Treatment of asthenia. Is it possible to offer something new?
Drobizhev M.Yu.¹, Fedotova A.V.², Kikta S.V.<sup>3

1</sup> First Moscow State Medical University named after I.M. Sechenov
² Russian National Research Medical University named after N.I. Pirogov, Moscow
³ City clinic №3 of the Facilities and Property Management Office under the RF President, Moscow

The article presents the data on two different approaches to the diagnosis and treatment of asthenia syndrome. The first one is based on the use of nonspecific diagnoses of the International Classification of Diseases of the 10th revision (ICD-10: R00-R99) and allows the use of food supplements, macro- and microelements, restorative herbal medicines, and antihypoxic drugs and antioxidants. The second approach is based on diagnosis of the syndrome within the frame of F06.6 (organic emotionally labile - asthenic - disorder) and F48.0 (neurasthenia). When treating an organic emotional labile (asthenic) disorder, it is necessary to conduct the therapy for the underlying disease (trauma, arteriosclerosis of vessels, epilepsy, viral or bacterial neuronal infections, tumor), which contributes to the damage of brain neurons and development of asthenia symptoms. In the treatment of neurasthenia, a rational choice of antidepressants or tranquilizers is possible, based on the ideas of impairment of neuronal activity and mechanisms of drugs action. In particular, milnacipran is preferred for the treatment of neurasthenia, which clinical picture is close to depression (depression, anhedonia, fatigue after mental work, or physical weakness and exhaustion after minimal effort, inability to concentrate, unproductive thinking, muscle tone increase with an inability to relax, muscle pain , tension headaches). In contrast, aminophenyl-butyric acid is advisable to use if the symptoms of neurasthenia are similar to those observed in anxiety (anxiety, concerns about mental and physical problems, muscle tone increase with inability to relax, muscle pain, tension headaches, symptoms of dyspepsia, unproductive thinking).

Key words: asthenia, neurasthenia, depression, anxiety, antidepressants, tranquilizers.
For citation: Drobizhev M.Yu., Fedotova A.V., Kikta S.V. Treatment of asthenia. Is it possible to offer something new? // RMJ. 2017. № 9. P. 671–676.