Asthenic disorders: contradictions and paradigms

Abstract

Asthenic disorders are a pressing problem for modern medicine. The lack of specificity of this disease makes it difficult to make a nosological diagnosis, since these disorders occur not only in somatic pathologies and infections, but also in various neurological and mental diseases. Attempts at systematization taking into account clinical variability did not lead to a single paradigm, since they did not reflect all possible variants of disorders. In ICD-10, conditions, the main manifestation of which is asthenia, are considered under various headings: Neurasthenia – F48.0; Organic emotionally labile (asthenic) disorder - F06.6; Other specified neurotic disorders – F48.8; Fatigue syndrome after a viral infection – G93.3; Condition after COVID-19 - U09.9; Overwork (burnout syndrome) – Z73.0; somatoform disorders – F45. Currently, there is no single concept in the treatment strategy for patients. With these disorders, the number of active receptors in the brain is reduced, the response to medications is reduced, even the addition of energy correctors does not fully stimulate the restructuring of the functional state of the central nervous system only with specific effects on neurotransmitter systems. Correction of the functional state of the central nervous system through nonspecific effects is necessary. Phenylpiracetam is the first drug with a neuromodulatory effect. The antiasthenic effect of the drug appears after a single use, prolonged action has its advantages for increasing the effectiveness of therapy, which allows reducing the pharmacological burden on the patient and thereby reduce the risk of developing polypharmacy.