Входя на эту страницу, Вы подтверждаете, что являетесь  медицинским работником.

Status message

Not the entire site translated, but only to "Magazine"

Adjuvant therapy of negative and cognitive disorders in schizophrenia with racemate of gopantenic acid

V.E. Medvedev1, V.I. Frolova1, A.Yu. Ter-Israelyan1,2, E.V. Gushanskaya1,2
1Department of Psychiatry, Psychotherapy and Psychosomatic Pathology RUDN University, Moscow, Russia
2Psychiatric Hospital № 13, Moscow, Russia

Nowadays efficacy of antipsychotic treatment of negative disorders in schizophrenia is often appreciated as insufficient. It causes the search for new drugs or drugs combination for increase of tolerability and efficacy of antipsychotic.

In naturalistic study of augmentation with gopantenic acid (Pantogam Aktiv, 1200-1800 mg daily) treatment of schizophrenia patients with negative disorders there was statistically significant reduction of total score on CGI-S (13,7 % vs. -9,6 %, p < 0,05), PANSS (25,3 % vs -20 %, p < 0,05) and BPRS. Dynamics of cognitive functions in patients of both group (p < 0,01),s show greater positive effect in Pantogam Aktiv group. Pantogam active prevents or diminishes symptoms of neuroleptic depression (45,4 % HDRS total score reduction in the main group vs 5,3 % increase in control group). Using Pantogam Aktiv in treatment regimen of negative disorders decreases extrapyramidal disorders. Everyday functioning of patients (GAF scale) in the main group improves on 60,8 % vs 35 % in control group (р < 0,01), mental state (SF-36) improves on 73,9 % vs 49,5 % (p < 0,01), physical state improves on 46,4 % vs 34,4 %.

Conclusion. Inclusion of D, L-gopantenic acid (Pantogam Aktiv) in treatment of negative symptoms of schizophrenia increases efficacy and tolerability of combined therapy, improves quality of life from the patient’s and doctor’s point of view.

References: 
  • 1. Mosolov S.N. Sovremennaya antipsikhoticheskaya farmakoterapiya shizofrenii // Russkii meditsinskii zhurnal. – 2004. – № 10. – S. 646.
  • 2. Mosolov S.N., Tsukarzi E.E., Kapiletti S.G. Antipsikhoticheskaya farmakoterapiya shizofrenii: ot nauchnykh dannykh k klinicheskim rekomendatsiyam // Biologicheskie metody terapii psikhicheskikh rasstroistv. Dokazatel'naya meditsina – klinicheskoi praktike/ pod red. S.N. Mosolova. – M.: Nauchno-politicheskaya mysl', 2012. – S. 11–61.
  • 3. Bodkin J.A., Siris S.G., Bermanzohn P.C. et al. Double-blind, placebo-controlled, multicenter trial of selegiline augmentation of antipsychotic medication to treat negative symptoms in outpatients with schizophrenia // Am J Psychiatry. – 2005. – No 162. – R. 388–390.
  • 4. Lieberman J.A., Stroup T.S., McEvoy J.P. et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia // N Engl J Med. – 2005. – No 353 (12). – P. 1209–1223.
  • 5. Meisenzahl E.M., Scheuerecker J., Zipse M. et al. Effects of treatment with the atypical neuroleptic quetiapine on working memory function: a functional MRI follow-up investigation // Eur Arch Psychiatry Clin Neurosci. – 2006. – No 256 (8). – R. 522–531.
  • 6. Belousov Yu.B., Zyryanov S.K. Belousov D.Yu. Farmakoekonomicheskaya effektivnost' atipichnykh antipsikhotikov u bol'nykh shizofreniei // Kachestvennaya klinicheskaya praktika. – 2011. – № 1. – S. 51–57.
  • 7. Bomov P.O. Defitsitarnye rasstroistva u bol'nykh shizofreniei s debyutom v pozdnem vozraste (kliniko-neiropsikhologicheskii i reabilitatsionnyi aspekty). Diss....kand. med. nauk. – Orenburg, 2007.
  • 8. Vorob'ev V.Yu. Shizofrenicheskii defekt (na modeli shizofrenii, protekayushchei s preobladaniem negativnykh rasstroistv). Disc. … d-ra med. nauk. – M., 1988.
  • 9. Morozova M.A., Beniashvili A.G., Burminskii D.S. Shizofrenicheskii defekt kak terapevticheskaya mishen' // Psikhiatriya. – 2008. – № 3. – S. 13–20.
  • 10. Mosolov S.N., Kabanov S.O., Sulimov G.Yu. Korrektsiya neirokognitivnogo defitsita u bol'nykh shizofreniei pri dlitel'noi antipsikhoticheskoi terapii // Novye dostizheniya v terapii psikhicheskikh zabolevanii / pod red. S.N. Mosolova. – M., 2002. – S. 110–126.
  • 11. Andreasen N.C., Carpenter W.T., Kane J.M. et al. Remission in schizophrenia: proposed criteria and rational for consensus // Am J Psychiatry. – 2005. – No 162. – R. 441–449.
  • 12. Juckel G., de Bartolomeis A., Gorwood Ph. et al. Towards a framework for treatment effectiveness in schizophrenia // Neuropsychiatric Disease and Treatment. – 2014. – No 10. – P. 1867–1878.
  • 13. Mosolov S., Potapov A.V., Ushakov U.V., Shafarenko A.A., Kostyukova A.B. Design and validation of standardized clinical and functional remission criteria in schizophrenia // Neuropsychiatric Disease and Treatment. – 2014. – Vol. 10. – P. 167–181.
  • 14. Mosolov S.N., Potapov A.V., Ushakov U.V. Remission in schizophrenia: results of cross-sectional with 6-month follow-up period and 1-year observational therapeutic studies in an outpatient population // Annals of General Psychiatry. – 2012. – Vol. 11. – P. 1–12.
  • 15. Medvedev V.E. Lechenie shizofrenii sovremennymi atipichnymi antipsikhoticheskimi preparatami: uchebno-metodicheskoe posobie po spetsial'nosti «Psikhiatriya». – M., 2014.
  • 16. Medvedev V.E. Negativnye rasstroistva: ponyatie i terapiya // Psikhiatriya i psikhofarmakoterapiya. – 2011. – № 6. – C. 16–21.
  • 17. Snedkov E.V. Atipichnye antipsikhotiki: poisk resheniya starykh i novykh problem. // Psikhiatriya i psikhofarmakoterapiya. – 2006. – № 4. – S. 45–50.
  • 18. Buchanan R.W. Persistent negative symptoms in schizophrenia: an overview // Schizophrenia Bulletin. – 2007. – No 4. – R. 1013–1022.
  • 19. Mosolov S.N. Shkaly psikhometricheskoi otsenki simptomatiki shizofrenii i kontseptsiya pozitivnykh i negativnykh rasstroistv. – M.: Novyi tsvet, 2001.
  • 20. Arango C., Buchanan R.W., Kirkpatrick B., Carpenter W.T. The deficit syndrome in schizophrenia: implications for the treatment of negative symptoms // Eur Psychiatry. – 2004. – No 19. – R. 21–26.
  • 21. Goldberg S.C. Negative and deficit symptoms in schizophrenia do respond to neuroleptics // Schizophr Bull. – 1985. – No 11. – R. 453–456.
  • 22. Stip E. Cognition, schizophrenia and the effect of antipsychotics // Encephale. – 2006. – No 32 (3 Pt 1). – R. 341–350.
  • 23. Shtok V.N., Ivanova-Smolenskaya I.A., Levin O.S. Ekstrapiramidnye rasstroistva. – M., 2002. – 604 s.
  • 24. Rosenheck R.A. Effectiveness vs. efficacy of second-generation antipsychotics: haloperidol without anticholinergics as a comparator // Psychiatr Serv. – 2005. – No 56. – P. 85–92.
  • 25. Ananth J., Parameswaran S., Gunatilake S., et al. Neuroleptic malignant syndrome and atypical antipsychotic drugs // J Clin Psychiatry. – 2004. – No 65 (4). – R. 464–470.
  • 26. Tsygankov B.D., Agasaryan E.T. Analiz effektivnosti i bezopasnosti sovremennykh i klassicheskikh antipsikhoticheskikh preparatov // Zhurnal nevrologii i psikhiatrii imeni C.C. Korsakova. – 2010. – № 9. – S. 64–70.
  • 27. Harrow M., Jobe T.H. Factors involved in outcome and recovery in schizophrenia patients not on antipsychotic medications: a 15-year multifollow-up study // Journal of Nervous and Mental Disease. – 2007. – No 195 (5). – R. 404–406.
  • 28. Kabinoff G.S., Toalson P.A., Healey K.M. et al. Voprosy metabolizma, svyazannye s primenyaemymi v psikhiatrii atipichnymi neiroleptikami: mify i fakty // Psikhiatriya i psikhofarmakoterapiya. – 2003.–- № 3. – S. …
  • 29. Murphy B.P. et al. Pharmacological treatment of primary negative symptoms in schizophrenia: a systematic review // Schizophr Res. – 2006. – No 88. – R. 5–25.
  • 30. Taylor D.M., McAskill R. Atypical antipsychotics and weight gain a systematic review // Acta Psychiatr Scand. – 2000. – No 101. – R. 416–432.
  • 31. Mosolov S.N. Nekotorye aktual'nye teoreticheskie problemy diagnostiki, klassifikatsii, neirobiologii i terapii shizofrenii: sravnenie zarubezhnogo i otechestvennogo podkhodov // Zhurnal nevrologii i psikhiatrii imeni C.C. Korsakova. – 2010. – T. 110, № 6. – S. 4–11.
  • 32. Alphs L. An industry perspective on the NIMH consensus statement on negative symptoms // Schizophr Bull. – 2006. – No 32. – R. 225–230.
  • 33. Lieberman J.A. Dopamine partial agonists: a new class of antipsychotic // CNS Drugs. – 2005. – No 18 (4). – R. 251–267.
  • 34. Karlson A., Lekrub'e I. Dofaminovaya teoriya patogeneza shizofrenii: rukovodstvo dlya vrachei / pod red. S.N. Mosolova. – London, 2004.
  • 35. Devis Dzh.M. Shizofreniya: vybor antipsikhoticheskoi terapii // Sotsial'naya i klinicheskaya psikhiatriya. – 2006. – № 3. – S. 77–80.
  • 36. Popov M.Yu. Ad"yuvantnaya terapiya paranoidnoi shizofrenii: optimizatsiya klinicheskogo deistviya galoperidola. Avtoref. … d-ra med. nauk. – SPb., 2012. – 49 s.
  • 37. Syropyatov O.G. Sovremennoe lechenie shizofrenii // Neironauki (UA). – 2007. – № 2. – S. …
  • 38. Katunina E.A., Malykhina E.A., Avanesova O.V. i dr. Primenenie Pantogama aktiv v kompleksnom lechenii distonicheskikh giperkinezov.
  • 39. Kontsevoi V.A., Rotshtein V.G., Bogdan M.N. i dr. Pantogam v povsednevnoi psikhiatricheskoi praktike // Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. – 2007. – № 12. – S. 34–39.
  • 40. Dzhuga N.P. i dr. Vliyanie gopantenovoi kisloty i glitsina na effektivnost' galoperidola pri terapii patsientov s paranoidnoi shizofreniei // Psikhiatriya i psikhofarmakoterapiya. – 2012. – № 2. – S. 23–29.
  • 41. Medvedev V.E. Nootropnye preparaty i neiroprotektory v lechenii psikhicheskikh rasstroistv. Uchebno-metodicheskoe posobie po spetsial'nosti «Psikhiatriya». – M.: Rossiiskii universitet druzhby narodov, Meditsinskii institut, Kafedra psikhiatrii, psikhoterapii i psikhosomaticheskoi patologii, 2015.
  • 42. Popov M.Yu. Ad"yuvantnaya terapiya paranoidnoi shizofrenii: optimizatsiya klinicheskogo deistviya galoperidola. Avtoref. … d-ra med. nauk. – SPb., 2012 – 49 s.
  • 43. Kovalev G.I., Starikova N.A. Pantogam aktiv: mekhanizm farmakologicheskogo deistviya // Russkii meditsinskii zhurnal. – 2010. – № 21. – S. 2–4.
  • 44. Sukhotina N.K. Pantogam kak sredstvo lecheniya pogranichnykh nervno-psikhicheskikh rasstroistv // Medlain ekspress. – 2006. – № 4 (187). – S. 44–45.
  • 45. Kanaeva L.S., Vazagaeva T.I., Yastrebova V.V. Perspektivy primeneniya preparata Pantogam aktiv u bol'nykh s astenicheskimi rasstroistvami // Psikhiatriya i psikhofarmakoterapiya. – 2009. – № 6. – S. 34–39.
  • 46. Duma S.N. Otsenka klinicheskoi effektivnosti neiroprotektorov, vliyayushchikh na sistemu gamma-aminomaslyanoi kisloty, pri lechenii kognitivnykh rasstroistv u patsientov s distsirkulyatornoi entsefalopatiei I-II stadii // Farmateka. – 2010. – № 15. – S. 96–100.
  • 47. Sobennikova V.V. i dr. Sravnitel'naya otsenka effektivnosti preparata Pantogam aktiv v terapii kognitivnykh rasstroistv // Psikhiatriya. – 2010. – № 5. – S. 41–46.
  • 48. Medvedev V.E., Israelyan A.Yu., Gushanskaya E.V., Frolova V.I. Optimizatsiya terapii negativnykh rasstroistv pri shizofrenii ratsematom gopantenovoi kisloty // Psikhiatriya i psikhofarmakoterapiya. – 2013. – T. 15, № 6. – S. 30–37.
  • 49. Hamilton M. A rating scale for depression // Journal of Neurology, Neurosurgery and Psychiatry. – 1960. – No 23. – P. 56–62.
  • 50. Chouinard G., Ross-Chouinard A., Annable L. et al. Extrapyramidal Rating Scale // The Canadian Journal of Neurological Sciences. – 1980. – No 7. – P. 233–239.
  • 51. Lingjarde O., Ahlfors U.G., Bech P. The UKU side effect rating scale. A new comprehensive rating // Acta Psychiatr Scand. – 1987. – No 334 (suppl.). – P. 1–100.
  • 52. Lezak M.D. Neuropsychological assessment. – Oxford [Oxfordshire]: Oxford University Press, 1995.
  • 53. Stroop J.R. Studies of interference in serial verbal reactions // Journal of Experimental Psychology. – 1935. – No 18 (6). – P. 643–662. DOI: 10.1037/h0054651
  • 54. Endicott J., Spitzer R.L., Fleiss J.L., Cohen J. The global assessment scale: a procedure for measuring overall severity of psychiatric disturbance // Arch Gen Psychiatry. – 1976. – No 33. – P. 766–776.
  • 55. Ware J.E., Snow K.K., Kosinski M., Gandek B. SF-36 Health Survey. Manual and interpretation guide. – Boston, Mass: The Health Institute, New England Medical Center, 1993.
  • 56. Medvedev V.E., Frolova V.I., Gushanskaya E.V., Ter-Israelyan A.Yu. Augmentatsiya antipsikhoticheskoi terapii pri shizofrenii ratsematom gopantenovoi kisloty // Zhurnal nevrologii i psikhiatrii imeni C.C. Korsakova. – 2015. – T. 115, № 8-1. – S. 28–34.