Abilify insomnia side effects

Allergic reaction

As with most drugs, Abilify can cause an allergic reaction in some people. But this side effect was rare in clinical studies.

Symptoms can be mild or serious and can include:

• skin rash
• itching
• flushing (temporary warmth, redness, or deepening of skin color)
• swelling under your skin, typically in your lips, eyelids, feet, or hands
• swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Abilify. But if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Boxed warnings

Abilify has two boxed warnings. These are serious warnings from the FDA.

Suicidal thoughts and behaviors in people younger than age 24 years. Like other antidepressant drugs, Abilify may increase the risk of suicidal thoughts and behaviors in children as well as young adults ages 18 to 24 years. It’s important to note that Abilify is not approved to treat depression in people ages 18 years and younger.

Increased risk of death in older people with psychosis due to dementia. Abilify belongs to a group of drugs called antipsychotics. If these drugs are used to treat psychosis caused by dementia in older people, they can, in some cases, increase the risk of death. Due to this risk, doctors typically will not prescribeAbilify to treat psychosis related to dementia in adults ages 65 years and older.

With psychosis, you lose touch with reality and may have hallucinations. With dementia, you have problems with communication, thinking, and memory.

What you can do

Here’s some information about what you can do regarding Abilify’s boxed warnings.

Although the boxed warning about suicidal thoughts and behaviors refers to certain ages, you should monitor yourself for these symptoms however old you are. You should also ask family and friends to help monitor you for any symptoms of suicidal thoughts or behaviors.

Symptoms to watch for while taking Abilify include certain changes to your mood or behavior, such as increased or unusual:

• aggression or violence
• anger
• anxiety
• irritability
• thoughts of harming yourself
• trouble sleeping

Regarding Abilify’s other boxed warning, if you or a loved one is an older adult with psychosis due to dementia, talk with your doctor. They can recommend a treatment other than Abilify.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

• Ask the tough question: “Are you considering suicide?”
• Listen to the person without judgment.
• Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
• Stay with the person until professional help arrives.
• Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Click here for more links and local resources.

Abilify may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Are any side effects specific to the 5-mg or 30-mg strengths of Abilify?

No side effects are known to be specific to any dose or strength of Abilify. Researchers in clinical studies didn’t compare side effects across different doses or strengths.

However, they did note that some side effects occurred more often with higher doses, such as the 30-milligram (mg) dose. These side effects included:

• sleepiness in adults
• sleepiness and tremor in children

If you have other questions about Abilify’s side effects, talk with your doctor or pharmacist. You can also refer to the above sections in this article.

Can stopping Abilify treatment cause side effects of withdrawal?

It’s not known whether stopping treatment with Abilify will cause withdrawal side effects. (Stopping treatment may also be known as “coming off” a drug.)

Withdrawal symptoms were observed when animals were no longer given Abilify in animal studies. But the effects of stopping Abilify treatment haven’t been studied in people. Animal studies don’t always predict what will happen in humans.

There was one published case about a man who suddenly stopped taking Abilify and reported withdrawal symptoms. These symptoms included dizziness, anxiety, nausea, muscle twitches, and insomnia. It’s important to note that this case involved one person who took Abilify. It’s not known how common withdrawal symptoms may be in other people.

It’s important to note that you should not stop taking Abilify without speaking to your doctor first. If you both agree that you should stop taking the medication, they can advise you on the next steps. Your doctor may lower your dosage slowly over time. This is known as a drug taper, and it may help reduce your risk of withdrawal symptoms.

If you have additional questions about withdrawal and Abilify, talk with your doctor or pharmacist.

Is weight loss a side effect of Abilify?

No, weight loss isn’t a known side effect of Abilify. Weight loss wasn’t reported by people who took the drug in clinical studies.

But Abilify is known to cause weight gain as a side effect. (To learn more, see the “Side effect specifics” section above.)

Talk with your doctor if you have concerns about your weight while taking Abilify. They can recommend ways to help you manage a moderate weight.

Below are important precautions to consider before taking Abilify. This includes boxed warnings.

Boxed warnings

Abilify has boxed warnings about the following:

• suicidal thoughts and behaviors in people younger than age 24 years
• increased risk of death in older people with psychosis due to dementia

These are serious warnings from the Food and Drug Administration (FDA). For details, see the “Side effect specifics” section above.

Other precautions

Be sure to talk with your doctor about your health history before you take Abilify. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. The conditions and factors to consider include:

Blood pressure problems. Abilify can affect blood pressure. If you already have blood pressure problems, you may have an increased risk of these side effects. Your doctor can help determine whether Abilify is safe for you to take.

Convulsions or seizures. In rare cases, Abilify can cause convulsions or seizures. If you have or have had seizures, you may have an increased risk for this side effect with Abilify. Your doctor can help determine whether Abilify is right for you.

CYP2D6 poor metabolizer. Your body uses certain enzymes to break down medications such as Abilify after you take a dose. One enzyme is called CYP2D6. If your body doesn’t make enough CYP2D6, you may be referred to as a CYP2D6 poor metabolizer. In this situation, you may have an increased risk of side effects from Abilify. Your doctor will likely prescribe a lower dosage of the drug.

Diabetes. Taking Abilify can cause changes to your metabolism. These changes may increase your blood sugar levels, which can lead to diabetes. If you already have high blood sugar or diabetes, you may have an increased risk for this side effect.

If you have diabetes or a family history of diabetes, your doctor will likely check your blood sugar levels before prescribing Abilify. They can help determine whether Abilify is the right medication for you.

Low white blood cell count. Taking Abilify can lower your white blood cell count. This can raise your risk of infection. If you already have low white blood cell counts, you may have an increased risk for this side effect. Your doctor can determine whether Abilify is safe for you to take.

Heart problems. Abilify can lower blood pressure. If you have a heart problem, you may be at higher risk of this side effect than usual. (Examples of heart problems include heart failure and having had a heart attack.) Low blood pressure can be serious if your blood pressure drops too low. Your doctor can help determine whether Abilify is right for you.

Allergic reaction. If you’ve had an allergic reaction to Abilify or any of its ingredients, your doctor will likely not prescribe Abilify. Ask them what other medications may be better options for you.

Alcohol use with Abilify

There’s no known direct interaction between drinking alcohol and taking Abilify. But alcohol may worsen some side effects of Abilify, such as dizziness and trouble sleeping. Talk with your doctor about how much alcohol is safe for you to consume while taking Abilify.

Pregnancy and breastfeeding while taking Abilify

It isn’t known if it’s safe to take Abilify while pregnant or breastfeeding. If you’re pregnant or planning to become pregnant, talk with your doctor before starting Abilify treatment. You should also talk with them if you’re breastfeeding or considering it. Your doctor can advise you on the risks and benefits of the drug.

It may be possible to misuse Abilify, but the risk for this wasn’t reported in clinical studies. The term misuse means taking a drug in a different way than how your doctor prescribed it.

You can decrease your risk for misuse by taking Abilify exactly as your doctor advises.

If you misuse drugs or have in the past, your doctor will likely monitor you more often than usual during your Abilify treatment. Or they may recommend a different medication.

If you have questions or are concerned about misuse with Abilify, talk with your doctor.

Treatment with Abilify can cause some side effects, but they’re usually mild. Most mild side effects of the drug go away with time and don’t require medical attention. However, serious side effects are possible, as with most medications.

If you experience mild side effects that don’t go away or are bothersome, talk with your doctor. You should also talk with them if you develop serious side effects.

If you’d like to learn more about Abilify, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug.

You can also do some research on your own. These articles might help:

• More information on Abilify. For details on other aspects of Abilify, refer to this article.
• A look at your condition. To learn more about mental health conditions, visit our mental health hub. You can also see our lists of articles about schizophrenia, bipolar disorder, and depression. For more about autism, refer to our list of autism articles.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Aripiprazole Side Effects: Common, Severe, and More

Written by Keri Wiginton

In this Article

• Muscle Movement Problems
• Metabolic Changes and Weight Gain
• Desire to Sleep
• Compulsive Behavior
• Neuroleptic Malignant Syndrome (NMS)
• Other Common Side Effects
• Less Common Side Effects
• Serious Side Effects
• After You Start Aripiprazole
• What Else You Should Know

If you have schizophrenia, your doctor may want you to take aripiprazole. That’s a prescription drug sold under the brand name Abilify.

Aripiprazole is an atypical or second-generation antipsychotic (SGA). It balances out your dopamine and serotonin levels. These are chemicals in your brain that affect how you think, feel, and act. Your thoughts may become clearer on this drug. You may stop hearing or seeing things that aren’t there. Your mood and motivation may get better.

Oral forms of the drug can also treat Tourette’s syndrome and symptoms of bipolar 1 disorder. Aripiprazole may help calm irritability in children and teens with autism. Your doctor may use it with other medicine to treat depression. You can get a shot of aripiprazole to treat agitation with schizophrenia or bipolar mania.

Aripiprazole can help your mind become more stable. But like any drug, it can cause unwanted side effects. Some are mild, but others can be serious. Talk to your doctor about what can happen if you or your child take this medicine.

Muscle Movement Problems

Restlessness. In clinical trials, about 8% of adults with schizophrenia reported akathisia. That’s a movement disorder that makes it hard to stay still. You may feel like you need to do something with your legs. You may want to pace or rock back and forth. It feels different than agitation or anxiety.

Extrapyramidal symptoms (EPS). If you’re younger than 20, you’re more likely to have muscles that move or twitch on their own. A review of 41 studies showed about 17% of young people on aripiprazole get EPS.

Symptoms of EPS include:

• Repeated muscle contractions (dystonia)
• Urge to move around (akathisia)
• Body parts that shake (tremor)
• Inability to bend (parkinsonism)

Tardive dyskinesia. This is a disorder where you can’t control the muscles in your tongue, mouth, face, and upper body. It can happen after you use antipsychotics for a long time. You’re more likely to get it if you have other medical or movement problems. But your chances may be lower on aripiprazole than older antipsychotics and some other SGAs. Tardive dyskinesia may stop once you quit your medicine. But sometimes it doesn't go away.

Metabolic Changes and Weight Gain

Atypical antipsychotics may boost your appetite or change how your body uses energy. This may lead to weight gain. Sometimes, these drugs can raise your blood sugar or cholesterol levels. That can make it more likely that you’ll have diabetes and heart disease.

But when compared to similar drugs, aripiprazole may lead to less weight gain and problems with your metabolism.

Children on SGAs are more likely to gain weight than adults, especially if they have schizophrenia or autism. But adolescents who take aripiprazole may gain less weight than kids on other antipsychotics.

Your doctor may want to keep an eye on your or your child’s weight. They may want to watch your glucose and cholesterol levels, too. In the meantime, make sure you eat a balanced diet and get plenty of exercise.

Desire to Sleep

Aripiprazole can make you tired. Somnolence, or a strong urge to sleep, is more common in children. The effects may be higher with bigger doses. But aripiprazole may cause less somnolence than similar drugs. It may go away with time.

Compulsive Behavior

It’s rare, but you may get an urge to gamble that you can’t resist. Less often, you may feel the need to have sex, shop, or eat in a way you can’t control. If your loved one acts like this, you may need to tell them. They may not know it’s not normal.

These urges usually go away when your doctor lowers your dosage or stops the medicine. But always talk to your doctor before you quit aripiprazole.

Neuroleptic Malignant Syndrome (NMS)

Rarely, this drug can cause a possibly fatal set of symptoms. NMS can affect your heart, muscles, and kidneys. You may also get:

• A high fever
• Stiff muscles
• A change in your mental state
• Irregular heartbeat or blood pressure
• High heart rate
• A lot of sweating

If you have any of these symptoms, check with your doctor right away. They’ll want to rule out other medical conditions first. If your medicine is the problem, you’ll stop taking aripiprazole right away. You’ll get treatment for your other symptoms.

Other Common Side Effects

In clinical trials, at least 10% of all adults (including those without schizophrenia) also had:

• Nausea
• Throwing up
• Constipation
• Headache
• Dizziness
• Anxiety
• Insomnia

At least 10% of all children and young adults (including those without schizophrenia) also had:

• Headache
• Tiredness
• Increased hunger
• Insomnia
• Nausea
• Symptoms of the common cold

Less Common Side Effects

Some people may have drooling or get blurry vision, dry mouth, or a rash.

Serious Side Effects

In elderly people. Aripiprazole should not be used to treat dementia-related psychosis in older people. It may make their chances of stroke and death greater. The drug may make elderly people sleepy and lightheaded. They may not be able to swallow easily. This may raise their chances of injuries from falls or choking.

In young people. Antidepressants may raise the chances of suicidal thoughts in people younger than 24. If you care for a child or teenager on antidepressants, watch them closely for changes in their behavior. This is even more important during the first few months of treatment or if their dose changes. If you get worried, talk to your doctor.

After You Start Aripiprazole

Don’t drink alcohol or use illegal drugs when you take aripiprazole. Your medicine may not work as well if you do. You may also have worse side effects, like sleepiness.

Don’t operate machines or drive until you know how you’ll react to aripiprazole. Since it makes you drowsy, you may be more likely to have an accident. You may fall and hurt yourself if you’re tired.

You should tell your doctor if you exercise a lot or if you’re going to be somewhere that’s hot. That’s because the medicine may make it harder for your body to cool off. You should make sure to drink enough water.

What Else You Should Know

Your side effects may go away with time. But tell your doctor if you have any symptoms that you can’t control. They’ll help you figure out if you need to lower your dose or quit taking the drug.

Even if you feel better, don’t stop taking your medicine. You’ll need ongoing treatment for your schizophrenia. And your symptoms may come back if you miss a dose. If you want to change or stop your medicine, talk to your doctor. They’ll let you know when it’s safe to adjust your aripiprazole.

If you want to get pregnant, talk to your doctor. It may not be safe for you or your baby for you to stop your schizophrenia treatment. Your doctor can help you decide what to do about your medicine. You should also know that aripiprazole will get into your breast milk. Talk to your doctor before you start breastfeeding.

Hazards of artificial sleep

Insomnia most often occurs in older people who go to bed early and, in addition, often sleep during the day. Thus, experts conclude that it is necessary to abandon daytime sleep instead of treating the nightly insomnia caused by it.

Dangerous Pills

At the same time, overuse or misuse of sleeping pills results in about half a million people taking "sleep pills" every day for at least a month, putting their health at risk for no good reason.

Correct dosage

Another danger is overdosing. A dosing study of hypnotic drugs showed that most (nearly 80%) people 65 years of age and older take an increased dose of flurazepam (30 mg), although doses up to 15 mg are recommended for older people. Commenting on the specifics of the use of sleeping pills in the elderly, physicians note: "The regular and long-term use of this group of drugs is of particular concern, which in itself has a dubious therapeutic efficacy and leads to an increased risk of developing negative effects from taking sleeping pills. "

Remember: sleeping pills should only be used in a limited number of cases, the increasing frequency of prescribing these drugs to the elderly, especially for long periods of time, poses a serious threat to their health.

Side effects

The most common side effects of sleeping pills are:

• daytime sleepiness,

• drug addiction,

• development of amnesia,

• increased risk of car accidents,

• impaired motor coordination and learning ability,

• slurred speech

• and even death.

This is especially likely if these drugs are taken with alcohol or other CNS depressant drugs.

The consequences of taking

These consequences, as studies show, do not depend on age. However, older people may not be able to clear these drugs as quickly as younger people. Older people are also more sensitive to the side effects of medications. However, despite the obviousness of this fact, sleeping pills are prescribed to people in old age more often than to people of middle and youthful age. Moreover, they usually receive the standard dose, not a reduced dose, which greatly increases the risk of side effects. Yes, and they take such drugs for much longer periods of time. Therefore, it is hardly surprising that the elderly are more at risk of negative effects, and the severity of such effects is greater.

Old age is not the cause

One of the biggest obstacles to identifying and overcoming these problems is that they are mainly associated with the aging process and not with medication. Deterioration of thinking processes, amnesia or loss of coordination in young people when taking the drug is perceived as an alarm signal. If the same symptoms appear in the elderly, especially if they develop rather slowly, then the doctor's reaction is often reduced to the remark: "Well, he (she) is already old, what did you expect?". And he recommends continuing the course of previously prescribed drug therapy, which gradually affects the weakened health of the elderly, aggravating all the negative side effects from taking sleeping pills themselves.

Respiration and lungs

The second most important and serious problem with benzodiazepines is respiratory depression. Older people often experience sleep apnea, when breathing stops temporarily after falling asleep. And if such people take sleeping pills, then holding their breath during sleep becomes less controlled and longer. And the probability of a lethal outcome increases, eventually, several times.

Another risk associated with the respiratory system is lung disease. People with these conditions should not use benzodiazepines. These drugs depress the respiratory center, which in pulmonary diseases can become life-threatening. Avoid taking sleeping pills and tranquilizers is especially recommended for asthmatics.

References

• Arkhipova NV. , Argunova YA., Pomeshkina EE. [Unresolved issues in the prevention of bronchopulmonary complications in a cardiac surgery patient from the standpoint of a rehabilitation therapist]. // Vopr Kurortol Fizioter Lech Fiz Kult - 2021 - Vol98 - N2 - p.65-69; PMID:33899454
• Powell-Wiley TM., Poirier P., Burke LE., Després JP., Gordon-Larsen P., Lavie CJ., Lear SA., Ndumele CE., Neeland IJ., Sanders P., St-Onge MP. Obesity and Cardiovascular Disease: A Scientific Statement From the American Heart Association. // Circulation - 2021 - Vol - NNULL - p.CIR0000000000000973; PMID:33882682
• Chen L., Han X., Li Y., Zhang C., Xing X. Complications of Cardiovascular Events in Patients Hospitalized with Influenza-Related Pneumonia. // Infect Drug Resist - 2021 - Vol14 - NNULL - p.1363-1373; PMID:33859482
• Li S., Luo C., Chen H. Risk factors of in-stent restenosis in patients with diabetes mellitus after percutaneous coronary intervention: A protocol for systematic review and meta-analysis. // Medicine (Baltimore) - 2021 - Vol100 - N15 - p.e25484; PMID:33847656
• Cao Z., Li S., Yang H., Xu C., Zhang Y., Yang X., Yan T., Liu T., Wang Y. Associations of behaviors, biological phenotypes and cardiovascular health with risks of stroke and stroke subtypes: Aive prospect cohort study. // EClinicalMedicine - 2021 - Vol33 - NNULL - p.100791; PMID:33842871
• Santi RL., Márquez MF., Piskorz D., Saldarriaga C., Lorenzatti A., Wyss F., Martín AV., Perales JS., Arcela JC., de Lourdes Rojas Gimon E., Sambadaro G., Perez GE ., Mendoza I., Lanas F., Flores R., Liprandi AS., Alexander B., Baranchuk A. Ambulatory Patients with Cardiometabolic Disease and Without Evidence of COVID-19During the Pandemic. The CorCOVID LATAM Study. // Glob Heart - 2021 - Vol16 - N1 - p.15; PMID:33833939
• Mehta A., Rigdon J., Tattersall MC., German CA., Barringer TA., Joshi PH., Sperling LS., Budoff MJ., Bertoni A., Michos ED., Blaha MJ., Stein JH., Shapiro MD. Association of Carotid Artery Plaque With Cardiovascular Events and Incident Coronary Artery Calcium in Individuals With Absent Coronary Calcification: The MESA. // Circ Cardiovasc Imaging - 2021 - Vol14 - N4 - p.e011701; PMID:33827231
• Li C., Wang S., Du M., Wei Y., Jiang S. Clinical Characteristics and Controllable Risk Factors of Osteoporosis in Elderly Men with Diabetes Mellitus. // Orthop Surg - 2021 - Vol - NNULL - p.; PMID:33821551
• Abu-El-Ruz R., Abdel-Rahman M.E., Atkin S.L., Elrayess M.A. Comparing Levels of Metabolic Predictors of Coronary Heart Disease between Healthy Lean and Overweight Females. // Metabolites - 2021 - Vol11 - N3 - p.; PMID:33804097
• Eckardt I., Buschhaus C., Nickenig G., Jansen F. Smartphone-guided secondary prevention for patients with coronary artery disease. // J Rehabil Assist Technol Eng - 2021 - Vol8 - NNULL - p.2055668321996572; PMID:33796334

Algorithm for the diagnosis and treatment of psycho-emotional disorders in patients with arterial hypertension | Dadasheva M.N., Dadasheva K.N., Karavashkina E.A., Taranenko N.Yu., Gorenkov R.V., Kruglov V.A., Agafonov B.

The article presents an algorithm for the diagnosis and treatment of psycho-emotional disorders in patients with arterial hypertension. It is shown that the earliest possible start of treatment allows to stabilize blood pressure, improve the quality of life of patients. The drug Tenoten has proven itself positively.

Introduction

The high social significance and urgency of the problem of arterial hypertension (AH) are due to its high prevalence, colossal risk of complications and mortality. AH affects a person at the most productive age, has a significant impact on health, duration and quality of life. Numerous studies have shown the importance of early diagnosis of hypertension and preclinical detection of lesions due to high blood pressure (BP) target organs: heart, brain, kidneys, retina, peripheral arteries. Hypertension is primarily the cause of diseases of the circulatory system, which include cardiovascular (coronary heart disease (CHD), cardiac arrhythmias, etc. ) and cerebrovascular diseases (CVD). According to the literature, with a persistent increase in blood pressure to 160/100 mm Hg. Art. and above, the risk of complications increases by approximately 4 times compared with that in persons with normal blood pressure, and with blood pressure over 200/115 mm Hg. Art. - 10 times. According to medical and demographic indicators, diseases of the circulatory system in Russia lead to premature death of almost every second person — for example, in 2016, the mortality rate was 677.2 per 100,000 population [1, 2].
One of the main target organs in hypertension is the brain. For its normal functioning, the constancy of cerebral blood flow is necessary, which is supported by the mechanism of autoregulation. When the perfusion pressure changes to maintain the rate of tissue blood flow, the diameter of the cerebral vessels, primarily arterioles, changes. Autoregulation of cerebral blood flow is provided by myogenic, neurogenic, metabolic and endothelial factors that modulate vascular tone and protect the brain from hypoperfusion. However, with a long course of AH, pathological restructuring of the intracerebral arteries leads to functional and morphological changes in the brain and the development of CVD [3, 4].
The polymorphism of the clinical picture of CVD in patients with AH is determined by the complexity of pathogenetic mechanisms. It is known that metabolic disorders in the form of hypercholesterolemia, hyperlipidemia, increased blood levels of thrombin and fibrin contribute to hemorheological changes associated with an increase in blood viscosity. Structural and cellular changes and dysfunction of the vascular endothelium lead to the growth of connective tissue in the vascular wall, the accumulation of low and very low density lipoproteins and the formation of atheromatous plaques. Over time, vascular stenosis is formed - atheromatous plaques begin to gradually rise above the surface of the intima and narrow the lumen of the vessel. Ischemia and hypoxia of the brain developing against this background cause the development of CVD. According to the clinical course, acute and chronic forms of CVD are distinguished: acute include stroke and transient cerebrovascular accident, chronic - chronic cerebral ischemia (CCI), slowly progressive insufficiency of blood supply to the brain. CCI leads to the development of morphological changes in the brain — multiple foci of necrosis and clinical changes — various neurological syndromes, in which the leading symptoms are cognitive and psychoemotional disorders (CI), the severity of which depends on the stage of CCI [5–8].
Purpose of the study: to study the clinical features of the course of CVD, including psychoemotional disorders, and the effectiveness of anxiolytic therapy in outpatient patients with hypertension receiving antihypertensive therapy.

Material and methods

150 people with AH aged 35–65 years were under observation (59 men, 91 women). The duration of hypertension averaged 12. 0±3.6 years. In 33 patients (22.0%), I degree AH was diagnosed, in 93 (42.0%) — II degree, in 34 (36.0%) — III degree. The study included patients who signed informed consent and who, as prescribed by a cardiologist, were taking a stable fixed combination of an angiotensin II receptor antagonist (AT1-subtype) - valsartan 80 or 160 mg and a dihydropyridine slow calcium channel blocker - amlodipine 5 or 10 mg 1 r./day in the morning at within 3 months. with a persistent value of blood pressure not higher than 140/90 mm Hg. Art. Initially, a dose of an antihypertensive drug of 80/5 mg was prescribed, in the absence of stabilization of blood pressure after 2 weeks. the dose was increased to 160/10 mg.
Patients with anxiety disorders and increased BP variability underwent a course of 4-week anxiolytic therapy - the 1st group of 30 people took tofisopam at a dose of 50 mg 2 times a day, the 2nd group of 30 people received antibodies to the brain-specific protein S- 100 in release-active (RA) form (Tenoten) 1 tablet 3 rubles / day.
When collecting anamnesis, it was found that before being included in the study, 45 people (men - 29, women - 16) did not know that they had increased blood pressure, since it was not measured. Fluctuations in well-being, headache, dizziness, irritability, anxiety, decreased activity that occurred intermittently and disappeared after rest, they associated not with hypertension, but with stress, overload, weather changes. However, 18 people (12 men, 6 women) knew that their blood pressure was rising, but they did not take the drugs or took them intermittently.

The survey algorithm included:

Physical and neurological examination, including an examination with the determination of vital functions: blood pressure (measurement was carried out by the clinical Korotkov method), heart rate (HR), 24-hour blood pressure monitoring (ABPM). ABPM made it possible to clarify the level of blood pressure during daytime activity, at night, the variability of systolic (SBP) and diastolic (DBP) blood pressure, to predict the risk of developing cardiovascular complications (CVD) and to evaluate the effectiveness of treatment.
The study of cognitive functions was carried out using tests and scales MMSE, D. Wexler No. 5 and No. 7, Schulte's test, test "two groups of three words".
To assess the psycho-emotional state, the Spielberger-Khanin Anxiety Scale and the Hamilton Anxiety and Depression Scale were used.
The results of the studies were recorded in the patient's individual registration card.
Statistical processing of results was performed using the application package STATISTICA (StatSoft, USA), version 6. Mann-Whitney statistical test was used for two unrelated groups. To compare groups on a qualitative binary basis, the classical criterion χ ² according to Pearson. In all cases, differences were considered significant at p<0.05.

Results and discussion

Against the background of taking antihypertensive therapy in 90 (60%) people, the pressure was not higher than 140/90 mm Hg. Art. In 60 (40%) of the subjects, there was an increased "intravisit" BP variability. According to the literature, it usually ranges from 10 to 20% of the mean BP according to ABPM data, with significant individual deviations. Considered to be increased variability in SBP of 15–20 mm Hg. Art., DBP - 14 mm Hg. Art. [9, ten]. Analysis of ABPM data before admission revealed a wide range of variability in SBP and DBP in the examined patients. Thus, in 27 (60%) patients, an increased variability of SBP was noted, in general, the SBP in the group was 18.6 ± 4.1 mm Hg. Art. Increased DBP variability was observed in 18 (20%) patients and amounted to 14.1±3.5 mm Hg in the group as a whole. Art.
During neurological examination, the identified syndromes met the criteria for the diagnosis of chronic cerebrovascular insufficiency, the clinical core of which were cognitive and psycho-emotional disorders, due to the unity of pathogenetic factors. CR is one of the manifestations of brain damage as a target organ in hypertension.
At stage I CCI, which was diagnosed in 105 (70. 0%) patients, diffuse neurological symptoms were detected in the form of convergence disorders, slight asymmetry of the nasolabial folds, tongue deviation, and anisoreflexia. Patients had mild CR, which were of a subjective nature in the form of impaired concentration, difficulty switching from one type of activity to another, absent-mindedness. According to the results of testing using the Spielberger-Khanin anxiety scale and the Hamilton anxiety and depression scale, asthenic syndrome was detected, which was characterized by a combination of asthenic symptoms with severe mental exhaustion, irritability, weakness, hyperesthesia, superficial sleep. Patients complained of headache, dizziness, intolerance to loud sounds, bright light, fatigue with little physical and mental stress. There was a change in mood, which often depended on various external circumstances and fluctuations in blood pressure. In 15 patients, asthenic symptoms were transient, predominantly astheno-vegetative reactions were noted.
In stage II CCI, which was diagnosed in 45 (30.0%) patients, there was an increase in neurological symptoms with the formation of neurological syndromes. Moderate CRs were typical in the form of a deterioration in mental production, volitional activity, working capacity, professional memory, an increase in the viscosity of thinking, a narrowing of the circle of interests, a decrease in criticism, and a change in personality. With prolonged hypertension, there was an increase in asthenic symptoms, persistent astheno-hypochondriac, astheno-anxiety, anxiety-phobic states were formed. Patients complained of low mood with anxiety, premonition of trouble, vague expectation that something bad might happen, were irritable, tearful. Various unpleasant bodily sensations, algia were noted.
In the development of psycho-emotional disorders in the studied patients, the leading factor was somatogenic — hypertension and complications developing against this background. The reaction of the individual to the disease determined the psychological state of the patient and depended on the premorbid features, the level of intelligence and the patient's knowledge of his disease. Personality traits determined the diversity and structure of psychopathological phenomenology. The range of symptoms ranged from mild, not disturbing the life of patients, to severe, with the inability to perform the usual functions, significantly disrupting social and labor adaptation.
In 60 patients we observed, despite the received antihypertensive therapy, there was an increased short-term "intravisit" BP variability. During testing, anxiety, phobias, pronounced vegetative disorders in the form of palpitations, excessive sweating, facial flushing, and dyspnea were detected. Patients had a depressed mood with a dysphoric tinge, tearfulness, and difficulty falling asleep. There were complaints with disturbing fears for health, phobic episodes. Anxiety disorders were manifested even in appearance, facial expressions, and movements. “Asthenic thinking” was noted with some of its slowness, difficulties in concentrating and focusing attention, memory loss, and the ability to volitional effort. The dream was superficial, disturbing, sensitive, often accompanied by painful, frightening dreams.
Patients with anxiety disorders and increased BP variability underwent a course of 4-week anxiolytic pharmacotherapy: the 1st group of 30 people took tofisopam at a dose of 50 mg 2 times a day, the 2nd group of 30 patients received antibodies to the brain-specific protein S- 100 in R-A form (Tenoten) 1 tablet 3 rubles / day. Tofisopam belongs to the group of benzodiazepine derivatives, has an anxiolytic effect, is not accompanied by a sedative, muscle relaxant, anticonvulsant effect. However, in some cases, according to the instructions, headache, insomnia, increased irritability, psychomotor agitation, confusion, loss of appetite, constipation, flatulence, nausea, dry mouth, pruritus, exanthema, muscle tension, muscle pain, depression breathing. The comparative evaluation of the two drugs was due to the fact that, despite the effectiveness of benzodiazepine tranquilizers, their administration to cardiac patients is not always indicated, which is associated with an adverse effect on hemodynamic parameters, interaction with antihypertensive drugs. Accordingly, therapeutic measures in relation to patients with hypertension require particularly careful monitoring, much attention is paid to their tolerability and safety [11].
Antibodies to the brain-specific protein S-100 in the RA form (Tenoten) belong to the group of RA drugs that have special properties. Tenoten is produced according to innovative technologies, during which the technological processing of dilutions of the original substance is used, leading to the release of a special pharmacological activity, called release activity. Technologically processed dilutions of antibodies (AT) affect both the antibody molecules and the antigens to which these antibodies are produced. It has been established that the action of R-A AT to the S-100 protein is similar to the action of the classical benzodiazepine tranquilizer diazepam. RA AT S-100 stimulate 5-HT1A, 5-HT2A, 5-HT2B and inhibit 5-HT2C receptors. RA AT S-100 affect the interaction of a specific ligand with the σ1 receptor, the GABA receptor, and the interaction of a specific ligand with the NMDA receptor of the glycine site. Pathological examination of the damaged area showed a clear neuroprotective effect of R-A AT S-100. Due to its complex action, the drug is an anxiolytic of a new generation, which has a wide spectrum of action: anti-anxiety, antidepressant, vegetative-stabilizing, stress-protective. It does not cause side effects and is combined with basic antihypertensive therapy [12, 13]. It has been established that there is a connection between anxiety, depressive neurotic disorders and the brain-specific protein S-100, which is expressed and secreted by microglial cells and astrocytes. The drug modulates the activity of the S-100 protein and has a positive effect, prevents the development of neurotic and neurosis-like conditions. The big advantage is that the drug does not cause lethargy, daytime sedation, muscle relaxation, dependence and withdrawal syndrome [14].
The anti-anxiety effect of both drugs was manifested on the 7th–10th day of therapy - irritability, fears and anxious fears decreased. In both groups, according to the Hamilton anxiety scale, there was a significant decrease in the total score in most patients by the 8th day of therapy, reaching its minimum by the end of the 4th week. observations (Fig. 1). However, when prescribing tofisopam, 3 people (10%) had a headache, 6 (20%) had fluctuations in blood pressure, while prescribing Tenoten, no adverse events were detected.

In the process of treatment on the Spielberger-Khanin scale, a regression of personal and reactive anxiety indicators was noted in the form of a reduction in the total score from 34.1 to 29.6.

Conclusion

Thus, the therapy of psychoemotional disorders in patients with hypertension causes known difficulties and requires great care. The goals of treatment are to stabilize blood pressure and the state in general, slow down the progression of CVD and improve the quality of life. When prescribing treatment, a whole range of factors should be taken into account.

• 
  Can psychopath change
• 
  Swing in the mood
• 
  Playing games with someone
• 
  Im never full
• 
  Migraine from crying
• 
  I feel like my body is going to explode
• 
  Ways to help bipolar depression
• 
  Differential diagnosis for ptsd
• 
  Signs of delusion
• 
  How can you take care of yourself
• 
  History insane asylum