Mar 05, 2018
Patients suspect the wife of treason, watch her, demand recognition in adultery;in a state of intoxication become aggressive, can commit socially dangerous actions. They are hospitalized in a psychiatric hospital.
Treatment - neuroleptic drugs: aminazine - 200-300 mg / day, triftazine - 20-40 mg / day, haloperidol 20-45 mg / day IM.
All these psychoses occur against the background of alcoholism. Symptoms of alcoholism here.
Alcoholic hallucinosis develops against abstinence;auditory hallucinations predominate without diminishing consciousness. The patient hears voices( two or several) that either scold or protect the patient. He listens to the voices, refers to them at first for a time, uncritically, perceiving them as real. Often, patients are excited, fearful and, under the influence of hallucinations, perform various, sometimes dangerous, actions.
Patients with acute alcohol hallucinosis are urgently placed in a psychiatric hospital, where they must be under round-the-clock supervision.
Treatment - detoxification means: unitiol, glucose, levomepromazine( tizercin), 50-75 mg / day in / m with simultaneous injection of 2 ml of cordiamine. After stopping the excitement with these drugs prescribe antipsychotics antigallutsinatornogo action: haloperidol - 10 mg IM / 3 times a day, trifazin - 10-15 mg IM / 3 times a day, simultaneously prescribe vitamins B and infusion in / in 20 ml40% glucose solution. Neuroleptics are injected intramuscularly until the disappearance of hallucinations, and then applied inside with a gradual decrease in doses. Further, anti-alcohol therapy is carried out.
In a number of cases, the course of the hallucinosis takes on a chronic character, hallucinations can last for years. Patients have a more critical attitude towards them. Hospitalization is necessary.
Treatment - neuroleptic drugs inside haloperidol - 30 mg / day, trifluperidol( trisedil) - 0.25 mg / day with a gradual increase in the daily dose to 2-8 mg, triftazine 60 mg / day, vitamins.
Alcohol delirium( white fever) develops with prolonged drinking or abstinence in the presence of additional harmful substances( somatic diseases, brain trauma, psychogeny, postoperative period).Characterized by a violation of sleep, a delirious dullness of consciousness, an affect of fear anxiety and motor excitement. Observed somatic disorders - tachycardia, falling blood pressure, sweating, dyspepsia, a general tremor, an increase in temperature. White fever begins with visual hallucinations at night. As psychosis develops, hallucinations become frightening and fantastic. There comes a confusion of consciousness in the form of delirium with disorientation in the surrounding while preserving the consciousness of one's own personality, with visual hallucinations of a clearly scenic, sometimes frightening character. It is accompanied by a sense of fear, sometimes by fragmentary delusions. Patients are excited, highly talkative, defended from their "visions."At a severe degree of delirium, there are uncoordinated movements( patients "take off", pull off "threads").
There are often micropsises: patients see small animals, small worms and little men. The course of the disease is acute, lasts for several days and ends either with the exit from a morbid state with incomplete memories, or lethal in the presence of severe cardiovascular insufficiency. Patients are subject to urgent hospitalization in a psychiatric hospital and should be on a bed rest under round-the-clock supervision.
Treatment. Cupping of the white fever is carried out with a solution of 0.3-0.4 g of phenobarbital in 20 ml of ethyl alcohol and 150 ml of water;the solution is given once, at the same time 2 ml of cordiamine are injected n / k. Further, detoxifying agents are used: unitiol 5 / ml 5% solution w / m, glucose 20 ml 40% / iv, large doses of vitamins B1 and B6, nicotinic acid, cardiac agents. The next day, appoint levomepromazine( tizercin) - 50 mg / day in / m( under the control of blood pressure) or haloperidol - 30 mg / day IM.
Korsakovsky psychosis is characterized by memory disorders and polyneuritis. Occurs most often after a white fever. Deep asthenia with severe exhaustion, weakness is noted. The memory is abruptly broken while remembering the past. Patients are not guided in time and in the surrounding, can not in the day report about the events that were in the morning. Criticism to the disease is absent. The course of psychosis is long.
Treatment - large doses of nicotinic acid, nootropil( piracetam) 0.4 g 3 times a day, vitamins B1, B6, restorative therapy, physiotherapy, physiotherapy.
Pathological intoxication is a mental condition that occurs when alcohol is taken in a special condition associated with a change in the environment, prolonged insomnia, overwork, emotional stress, a recent illness. Can develop when flying in an airplane or moving in a train. Characteristic is the darkening of the consciousness of the type of the twilight: the perception of the surrounding suddenly changes, delusions of persecution, hallucinations, fear appear. In patients, excitement arises with anger, rage, aggression. A characteristic feature is the absence of a disorder of coordination of movements( the patients do not stagger, their gait is sure).The pathological intoxication begins suddenly, proceeds for a short time and also ends suddenly with a very deep sleep, accompanied by amnesia( loss of memory).