At some somatic diseases ...

For some somatic diseases, there are additional problems of the benzodiazepines - eg, they are contraindicated in patients with chronic obstructive pulmonary disease, because reduce the activity of the respiratory center, impair lung function and exercise tolerance [27]. Nonetheless, benzodiazepines, it is quite possible to assign the acute alarm reaction under stress or for a short time - with the worsening of GAD and sleep disturbances against the background of the beginning of antidepressant therapy. Unfortunately, according to some reports, drugs benzodiazepine takes 5-10% of the population, of whom more than half - a long time [55]. Often to relieve symptoms of anxiety particularly evident cardiac complaints and increased nervousness, the patients themselves or on the advice of a doctor taking drugs such as valokordin (korvalola, valoserdina). The main active ingredient in them is phenobarbital. Receiving valokordin occasionally in small doses, say, but in practice there are many cases where patients (usually this is the patients with GAD) have resorted to long-term, daily receiving these drugs in ever-increasing doses - up to half and whole bottles in day. In fact, here we have the development of one of the most severe forms of drug dependence - barbituric. It is most difficult to therapy and carries a serious withdrawal syndrome when trying to discontinue. Consequently, for long-term relief of anxiety symptoms, these drugs are contraindicated. Finally, the international recommendations result in another drug for the treatment of GAD - Hydroxyzine (Atarax), which is a double-blind studies proved the effectiveness of similar buspirone and benzodiazepines, but without the typical side effects of benzodiazepines [56.60]. Hydroxyzine is a piperazine derivative and the blocker of H1-histamine receptors. He has a strong protivotrevozhnym, antihistamine, antipruritic and antiemetic effects. Like benzodiazepines, hydroxyzine is effective in GAD and other anxiety states with predominantly somatic symptoms, particularly in acute anxiety after severe stress, with subsyndromal anxiety, etc. In addition to the anxiolytic actions, hydroxyzine has a positive effect on psycho-vegetative and somatic symptoms, relieves irritability and improves sleep. It is characterized by very rapid onset of effect and the absence of the phenomenon of "return" in a sharp reversal. His method was not accompanied by the risk of drug addiction and dependence; drug does not violate the cognitive function, and according to some sources even helps them in some improvement [2.75]. In particular, hydroxyzine generate sustainable positive attitude of patients to themselves and others, increases wakefulness without causing excitation, etc. It increases the effects of sedatives and sleeping pills and alcohol, but practically does not interact with other medications, including applicable for the treatment of somatic patients.