Strategy for the management and prevention of psycho-emotional disorders in the GP’s practice

Abstract

Psycho-emotional disorders, such as anxiety disorders, acute and chronic stress, are significant risk factors for the development and complicated course of both major cardiovascular and other common chronic non-communicable diseases. The psycho-emotional disorders significantly reduce patients’ motivation and adherence to lifestyle changes and drug therapy, significantly worse quality of life, increase the risk of disability and healthcare system expenditures. The topicality of the issues of diagnosis and management of psycho-emotional disorders in the general practitioner’s practice is caused, on the one hand, by high rates of these disorders in patients with cardiovascular and other chronic diseases, deterioration in quality of life and an increase in adverse outcomes, and on the other hand, inadequate awareness of the risks associated with the sphere of psycho-emotional status in patients. The management of psycho-emotional disorders includes both pharmacological and non-pharmacological treatments. Antidepressants that fall into the class of selective serotonin or serotonin and norepinephrine reuptake inhibitors are the first-line drugs used for the treatment of most of the disorders discussed. However, prescription of these drugs requires to take into account a wide range of possible side effects in patients with chronic diseases, including CVDs. Drugs that have fast onsets of sedative and anti-anxiety action, also known as tranquilizers, are more widely used in real-world clinical practice. Tofisopam is the most promising from this group of drugs in therapeutic and cardiological practice. The efficacy and safety of tofisopam have been studied in numerous studies in patients with chronic non-communicable diseases and a wide range of anxiety disorders, including the long-term use of the drug.