Prevention

Preventive measures are reduced to abstinence from the use of alcoholic beverages, the fight against alcoholism, the treatment of addiction. Those who have experienced a psychotic state should be given active anti-alcohol therapy.

Persons with alcoholism and in a state of psychosis often commit serious misconduct and deeds.. Therefore, at the first signs of a mental disorder, an immediate reaction should follow from the side of relatives.

Calling a qualified psychologist-narcologist at home will help to avoid the progression of the disease and keep your loved one in good health.

In more detail about alcoholic psychosis, experts will tell in the video below:

ALCOHOLIC PSYCHOSIS. The main factors leading to the occurrence of alcoholic psychosis are metabolic disorders caused by chronic (usually at least 5 years) alcohol abuse.

Delirium tremens(alcoholic delirium) usually develops against the background of an abstinence syndrome with a sharp cessation of drinking or (less often) during a period of abstinence from alcohol in cases of the addition of somatic diseases, injuries (especially fractures). The initial signs of delirium tremens are worsening of night sleep, individual vegetative symptoms (sweating and hand trembling), as well as general fussiness of the patient. For a short time, various shades of mood can be noted, while usually with a hangover syndrome, the mood is monotonous, characterized by depression and anxiety. The condition worsens in the evening (at nightfall), while during the day it may improve so much that it allows the patient to perform his professional duties. In the future, insomnia appears, against the background of which visual illusions first appear, and then various hallucinations and delusions. The predominance of visual hallucinations, which are characterized by a plurality of images and mobility, is characteristic. More often these are insects (cockroaches, beetles, flies) and small animals (cats, rats, mice). Characterized by visions of devils, snakes, "little aliens", deceased relatives. Often, auditory, tactile, olfactory hallucinations are simultaneously noted. At the same time, the mood of patients is extremely variable: for a short time one can observe fear, complacency, bewilderment, surprise, despair.

Patients usually move continuously, their facial expressions are expressive. Motor reactions correspond to hallucinations and mood existing at the moment. So, with fear and frightening hallucinations, the patient hides, defends himself, is excited, and is passive during a good mood. The delusion is fragmentary and reflects the content of hallucinations, more often it is the delusion of persecution. Patients are usually incorrectly oriented in the place (being in the hospital, they say that they are at home, at work, etc.), but oriented in their own person. Delirium tremens is characterized by the periodic disappearance of some of the symptoms, i.e., "light" intervals are noted, as well as a naturally pronounced increase in symptoms in the evening and at night.

Delirium tremens is constantly accompanied by a variety of vegetative disorders - hand trembling, severe sweating, flushing of the skin, especially the face. Body temperature is often subfebrile. The pulse is fast.

Without treatment, delirium tremens drags on for 1-1.5 weeks, may be complicated by alcoholic encephalopathy. Recovery often occurs after deep prolonged sleep.

Alcoholic hallucinosis develops with withdrawal symptoms or at the height of binge. In this case, the main disorder is profuse auditory hallucinations, combined with delusions of persecution. The patient usually hears words "spoken" by a large number of people - "a chorus of voices." Often there is a conversation of "voices" among themselves about the patient, less often they are addressed to the patient himself. At the same time, the “voices” threaten, accuse, insult. Often hallucinations are mockingly teasing in nature, sometimes intensifying to a scream, sometimes weakening to a whisper. Crazy ideas (delusions of persecution, physical destruction) are closely related to the content of auditory hallucinations, they are fragmentary and unsystematic. The mood is dominated by intense anxiety and fear. At the onset of alcoholic hallucinosis, motor excitation is observed in patients, but soon there is some lethargy or an orderly, disease-masking behavior, which creates a false and dangerous idea of ​​an improvement in the condition. As a rule, the symptoms of the disease are aggravated in the evening and at night. Vegetative disorders common for withdrawal syndrome are noted. The duration of alcoholic hallucinosis is from 2-3 days to several weeks, in rare cases it drags on for up to several months.

Alcoholic depression appears against the background of withdrawal symptoms, is characterized by a depressed and anxious mood, tearfulness, ideas of self-destruction, as well as separate delusional ideas of attitude and persecution. Duration from several days to 1-2 weeks. In a state of alcoholic depression, patients can commit suicide.

Alcoholic epilepsy It is characterized by large convulsive seizures that occur at the beginning of the withdrawal syndrome (being a harbinger of the onset of alcoholic delirium), with delirium tremens, less often at the height of intoxication. Small seizures, twilight stupefaction, auras (see Epilepsy) do not happen. With the cessation of alcohol abuse, seizures most often disappear.

Alcoholic paranoid develops in a state of withdrawal syndrome or at the height of binge, is characterized by the presence of delirium. The content of delusional ideas is exhausted by the ideas of persecution or adultery. In the first case, patients believe that there is a group of people seeking to rob or kill them. In the gestures, actions and words of those around them, they see confirmation of their thoughts. Characterized by confusion, intense anxiety, often replaced by fear. The actions of patients are impulsive: they jump off vehicles on the move, suddenly take to flight, seek help from the police, sometimes attack imaginary enemies. In some cases, delirium is accompanied by mild verbal illusions and hallucinations, individual delirious symptoms that occur in the evening and at night. Alcoholic paranoid lasts from several days to several weeks, occasionally several months.

Alcoholic delirium of jealousy occurs almost exclusively in men, as a rule, after 40 years, develops gradually. At first, the patient notes that his wife began to treat him inattentively, and over time, simply with hostility. Increasingly, in his opinion, she shows coldness in intimate relationships and even simply evades them. At the same time, it seems to him that his wife begins to carefully monitor her appearance, more and more often she goes somewhere, constantly lingers, and when she comes home, she looks unusually lively and embarrassed. The patient becomes rude, excitable, unrestrained, he demands "explanations", which entails more and more frequent scandals. However, the wife's behavior only "worsens". Suspicions of her infidelity, at first vague and arising in connection with drunken states, become constant and more certain. The patient usually claims that his wife is cheating on him with one of the men in his inner circle - young relatives, neighbors. If at first "betrayals" are committed outside the home, then over time the wife "becomes impudent" and indulges in "debauchery" already in her apartment. The patient begins to follow his wife, turns to various authorities for help, and can even use violent acts against his wife, often commits murder. With the progression of the disease, the patient begins to assert that his wife has cheated on him in the past, even before marriage, and that the children were not actually born from him. Alcoholic delirium of jealousy usually takes a chronic course with periodic exacerbations.

Alcoholic encephalopathies occur with alcoholism, accompanied by chronic gastritis or enteritis, mainly in people who drink a lot, but eat little. They usually develop against the background of hypovitaminosis in the spring months. The most common form of acute alcoholic encephalopathy is Gaye-Wernicke encephalopathy. It usually begins gradually, lasts 2 - 3 months, rarely longer. There is a growing asthenia, manifested by weakness, exhaustion in combination with memory disorders. Appetite decreases, and then completely disappears, night sleep is upset, loose stools, vomiting, headaches, dizziness, loss of balance are somewhat less common. The resulting psychosis is most often represented by professional or exaggerated delirium, less often by anxiety-delusional states. A few days after the onset of these disorders, stupor or symptoms of apathetic stupor, turning into a coma, are noted. Neurological disorders are constant and pronounced: an increase in muscle tone and sensitivity to pain, such as injections, is detected. Often there are various hyperkinesias. The appearance of paralysis of the oculomotor muscles, photophobia, nystagmus usually indicates the highest phase of the disease. Polyneuropathy phenomena of different intensity and localization are observed. Of the autonomic symptoms, heart rhythm and breathing disorders, fever of central origin, urinary and fecal incontinence are usually noted; the skin is pale or dark brown. The general physical condition of patients is characterized by progressive weight loss, up to cachexia. The disease without treatment most often ends in death.

Chronic alcoholic encephalopathies include Korsakov's psychosis and alcoholic pseudoparalysis. In some cases, they develop over a number of months, in others - acutely, as a rule, after delirium tremens.

Korsakov's psychosis develops against the background of chronic alcoholism, more often - after severe alcoholic delirium. There are gross violations of memory for current events with the inability to remember and reproduce (fixation amnesia). As a result of mnestic disorders, there is disorientation in place and time, unrecognition of others. Memory gaps are replaced by false memories. Previously acquired skills and knowledge are usually retained to a sufficient extent. The mood can be euphoric in combination with a complete or partial lack of criticism of one's condition. In the neurological status appear ophthalmoplegia, nystagmus, ataxia, disorders of tendon and periosteal reflexes in the upper and lower extremities, sometimes combined with muscle atrophy.

Alcoholic pseudo-paralysis is characterized by dementia with severe memory impairment: memory disorders in combination with confabulations (see Amnesia), loss of acquired knowledge and skills, impaired judgment, lack of criticism of one's disease. The background of the mood is determined by carelessness, in some cases ideas of greatness are noted. The course is long.

Pathological intoxication- a rare variant of acute psychosis that occurs with a picture of twilight disorder of consciousness or acute paranoid syndrome, which develops after drinking small doses of alcohol and can occur after a state of simple alcohol intoxication. Pathological intoxication often occurs in people with organic CNS damage, epilepsy, oligophrenia, psychopathy and lasts from several minutes to several hours, followed by deep sleep and amnesia of everything that happened. The patient's behavior is determined by delusional experiences of fear, hallucinations, in connection with which he performs inadequate aggressive actions, suicidal attempts. Outwardly, this state is manifested by chaotic motor excitation, often silent, accompanied by a sharp pallor of the face. Cases of pathological intoxication almost always become the subject of subsequent forensic psychiatric examinations.

medical tactics. First of all, it is necessary to exclude (when examining the patient) traumatic psychosis. The increase in the severity of the condition, the deepening of the impairment of consciousness, the appearance and intensification of neurological disorders with meningeal symptoms, the lack of improvement in the condition during the day, the persistence of delirium disorders suggest a complex (alcohol-traumatic) nature of delirium.

Taking into account the fact that psychotic disorders in acute alcoholic psychosis can be temporarily stopped by ingestion of alcohol, it is advisable to use a mixture of 0.3-0.4 g of phenobarbital dissolved in 30-50 ml of ethyl alcohol with the addition of 100-120 ml of water before starting infusion therapy given to the patient to drink. Then it is necessary (especially in the first hours) to take care of the mechanical fixation of the patient. You can use for this, for example, a net from an ordinary country hammock, covering the patient with it: for all the outward ugliness, this is the least traumatic remedy and is preferable to the generally accepted "knitting".

Treatment of alcoholic delirium is based solely on pathogenetic principles. Intensive infusion therapy (the same as with alcohol withdrawal) should be combined with large doses of psychotropic drugs: intravenously or intramuscularly injected 3 - 4 ml of 0.5% solution of seduxen up to 2 - 3 times a day; intramuscularly 1-2 ml of a 0.5% solution of haloperidol, 2-3 ml of a 2.5% solution of tizercin or chlorpromazine (the latter, in cases of severe psychotic symptoms, can also be administered intravenously). Large doses of vitamin B are needed (5 ml 3-4 times a day). The best prognosis is observed with the addition of large doses of nootropil (up to 5 g orally or up to 20 ml intravenously).

Infusion therapy for alcoholic hallucinosis is usually carried out once and only in cases of severe autonomic disorders. The main place in the treatment belongs to psychotropic drugs: tizercin, haloperidol, stelazine (triftazine), which are administered parenterally in the first days.

In the treatment of alcoholic encephalopathy, the main attention is paid to massive vitamin therapy (vitamins of groups B and C) and nootropic drugs.

At all stages of the treatment of alcoholic psychoses, the nursing staff must fulfill all prescriptions with the utmost care, carefully monitor changes in the patient's condition and report them to the doctor. The importance of nursing care for patients with alcoholic psychosis is equated with the importance of care for postoperative patients.

The site administration is NOT responsible for the consequences of self-treatment.

Alcoholic psychosis - symptoms and treatment at home or clinic of various types of illness

A dangerous complication of alcoholism is alcoholic psychosis - the symptoms and treatment make it clear that it will not be easy to get rid of delirium and delusional ideas even in a hospital setting. Such a critical state is not limited to withdrawal symptoms, irreversible changes occur in the psyche of a chronic alcoholic, his worldview. Alcoholic psychosis is observed when a smaller dose of ethanol enters the blood, and this is a problem. It will be very difficult to recover, to return to a full life.

What is alcoholic psychosis

Such an acute mental disorder is provoked by prolonged abuse of alcoholic beverages. Simply put, this is a serious complication of alcoholism, which, in addition to insomnia, causes amnesia, delirium tremens. The disease has a chronic form, however, if the attack is stopped for up to 10 days, a stable and very long period of remission can be achieved. More often, male alcoholics suffer from a characteristic pathology, but the development of alcoholic psychosis in the female body should not be ruled out. This is the official diagnosis, which has the ICD-10 code F 10.4.

The main provoking factor is alcoholism, which gradually destroys all internal organs and body systems. This is a pathological process lasting no one year. Alcoholic psychosis progresses more often in chronic alcoholics of stages 2 and 3, and is prone to recurrence. Additional contributing factors are:

• social factor;
• genetic predisposition;
• violation of metabolism and chemical composition of blood;
• prolonged stress, mental trauma;
• chronic fatigue, apathy;
• physical and mental overload;
• low level of comfort.

If the patient falls into an alcoholic depression, these are the first prerequisites for an exacerbation of psychosis. It is not easy to cure a chronic disease, especially since the clinical picture is only getting worse. The pathological process begins with acute intoxication of the body, does not exclude the appearance of systemic and neurological symptoms. It is recommended to pay attention to the following changes in general well-being:

• disturbed breathing with hoarseness;
• cyanosis around the eyes, corners of the mouth;
• nightmares;
• obsessive ideas;
• delirium with visual hallucinations;
• bouts of emotional arousal;
• progressive delirium;
• paranoia, fit of hysteria;
• progressive mental disorder;
• suicidal tendencies;
• dementia symptoms;
• progressive epilepsy;
• panic with auditory hallucinations.

Types of alcoholic psychosis

Prolonged alcohol intoxication in the absence of desire on the part of the patient is difficult to cure, so psychosis develops over time. Given the extensive list of delusional disorders, narcologists provide the following conditional classification for a quick diagnosis of a patient with alcoholism. So, the following types of alcoholic psychosis are distinguished:

• alcoholic delirium;
• hallucinosis;
• alcoholic depression;
• alcoholic pseudo-paralysis;
• Korsakov's alcoholic psychosis;
• delusional alcoholic psychosis.

In fact, this is "white tremens", which, with somatic disorders, drives the patient to insanity. A dangerous attack is more often associated with a sharp decrease in the dose of ethanol in the blood after a long binge. Not only is there a complete degradation of the individual, but also there is a real threat to society from a violent alcoholic. His actions in alcoholic delirium are difficult to guess and predict.

Such a pathology is more accompanied not by a physical disorder, but by a psychological one. The patient personally encounters auditory and visual hallucinations, exists in a state of severe stress, emotional instability and alcohol addiction. He constantly hears extraneous voices, with whom he even conducts a conversation. In practice, eye symptoms are much less common, but they also become an eloquent manifestation of alcoholic psychosis and require timely treatment.

This symptom is associated with intense jealousy, which borders on signs of insanity. In such a clinical picture, even a human life may depend on the further behavior of patients, since an alcoholic in a state of passion is able to “strangle” the object of jealousy or a conditional rival. Therefore, with prolonged binges, the prognosis is unfavorable, you can be “behind bars” after sobering up.

With progressive alcoholic encephalopathy, a drunken alcoholic periodically loses his memory. We are talking about temporary episodes of amnesia, which he tries to make up for with his own fantasies. Each time he comes up with a new story of what happened, but in reality everything was completely different. Such stories cause alarm in relatives, so treatment for alcoholic psychosis should follow immediately. It is important to understand that Korsakoff's syndrome belongs to the category of chronic alcoholic encephalopathies.

Acute alcoholic psychosis

Gaye-Wernicke encephalopathy occurs exclusively in an acute form, and develops against a background of severe delirium. With vegetative disorders, extensive brain damage is observed due to a deficiency of thiamine - vitamin B1 against the background of chronic alcoholism, malnutrition, and incessant vomiting. Metal-alcohol psychosis of this variety is accompanied by increased drowsiness, disturbed sleep phase, general weakness in the limbs, nightmares and a feeling of emptiness. All manifestations of depressive disorders are difficult to treat.

Treatment of alcoholic psychosis

With prolonged binges, extensive disorders of the psycho-emotional state are not excluded, which need timely correction by medical methods. Treatment is carried out in a hospital, the main task is to reduce the risk of developing irreversible damage to the brain and internal organs and systems. If post-alcoholic psychosis is diagnosed, the general recommendations of certified narcologists are presented below:

1. An alcoholic with severe symptoms needs to be hospitalized, otherwise he may harm himself and others.
2. To get rid of the symptoms of psychosis, it is necessary to carry out infusion therapy in order to productively clear the systemic circulation of heavy metals.
3. With attacks of psychosis associated with a hangover syndrome, the patient must be isolated from others.

Medications

After performing a series of tests to make a final diagnosis, getting rid of such an extensive pathology is possible only with an integrated approach. The basis of intensive care in a hospital is infusion therapy for the rapid and safe removal of alcohol breakdown products. Additionally, narcologists appoint representatives of the following pharmacological groups:

• psychotropic drugs to eliminate the symptoms of psychosis;
• saline solutions for high-quality blood purification;
• a mixture of phenobarbital and alcohol with the addition of water to fix an alcoholic;
• vitamin B1 in large doses to avoid extensive brain damage;
• nootropics, tranquilizers to calm a violent patient;
• sleeping pills to subdue a violent patient;
• antipsychotics recommended to the patient with thoughts of suicide;
• multivitamin complexes for quick recovery of the body.

These medications can only be prescribed on an individual basis with correction of daily dosages. Treatment of unpleasant symptoms of psychosis against the background of alcohol dependence should proceed only in a hospital, under strict medical supervision. Here are effective medicines in a given direction:

1. diazepam. 0.5% solution for intramuscular injections. It is recommended to administer 2-4 ml of the drug at a time, up to 2-3 approaches per day. Treatment continues until the complete disappearance of unpleasant symptoms.
2. Carbamazepine. This is a drug in the form of tablets, which is prescribed for seizures. The daily dose is 1.2 g, an overdose is completely excluded (dangerous for the health of an alcoholic).

Psychotropic drugs

With dipsomania without representatives of the specified pharmacological group, successful treatment of the patient is excluded. To remove the symptoms of aggression and inappropriate behavior, narcologists recommend the following psychotropic drugs in the hospital:

1. Aminazin. Therapeutic solution with a concentration of 2.5%. It is recommended to administer 2-3 ml, while daily doses are adjusted individually depending on the unpleasant symptoms of psychosis. It can be replaced with a solution of Tizercin - the principle of use is similar.
2. Seduxen. Another treatment solution with a concentration of 0.5% for drip administration. It is recommended to administer 3 ml of the drug 2 to 3 times a day until the symptoms disappear completely.

If the symptoms of alcoholic psychosis are not eliminated in a timely manner, the patient becomes socially dangerous, can threaten the lives of healthy and adequate people. His actions are difficult to predict, and conversations do not have a calming effect. Therefore, a violent alcoholic needs to be urgently neutralized and isolated, treatment should be carried out only in a specialized clinic. Potential complications include:

• gradual but steady decline in mental capacity;
• progressive amnesia;
• regular convulsions and tremors of the limbs;
• complete degradation of the personality;
• extensive lesions of internal organs and systems;
• death at a relatively young age;
• gradual development of chronic alcoholic psychosis with frequent relapses.

Alcoholic psychosis is a disease known for a long time, but people did not attribute it to a disease for a long time. The drinker was simply isolated from society until his condition improved. In our time, chronic alcoholism is ranked among the difficult to treat diseases. But it is necessary to fight it, since alcoholic psychosis can lead to pathological changes in the central nervous system.

A feature of alcoholic psychosis is that it occurs after many days of drinking, under the influence of alcohol breakdown products. Alcoholic psychosis is the result of alcohol intake, which is combined with mental stress and an unhealthy nervous system of a person.

Alcoholic psychosis causes

Very often, the cause of the development of alcoholic psychosis can be a genetic predisposition. Much less often - living conditions and social environment. The next reason may be the abuse of alcoholic beverages for 3-5 years, in which the metabolism is disturbed, affecting the internal organs.

Recently, there has been a “rejuvenation” of the age of drinkers. Already in adolescence, boys, and often girls, begin to drink alcohol in the form of energy drinks. The nervous system at this age is not yet formed at the proper level, which entails the body's addiction to alcohol and becomes the subsequent cause of the disease.

Alcoholic psychosis symptoms

The most common type of psychosis is delirium tremens, medically called delirium tremens. The disease develops mainly with a sharp reduction in the use of alcoholic beverages associated with the transfer of injuries or serious illnesses.

The first signs of delirium tremens are worsening sleep at night, sweating, anxiety of the patient, a sharp change in mood, depression. During the day, the patient can go to work and cope well with it. By evening, the condition worsens, and at night, depending on the stage of the disease, hallucinations and delusions occur, characterized by various images and mobility. It seems to the patient that flies, cockroaches, mice crawl over him, dogs bite him, someone pricks him with needles. Devils, dead relatives are often seen. Trembling of the extremities (trembling delirium), increased heart rate, flushing of the skin are also symptoms of delirium tremens.

At the same time, both tactile and auditory hallucinations can appear, in which the patient hears numerous voices that threaten him, accuse him of something. They can be quiet or very loud, to the point of screaming.

Alcoholic psychosis and its symptoms: mood swings in a short time, expressive facial expressions, and continuous movement in which the patient hides from someone, defends himself, shakes the sheets and blankets, fights imaginary insects, catches invisible birds. At the same time, his delirium is fragmentary, reflecting the meaning of hallucinations. Often patients are not guided in the place of their stay.

Types of alcoholic psychoses

Korsakov's psychosis, like alcoholic pseudo-paralysis, are chronic encephalopathies.

Korsakov's psychosis (the third stage of alcoholism) occurs in people aged 40-50 who abuse various surrogates.

Korsakov's psychosis develops against the background of chronic alcoholism, with pronounced mental disorders with lesions of the peripheral nervous system, most often after severe alcoholic delirium. In this case, fixation amnesia is manifested - memory impairment for events from life and the inability to remember, as well as reproduce.

There is disorientation in time, often not recognizing others, not remembering names. Deep gaps in memory appear, which are associated with a disorder of orientation in the environment and in time. The mood can be euphoric, with a lack of control over one's behavior. Muscle atrophy and impaired tendon reflexes in the limbs may occur. The gait changes.

Alcoholic pseudo-paralysis is expressed in dementia with pronounced memory impairment: amnesia, memory disorders, loss of acquired skills and knowledge. The mood is characterized by carelessness, the presence of megalomania. The course of the disease is long.

With alcoholic depression that occurs after drinking, the patient does not show interest in everything around him, becomes tearful, he has a breakdown. Depression is also recommended to be treated in a hospital.

Acute alcoholic psychosis

In acute alcoholic psychosis, a certain frequency of clinical manifestations can be traced. At the same time, psychotic disorders can replace each other.

Acute alcoholic psychosis includes alcoholic depression, delusional psychosis, alcoholic epilepsy, and alcoholic hallucinosis.

Alcoholic hallucinosis (second after alcoholic delirium) is marked by auditory hallucinations, anxiety disorders, delirium, sleep disturbance. It is noted mainly at the end of binges. There are frequent panic attacks, suspicions. The patient hears voices, and it seems that they are talking about him threateningly. He "argues" with them and may even turn to the police. This can be observed in the third stage of alcoholism, mainly in the elderly.

In acute psychoses, delusions of persecution are observed. On the part of the patient, aggressive actions against the alleged persecutor are possible. There are crazy systems of jealousy in relation to loved ones. Statements and discontents become ridiculous and continue for a long time. Sometimes the alcoholic delirium of jealousy acquires a chronic course, bringing trouble to both the patient and loved ones.

Alcoholic psychosis treatment

Alcoholic psychosis at home is not treated, as it carries a danger, both for the patient and for others. During the treatment of alcoholic delirium, it is necessary to completely exclude the use of alcohol.

Before intensive therapy, the patient is given to drink 0.3-0.4 g of Phenobarbital dissolved in 100 g of water with the addition of 30-50 ml of ethyl alcohol. In the first hours, the patient should be mechanically fixed. Then large doses of psychotropic drugs are used with the introduction of 3 ml of a 0.5% solution of Seduxen 2-3 times a day, 2-3 ml of a 2.5% solution of Aminazine or Tizercin. Be sure to add B vitamins - Aerovit, Complivit, Centrum, 1 tablet per day.

With alcoholic hallucinations, infusion therapy is usually carried out with pronounced autonomic disorders. The following psychotropic drugs are used in the treatment: Haloperidol, Tizercin, Stelazin. Vitamins B, C and nootropics are also mandatory.

Alcoholic psychosis is treated successfully with the right therapy. In cases of severe course, detoxification therapy is used with the appointment of enterosorbents. You can also recommend plasmapheresis, which is carried out once a day for up to 3 days. It is also desirable to prescribe psychopharmacotherapy with the use of tranquilizers, which dull the feeling of fear and anxiety. These are drugs: 0.5% solution of Diazepam 2-4 ml intramuscularly, solution or tablets of Phenazepam (daily dose 0.01 g). Additionally, sleeping pills are prescribed at night: Reladorm 0.11-0.22 g, Ivadal 0.01 g or Phenobarbital 0.1-0.2 g. To eliminate convulsive seizures, narcologists prescribe Carbamazepine up to 1.2 g per day. If the patient has seen cases of suicidal behavior, then the neuroleptic Neuleptil 15-20 mg per day should be used.

Alcoholic psychosis consequences

Difficulties in assimilation of new information are very serious consequences of alcoholic psychosis. A person becomes stupid, becomes dumb, forgets much of what he knew.

In addition to damage to the central nervous system, other internal organs also suffer: the liver, brain, heart, gastrointestinal tract. When alcohol is abused, the liver takes a hit on itself, which can lead to its cirrhosis. If you start treatment for alcoholic psychosis in time and do not drink alcohol, you can prolong liver function much longer.

As a result of alcohol abuse, the function of the heart muscle is weakened, its contractility is reduced. Can develop coronary heart disease, hypertension. With alcohol intoxication, gastric ulcer develops into acute pancreatitis.

At stages 2-3 of alcoholism, alcoholic psychosis often develops, manifested by a combination of mental disorders. Most often, it occurs either during the period of binge, at its height, or after several days of abstinence, especially if the binge was interrupted abruptly. The most common manifestation of alcoholic psychosis is delirium tremens (delirium) - a frequent companion of withdrawal symptoms. Somewhat less often observed hallucinosis, characteristic of patients with a long history of alcoholism. The typical manifestations of psychosis also include alcoholic paranoid - delusions of persecution, jealousy.

Delirium, hallucinosis, alcoholic paranoid - the triad of the main components of alcoholic psychosis. Drunken alcoholics also suffer from other mental disorders: depression, encephalopathies (pseudoparalysis, Korsakov's psychosis), epileptic seizures. In patients with severe organic lesions of the central nervous system, pathological intoxication is possible, manifested in the form of acute paranoid or twilight disorder of consciousness.

If you notice the symptoms of a mental disorder in an alcoholic, you should immediately contact a specialist narcologist. A person in this state is a danger to others and to himself.

Almost 80% of manifestations of alcoholic psychosis are accounted for by delirium tremens. Withdrawal leads to the development of alcoholic delirium, usually symptoms appear already on the second day of abstinence from drinking alcohol, but sometimes they can occur after a week. The Latin name delirium tremens (shaking stupefaction) reflects the main signs of this disorder - tremor, clouding of consciousness. Periods of stupefaction are replaced by bright intervals, more often the condition worsens in the evening, at night. In acute alcoholic delirium observed:

• increased anxiety, mood swings, insomnia;
• psychomotor agitation, disinhibition, expressive changeable facial expressions;
• confusion, manifested by disorientation in time and space, frightening visual, tactile, less often olfactory hallucinations (devils, aliens, monsters, insects crawling over the body, hair in the mouth). At the same time, orientation in one's own personality is preserved;
• trembling, pallor or redness of the skin, muscle weakness, palpitations, subfebrile temperature, increased sweating.

With atypical forms of delirium, hallucinations can be scene-like, of a fantastic nature. Delirium tremens can turn into a chronic, prolonged form, its symptoms appear for several months. Prolonged delirium is accompanied by twitching of the limbs, fever, sweating, psychomotor agitation. Often a person makes monotonous movements related to his professional activities. They also distinguish exaggerating delirium, in which a person renounces reality, makes chaotic movements, mumbles something incoherently.

Alcoholic hallucinosis develops at the peak of a prolonged binge or shortly after it ends. Acute alcoholic psychosis manifests itself in the form of hallucinosis in patients older than 40 years with a disease experience of 10 years. It is characterized by the predominance of auditory hallucinations, voices push a person to aggressive actions. Auditory, less often visual hallucinations are accompanied by delusional ideas, increased anxiety, and a sense of fear.

Unlike delirium, with hallucinosis the patient not only realizes who he is, but also retains his orientation in time and space.

Protracted forms of hallucinosis stretch for several months and even years.

Manifestations of paranoid

Alcoholic paranoid develops in people suffering from alcoholism for 12-13 years, and usually acquires a chronic course. For this condition, delusional obsessions are typical, its main manifestations are:

1. Delusions of persecution;
2. Alcoholic delirium of jealousy.

Less common are delusions of relationships (everyone despise me, hate me), delusions of self-accusation (I deserve to die), and others. A patient with delusions of persecution is convinced that they want to kill him, rob him, torture him. Excessive anxiety and suspicion leaves an imprint on the behavior of the patient, he is often at a loss, is frightened.

Alcoholic paranoid is a state in which a person is capable of impulsive acts:

• runaways from home;
• aggressive behavior allegedly in self-defense;
• fighting an imaginary enemy;
• appeal to law enforcement agencies with complaints of persecution, requests for protection.

Alcoholic paranoid may be accompanied by visual and auditory hallucinations. For men, alcoholic delirium of jealousy is characteristic, an alcoholic begins to suspect his wife of infidelity, reproaches her for coldness, evading marital duties. Symptoms increase gradually, at first the person becomes suspicious, then rude, unrestrained, from verbal reproaches goes to insults and assault. As the disease progresses, the list of "sins" of the wife increases, if the patient has children, he begins to doubt his own paternity. This is a very dangerous mental disorder; under the influence of delusional ideas, an alcoholic can beat his wife and even commit murder.

Alcoholic encephalopathy, epilepsy

Alcoholic psychosis can manifest itself in the form of encephalopathies, in which mental disorders are combined with somatic and neurological. For the development of diseases of this group, 5-7 years of alcohol abuse are enough. The risk of alcoholic encephalopathy increases with the use of alcohol surrogates, which cause severe harm to health. There are acute and chronic forms of this disease.

The development of Heine-Wernicke encephalopathy begins with the onset of symptoms of severe delirium (obsessive movements, muttering, withdrawing into oneself), and an anxiety-delusional state is also possible. Then disturbances of consciousness of different depths appear, from stunning to stupor (stupor) and even coma. The disease is characterized by such somatovegetative and neurological symptoms:

• violation of muscle tone, oculomotor activity, hyperkinesis, increased sensitivity to pain;
• progressive asthenia, dizziness, imbalance, headaches;
• sleep disorders, memory
• disorders of appetite and digestion, leading to exhaustion up to cachexia;
• respiratory and cardiac disorders, fever, abnormal skin color.

Quite often, the progression of this form of encephalopathy leads to death. Its transition to other forms (syndromes) is also possible - Korsakov's psychosis or pseudo-paralysis. Korsakov's psychosis is more typical for drinking women over 40 years old, it manifests itself in severe memory impairment, amnestic syndrome, disorientation, impaired reflexes, and atrophy of the muscles of the limbs is possible. Pseudoparalysis is more common in men, its symptoms are: memory disorders, dementia, impaired critical attitude to reality. Long-term use of alcohol, especially low-quality alcohol, can also provoke epileptic seizures.

Therapy for alcoholic psychosis

If a patient is diagnosed with alcoholic psychosis, he needs hospitalization and treatment under the constant supervision of specialists. First, the patient is examined to clarify the nature of the psychosis: it can be not only alcoholic, but also alcoholic-traumatic, requiring more complex treatment. Treatment of alcoholic psychosis begins with infusion (drip) therapy. For the period of its implementation, it is important to fix the patient on the bed.

Medical staff should carefully note the symptoms and, if necessary, make adjustments to the treatment.

In delirium, in addition to the standard infusion therapy indicated for withdrawal symptoms, a number of drugs are prescribed to normalize the mental state: seduxen, haloperidol, chlorpromazine or tizercin. It is also necessary to administer nootropil and vitamin B. With hallucinosis, they mainly resort to injections of haloperidol, triftazin, tizercin. Alcoholic paranoid, including alcoholic delirium of jealousy, requires treatment with neuroleptics, antidepressants, tranquilizers, and vitamin therapy. In the treatment of alcoholic encephalopathy, an important role is played by vitamin therapy, nootropic drugs.