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№ 2 (2023)

ПРАКТИКА

СИНДРОМ ОТМЕНЫ ПРИЕМА АНТИДЕПРЕССАНТОВ (АЛГОРИТМ ПРОФИЛАКТИКИ И КОРРЕКЦИИ)

https://doi.org/10.21265/PSYPH.2023.15.79.005

Опубликован 2023-06-30

  • А.К. Хасанова
    • ,
  • С.Н. Мосолов

А.К. Хасанова
Российская Медицинская Академия Непрерывного Профессионального Образования

С.Н. Мосолов
1 ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации; ФГБУ «Национальный медицинский исследовательский центр психиатрии и наркологии имени В.П. Сербского» Министерства здравоохранения Российской Федерации

Аннотация

Антидепрессанты (АД) являются одним из наиболее часто используемых классов лекарственных препаратов (ЛП), при этом частота их назначения и длительность приема ежегодно растут. В клинической практике врачи нередко сталкиваются с необходимостью отмены или замены АД вследствие недостаточной эффективности или плохой переносимости. Данная задача является непростой для практикующего врача, так как отмена или резкое снижение дозы АД может привести к появлению соматических и психических симптомов отмены различной степени тяжести и продолжительности от легких и кратковременных до тяжелых и длительных, приводящих к нарушению функционирования пациента и психосоциальным проблемам. В литературе этот феномен получил название синдрома отмены приема АД (СОПА). В обзорной статье изложены основные результаты клинических исследований, посвященных изучению СОПА, и   современные теоретические представления о данной проблеме. В эпидемиологической части обзора нами было проанализированы результаты 4 международных опросов, 137 онлайн постов, 2 систематических обзоров, 3 когортных исследований, 2 рандомизированных клинических исследований с общей численностью выборки более 9171 человек.  На основании чего было выявлено, что показатели заболеваемости СОПА колеблются в диапазоне от 27% до 86%; при этом 43% - 51% опрашиваемых отмечают, что симптомы отмены имеют тяжелую степень выраженности и могут продолжаться более 2 недель. В статье также рассмотрены вероятные нейробиологичские механизмы развития СОПА, даются практические рекомендации и алгоритм по профилактике и коррекции симптомов СОПА. 

Ключевые слова

антидепрессанты, синдром отмены, симптомы, диагностика, нейробиология

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