze myof pacientTa 18% da haloperidoliT mkurnalobaze myof pacientTa 33%-Si.

sxva gverdiT efeqtebs rispoleptiTa da haloperidoliT mkurnalobisas warmoadgenda sxeulis masis momateba 34%-25%-Si, seqsualuri interesis Semcireba 10% da 12%-Si, ereqciuli disfunqcia 9%-13%-Si. Sesabamisad, pacientTa cxovrebis xarisxis momateba atipuri neiroleptikebiT mkurnalobisas tradiciulTan SedarebiT warmoadgens erT-erT mniSvnelovan daskvnas Catarebul gamokvlevebSi. cxovrebis xarisxis dadebiTi dinamika dakavSirebulia pozitiuri simptomatikis reduqciasTan, romelic korelaciaSia socialuri urTierTqmedebis amaRlebasTan, pacientTa socialur garemoSi integraciis SenarCunebasTan, daavadebis ukeTes Soreul SedegebTan, xolo negatiuri simptomatikis reduqcia sifxizle-Zilis ciklis gaumjobesebasTan da energiisa da zogadi tonusis aRdgenasTan. samuSaos ZiriTadi amocanebi moicavda xsnaris formis (1,0 ml. = 1,0 mg) rispoleptis fsiqotropuli efeqtis profilis da misi gverdiTi efeqtebis Seswavlas klinikurad erTgvarovan SizofreniiT daavadebul pacientTa jgufze, halucinatorul- paranoiduli simptomebis upiratesi gamovlinebiT.

gamokvlevSi CarTuli iyvnen mamakacebi 21-da 47 wlamde mwvave fsiqozuri mdgomareobiT (fsiqomotoruli, bodviTi, halucinatoruli da maniakaluri agznebis CaTvliT), romelic Seesabameboda erT-erT qvemoT CamoTvlil diagnozs ISD-10-is mixedviT: paranoiduli Sizofrenia F20,0 -14 avadmyofi ,aradiferencirebuli Sizofrenia F20.3 – 6 vadmyofi, Sizoafeqturi aSliloba maniakaluri tipi da F25.0 – 4 avadmyofi.

avadmyofTa ZiriTadi daxasiaTeba

asaki	21-47 weli
mamakacebi	24 pacienti
diagnozi: -Sizofrenia paranoiduli F20.0 Sizofrenia aradiferencirebuli F20.3 Sizoafeqturi aSliloba maniakaluri tipiT	14 6 4
daavadebis xangrZlivoba	1Tve-33 weli
daavadebi mimdinareobis tipi: uwyveti SeteviT mimdinare	8 16
pirveladi hospitalizacia	4
ganmeorebiTi hospitalizacia	20
fsiqopaTologiurad datvriTuli     memkvidreoba	8
mimdinare debiutis gamravlebis      sindromaluri Sefaseba afeqtur- bodviTi sindromi halucinatorul- paranoiduli sindromi depresiul- paranoiduli sindromi parafreniuli sindromi	6 8 4 6

gamokvlevidan gamoiricxeboda pacientebi cns-is oragnuli dazienebiT, mwavve da qronikul somaturi daavadebiT. yvela av-ma mogvca informaciuli Tanxmoba gamokvlevaSi monawileobaze. monawileobas ar iRebdnen is pacientebi, romlebsac utardebodaT mkurnaloba prolongirebuli neiroleptikebiT  gamokvlevis dawyebis win.

tabula 2

parametrebi	av-Ta raodenoba
wina antifsiqozuri Terapia -               ar Catarebula -               mxolod amJamindeli hospitalizaciis dros -               mxolod wina gamwvavebis dros	4 15 5
adre iRebdnen: -        klasikur neiroleptikebs -        atipiur neiroleptikebs -        benzodiazepinebs -        an antidepresantebs	20 0 6 7

rispolepti iniSneboda Semdegi sqemiT: IdR.-1,0 mg. II dR. – 2,0 mg. III dR. 3.0 mg da a.S. Semdeg dozebs cvlidnen Terapiuli efeqturobis mixedviT da yvelaze maRali dR. doza iyo 8,0 mg. or miRebaze. Zilis daRvevis, mousvenrobis, agresiuli qcevebis SemTxvevaSi, rogorc wesi, iniSneboda azaleptini 50,0-150.0 mg/dR. es doza iyofoda erT- or miRebaze. eqstapiramiduli atipiuri movlenebis ganviTarebisas iniSneboda koreqtori (triheqsafenidini) efeqtur dozebSi.

rispoleptiT mkurnalobisas Setevismagvari SizofreniiT daavadebul avadmyofebSi Setevis halucinatorul-bodviTi sturqturiT, (16 avadmyofi), roca klinikur suraTSi gamoxatulia verbaluri halucinozis gamovlinebebi imperatiuli an makomentirebeli Sinaarsis ganuwyveteli halucinatoruli monologis saxiT. GMmdgomareoba xasiaTdeba uxvi,SinaarsiTa da garegani proeqciiT ukiduresad cvalebadi WeSmariti verbraluri halucinaciebis arsebobiT. Aafeqturi aSliloba gamorCeulia SiSis SegrZnebiT, SfoTviT, depresiiT. avadmyofTa qceva damokidebulia  halucinatoruli aSlilobis Sinaarsze. bodviTi gamonaTqvamebi am grZnobadi bodvis sazRvrebSi gamorCeulia arasistematurobiT da warmoadgens halucinatoruli SegrZnebebis ukritiko Txrobas.                                                        

P pozitiuri dinamika aRiniSneboda pirveli ori kviris ganmavlobaSi saSualo 4.0-6.0 mg dR. dozaze. Ppirvel rigSi qreboda gafantuloba, daZabuloba, rig SemTxvevebSi aRiniSneboda reduqcia rogorc afeqturi,aseve halucinatorul-bodviTi aSlilobisa, halucinaciuri simptomatikis reduqciis garkveuli winswrebiT.

  dakvirvebaTa umetesobaSi ukuganviTareba iwyeboda afeqturi daZabulobis daqveiTebiT, xolo halucinatorul-bodviTi struqtura reducirdeboda TandaTanobiT, maTi formirebis ukuTanmimdevrobiT. bodviTi gamovlinebebi kargavda aqtualobas. Aucilebelia aRiniSnos mwvave grZnobadi bodvis intensivobis daqveiTeba, Semdgom mJRavndeba mentizmis reduqcia, gaxsnilobis ideis, azrTa wakiTxvis, naZaladeobis, maSin roca damokidebulebis devnis, ideebi, reduqciisadmi midrekili aris mkurnalobis me-3, me-4 kviridan. Aucilebelia xazgasma rogorc efeqtis miRebis siCqarisa, aseve antifsiqozuri zemoqmedebis globalurobisa. TvalSisacemia avadmyofTa qcevis SesamCnevi mowesrigeba, subieqturad preparatis kargi amtanoba, modunebisa da Sekavebis mcire gamovlinebiT.

  rispoleptma aCvena gansazRvruli efeqturoba aramarto mwvave bodviTi Setevis kupirebisas, aramed, rac gansakuTrebiT mniSvnelovania, qvemwvave  halucinatorul-bodviTi mdgomareobebis gamwvavebisas, uwyveti Sizofreniis farglebSi.

U upiratesad bodviTi variantebisas (6 SemTxveva) aRiniSneboda rogorc monoTemarturi aseve poliTematuri bodviTi ideebi sistematizaciis gansxvavebuli xarisxiT, rac gamoixateboda Zilis formulis cvlilebaSi. pirovnebis cvlileba atarebda sakmarisad gamokveTil xasiasiaTsa da gamovlenili iyo CaketilobiT , emociuri gasadavebiT da nebiTi potencialis daqveiTebiT.

M msgavsi mdgomareobebis kupirebisaTvis rispolepti amJRavnebda efeqtur zemoqmedebas 6,0-8,6 mg. dR. doziT. Mmdgomareobis ukureduqcia fiqsirdeboda Teraiis me-3, me-4 kvirisaTvis da misi efeqturoba ZiriTadad damokidebuli iyo simptomis dasrulebulobaze da negatiuri gamovlinebebis gamoxatulebaze.sinromi rac ufro mcired sistematizebuli iyo, xolo negatiuri gamovlinebebi ar atarebdnen totalur xasiaTs, miT warmatebuli iyo mocemuli gamwvavebebis kupireba. Aaucilebelia aRiniSnos kognituri funqciebis paraleluri aRdgenis tendecia, rac  Zalze mniSvnelovania.

P  paranoiduli Sizofreniis halucinatoruli variantebis (8 avadmyofi) SemTxvevaSi, gamoxatuli iyo  calkeuli verbaluri halucinacia CaZaxilebis saxiT, WeSmariti verbaluri falucinaciis Semdgomi ganviTarebiT “gakeTebulobaSi” swrafi gadasvliT. “xmebi” Cndebodnen TavSi, anu iRebdnen fsevdohalucinatoruli  aSlilobebis xasiaTs. erwymoda asociaciuri avtomatizmis gamovlinebebs, Tumca mainc inarCunebda upiratesobas. bodviTi aSliloba imyofeboda halucinaciebis mWidro kavSirSi.  rispolepti ukve pirveli ori kviris ganmavlobaSic 4,0-6.0 mg. dR. doziT iCenda dadebiT gavlenas bodviT, halucinaciur, afeqtur da negatiur simptomatikaze. aRiniSneboda halucinaciebis, bodvis fsiqomotorul agznebis harmoniuli reduqcia. im SemTxvevaSi sadac Cven ver viRebdiT sakmaris efeqts, mainc xdeboda bodvis da halucinaciebis dezaqtualizacia, qveiTdeboda fsiqikuri avtomatizmis gamovlenis intensivoba, mcirdeboda afeqturi aSlilobis simkveTre, pozitiuri produqcia kargavda aqtualobasa da SesamCnevad wesrigdeboda avadmyofTa qceva. Ddozis mcire Semcirebas me-4 kviris bolosaTvis rig dakvirvebaSi (3) kvlav mivyavdiT gamwvavebisaken, rac saWiroebda azaleptins 100.0-150.0mg. dR. dozamde Aucilebel gazrdas an aminazinis ineqciebis kunTebSi daniSvnasac ki 100.0mg. dR. doziT.

rac Seexeba negatiur ganovlinebebs, iseTisa, rogoric aris emociuri gaRaribeba,  afeqtis daClungeba, ukve pirveli aTi dRis ganmavlobaSi avadmyofebi xdebodnen ufro cocxali da aqtiuri, gamoiyurebodnen ufro komunikalurad; SeiZleba es dakavSirebuli iyo sawyisi produqtiuli simptomatikis SesustebiT. Cvens dakvirvebaSi  veTanxmebiT rispoleptis negatiur simptomatikaze  ara gaSualebuli zemoqmedebis efeqts, aramed mis pirvelad zemoqmedebas  negatiur simptomebze.

6 dakvirvebaSi, sadac klinikur suraTSi prevalirebda parafreniuli da maniakalur-parafreniuli mdgomareobebi, fantastiuri an absurduli Sinaarsis bodviTi, aseve fsevdohalucinatoruli parafreniis SemTxvevaSi Terapiuli taqtika saWiroebda dozebis swraf zrdas 8,0 mg-mde dReSi. miuxedavad amisa, SesamCnevi dinamikis dafiqsireba ver moxerxda, aRiniSneboda mxolod parafreniuli gamonaTqvamebis kuTri wonis umniSvnelo Semcireba, Tumca am SemTxvevaSic wesrigdeboda avadmyofTa qceva. SesaZloa mocemuli mdgomareobebis reduqciisaTvis aucilebelia ufro xangrZlivi dro, Cveni dakvirveba da mkurnaloba ki mxolod 4 kvira grZeldeboda.

depresiul-bodviTi aSlilobebi 4 avadmyofSi gamovlinda TviTbraldebis, TviTdamcirebis ideebTan inscenirebis grZnobadi bodvis elementebis kombinaciiT, damokidebulebis, devnis bodviT, depresiul an SfoTviT-depresiul fonze.

Am SemTxvevebSi rispoleptma SedarebiT dabal dozebSi – 2,0-4,0 mg/dR. mogvca garkveuli dadebiTi efeqti ukve Terapiis pirveli ori kviris ganmavlobaSi – nivelirdeboda depresiuli afeqti, depresiuli Sinaarsis aqtualuri bodviTi ideebi iwyebdnen aqtualobis dakargvas; qreboda SiSi mdevnelTa mimarT, mcirdeboda grZnobadi bodvis gamovlenis intensivoba. aucilebelia aRiniSnos, rom rispolepti aqtiurad zemoqmedebs afeqtur darRvevebze, SfoTvis da depresiis gamovlinebebis sifarTovis CaTvliT. mocemul dakvirvebebSi erTdroulad rispoleptTan erTad daniSnuli iyo antidepresantebi, kerZod, amitriptilini 75,0 mg-dan 125 mg-mde dReRamuri doziT.

rispoleptis gverdiTi gamovlinebebi:

eqstrapiramiduli gverdiTi gamovlinebebi gamovlinda 3 avadmyofSi. 2 maTganSi tremoris, bradikineziis saxiT, moZraobis SekavebiT. rogorc wesi, is warmoiSoboda 4,0 – 6,0 mg/dR. doziT. kupirdeboda qolinolizuri (antiparkinsonuli) Terapiis daniSvnisas.

ZiriTadi eqstrapiramiduli gverdiTi efeqtebis gamovlenis sixSire mkurnalobis sxvadasxva vadisas.

	rispoleptis xsnari Sinagani miRebisTvis
simptomatika	sqemiT
	gamokvlevis dRe
X	3	7	14	21	28
siarulis SezRudva	2	2	0	0	0
kunTebis rigiduloba	2	2	2	0	0
tremori	0	2	2	0	0
neiroleptikuri depresia	0	0	0	1	0

gansakuTrebulad unda aRiniSnos 1 dakvirveba, romelic Cveni interpretaciiT iyo neiroleptikuri depresia. is xasiaTdeboda guneb-ganwyobis monotonuri daqveiTebiT,  upiratesi asTeniuri  gamovlinebebiT, garkveuli gafantulobiT,daZabulobiT.  msgavsi mdgomareoba warmoiSva mkurnalobis me-3 kviraze 6,0 mg/dR. dozis pirobebSi. damatebiT anafranilis (klomipraminis) 50,0 mg dRiuri dozis daniSvnam saSualeba mogvca rispoleptis dozis cvlilebis gareSe, mogvexdina msgavsi gamovlenis kupireba.

aucilebelia aRiniSnos, rom rispoleptiT mkurnalobisas gverdiTi gamovlinebebi da negatiuri efeqtebi atareben iSviaT xasiaTs, isini ar iyvnen gamoxatuli da rac metad mniSvnelovania, sakmarisad iolad kupirdebodnen antiqolinerguli preparatebis adeqvaturi dozebiT.

Sedegebi: Catarebulma gamokvlevam aCvena rispoleptis (xsnaris saxiT) didi efeqti SizofreniiT daavadebul avadmyofTa mwvave da qvemwvave mdgomareobis kupirebisas. preparati, miuxedavad mcired gamoxatuli sedatiuri efeqtisa, sakmarisad swrafad, 7-10 dRis gan-Si axdenda produqtiuli siptomatikis reducirebas, anu antifsiqozuri moqmedeba vlindeba mkurnalobis pirvelive dReebidanve. rispolepti axdens dadebiT zemoqmedebas ,rogorc halucinatorul, aseve bodviT siptomatikaze, pirvelze umniSvnelo upiratesobiT. garda amisa, is kargad axdens afeqturi gamovlinebebis – SiSis, SfoTvis, bodviTi depresiis kupirebas afeqtur-halucinatoruli da afeqtur-bodviTi sindromis farglebSi Setevismagvari Sizofreniisas.

  aucilebelia xazi gavusvaT, rom TviT fsiqikuri daavadebis xangrZlivoba mocemuli mimdinareobis farglebSi ar warmoadgens gansakuTrebul  winaRobas.

   aucilebelia, aseve, aRiniSnos rispoleptis swrafi zemoqmedeba avadmyofTa qcevaze, romelic xdeba ara marto mowesrigebuli, aramed matuliobs aqtiurobac. aseve xdeba agresiis gamovlinebebis kupireba,rbildeba gamRizianebadobisa da disforiis gamovlinebebi.

   rispolepts gaaCnia kargi amtanoba, ar iwvevs mniSvnelovan eqstrapiramidul da diskineziur aSlilobas, xolo maTi gamovlenis SemTxvevaSi, rogorc wesi, es gamoixateba mcire xarisxiT. gverdiTi movlenebi advilad kupirdeba  preparatebis dozis SemcirebiT an koreqtoris xanmokle daniSvniT.

   rispoleptiT Terapia ar arTulebda pacientTa resocializaciis Catarebas.

   Литература:

      1. Аведисова А.С. – Научные обоснования и практические рекомендации перевода  больных с типичных нейролептиков на рисполепт. «Психиатрия и психофармакотерапия», 2001, 6, 210-213

      2. Ильина Н.А. – Применение рисполепта при шизофрении. «Психиатрия и психофармакотерапия», 2005, 5, 142-144

      3. Калинин В.В., Сулимов Г.Ю. – Купирование острой психотической симптоматики у больных шизофренией атипичным нейролептиком рисполептом «Психиатрия и психофармакотерапия», 2001, 3, 69-71

      4. Молосов С.Н., Калинин В.В., Еремин А.В. и др.- Сравнительное рандомизированное исследование эффективности и толерантности респирдона и галоперидола при купировании острых состояний у больных шизофренией и шизоаффективнным психозом «Психиатрия и психофармакотерапия» 2000, Приложение №2,3-6.

      5. Раевский К.С. – Современные нейролептики : взаимодействие с системами нейротрансмиттеров мозга. «Психиатрия и психофармакотерапия» 2000, 5, 132-134.

      6. Точилов В.А., Снедков Е.В. – Раствор рисполепта для перорального применения: новые возможности купирования острых психотических сосотояний у больных. «Социальная и клиническая психиатрия», 2002, 2, 85-91.

      7. Beng – Choon H., Miiler D. – A  comparative effectiveness study of risperidone and olanzapine in the treatment of shizophrenia. J. Clin. Psychiatry – 1999, vol, N 10, pp. 658-663.

      8.  Key S.R., Fisbein A. – The Positive and Syndrome Scale (PANSS) for shizophrenia. Shizophrenia, Bull., 1987, vol. 13, p.261.

      9. Lieberman J. – Atypical antipsychotic drugs as a first line treatment of shizophrenia: a rational and hypothesis. J. Clin. Psychiatry, 1996, vol. 57, Suppl. 11, pp. 68-71.

      10. Marders  S., Meibach R. – Risperidone in the treatment of shizophrenia. Am. J. Psychiatry, 1994, vol. 151, N6, pp.825-835.

      11. Meltzer H. – The role of serotonine in shizphrenia and the place of serotonine-dopamine antagonist antipsychotics. J.Clin. Psychitary, 1989, vol. 40, N9, pp.921-927.

      12. Weiden P., Aqulia – Antypical antipsychotic drugs and long-term outcome in shizophrenia. J. Clin. Psychiaty. 1996, vol. 57, suppl. 11, pp. 5360