На
ук
а о жизни и з
доровье №2, 2020
105
symptoms occurring after amphetamine
intake can be ambiguously related to only one
of the diagnostic clusters, unless a clinician
comprehensively scrutinizes the history of
symptom sequences and makes an assumption
about a possible dual diagnosis [5].
Treatment
strategies
concerning
substance use with mental disorders are
limited by the lack of evidence-based
recommendations and poor approaches
toward rehabilitation for the group of patients
in question. Increased treatment intensity is
underlined as a general principle of clinical
management by a wide range of concerned
specialists and expert groups that develop
standardized protocols and guidelines for dual
diagnosis. While conceived as an umbrella
term, the dual diagnosis poses challenges
for the development of reliable tailored
recommendations and practical steps due to
the heterogeneity of the possible combinations
of drugs and mental disparities.
The complications that distinguish the
patients with dual diagnosis from those with
monodiagnosis are poor treatment compliance,
aggressive and violent behavior, frequent
emergency room visits, psychotic episodes,
suicidal thinking [8].
In this context, the emergence of novel
psychoactive substances introduces new
challenges for drug addiction specialists,
especially for those working with dual
diagnosis. The profound addictive NPS effects
have the potential to change the course of
parallel mental pathology, causing additional
risks for those patients who are on basic
antidepressant and antipsychotic therapy.
To the best of our knowledge, the
literature data have mostly described the
clinical cases and observational studies with
acute clinical symptoms of NPS intoxications
in patients with bipolar disorder [9].
Meanwhile, the information concerning the
course of NPS addiction against the backdrop
of bipolar affective pathology is sparse.
Given that, the aim of this paper is to
obtain the preliminary insight into clinical cross
talks between NPS addiction and endogenous
affective disorders by describing a clinical
case of NPS (synthetic stimulant) addiction
associated with index bipolar disorder.
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