Capsules Stresam (Biocodex) - reviews

pharmachologic effect

Anxiolytic (tranquilizer).
Etifoxine hydrochloride belongs to benzoxazine derivatives. As an anxiolytic agent, etifoxine has an autonomous regulatory effect. In vitro and in vivo studies in rats and mice showed that the anxiolytic activity of etifoxine is due to the dual mechanism of its action (direct and indirect) on GABA-A receptors, which improves GABAergic impulse transmission.

When acting directly on the GABA-A receptor through allosteric modulation, etifoxine binds predominantly to the β2- or β3-receptor subunits; studies have shown that etifoxine binds to the GABA-A receptor at sites different from the binding site of benzodiazepines. The indirect effect is achieved by increasing the synthesis of neurosteroids (via activation of mitochondrial translocator protein), such as allopregnanolone, which is also a positive aplosteric modulator of the GABA-A receptor.

Anxiety disorders and experience with paroxetine

Anxiety disorders are extremely common, with 13–25% of the population experiencing anxiety disorders in their lifetime. According to the DSM-IV (Diagnostic and Statistical Manual) classification, anxiety disorders include [10]:

• panic disorder;
• generalized anxiety disorder;
• agoraphobia without panic disorder;
• obsessive-compulsive disorder;
• social phobia;
• specific phobias;
• post-traumatic stress disorder;
• acute stress disorder.

Many people are familiar with the symptoms of anxiety. They can be divided into general (mental and vegetative) and specific, determining the type of anxiety disorder. Common mental symptoms include restlessness, irritability, anxious thoughts, motor agitation, flinching at sudden sounds, decreased concentration, increased fatigue, impatience, inability to relax, sleep disturbances, and nightmares. The anxious mood is perfectly conveyed in Edvard Munch’s painting “Anxiety” (Fig. 1).

As a rule, mental symptoms of anxiety are accompanied by vivid vegetative symptoms. Thus, the face of the woman depicted in the picture is pale, tense, and her lips are dry. She keeps her hands on her neck. Perhaps this is a feeling of shortness of breath, a coma in the throat and a feeling of chills. Other autonomic symptoms of anxiety include tachycardia, increased sweating with cold, clammy palms, hot flashes or chills, dyspeptic disorders (abdominal pain, flatulence, diarrhea), dizziness, increased urination, increased physiological tremor, and increased muscle tone.

Clinical forms of anxiety disorders

Generalized anxiety disorder (GAD) is one of the most common forms of anxiety, with 4–9.2% of the population experiencing it during their lifetime [20]. The DSM-IV criteria for GAD are the presence of anxiety and restlessness in combination with at least three of the following symptoms:

• impatience or feeling on edge;
• increased fatigue;
• difficulty concentrating or feeling empty in the head;
• irritability;
• muscle tension;
• sleep disorders.

The duration of the disease must be at least 6 months, the symptoms must cause significant distress or affect social, professional and other areas of activity.

Panic disorder is also extremely common: according to epidemiological studies, panic attacks are observed in 1.5–4% of the population [11], although 35.9–46% of the human population have experienced panic at least once in their lives [2]. Panic disorder affects 6% of people seeking primary care [2]. The main clinical manifestation of panic disorder is panic attacks - attacks of severe anxiety, accompanied by somatic and cognitive symptoms. The main diagnostic signs of panic attacks are paroxysmal occurrence, polysystemic vegetative symptoms, and the presence of emotional disorders, the severity of which can range from a feeling of “discomfort” to “panic” [2]. Agoraphobia is very similar to panic disorder and is defined as anxiety that occurs in response to situations in which the solution is difficult or difficult, or when help will not be available if a panic attack develops. If anxiety in panic disorder can be defined as anxiety in anticipation of a subsequent attack, then agoraphobia is characterized by the presence of provoking factors or situations - being alone outside the house, being in a crowd, on a bridge (as in a Munch painting), traveling on public transport, etc. Provoking situations are actively avoided by patients; getting into them is accompanied by significant distress.

Specific phobias are characterized by the connection of anxiety with certain situations (air travel, contact with animals, the sight of blood, etc.), also accompanied by an avoidance reaction. Finding yourself in a phobic situation provokes an anxious reaction, similar to a panic attack. Patients are critical of their experiences, however, phobias have a significant impact on various areas of the patients’ activities. An example of a specific phobia can be found in the famous artist Pablo Picasso. “For a long time he was deathly afraid of getting his hair cut. For months I wore my hair too long and was hesitant to go to the hairdresser. As soon as someone started talking about it, he fell into a real panic. As a rule, it ended with him asking his loved ones to shorten his hair or locking himself in a small room and trying in vain to cut off his hair himself” [3, 11].

Social phobia is characterized by the occurrence of anxiety in social situations - communication and self-presentation (public speaking or even being in public), fear of possible condemnation from others. As with other anxiety disorders, patients actively avoid social situations because the anxiety causes them significant distress. Thus, the Russian critic and publicist V. G. Belinsky writes: “One thing torments me terribly: my timidity and embarrassment do not weaken, but increase in monstrous progression. I can’t show myself in public: my face is flaring up, my voice is trembling, my arms and legs are shaking, I’m afraid of falling. Self-affirmation is carried out in forms that are in every possible way opposed to accepted norms of behavior. Hence the eccentricity, wildness, and absurdity” [7, 11].

Obsessive-compulsive disorder is characterized by the presence of intrusive thoughts (obsessions) that increase anxiety and ritual actions or thoughts aimed at suppressing this anxiety. There are two key characteristics of symptoms in obsessive-compulsive disorder: egodystonia (the patient is unable to ignore or suppress the symptoms, although he is fully aware of their absurdity) and the presence of significant distress for a significant time (more than an hour a day). The most common obsessions are fear of contamination (45%), pathological doubts (42%), somatic obsessions (36%), the need for symmetry (31%), aggressive impulse (28%), sexual impulse (26%) [14]. Among the compulsions, the most common are checking (60%), washing (50%), counting (36%), the need to ask or admit something (31%), the need for symmetry/neatness (28%), hoarding (18%). ). Distinctive features of obsessive-compulsive disorder from other forms of anxiety disorders are an earlier age of onset, equal representation among both sexes (other forms of anxiety are more common in women), and a fairly high resistance to serotonergic drugs.

Post-traumatic stress disorder has 17 core symptoms, grouped into three groups: re-experiencing the trauma (instructive thoughts, nightmares, emotional and somatic reactions in response to memories), avoidance of memories associated with the trauma (avoidance of thoughts, feelings, places, acquaintances, inability to remember details of a situation, decreased interest in entertainment, withdrawal from other people, lack of prospects for the future) and agitation (sleep disturbances, irritability, difficulty concentrating, hypervigilance and increased startle reflex).

Difficulties in diagnosing anxiety disorders

The main reasons for underdiagnosis of anxiety disorders are the presence of subsyndromal forms of anxiety, as well as a wide range of comorbid disorders - depression, chronic pain syndromes, and other forms of anxiety disorders.

Diagnostic criteria for anxiety disorders are widely presented in the literature and are known to practicing physicians. However, in their daily practice, neurologists and internists much more often see not developed, but subsyndromal forms of anxiety disorders, when in the clinical picture of the disease it is not the mental, but the somatic or neurological components of anxiety that come to the fore. Thus, in the case of GAD, the DSM-IV diagnostic criteria have a significant drawback - they are mainly focused on the presence of mental symptoms, which can lead to underdiagnosis of the anxiety disorder. In the ICD-10 criteria, to make a diagnosis of GAD, the presence of 4 symptoms out of 22, divided into five groups - vegetative, respiratory or gastrointestinal symptoms, symptoms affecting mental activity, general symptoms and nonspecific symptoms, is required, but internists and doctors It is not always convenient for other specialties to use ICD-10 criteria. Starcevic V. et al. identified the most significant symptoms of GAD from the DSM-IV and ICD-10 classifications. The criteria proposed by the authors are much more convenient to use in everyday practice (

.) [18].

Recent epidemiological studies have shown a high prevalence of subsyndromal panic disorder that does not meet diagnostic criteria. In these cases, panic attacks, although rare, anxiety also significantly affects the lives of such patients [15]. Certain diagnostic difficulties can be caused by atypical panic attacks when clinical phenomena not covered by DSM-IV criteria are observed during an attack—diffuse or local pain syndromes, senestopathies, muscle tension, obsessions and compulsions, etc. [2]. There are 10 atypical, conversion symptoms of panic attacks: (1) feeling of a lump in the throat, (2) feeling of weakness in an arm or leg, (3) visual or hearing impairment, (4) gait disturbance, (5) speech or voice disturbance, ( 6) loss of consciousness, (7) a feeling that the body is arching, (8) cramps in the arms and legs, (9) nausea, vomiting, (10) abdominal discomfort [2].

When making a diagnosis of agoraphobia, it is necessary to remember that in cases where the patient has only one or two anxiety-provoking situations, it is necessary to think about specific phobias, and if the anxiety is associated only with social triggers, then about social phobia.

Another feature of panic disorder and agoraphobia is the presence of permanent autonomic disorders, which can occur predominantly in one system or be multisystem in nature [2]. These disorders can be the reason for contacting specialists of various profiles. Thus, patients can come to see a cardiologist with cardialgia, cardiosenestopathies, arterial hypo- and hypertension, syncope and lipothymic conditions, a feeling of lack of air, a feeling of suffocation, and Raynaud's syndrome. Gastroenterologists may encounter in their practice patients who persistently complain of dyspeptic symptoms, dry mouth, nausea, abdominalgia, constipation or diarrhea. Such patients should always request that their anxiety disorder be excluded.

Like other anxiety disorders, obsessive-compulsive disorder is underdiagnosed. Typically, patients with obsessive-compulsive disorder are embarrassed to talk about mental symptoms, even when asked about them directly. The following 5 questions can help a practitioner diagnose this type of anxiety disorder [19]:

1. Do you wash or clean things a lot?
2. Do you check something over and over again?
3. Do you have thoughts that bother you that you would like to get rid of, but you can’t?
4. Do your daily activities take up a lot of your time?
5. Is your attention focused on any order or symmetry?

Depression is an integral accompaniment of anxiety. Anxiety disorders occur in 57% of patients with depression [15]. The combination of anxiety and depression significantly aggravates the course of the disease. This is manifested by more severe symptoms, a tendency to chronicity, mental dysfunction, refusal to work, greater seeking of medical help, a greater risk of suicide and resistance to therapy.

Paroxetine in the treatment of anxiety disorders

Drugs of various pharmacological groups are used to treat anxiety disorders. However, antidepressants are currently considered the drugs of choice. Widely used until recently, anxiolytics, most of which are benzodiazepines, are not used as a basic drug, primarily due to frequent complications: sedation, behavioral toxicity, paradoxical reactions, tolerance, addiction, dependence, withdrawal and rebound syndrome, as well as the presence of drugs interactions. Among antidepressants, preference should be given to selective serotonin reuptake inhibitors (SSRIs) as they are effective and the most well tolerated drugs. Among the SSRIs, paroxetine is the most studied drug in the treatment of anxiety disorders.

For GAD, paroxetine has shown its effectiveness both in comparison with placebo and tricyclic antidepressants and benzodiazepines [17]. Thus, among patients receiving paroxetine, remission was achieved in 72%, while among patients receiving placebo, only 34% (p < 0.001). Already at 4 weeks of use, paroxetine significantly improved the level of anxiety on the HAM-A scale by 15.6 points compared to benzodiazepine, which improved the anxiety score by only 11.8 points (p < 0.01). The dose of paroxetine effective for the treatment of GAD is 20–40 mg/day (10–50 mg/day) [17].

Paroxetine is the most studied drug in the treatment of panic disorder and agoraphobia. In a large placebo-controlled study, paroxetine was effective compared with placebo, characterized by the occurrence of an attack-free period, at a dose of 40 mg/day (p < 0.02). Thus, when taking paroxetine, an attack-free period occurred in 86% of patients, and when taking placebo - in 50%. Paroxetine also had a significantly lower relapse rate (5%) compared to placebo (30%), p = 0.002 [16].

Studies have also been conducted on the effectiveness of paroxetine for social phobia and post-traumatic stress disorder. Among patients with social phobia, 55% of patients taking paroxetine and 24% of patients taking placebo were responders. In a study of the effectiveness of paroxetine for post-traumatic stress disorder, the differences with placebo were less significant due to the high placebo effect. In the paroxetine group, 60% of patients were responders, in the placebo group - 49% [19].

Obsessive-compulsive disorder is the most resistant to treatment among anxiety disorders. However, the effectiveness of paroxetine has also been proven in this form of anxiety, although in higher doses (40–60 mg/day). The paroxetine group showed a significant improvement on the Y-BOCS scale compared to placebo. The relapse rate was also significantly lower in the paroxetine group (38%) compared with the placebo group (59%), p < 0.033 [13].

Paroxetine has a favorable safety profile. The main side effects when taking it are headache, nausea and other gastrointestinal disorders, sleep disorders and sexual dysfunction. Side effects are not pronounced and regress on their own during the first weeks of taking the drug. The cardiac safety of paroxetine appears to be proven [12].

There is extensive experience in the use of Rexetine (paroxetine), including in domestic clinical practice. The clinical effects of Rexetine have been most studied in the treatment of anxiety disorders encountered in the practice of a neurologist and internist, although it can also be used in psychiatric clinics. Thus, in a study of the effectiveness of Rexetine at a dose of 20–60 mg/day in the treatment of anxiety and depressive disorders in patients who consulted a psychiatrist, the proportion of responders was 50% [1]. When taking Rexetine in patients with anxiety and depressive disorders against the background of dyscirculatory encephalopathy, remission was observed in 91% of patients [8].

In a neurological hospital, Rexetine was effective not only for panic disorder, but also for other diseases accompanied by anxiety - somatized dysthymia, “masked” depression, migraine, tension headache, and other chronic pain syndromes [4].

In the work of Less Yu. E. et al. [6] studied the effectiveness of Rexetine at a dose of 20 mg/day for GAD, taking into account comorbid anxiety and affective conditions (panic disorder, agoraphobia, obsessive-compulsive disorder, depression). The patients were divided into three groups. The first group consisted of patients with isolated GAD, the second group included patients with GAD accompanied by erased comorbid disorders at the subsyndromal level. The third research group included individuals with extensive, clinically significant comorbid disorders. The study confirmed the high effectiveness of Rexetine for GAD. In 35.9% of patients, a remission level was achieved by the end of the course of therapy, 17.9% were classified as responders, 28.3% as partial responders, and only 17.9% as non-responders. The dynamics of anxiety on the Hamilton scale, assessed in this study, are presented in

.

According to the dynamics of the total HAM-A score, a significant decrease in anxiety was noted at all time points (7, 14, 21, 28, 35 and 42 days from the start of taking Rexetine). The rate of reduction in symptoms, which was the same in all groups during the first two weeks of therapy, further slowed down in the group of patients with severe comorbid disorders, while in the groups of patients without comorbid disorders and with subclinical comorbid disorders, the therapeutic effect steadily increased, reaching a maximum level by the end of the study. By the time the course of therapy was completed, the regression of anxiety symptoms in the groups of patients without comorbid disorders and with subclinical comorbid disorders was significantly greater than in the group of patients with severe comorbid disorders [6]. Thus, this study confirms the information about the high effectiveness of Rexetine in the treatment of GAD. The anti-anxiety effect of the drug begins to manifest itself from the first days of therapy and gradually increases, reaching a maximum after a month of treatment. A dose of 20 mg appears to be adequate in most cases, but in cases of GAD complicated by comorbid emotional disorders, the dose of Rexetine should apparently be increased [6].

Rexetine has proven to be a highly effective drug for the treatment of specific phobias. With this form of anxiety disorder, a fairly rapid effect of Rexetine was noted. Already in the first week, there is a decrease in the feeling of internal tension, regression of vegetative symptoms (sweating, the intensity of the feeling of “incompleteness” of inspiration has decreased), and sleep improves. The most pronounced reduction in the intensity of anxious experiences and improvement in the well-being of patients was observed during the first 4 weeks of Rexetine therapy. Normalization of well-being to the initial, pre-painful state was observed starting from 3–4 weeks of treatment [9].

There is experience in using Rexetine in patients with somatic diseases and concomitant anxiety and depressive disorders. Thus, Rexetine can be used with antihypertensive, vascular, cardiological, antidiabetic and other drugs that are often necessary for patients for health reasons. It has been established that it does not cause addiction or dependence [5].

Our experience in using Rexetine in patients with anxiety and anxiety-depressive disorders showed that among 20 observed patients, 12 people (> 50%) noted complete remission after 6 months of therapy. In approximately 2/3 of cases (13 patients), comorbidity with depressive spectrum disorders was noted. The most common manifestations were: sad mood, depression, sleep disturbances, pain (in the neck and lower back), slowness of movements and speech. During therapy, a gradual reduction of these manifestations was observed. In the dynamics of anxiety symptoms, such manifestations as anxiety, fatigue, irritability, and muscle tension underwent the greatest regression. It should also be noted the effect of therapy on the presentation of autonomic manifestations of anxiety: tachycardia, hot and cold flashes, cold extremities. In general, according to patient reports, 14 of them (70%) rated the results of treatment as “good” or “excellent”. It should be noted that at the time of therapy, 4 patients were taking pharmacological agents prescribed by internists for concomitant diseases (beta-blockers, antihistamines, vasoactive drugs). In no case were there any signs of drug interactions. In addition, during therapy, one patient noted a decrease in episodes of existing tension-type headaches, in two cases a reduction in insomnia was observed, 4 patients noted a decrease in the intensity of accompanying pain manifestations (pain in the cervical region and lower back) and a decrease in the amount of analgesics consumed while taking Rexetine.

Thus, the proven effectiveness, high safety of Rexetine and extensive experience in its use in the treatment of anxiety disorders allow this drug to be actively used in everyday practice by doctors of various specialties.

Literature

1. Bobrov AC, Petrunko OB, Kovaleva AB, Pavlova O. N. Rexetine in the treatment of depressive states // Journal of Neurology and Psychiatry named after. S. S. Korsakova. 2005. No. 11.
2. Vein A. M., Dyukova G. M., Vorobyova O. V., Danilov A. B. Panic attacks. M.: Eidos Media. 2004. 408 p.
3. Gaev G. Geniuses in private life. M.: Kron-press. 1999.
4. Dmitriev O.V. Experience of using the drug Rexetine in a neurological hospital // Breast Cancer. 2005. T. 13. No. 22.
5. Enikolopov S. Anxiety and hypertension. Vicious circle // Ukrainian Rheumatology Journal. 2008. No. 2 (32). pp. 27–28.
6. Less Yu. E., Malygin Ya. V., Chakhava V. O. Efficacy of the drug Rexetine in patients with generalized anxiety disorder // Breast Cancer. 2005. T. 13. No. 22.
7. Pietsukh V. A. Literary dreams of V. G. Belinsky. A comment. M.: Moscow worker. 1989.
8. Retyunsky K. Yu., Khmelnova I. V., Malkova E. B. Therapeutic effectiveness of rexetine in vascular depression // Psychiatry and psychopharmacotherapy. 2005. T. 7. No. 6.
9. Rumyantseva G.M., Stepanov A.L., Levina T.M. Clinical effectiveness of the drug “Rexetine” (paroxetine) for anxiety spectrum disorders // Psychiatry and psychopharmacotherapy. 2005. T. 7. No. 6.
10. Smulevich A. B. Depression in general medical practice. M., 2000. 160 p.
11. Shuvalov A.V. Psychiatry, narcology, sexopathology. New classification of ICD-10. M.: Soviet sport. 2001.
12. DeVane CL Pharmacokinetics, drug interactions and tolerability of paroxetine and paroxetine CR // Psychopharmacology Bulletin. 2003. V. 37 (Suppl1). P. 29–41.
13. Ninan TP Obsessive-compulsive disorder: implications of the efficacy of an SSRI, paroxetine // Psychopharmacology Bulletin. 2003. V. 37 (Suppl. 1). P. 89–96.
14. Nutt D., Ballenger J. Anxiety disorders. Generalized anxiety disorder, obsessive-compulsive disorder and post-traumatic stress disorder // Blackwell Publishing. 2005. 242 p.
15. Nutt D., Feeney A., Argyropolous S. Anxiety disorders comorbid with depression: panic disorder and agoraphobia // Martin Dunitz. 2002. 111 p.
16. Pollack MH, Doyle AC Treatment of panic disorder: focus on paroxetine // Psychopharmacology Bulletin. 2003. V. 37 (Suppl. 1). P. 53–63.
17. Sheehan DV, Mao CG Paroxetine treatment of generalized anxiety disorder // Psychopharmacology Bulletin. 2003. V. 37 (Suppl. 1). P. 64–75.
18. Starcevic V., Bogojevic G. The concept of generalized anxiety: disorder between the too narrow and too wide diagnostic criteria // Psychopathology. 1999. V. 32. P. 5–11.
19. Stein DJ, Hollander E. Anxiety disorders comorbid with depression: social anxiety disorder, post-traumatic stress disorder, generalized anxiety disorder, obsessive-compulsive disorder // Martin Dunitz. 2002. 72 p.
20. Walley EJ, Beebe DK, Clark JL Management of common anxiety disorders // Am Fam Physician. 1994. V. 50. P. 1745–1753.

G. R. Tabeeva Yu. E. Azimova

MMA im. I. M. Sechenova, Moscow

Table.

Rice. 2.

Pharmacokinetics

Suction

After oral administration, the drug is quickly absorbed from the gastrointestinal tract. The time to reach Cmax in the blood is 2-3 hours.

Distribution

Penetrates through the placental barrier.

Metabolism

Rapidly metabolized in the liver to the formation of several metabolites. One of the metabolites, diethylethifoxine, is active.

Removal

T1/2 of etifoxine is about 6 hours, T1/2 of the active metabolite is 20 hours. It is excreted mainly in the urine in the form of metabolites and in small quantities unchanged; also excreted in bile.

Side effects

Determination of the frequency of adverse events (AEs) observed while taking this drug: rare (≥1/10,000 and <1/1000), very rare (<1/10,000) in descending order of frequency.

From the nervous system:

rarely - slight drowsiness that appears in the first days of treatment and usually disappears on its own during treatment.

From the skin and subcutaneous tissue:

rarely - maculopapular rash, erythema multiforme, itching, facial swelling.

Allergic reactions:

very rarely - urticaria, Quincke's edema; frequency not established - anaphylactic shock, drug-induced hypersensitivity syndrome with eosinophilia, Stevens-Johnson syndrome, leukocytoclastic vasculitis.

From the liver and biliary tract:

frequency not established - hepatitis, cytolytic hepatitis.

From the genital organs and breast:

frequency not established - metrorrhagia in women taking oral contraceptives.

From the digestive system:

frequency not established - lymphocytic colitis.

Capsules Stresam (Biocodex) - reviews

Swity

I suffer from depression and anxiety-neurotic disorders; after an accident a year ago, I suffered a serious injury to the head and spine. Astheno-neurotic states follow and, accordingly, psychosomatics rush. I always slept with Gidazepam... but then the moment came again, terrible stress, it blew me away. She explained to the psychotherapist that there was a vacuum in my head and, in general, panic attacks against the background of my neuroses... and she said that gidazepam makes me sleepy and it doesn’t help much. She switched me to Stresam... In general, the first pill lifted my spirits and made me more confident, well, I feel the drugs very quickly. Then I continued to drink it and felt the anxiety go away... somewhere far away I felt these attacks of noo very, very far away... the condition was even.. on the 5th day I began to become Aggressive.. I became very tough, then pain appeared in the thoracic region and on the left side body...then I felt a vacuum, I heard it from the side, I slept from 23.00 to 7.00 steadily. I didn’t notice any interruptions in my heart... but on the 8th, 9th, 10th day of taking it, I just started dying... what was happening to me... I was terrified. I just fell and stumbled... not that I was slowing down, but just stupidly, I became like crazy... a very terrible state. Today, after 10 days, I switched to Gidazepam... because severe dizziness began. The drug Strezam is good for relieving panic and anxiety... but the rest and the side effects made me feel so terrible.

Larisa

I took strezam - terrible heartburn after taking the capsule, especially at night

nikarenat

https://otzovik.com/review_4821023.html

The drug was prescribed to me by a neurologist, whom I see with complaints of constant headache. Vascular medications bring temporary relief, so the neurologist decided to use Stresam, which was supposed to normalize sleep and reduce general anxiety.

1 day of taking 1 tablet/3 times a day. I didn’t feel any shelves, and, accordingly, no effect either. But mine got better within the first day of taking it. It is a fact.

2 days of use in the same dosage. The dosage will be the same for the entire course of treatment. A slight anxiety appeared, which was expressed in restlessness, a desire to constantly do something.

3rd day of use: already after the morning pill I began to feel unusual anxiety, which was expressed in irritability, tremors of the arms and legs.

Day 4 of admission: from the very morning the irritation was so strong that I was ready to leave the house just to go somewhere. It was difficult to communicate normally with loved ones; everything was terribly annoying. The tremors became continuous. Tachycardia appeared.

Since there was no way to see a doctor in the near future, I stopped the drug myself.

Within 5 days everything returned to its previous state, quite stable. And although anxiety has a place in my body, it is still not as pronounced as with this drug.

Later, in consultation with a psychiatrist, I heard that this drug can cause such side effects, as it has a mild anxiolytic effect.

Well, in general, the drug is good, it is prescribed often, and is not addictive. It all depends on your disease. Find a good doctor and be open about any unwanted side effects. I will recommend it, since there are no similar organisms or reactions to the drug.

Be healthy and don't worry!!!

Kulmandi

https://otzovik.com/review_4113400.html

They gave it at the neurosis clinic. There was terrible anxiety, panic attacks, neurosis. Oh, I don’t even know who and what it can help with... well, maybe those who need enough valerian. given 3 times a day, 2-3 capsules. after a week there was zero effect, and this despite the fact that in addition to it there was a bunch of other things that, according to the instructions, were supposed to enhance the effects. Many people in the department drank it. I interviewed almost everyone with anxiety or attacks, and no one could respond positively.

Anastasia Arefieva

https://med-otzyv.ru/lekarstva/160-s/91607-strezam#scomments

Terrible drug. It feels like the roof is moving. Terrible dizziness, feeling of swelling of the face and itching all over the body.

Mila Doch

https://vk.com/topic-92998487_36470300

Strezam had no effect on me, what I took, what not. I reached 7 tablets a day, I didn’t increase it further, I was afraid for my health

Kochev V.

https://protabletky.ru/strezam/#otzivi

It has become widespread for the treatment of anxiety among neurologists, and the worries among neurologists are not in vain - the drug helps extremely rarely. For many it is not suitable at all, for some intolerance - one of the drugs that is effective in less than half of patients. No match for proven means

Olga D.

https://protabletky.ru/strezam/#otzivi

Constant worry for nothing. Expecting trouble. I was forced to see a doctor. Strezam was prescribed to help the nervous system. Perhaps it helps someone, has a beneficial effect. Three days later we had to stop taking Strezam. Aggressive behavior was combined with screaming and inappropriate actions. We have Parkinson's disease. We take other medications. The doctor suggested that it was an unfavorable reaction of the body in combination. In the instructions I read about the reaction to the body of mice. I assumed that there were no tests of the drug's reaction in humans.

special instructions

If skin or allergic reactions occur, as well as complications from the liver, the drug should be discontinued.

If you miss a dose of the drug, you should not double the dose the next time you take it.

The dose prescribed by the doctor should not be exceeded.

It is not recommended to take the drug while drinking alcoholic beverages.

Use in pediatrics

It is not recommended to use the drug in children and adolescents under 18 years of age.

.

Impact on the ability to drive vehicles and operate machinery

Due to the risk of drowsiness, you should avoid driving vehicles and activities that require increased attention, such as operating various mechanisms.

STRESAM (capsules)

take a tranquilizer, but it is very light.
Its main focus is precisely eliminating anxiety, as well as reducing irritability and improving mood. In the photo you can see the indications for use: There are relatively few contraindications.

The only possible side effects are drowsiness in the first days of use and allergies. “Strezam” should not be consumed with alcohol and the dose should not be exceeded. Well, a tranquilizer, after all.

The drug is sold in packages of 24 and 60 capsules. I always bought at 24, although I wanted 60. So, as a rule, it turns out cheaper. But I haven’t found such packaging anywhere.

The capsule is white and blue, medium in size, just right for swallowing.

I was prescribed the drug, 1 capsule 3 times a day for a month. That is, for a month you need 4 packages (24 capsules each). Not cheap, but health is more expensive. The drug is sold as indicated in the instructions, with a prescription. Not a single pharmacy asked me for a prescription.

I tolerated the drug well, it didn’t make me sleepy. But, do not take Stresam on an empty stomach, especially for those who have any problems with it. I have chronic gastritis and if I took it on an empty stomach, it began to hurt and terrible heartburn appeared, which, in principle, I do not suffer from.

According to its intended purpose, the drug did not work immediately. At first I didn’t think it was effective at all. But I was wrong. The effect begins somewhere on the fifth day of administration. The anxiety became a little less while taking Strezam. I became calmer, the tension in my muscles went away, the irritation that was just off the charts before taking the drug went away. Moreover, I did not have such calm drowsiness. No. It was inner peace that came. The waterfall of completely causeless tears stopped.

But, I want to say that in the stage of exacerbation of panic attacks, this drug turned out to be completely useless for me and when the anxiety associated with panic attacks goes off scale, and not that anxiety before an exam, roughly speaking. Those who have a diagnosis like mine understand what I mean. When this attack occurs, Strezam does not supervise it at all. He is no help to you here. But after the crisis has passed, it can be accepted. Since stronger trunks cause addiction and a “vegetable” state.

I want to say that Strezam only works when you take it, when you stop taking it, everything comes back again. And tearfulness and loss of mood. So far I haven’t come across anything better for myself in this segment, some make you feel like an “amoeba”, and some cause the opposite effect. I want to say that if you have a severe anxiety disorder with panic attacks, neurosis, then this drug is too weak. It is suitable for those who have mild anxiety, a little nerves and who have not previously taken stronger trunks.

Now I take Mezapam and Alprozolam. And, of course, I’m getting ready for recovery!

The advantage of this drug is that it is not addictive, like many drugs of this kind.

I recommend the drug!

We wish you all health and a strong nervous system!

Release form, composition and packaging

Capsules

gelatin, size No. 2, smooth, shiny, with a white body and a blue lid; the contents of the capsules are white or white powder with a slight yellowish tint.

Excipients:

lactose monohydrate - 119 mg, talc - 15 mg, microcrystalline cellulose - 10 mg, colloidal anhydrous silicon dioxide - 3 mg, magnesium stearate - 3 mg.

Shell composition:

titanium dioxide, gelatin, indigo carmine.

12 pcs. - blisters (2) - cardboard packs. 20 pcs. - blisters (3) - cardboard packs.