From Big Medical Encyclopedia

PSYCHOGOGIC MEANS (Greek psyche of a shower + lat. stimulare to drive, excite; synonym: psychoanaleptics, psychoanaleptic substances, psychotonic means) — the pharmaceuticals stimulating mental processes.

Items of page divide into two groups — psychomotor and psychometabolic stimulators. Carry derivatives of xanthine to psychomotor stimulators — caffeine (see), fenilalkilamina — Phenaminum (see), derivatives of a fenilalkilpiperidin — measures of ides silt (see), derivatives of a fenilalkilsidnonimin — Sydnocarbum (see) and Sydnophenum (see); to psychometabolic — drugs of piperidic acid (see) and its analogs, and also some other drugs.

Items of page of the first group are effective hl. obr. at functional disturbances of cerebration and clearly change various indicators of activity of a brain (EEG, etc.). Drugs of the second group are effective at organic intellectual insufficiency and improve cogitative functions without noticeable neyrofiziol. shifts in this connection such drugs designate as nootropic means (see).

Psychomotor stimulators improve a number of behavioural reactions, increase intellectual and physical effeciency, especially against the background of its decrease, weaken feeling of fatigue, drowsiness. Under the influence of drugs of this group people are longer and more qualitatively capable to perform mental and physical work, they have a feeling of cheerfulness, confidence in the forces, interest in surrounding, motor and speech performance increases. By value judgment, there is an acceleration of a current of thoughts, there are associations easier, performance of intellectual operations is facilitated. Animals react to effect of such drugs increase in the research activity lowered by fatigue, the accelerated and more exact behavioural acts. Along with specific psychotropic action psychomotor stimulators possess also others pharmakol. properties which range and expressiveness vary depending on structural features of separate drugs. So, drugs of this group can cause euphoria (it is especially expressed at fenilalkilamin), have the awakening and anti-cataleptic effect, stimulate breath. Besides, separate drugs (e.g., Phenaminum) have the expressed peripheral sympathomimetic effect, and in this regard stimulate cordial activity and raise the ABP. Fenilalkilamina cause also anorexigenic effect developing as a result of influence of these substances on the hypothalamic centers of hunger and saturation, partially at the expense of the arising hyperglycemia and increase in level free fat to - t in a blood plasma.

Medicinal psychostimulation represents difficult neyrofiziol. and psikhofiziol, the phenomenon caused by change of activity of a number of structures of a brain; In neyrofiziol. the relation medicinal psychostimulation is followed by the general increase in a functional condition of a brain, shifts in emotional and motivational reaction and strengthening of motor functions. To the structures responsible for these processes, some zones of bark of big hemispheres, the separate limbic centers belong. Psychostimulation is also connected with excitement of a reticular formation of a brainstem and weakening of the constraining function of striotalamokortikalny system. As a result at P.'s action by the village the tone of the multi-component activating system of a brain with primary or secondary weakening of the inactivating mechanisms begins to prevail. Extent of involvement of separate structures of a brain in process of psychostimulation is not identical and depends on neurochemical features of action of psychomotor stimulators. At xanthines, e.g., direct exciting impact on bark prevails, at the same time they influence activity of the subcrustal centers more weakly. At fenilalkilamin influence on reticular structures of a trunk and kernel of a neoncephalon is leading.

In development of some psikhofiziol, the changes caused by P. page participate, obviously, the same structures of a brain. It is established that some substances improve processes of perception and an identification, active attention, memory and training. However P.'s impact by the village on actually mental processes is studied worse, than on neyrofiziol. the mechanisms connected with ensuring basal functions of a brain.

Depending on features of chemical structure of P. of page differently influence activity of the central neurons. P.'s activity of the village having sympathomimetic properties is caused by strengthening of both noradrenergichesky, and dofaminergichesky transfer. The change found by nek-ry scientists under the influence of these substances of serotonergic processes has probably no essential value for specific effect of drugs. As the reason of excitement of monoaminergichesky synapses serves strengthening of emission caused by drugs and restriction of the return capture of a mediator with the prespnaptichesky terminations, and weakening of its euzymatic destruction, obviously, has smaller value. Derivatives of xanthine slightly influence synoptic transfer, though increase sensitivity of postsynaptic receptors to catecholamines. These drugs generally directly activate nervous cells, increasing their energy potential by inhibition of phosphodiesterase.

The main indication to use of psychomotor stimulators is decrease in intellectual and physical effeciency. Some drugs are appointed for treatment of an adynamy of various etiology, at a narcolepsy, as the awakening substances at acute poisonings with hypnagogues chronic less often. Caffeine is used as an analeptic at respiratory depression and activity of cardiovascular system.

Psychomotor stimulators are contraindicated to patients with organic diseases of a brain and heart, at atherosclerosis, a hypertension.

By-effects are expressed by increase in excitability of c. item of page, irritability, sleeplessness. Development of mental disturbances is in certain cases possible (see below). The eyforiziruyushchy effect of drugs which is especially sharply expressed at Phenaminum is undesirable. Besides, side effect of drugs can be shown by loss of appetite, increase in the ABP and tachycardia. The last effects are more weakly expressed at Sydnocarbum and other means offered as substitutes of Phenaminum. At prolonged use of P. of page development of medicinal dependence (see) to them in this connection drugs of this group cause the corresponding toxicomanias (see), and P. the pages carried to narcotic substances (e.g., Phenaminum, meridil) — drug addiction is possible (see). At the same time among P. of page there are drugs (e.g., nootropic drug piracetam) which even at long (within several years) use do not cause development of medicinal dependence.

Acute poisoning at a single dose of high doses of Phenaminum and other drugs with sympathomimetic properties is followed by motive concern, mental disorders (see below) and vegetative disturbances. The acute intoxications caused by xanthines proceed easier, than poisonings of a fenilalkilaminama. Therapy of poisoning comes down to the actions directed to removal of the remains of substance from went. - kish. a path, reduction of concentration of drugs in blood (an artificial diuresis, etc.) and to purpose of calmatives (tranquilizers, somnolent). For elimination of sympathomimetic effects administer the adrenoceptor blocking drugs, and mental disturbances stop neuroleptics.

Mental disorders at use of psychogogic means. In the course of P.'s treatment by the village there can be various mental disturbances which degree of manifestation depends hl. obr. from duration of use of these means and their dosages.

At short-term (in certain cases single) P.'s reception by the village in high therapeutic or toxic doses development of acute intoksikatsionny psychoses (see), most often a delirium is possible (see. Delirious syndrome ), which sometimes is followed by epileptiform attacks. In some cases under the influence of P. the page notes development of a psychoorganic syndrome (see). At some faces in response to a single dose P. of page there can come paradoxical reaction in the form of apathy, slackness, drowsiness.

The long use of P. of page can be followed by development of accustoming, mental and physical dependence. In such cases various neurosis-like, psychopatholike and affective frustration, napr, a condition of depression, a dysphoria are often observed (see). At some persons, it is long abusing Phenaminum, hallucinatory-dilision psychoses with resistant auditory hallucinations, the crazy ideas of prosecution, poisoning, etc. can develop long or hron (see. Paranoid syndrome ), similar on a wedge, a picture with psychotic symptomatology at schizophrenia.

At patients with psychoses P.'s use by the village in some cases can be followed by an aggravation of the existing psychopathological symptomatology or emergence of earlier observed mental disorders.

Bibliography: Arushanyan E. B. Neurochemical and neurophysiological mechanisms of psychogogic action of Phenaminum, Pharm. and toksikol., t. 38, No. 1, page 111, 1975; Arushanyan E. B. and Belozertsev Yu. A. Psychogogic substances, Chita, 1979, bibliogr.; Stolyarov G. V. Medicinal psychoses and psychotomimetic means, L., 1964; Meyler’s side effects of drugs, 1972 — 1975, ed. by M. N. G. Dukes, Amsterdam a. o., 1975; Side effects of drugs, Annual, ed. by M. N. G. Dukes, v. 1 — 6, Amsterdam a. o., 1977 — 1982.

E. B. Arushanyan; A. G. Vrublevsky (psikhiat.).