The first signs of psychosis. Psychoses and their treatment

30.11.2019

Acute psychosis is a pronounced violation of mental activity, manifested in an inadequate perception of reality and oneself. With this disease, a person can completely lose control over their own behavior and actions.

In this state, are often observed,. The disease can develop against the background of a somatic illness, psychotrauma, or after strong emotional upheavals.

Psychosis in an acute form is usually not a single phenomenon, but constantly recurring. At what the probability of a recurrence is high. But unlike the chronic form, acute psychosis is a temporary mental disorder that can last for several days or weeks. The prognosis of therapy is favorable.

People suffering from this disease often withdraw into themselves and do not accept the help and advice of loved ones. Therefore, it is important to diagnose the problem as early as possible so that timely therapy, albeit forced, is prescribed. Indeed, over time, the adequacy of a person becomes lower and lower, against the background of which irreversible for mental state processes.

Causes and forms of acute psychosis

According to statistics, women are more likely to suffer from acute psychosis. This is probably due to hormonal imbalances.

Depending on the cause that provoked the development of the disease, the following types are distinguished acute psychosis:

By clinical manifestations the following types of deviations are observed:

Often difficult to diagnose initial reason illness. The impetus may be a combination of several factors.

alcohol form

Acute develops in those people who abuse alcohol for several years. And it develops when a person abruptly renounces his bad habit. Alcoholic psychosis manifests itself as follows: there is a sharp change in mood, hallucinations and delusions appear, the patient is dangerous to others.

In this condition, immediate admission to the hospital and bed rest is required. Usually the patient does not understand what is happening and resists.

In the hospital, he will be constantly monitored, and an appropriate course of therapy will be prescribed.

mental breakdown after childbirth

This condition may appear in the first weeks after the birth of the baby. The main cause of mental disorders is illness during childbearing and pain shock during childbirth. How does it manifest itself? The woman becomes very emotional, tearful, sleep problems appear, there is no appetite.

Emotional behavior can be different. Some women are indifferent to their baby, while others begin to take care of all the children in the ward. Some young mothers may be in a state of euphoria, while others, on the contrary, become withdrawn and taciturn.

Acute psychosis should not be confused with postpartum depression. In the second case, delirium and hallucinations are absent. Women in labor with such mental disorders should be referred for treatment, otherwise there may be terrible consequences, up to suicide or the death of the baby.

Psychotic behavior in children can manifest itself in different ways. The most important sign is, that is, the ability to hear and see what is not in reality.

There is also delirium, incomprehensible laughter for no reason and irritation. Psychosis in a child can develop against the background of short-term or long-term states of physical appearance. It's drug use fever, hormonal disruptions. It is important to cure the underlying disease, then the mental deviation will also pass.

If psychosis is suspected, the necessary diagnostic tests should be carried out. It is required to visit a neuropathologist, a specialist in developmental diseases, an ENT doctor, a speech therapist. If the child has experienced severe stress, long-term psychotherapeutic support will be required.

Risk factors

In different life cycles, there may be different types mental deviations. In adolescence, there is a high probability of development.

In old age, when age-related changes often occur in the vessels and are disturbed, it is formed.

manic depressive young ambitious individuals are more likely to be seen. During this life period, some global changes in fate can adversely affect mental health.

As for the gender factor, statistics show that the disease develops in men and women in the same way. But there are types of the disease, which men are more susceptible to. This and also at . But manic-depressive syndrome is three times more common in women, since hormonal surges often occur in the weaker sex.

If we consider the geographical factor, it is noted that mental illnesses affect residents of large cities more. Because in the metropolis there is a high level of stress and a frantic pace of life, so the psyche suffers.

The social factor manifests itself when a person could not realize himself. For example, a girl did not marry and could not give birth, or a man did not achieve his goals. In such cases, the burden of negativity puts pressure on the person, but contributes.

Symptoms of the disease

The disease manifests itself from different sides. It all depends on the characteristics of the organism and the causal factor that led to the failure in the psyche.

Warning symptoms that may indicate a possible acute psychosis:

changeable mood, depression and phobias develop;
change in character: appears

Modern approach to treatment

Treatment of acute psychosis should begin as early as possible. Only a qualified psychotherapist can identify the provocative cause and prescribe high-quality therapy. You can not leave the patient at home on self-treatment.

Modern specialists use the following methods of therapy:

For high-quality treatment, a complex of different measures is needed. Such a complex is individual for each person and only a good doctor can pick it up. Timely therapy will help increase the likelihood of a good prognosis.

It should be remembered that psychosis is a curable disease. The main thing is not to delay the therapy. Only self-discipline, regular use medicines, psychotherapy and the help of others will help restore mental health and joy of life.

Acute psychosis is a severe mental illness accompanied by a violation of the objective perception of the surrounding reality, a critical assessment of events and information, hallucinations and delusional states. At the same time, a person does not consider himself sick and cannot adequately assess what exactly in his perception the people around him consider abnormal.

As a rule, acute psychosis has a relapsing course, that is, after a period of absence symptomatic manifestations there may be a sharp deterioration in the condition. If there is a history of this disease, a person needs constant monitoring by others, since during an attack the patient may forget himself and his identity, place of residence and other important information.

Reasons for development

Acute psychosis, like many other mental illnesses, is currently not fully understood by psychiatric medicine. The complexity of understanding the causes of the development of such conditions lies in the fact that the human brain is an extremely complex and not fully understood structure, which can be negatively affected by both external and internal factors. Most often sharp forms psychosis are observed in adolescents at puberty, as well as in women over 50 years of age, which is a consequence of serious hormonal changes. Depending on the reasons that led to the development of this mental illness, 3 main types of psychosis are distinguished, including:

endogenous;
exogenous;
organic.

The endogenous type of psychosis develops due to the influence of various internal factors. These internal factors often include severe chronic diseases endocrine system and neurological disorders, in addition, to contribute to the development of this type of psychosis can genetic predisposition and schizophrenia. The group of endogenous types of psychoses also includes a fairly common senile psychosis, which is a consequence of age-related changes, atherosclerosis and hypertension.

Exogenous types of psychosis develop due to the influence of various external factors. To such external factors relate:

severe stress;
severe alcohol or drug intoxication;
infectious diseases.

It should be noted that exogenous types of psychoses are currently considered the most common. These forms of acute psychosis include delirium tremens. Organic psychosis develops, as a rule, as a result of various brain damage, including against the background of severe traumatic brain injuries and tumor growths.

There are many various forms course of the disease, each of which has its own characteristics of development and prognosis. The most common variants of this mental illness include:

manic-depressive;
manic;
reactive;
polymorphic.

Conditions such as acute manic-depressive disorder, also known as bipolar disorder, are accompanied by a change in severe depression and phases of excessive arousal. The manic variant of psychosis is accompanied by persistent excessive arousal and a desire to constantly do something.

The reactive form of the disease develops as a result of severe stress, which can appear in a person with a weak psyche in situations that threaten his life or health. This type of mental disorder usually resolves without treatment once the person is safe. Acute psychosis of the polymorphic form usually manifests itself in children aged 10 to 15 years. Similar mental disorder may indicate developing schizophrenia.

This is far from full list forms of psychosis. In fact, there are many variants of such a mental disorder, but only a qualified psychiatrist can correctly diagnose in a particular case.

Symptoms

Acute psychosis is characterized by the appearance of a mass of various symptomatic manifestations. Development of this pathological condition can be noticed long before the acute phase, characterized by complete loss of orientation in space and hallucinations. People around a person suffering from this mental illness should pay attention to the following symptoms:

personality change;
nervousness;
fast fatiguability;
inability to concentrate for a long time;
distortion of the perception of sound and light;
sleep disorders;
depression;
unreasonable fears;
sudden mood swings.

All these signs of a developing attack often go completely unnoticed by both the patients themselves and their relatives. If the beginning attack was not stopped by medication at this stage, there are signs of the acute phase of the disease, including:

hallucinations;
pseudo hallucinations;
loss of a sense of self;
derealization;
incoherent speech;
distorted logic;
misunderstanding of the meaning of what is being said.

All symptoms of the disease can remain with a person for several hours, and sometimes months. At this time, the patient requires special attention from loved ones and medical staff psychiatric hospital.

Treatment Methods

In the vast majority of cases, the treatment of acute psychosis is aimed at stabilizing the patient's condition and eliminating the manifestations of the disease. First assigned drug therapy which includes:

neuroleptics;
antidepressants;
tranquilizers;
means for detoxification.

The scheme and dosage of taking medications is selected by the attending psychiatrist.

After the manifestations of psychosis decrease, long-term psychotherapeutic treatment is often required.

Properly carried out psychocorrection allows you to create an atmosphere of trust between the doctor and the patient, and in addition, to teach a person suffering from psychosis to adequately assess themselves and the actions of others, as well as to understand reality. This allows a person suffering from bouts of psychotic delusions to get rid of obsessive fears.

Among other things, electroconvulsive therapy is currently being used for some varieties of acute psychosis. Besides, positive effect reflexology, physiotherapy exercises, acupuncture and spa treatment can provide. Complex treatment, as a rule, has a positive effect, and the person returns to normal life.

If a person suddenly begins to behave completely inappropriately, they usually say about him that he has "lost his mind." Under this vernacular expression, a very specific medical diagnosis is usually hidden - psychosis or "a pronounced disturbance of mental activity, in which mental reactions grossly contradict the real situation."

This definition of psychosis belongs to the famous Russian scientist Ivan Petrovich Pavlov, the creator of the science of higher education. nervous activity, more known to all of us from the famous experiments with reflexes in dogs. The great scientist practiced at the beginning of the 20th century, since then medicine and science have stepped far forward, but his conclusions about the essence of psychosis and descriptions of this condition remain relevant at the present time.

Modern doctors believe that not a single person in the world is immune from the development of psychosis. Symptoms of psychotic disorders in adults and children can manifest as a result of a variety of diseases and conditions, injuries and brain disorders. The most common provoking factors include:

Unfavorable heredity. Scientists have identified at least one gene (ZNF804A) associated with psychosis, and have long proven that the condition can be passed from parent to child.
Brain injury. The more severe the damage to the brain, the higher the risk of developing psychosis, and it may not appear immediately, but after a long time.
Alcoholic or drug intoxication. Chemical poisoning of the brain, which occurs when taking alcohol or drugs, eventually leads to the destruction of its individual structures and can provoke the development of many mental disorders, including psychosis.
Taking certain medications.
Diseases nervous system such as epilepsy, stroke and so on.
Infectious diseases accompanied by disorders of brain activity.
Tumors of the brain.
Hormonal fluctuations in diseases or certain conditions - puberty, pregnancy, childbirth, and so on.
Deficiency of certain vitamins and electrolyte disorders (lack or excess of minerals) in the body.
Severe immune disorders.
Serious stress, psychotraumatic events.

This is not a complete list of reasons that can cause psychotic disorders. Each case of psychosis is largely individual, and in the treatment of the disease, doctors have to take into account many concomitant factors, the combination of which led to the development of a painful mental state.

An example of acute psychosis after prolonged alcohol use: delusions of persecution, clouding of consciousness, the condition is complicated by cardiopathy

Classification of psychoses

Several types of classifications are used to systematize psychotic disorders. Most often, two schemes are used, according to which psychoses are divided according to the causes of their occurrence and according to the characteristics of the clinical picture.

According to the etiology and mechanisms of development, psychoses are divided into:

(in their development, the main role is played by internal factors of a neuroendocrine nature).
Organic (associated with damage to brain tissue).
Somatogenic (associated with other chronic diseases).
Psychogenic or (manifested in response to a serious psychological shock, stress).
Intoxication (caused by poisoning of brain cells with various poisons, alcohol, drugs, for example).
Withdrawal and post-withdrawal (occurring after drinking alcohol).

There is also a classification of psychoses according to the prevailing symptoms, based on the clinical picture:

Paranoid (with severe delusional experience).
Hypochondriacal (complaints about health).
Depressive (depression).
(state of overexcitation).

Quite often there are various combinations of different psychoses, because the course of the disease is not always accompanied by only one type of complaint.

Symptoms of psychosis

The signs of psychosis are usually so vivid that they are difficult to confuse with any other mental conditions.

The first thing that should alert others in human behavior is obvious inadequacy, increased activity, or vice versa, pronounced lethargy. These symptoms can be considered "early", usually they precede the development of the typical clinical picture of acute psychosis. In the future, other signs of the disorder may appear:

motor excitement or complete stupor when the patient is in one position and does not respond to external stimuli;
crazy ideas. It may seem to a person that someone is following him, wants to kill him, steal his things, that he is sick with a terrible disease, and so on. Delusions of jealousy are common in men, psychosis in women may be accompanied by delusions related to children (that someone will harm them, steal them, or that a child is a doll, animal, inanimate object);
the patient can completely refuse food, sleep also often disappears;
a person in a state of psychosis can speak in separate phrases or words, he is practically inaccessible for contact, does not understand the speech addressed to him;
quite often there are hallucinations - visual (the patient sees something that is not really there), auditory (hears voices), tactile (feels non-existent touches, pain), taste;
uncontrollable outbursts of rage, aggression are possible - both to oneself and to others;
often the patient tries to commit suicide, not always understanding what result his actions can lead to. For example, he jumps from the window, “seeing” below not several floors of the building, but a cozy clearing with flowers;
in a state of hyperactivity, a person sees no obstacles to his actions, gushes of energy, may begin to abuse alcohol, engage in promiscuous intimate relationships.

This is a fairly general and short list. possible symptoms psychosis. On practice clinical picture may be the most unpredictable, and even the variety of delusions in this disorder can be combined into a separate book, which will turn out to be quite thick. But in any case, one remains true important feature- absolute inadequacy of the patient's behavior in relation to the surrounding reality.

Psychoses in men and women

Statistics show that psychosis is more common in women than in men. The reason lies in the more global hormonal changes to which female body throughout life. There are also types of psychoses that develop exclusively in the fairer sex - during pregnancy and after childbirth -.

In addition to hormones, the characteristics of the female nervous system also play a role. The reaction to stress in women is, on average, more violent than in men, so it is easier for them to "shake" their nerves up to a psychotic disorder.

With regard to the symptoms and treatment of psychosis, there are no special differences between the sexes. Mental disorders in women, the course is about the same as in men, and sometimes even more difficult. For example, women often turn their aggression on children (up to killing or causing serious injuries), but men are more susceptible to alcoholic psychosis, since their alcoholism is almost always more severe.

First aid for psychosis

Early signs of approaching psychosis are quite difficult to determine by an outsider who has nothing to do with medicine. As a rule, the surrounding people begin to sound the alarm already when the patient's condition becomes really frightening, and no one has any doubts that the person has really gone crazy. What to do in this case, to help the patient and not harm himself?

Treatment at home is out of the question! To remove this condition, the patient needs mandatory hospitalization, and after it - long-term and regular monitoring of the local psychiatrist.

The first thing to do if someone around you shows symptoms characteristic of psychosis is to call ambulance and correctly describe the situation. The doctors themselves will figure out which team to send to the call and which hospital to take the patient to.

Before the arrival of doctors, you need to try to make sure that the patient does not harm himself or anyone else. Sometimes you even have to use physical strength to deprive an overexcited person of the opportunity to move. This must be done as carefully as possible so as not to hurt yourself and not injure the patient.

If everything is not so critical, and the patient is just inadequate, but not aggressive, you can try to establish contact with him, explain that nothing terrible is happening, that no one will harm him. There is no guarantee that this technique will work, but many people, even in an altered state of consciousness, can be calmed by the sound of a voice. loved one and friendly tone.

Some types of psychosis require more specific help - to put to bed, drink, warm, and so on. But since not even every doctor can make a diagnosis “by eye”, it is better not to go into details and not to guess what needs to be done in a given situation. Just stay close and wait for the ambulance to arrive.

Diagnosis and treatment

It is difficult to find a person who would not be afraid at one fine moment to be treated "in a psychiatric hospital", but in acute psychosis (especially if this is the debut of the disease), hospitalization is often inevitable. Even if the patient has known about his diagnosis for a long time, sometimes there are situations when the medicines prescribed by the doctor cease to properly influence the patient's condition, the psychosis recurs, and the person has to go to the hospital again.

Treatment in the clinic

In a hospital setting, it is much easier to make a diagnosis and choose the right treatment tactics. The patient is under round-the-clock supervision of experienced doctors, which minimizes the negative effects of psychosis.

The treatment of psychosis begins with the fact that with the help of medications (neuroleptics and tranquilizers) the patient is taken out of an inadequate state. If the cause of the disorder is drug or alcohol intoxication, a course of detoxification of the body is carried out at the same time.

At the same time, the doctor collects an anamnesis, monitors the patient and interviews his relatives to find out what could cause psychosis. It is not always easy to make a correct diagnosis, since there are a great many psychotic disorders, while they sometimes manifest very similar symptoms, but the treatment of different psychoses can also be quite different.

When the diagnosis is made and the cause is clarified, the main stage of treatment begins.

The doctor selects for the patient the necessary dosage of drugs that he will take for a long time, sometimes for life. It is important to remember that the doses and regimen of taking medications cannot be changed on their own in order to avoid side effects and new manifestations of the disease.
If some other disease has become the cause of psychosis, the psychiatrist will recommend contacting another specialist (neurologist, endocrinologist, etc.), who will prescribe therapy for the underlying disease.
A patient suffering from alcohol or drug addiction will be recommended an extended course of rehabilitation in a specialized center or clinic.
Sometimes psychotherapy is also used to treat psychosis, but for psychotic disorders, this method is auxiliary, and not the main one.

Treatment at home

How long it will take to treat psychosis can only be determined by the attending psychiatrist. In order to get rid of acute symptoms, usually a standard course of treatment in a hospital is enough (how long it will last is also determined by the doctor), but the therapy does not end there - recovery from psychosis lasts much longer than the patient is in a medical institution.

Relatives of the patient are usually given advice on how to behave and what to do to prevent the manifestation of new signs of psychosis. Relatives need to make sure that the patient regularly takes medication, follows the prescribed regimen and appears on time for an appointment with a doctor. Never try to treat psychosis folk remedies, refusing drugs - this inevitably leads to another exacerbation of the disease.

Another important factor can be called the situation in the family. Often, especially in women, psychosis develops against the background of constantly suppressed negative emotions. And their cause, in turn, is a feeling of helplessness and lack of support from loved ones. Psychotherapists can help in working with such a condition, but in this case, therapy is not a quick matter, and while it continues, the patient must feel attention to himself and help from relatives.

Each person from the patient's close circle should know what psychosis is, how it manifests itself, and what signs indicate its approach. And if any behavioral disorders appear in the patient, you should immediately inform the psychiatrist about this.

Conclusion

Can psychosis be cured? The question is certainly very important, but not every doctor can answer it. Psychosis is a rather serious illness, its course depends on many factors, and even modern medicine until she invented a magical remedy that could rid the patient of all symptoms once and for all.

One thing is for sure - if the patient is carefully treated, exactly fulfills the prescriptions of doctors, then the prognosis is more than favorable. Doctors have long learned to cure many (though not all) types of psychosis, so there are quite a lot of cases when the patient completely got rid of the manifestations of the disease and returned to normal life. Not every psychosis is curable, because there are too many factors involved, but if you know how to treat this condition, then it is much easier, and sometimes goes away for good.

Juan Miro, The Rooster and the Sun (1972). Image from orwellwasright.wordpress.com

What is acute psychosis?

Acute psychosis is a clear violation of mental activity, a violation of consciousness. It manifests itself in a distorted perception of real events and oneself. In a state of acute psychosis, a person loses control over his behavior and cannot help himself - he is led by his painful condition.

Acute psychosis is of exogenous and endogenous origin. That is, either arises from the impact on the psyche from the outside, or internal reasons for example due to schizophrenia.

Symptoms of acute psychosis caused by external causes

Psychosis caused by external influences - intoxication (alcohol, drugs), trauma or stress - manifests itself through clouded consciousness, stunning, stupor, disorientation in space and time. A person begins to see what is not there, that is, to hallucinate.

A classic example is alcoholic delirium, delirium tremens. At a certain stage of withdrawal, cerebral edema occurs, and the person begins to see something terrible, but not present in reality.

Because of these visions, the patient may begin to fight for his safety and harm others. And sometimes it can harm itself - a person is so scared that he tries to kill himself in order to end his visions. Alcoholic delirium is one of the most potentially fatal mental disorders.

Symptoms of acute psychosis caused by internal causes

If a person has schizophrenia - that is, an endogenous disease that does not have external causes - then acute psychosis manifests itself through a disorder of visual, auditory and olfactory perception. Crazy ideas come up. They occur more often than hallucinations.

What are crazy ideas?

Crazy ideas are a manifestation of the disease. They have their own internal logic, which is incomprehensible to other people, but is quite clear to a sick person. At the same time, the carrier of delusional ideas is not amenable to persuasion.

Where do crazy ideas come from?

There are several theories about how delusions are formed. Once a person begins to understand that something is wrong with him, somehow he is restless, anxious. And our brain is arranged in such a way that it needs to find the reason for what is happening - and it offers options.

Most often, a person stops at the idea that someone is following him. To strengthen the theory, a suitable candidate will be selected - classmates, neighbors, special services. The longer this goes on, the more complex the system of delirium will become. A crazy idea is like a ball of thread pulled by a person.

The idea of persecution at some point is projected into behavior - a person can start hiding, hiding from wiretapping in the bathroom, not opening doors and windows, not going out into the street.

There is another theory of the emergence of crazy ideas, when their appearance is associated with an excess of dopamine in the body, the hormone of pleasure.

All people constantly perceive a large number of information. Part of our brain is perceived as significant, the rest is filtered out. If there is no filter, we will go crazy from the abundance of colors, sounds and smells. Just such a broken filter, according to some researchers, is the cause of acute psychosis in endogenous diseases.

Insignificant information that has nothing to do with a person begins to be perceived by him as very significant. Things, events that are not connected with each other, are firmly connected in the mind of the patient. Suppose he saw a green cucumber in a store - this can make him go to the forest and climb a tall tree. Why this happens is unclear.

What determines the content of delusional ideas?

But more often all the same, crazy ideas are negative, scary, pushing for aggressive behavior. It must be understood that a person does not control himself, does not consciously participate in the process.

What causes acute psychosis in a schizophrenic?

Since schizophrenia is a disease caused by genetics, it can worsen without any visible reasons. It is believed that there is a seasonal dependence of exacerbations, but this is not always and not for everyone. Someone exacerbation can occur at any time of the year.

Acute psychosis can be provoked, as with any other disease, by stress, psychotrauma, forced sleep disturbance, prolonged physical activity. All of these factors can be a catalyst for psychosis.

How to recognize the onset of acute psychosis at an early stage?

The character of a person changes: he becomes more irritable, nervous. His sleep may be disturbed - a person may suddenly begin to wander at night, immersed in his thoughts. Loss of appetite, loss of interest in life is also a symptom.

Sudden mood swings, the emergence of some new fears, while the desire for self-isolation may also indicate that not everything is fine. A person becomes cold to loved ones, moves away from them, loses the ability to empathize.

What if the other person has acute psychosis?

If this is a familiar person, friend or relative, you need to call an ambulance.

If you see a person for the first time, then it is better not to make contact with him, but still try to somehow convey to those who know him that the person needs psychiatric help.

If a stranger poses a threat to themselves or others, it is also necessary to call a psychiatric team.

Before we look at the symptoms of psychosis and learn about its treatment, let's formulate the concept itself. Psychosis is not a specific disease, but a generalized class. Their common feature is a disturbed process of reflecting objective reality. In other words, a sick person perceives the world around him in a distorted form.

Psychosis: symptoms, treatment

Big Picture

Distorted Vision real world manifests itself in the manifestation of unusual syndromes and symptoms. Psychosis in no way gives rise to any new phenomena, it is just a loss of activity of higher brain levels.

Symptoms of psychosis

Generally, common features This state is considered to be all kinds of delusional states and various hallucinations. Regardless of the variety, the symptoms of psychosis include the obligatory agitation of actions.

All of the above symptoms of psychosis are its main features, but, mind you, not the only ones! In order to accurately determine the type of a particular mental disorder, it is necessary to conduct a long observation with a psychiatrist, after which the doctor will make an official conclusion and prescribe the appropriate treatment.

How to treat?

Usually the patient is placed in the current therapy is not complete without the use of special psychotropic drugs - neuroleptics (sometimes - tranquilizers or antidepressants). The treatment process is accompanied by the intake of drugs that strengthen the patient's body, or medications that help reduce the phenomenon of intoxication.

senile psychosis

Symptoms

This is a generalized group mental illness that occur in people over 60 years of age. This manifests itself in a state of clouded consciousness on the part of an elderly person, as well as in various endoform disorders. Important! does not cause total dementia!

Kinds

Today, doctors distinguish between two types of senile psychosis:

acute forms, which are manifested by clouding of consciousness;
chronic forms, manifested in paranoid and hallucinatory states.

Treatment

It should be carried out depending on the physical condition of the patient. Such psychotropic drugs, like "Pyrazidol", "Azafen", "Amitriptyline" and others. In some cases, treatment occurs with the use of two drugs. In addition, it is necessary to constantly monitor the somatic condition of patients.