[The possibility of using neurotropic therapy in patients with persistent postural-perceptual dizziness].

Abstract

Objective: The purpose of this study is to study the effectiveness of the use of Cortexin and Recognan drugs in complex therapy in patients with persistent postural perceptual dizziness (PPPD).

Material and methods: 60 patients with PPPD were included in the observational study. Patients in the study group received escitalopram at a dose of 10 mg in basic therapy for 6 months. After 2 weeks from the start of basic therapy, the patients were divided into 3 groups of 20 patients each. Patients of the 1^st group were prescribed Cortexin 10 mg intramuscularly, 1 time per day for 10 days, the 2^nd group - Cortexin 10 mg intramuscularly, 1 time per day for 10 days, and the drug Recognan 1000 mg 1 sachet 1 time per day for 10 days. Patients of the 3d group received basic therapy Escitalopram 10 mg once a day. The patients' condition was assessed three times: before the start of therapy, after the end of the 10-day course of therapy, and a follow-up examination 2 months after the end of the course of therapy while continuing to take the SSRI drug. To study the severity of dizziness and balance disorders, the VSS-ST scale was used - a short form of the scale of symptoms of dizziness, which has two subscales - the Vestibular Balance Scale (VSS-ST-V) and the Vegetative Anxiety Scale (VSS-ST-A). To assess sleep disorders in the study group, testing was performed on the Insomnia Severity Scale. Anxiety was assessed on a GAD-7 Scale (Generalized Anxiety Disorders -7). In addition, the Anxiety Sensitivity Index -3 Anxiety Sensitivity Index-3 (ASI -3) was determined in patients.

Results: Prior to therapy, high scores in the VSS-ST-V subscale (average score 27.15±2.83) and moderate manifestations in the VSS-ST-A subscale (average score 16.05±2.35) were detected in all patients. Clinically significant insomnia was detected in patients of all groups (mean score 18.3±1.76). High indicators of anxiety, as well as the index of anxiety sensitization, were revealed. The second study of patients showed a significant improvement in vestibular balance, a decrease in anxiety and sleep disorders, especially in patients receiving complex therapy. In the third test, patients receiving Cortexin and Recognan showed statistically significant positive changes in almost all indicators: VSS-ST-V and VSS-ST-A subscales (average score 27.15±2.83), insomnia, and ASI-3. This reflects the fact that for the relief of anxiety disorder associated with dizziness, it is necessary a sufficient amount of time from the start of complex therapy requires activation of the processes of central vestibular compensation.

Conclusion: It should be noted that the positive results of this study can be considered a decrease in the severity and severity of symptoms of dizziness, anxiety, insomnia, and a decrease in the index of anxiety sensitization in patients of all observation groups. Patients receiving complex therapy had the most statistically significant changes. In this situation, it is important to give preference to the complex administration of drugs with a multimodal mechanism of action, as well as to create optimal combinations of drugs that potentiate each other's effects.