Treatment options for situational anxiety in the neurology physician practice

Abstract

Recent decades have been characterized by high stress levels, which inevitably leads to neuroticism and psychopathization of the population. Emotional stress and the anxiety that follows it can be the cause and provocateur of some pathological processes and diseases. Unlike normal anxiety, intended to adapt the body, protect it and preserve life, pathological anxiety is inadequate to the intensity of the threat, is long-lasting, severe, and disrupts the quality of a person’s life and his activities. Activation of the hypothalamic-pituitary-adrenal axis caused by stress leads to the development of psycho-vegetative syndrome – a complex of somatic, vegetative, and mental symptoms. However, in clinical practice, doctors usually encounter the fact that the patient more often presents various multisystem somatic complaints, ignoring emotional experiences. Undiagnosed anxiety can lead to chronicity or relapse of the disease, the prescription of only symptomatic therapy and aggravation of the course of the missed anxiety disorder. For a doctor to qualitatively assess the clinical picture, it is necessary to understand the structure of autonomic dysfunction in various systems and “recognize” the manifestations of anxiety. Managing such patients, especially comorbid ones, is a complex task, the solution of which will be most effective through joint efforts with psychiatrists and psychotherapists. Psychotherapy, cognitive-behavioral therapy, art therapy, music therapy, medications are an integral part of the therapy for this category of patients. Psychotropic drugs can reduce both anxiety and vegetative symptoms. For subclinical anxiety disorder with somatic manifestations, herbal sedatives or drugs based on them are used in outpatient practice, which have a favorable safety profile with sufficient effectiveness. The drug of choice may be Valocordin, which has sedative, antispasmodic, and hypnotic effects, which corresponds to the goals of treating psychovegetative syndrome.