The drug "Carbamazepine" is widely used in modern narcology. It is well tolerated, has a low incidence of side effects, and has very low hepatotoxic and hypnotic effects.
Alcoholism is an addiction with a complex pathogenesis and a variety of symptoms. A variety of medications and therapies are used to overcome alcohol addiction.
Alcoholism occurs after prolonged abuse of alcoholic beverages. As a result of alcohol addiction, a person’s activity of all organs and systems is disrupted. This is reflected in the concept of alcoholic visceropathy and alcoholic illness.
Medicine has proven that alcoholism disrupts all types of neuromediation, such as:
- the metabolism of catecholamines (dopamine and serotonin) changes,
- the functioning of the opioid, GABAergic and enzyme systems changes.
Chronic alcoholism leads to poisoning of the body and entails pathological changes in the activity of calcium, potassium and sodium channels. The result of this is severe disturbances in the functioning of the brain, which are aggravated on days of abstinence from alcohol.
The main symptom of the disease is a pathological craving for alcohol, which occurs due to disruption of the activity of certain structures of the brain stem and limbic system.
A variety of pathologies of the brain and internal organs will necessarily lead to the emergence of pathological cravings for alcohol intoxication, sleep disturbances, affective disorders, the occurrence of seizures and psychotic states.
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Indications for use of "Carbamazepine"
Narcologists prescribe Carbamazepine as a drug that has a psychotropic and anticonvulsant effect.
This drug has a pronounced anticonvulsant effect, inhibits voltage-sensitive sodium channels, has an inhibitory effect on excitatory amino acid transmission in the limbic system, inhibits GABA metabolism, suppresses the presynaptic activity of serotonin with a single intake of alcohol in the body and enhances it with chronic administration.
Carbamazepine has an antimanic effect, which is not directly related to the dopamine blocking effect. The antidepressant activity of the drug is determined by its effect on the GABAergic system. Carbamazepine also inhibits calcium channels. Therefore, the drug is very effective in the treatment of epileptic patients and patients with affective psychoses.
Carbamazepine is able to re-synchronize a disturbed bio-rhythmic organization. The purpose of this drug for the treatment of alcoholics is explained by the effect of the drug on sodium and potassium channels and the flow of calcium into cells, the suppression of the activity of the glutamatergic system and inhibition of GABA metabolism, and changes in the functioning of the serotonergic and dopaminergic systems.
Initially, Carbamazepine was used to relieve alcohol withdrawal syndrome, since the drug has an anticonvulsant effect and reduces the severity of vegetative and mental disorders.
The drug is widely used for its low frequency of side effects and the virtual absence of hepatotoxic and hypnotic effects.
Cautions and contraindications
- You need to watch for bleeding, bruising, mouth ulcers, infections, and fever. Taking carbamazepine increases the risk of aplastic anemia and agranulocytosis by 5-8 times.
- Use cautiously with MAOIs.
- May cause exacerbation of angle-closure glaucoma.
- Reduces the effectiveness of hormonal contraceptives.
- Restriction of fluid intake may be necessary due to the risk of interfering with antidiuretic hormone production.
- Cannot be used if the patient has a history of bone marrow suppression.
- Do not use if the patient is allergic to any tricyclic compounds.
Use of the drug "Carbamazepine" in Russia and abroad
In foreign countries, Carbamazepine has been used to relieve alcohol withdrawal syndrome since the mid-1980s.
The fact is that when relieving withdrawal symptoms, which are characterized by a decrease in the threshold of convulsive readiness, it is necessary to prevent the occurrence of convulsive paroxysms.
In Russia, the drug was first used in 1973 to relieve alcohol withdrawal syndrome. The drug effectively relieves psychotic states, alcoholic hallucinosis and full-blown white fever states. In these cases, the daily dose of the drug should be no more than 1.2 g, 0.4 g 3 times a day. In psychotic conditions, the dose of the drug is increased to 1.8 - 3.4 g. In addition to the pronounced sedative effect, Carbamazepine has an antipsychotic effect. After psychosis, the drug promotes long-term sleep. According to some scientists, it is important that treatment with Carbamazepine be carried out in combination with detoxification therapy. The drug can be combined with antipsychotics, tranquilizers, antidepressants and nootropics. Combination with various psychotropic drugs expands the range of use of the drug.
Carbamazepine was also used to relieve cravings for alcohol intoxication. Clinical studies have made it possible to consider pathological cravings for alcohol as an expression of latent epileptiform activity. This was clearly manifested during the paroxysmal onset of craving for alcohol, which is often observed in female alcoholics. Carbamazepine is effective in suppressing pathological cravings for alcohol and preventing relapse of the disease.
Treatment regimen
Dosage and dose selection
- 400-1200 mg/day
- Children under 6 years: 10-20 mg/kg per day
Bipolar disorder, seizures (adults, children over 13): Start with 200 mg twice daily; increase every week by 200 mg/day in several doses; maximum for adults 1200 mg/day; maximum for children 13-15 years old – 1000 mg/day; some patients may require doses up to 1600 mg/day.
Trigeminal neuralgia pain: start with 100 mg twice daily; increase every week by 200 mg/day in divided doses.
- Best taken with food
- Slowly increasing the dose delays the onset of the therapeutic effect, but increases tolerance to sedative side effects
- If other sedatives are being taken, increase the dose slowly
- Over time, after several weeks of treatment, dose adjustment is required
How quickly does it work?
Response to acute mania may occur within a few weeks.
It may take several months for your mood to stabilize.
Cramps should stop after 2 weeks.
Expected Result
Disappearance of symptoms.
Treatment can be continued indefinitely to prevent mania or seizures.
If it doesn't work
(for bipolar disorder)
Increase the dose;
Switch to another drug or add another drug;
Connect psychotherapy;
Determine if there is a comorbid condition
How to stop taking it
Reduce the dose gradually. Abruptly stopping use increases the risk of bipolar disorder relapse. In epilepsy, abrupt cessation can trigger seizures [1].
Treatment combinations
- Lithium
- Valproic acid
- Atypical antipsychotics
- Lamotrigine
- Antidepressants (with caution, as there is a risk of mood destabilization) [1].
What medications should I take for osteochondrosis?
Medicines for osteochondrosis differ not only in the form of release. They are also divided into the following pharmacological groups.
Anti-inflammatory drugs for the treatment of osteochondrosis
The work of non-steroidal anti-inflammatory drugs for osteochondrosis is based on suppressing the production of prostaglandins - hormone-like substances that cause inflammation and pain in the affected areas. Non-steroidal drugs for osteochondrosis can quickly eliminate pain and hot skin, restore local metabolism, relieve swelling, discomfort and deterioration of sensitivity, and relieve pressure on the nerve roots of the spine.
Non-steroidal anti-inflammatory drugs for the treatment of osteochondrosis are produced in various dosage forms - capsules and tablets, gels and creams, solutions for intramuscular, intravenous or subcutaneous administration. Treatment of NSAID drugs for osteochondrosis usually involves a combination of different forms. For example, tablets are used as the main therapy, gels and ointments “quench” residual inflammation, and injections are needed for pain relief. Patches (for example, Voltaren, Versatis) help relieve inflammation at all stages of treatment.
The list of NSAID drugs for osteochondrosis includes:
- artradol;
- ibuprofen (nurofen, dolit, ibuprom);
- ketoprofen (ketonal, fastum, bystrumgel, flexen);
- diclofenac (Voltaren, Diclac, Diclobene, Dicloran Plus, Ortofen);
- ketorolac;
- xefocam;
- indomethacin (indovazin, indobene, indocid);
- nimesulide (nimesil, nise, nimulid, nimika);
- naproxen;
- piroxicam;
- Celebrex (celecoxib);
- febrofide;
- meloxicam (movalis, movasin).
Steroid (hormonal) anti-inflammatory drugs for osteochondrosis are rarely used - mainly in the most advanced cases. These include prednisolone, cortisone, dexamethasone and others.
Chondroprotectors
With osteochondrosis, the spring function of the intervertebral discs deteriorates, which directly depends on the volume of cartilage tissue and its elasticity. To maintain sufficient cartilage thickness, the body must regenerate cartilage cells (chondrocytes) at a rate that roughly matches their destruction. But with dehydration, unbalanced nutrition, stress, metabolic or anatomical disorders, the rate of decay of chondrocytes increases, and new cells are either inhibited in growth or have an insufficient margin of safety. To protect cartilage and restore its normal growth rate, it is worth taking special products based on glucosamine and chondroitin - chondroprotectors. Chondroprotective drugs for the effective treatment of osteochondrosis can stabilize the condition of cartilage, prevent its further destruction and, subject to all medical recommendations, even help restore lost chondrocytes.
Chondroprotective drugs for osteochondrosis include:
- artracs;
- chondrolone;
- rumalon;
- Don;
- chondroxide;
- osterepar;
- teraflex;
- alflutop;
- collagen ultra.
Some of them (for example, Dona) contain only glucosamine, others (Structum, Chondroxide) - only chondroitin. Modern drugs combine active ingredients and additionally include vitamins (artracam).
For a sustainable effect, chondroprotectors (in the form of tablets, injections or external agents) must be taken for life, in courses of 3-6 months.
Warming drugs
To eliminate discomfort in osteochondrosis, the so-called. warming medications. They:
- dilate blood vessels in the skin, which inhibits the transmission of pain impulses to the brain;
- improve blood microcirculation in connective tissue;
- distract the patient from unpleasant sensations.
When irritating drugs are applied, the peak effect is observed after half an hour, and the analgesic effect lasts for 2-4 hours. A local increase in skin temperature is normal.
The list of drugs for the treatment of osteochondrosis includes ointments, creams, gels and tinctures based on:
- camphor (camphor ointment);
- turpentine;
- benzyl nicotinate;
- nonivamide;
- capsaicin (espol ointment, capsicum tincture);
- bee and snake venom.
Most of these drugs have a combined composition - for example, bee venom and NSAIDs or snake venom, salicylic acid and turpentine. Therefore, before use, you must make sure that you are not allergic to each of the components.
Local and general analgesics
Painkillers for osteochondrosis are usually used in the form of tablets and injections. For moderate pain, the usual medicines in the medicine cabinet can help - analgin or paracetamol. Nefopam and Ambene are also effective (has an anti-inflammatory effect, which reduces pain).
In the later stages of osteochondrosis, opioids are prescribed - potent drugs with a number of contraindications. These include tramal (tramadol).
For complex pain relief (for example, blockade), the so-called. “cocktails” that simultaneously have an analgesic, decongestant, anti-inflammatory, local anesthetic and allergen-reducing effect. The composition may include lidocaine or novocaine, bupivacaine, corticosteroids, vitamin B12 and other components.
Important! Analgesics only relieve pain without affecting its cause. Therefore, without proper treatment, osteochondrosis continues to progress, requiring a transition to increasingly serious painkillers.
Vasodilators
Vasodilators for osteochondrosis, or vasodilators, help restore normal blood supply to the tissues around the affected intervertebral joints.
Pain and muscle tension cause the blood vessels to narrow. This impairs tissue nutrition, causes oxygen starvation of the brain and accelerates the progression of the disease. Therefore, in case of cervical osteochondrosis, drugs to normalize blood circulation are especially important. During rehabilitation therapy the following are used:
- pentoxifylline, or trental (vasodilator);
- xanthinol nicotinate (improves blood flow, reduces swelling of nerve roots);
- aminophylline (eliminates circulatory failure);
- Mexidol (pressure and metabolic processes stabilizer);
- vasonite-retard, octolipene (microcirculation stimulants);
- actovegin (tissue regeneration stimulator);
- Cavinton (promotes saturation of tissues with oxygen, dilates blood vessels);
- berlithion (antioxidant).
Vascular medications for osteochondrosis improve peripheral blood circulation and cellular metabolism and relieve pain.
Antispasmodics and muscle relaxants
To eliminate spasm and tension, antispasmodics and muscle relaxants are used. They normalize blood circulation, relieve pain, and restore mobility. Patients are prescribed:
- sirdalud (tizanadine);
- mydocalm (tolperizole);
- baclofen;
- cyclobenzaprine;
- novocaine, lidocaine, trimecaine.
To enhance the effect of drugs to relax muscles in osteochondrosis, they can be prescribed together with clonazepam or diazepam (prescription drugs). These drugs can be addictive, so they are used with caution.
Sedatives
Symptoms of osteochondrosis and treatment with drugs often provoke chronic stress, emotional stress, depression and other disorders of the psycho-emotional spectrum in patients
For general calming and combating insomnia, you can use herbal preparations - for example, tincture of valerian, motherwort, peony.
For more serious disorders, antidepressants are recommended - gidazepam, Cymbalta, Eglonil, Donormil.
Vitamin and mineral complexes
Since osteochondrosis is considered a disease of the whole body, complex vitamin and mineral therapy (complivit, duovit, doppelhertz, multi-tabs) is of great importance. Vitamins A, groups B, C, D, E, calcium and phosphorus preparations help to significantly improve the condition.
Vitamin A
(retinol acetate) is a natural antioxidant that stimulates collagen production and reduces the destruction of chondrocytes, promotes the renewal of joint tissue.
B vitamins
(cyanocobalamin, milgamma, neuromultivit, neurobion, neurorubin, neuroplex, celtican complex, pyridoxine, thiamine) reduce pain, inflammation and numbness of the hands, improve the sensitivity of nerve fibers.
Vitamin D
(calciferol, aquadetrim, vigantol) is responsible for the absorption of calcium and helps restore bone tissue lost due to osteochondrosis.
Vitamin E
(tocopherol) is necessary for normalizing blood circulation, protecting against free radicals and cartilage regeneration.
Don't self-medicate! Good luck to you in the treatment of osteochondrosis!
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