Combined treatment of manic-depressive psychoses
The temptation to use a number of theoretical possibilities simultaneously is supported by the fact that only a few patients have a clear, psychopathologically clean clinical picture. Whether it is possible to use combined therapy in manic-depressive psychoses and whether it promises to be more effective here than any single method, it is still not clear. It should only be emphasized that one can never "combine" in cases when it is a question of testing some medical method.
Regarding the first question, we already know that various methods of convulsive therapy can be combined with inhalation, and pharmacotherapeutic. It is possible to combine convulsive therapy with medium doses of phenothiazine preparations, tofranil, relaxants, evipan anesthesia. In this case the dosage of evipan should be relatively a namesake. It is also possible to perform simultaneous inhalation and pharmacological therapy. Reserpine can be used along with convulsive therapy in combination with orfenadrine. Known caution is recommended, however, and in this case. After taking pure reserpine, convulsive or inhaled treatment is possible no earlier than 48-96 hours.
It is much more difficult to answer the second question - the degree of expediency of combined treatment. In our opinion, the time necessary for the onset of remission is not reduced here. But it is true-and this is very important-that convulsive treatment with simultaneous daily inhalation therapy reduces the number of convulsive-therapeutic procedures needed for remission. The same applies to the combination of convulsive therapy with pharmacological therapy. In addition to reducing the required number of shocks, this combination therapy is also gentle. If, on the basis of the first impressions, they do not dare to carry out only pharmacotherapy alone, one can start using electroconvulsive therapy starting with it. This leads to the fact that patients suffering from various manifestations of their psychosis, rather, begin to feel relieved and do not suffer so painfully the fact of being in the hospital.
The question of which therapeutic combination to choose, it is necessary to solve individually. Some data for this solution is provided by the study of the psychopathological picture, but other factors must also be taken into account: the patient's age, general somatic state, blood circulation, blood pressure, cerebral blood supply, metabolism, allergic reactions, etc.,for example, his insuperable fear of shock.
Women's magazine www. BlackPantera.com: Carl Leonard