It lists 5 benzodiazepine tranquilizers (despite the fact that ALL foreign guides indicate that PTSD has a VERY high risk of developing benzodiazepine dependence, as well as all sorts of paradoxical reactions, such as intoxication, disinhibition and aggressiveness and “emergence” in the memory of traumatic memories, instead of sedation and anxiety and amnestic effects, “forgetting troubles” – and that is why it is for PTSD, unlike many other anxiety and “neurotic” disorders, that benzodiazepines are not recommended, and in any case – they are not recommended for a long time).
Of the entire arsenal of SSRIs, only two are prescribed in the standard – paroxetine and sertraline. Other classes of blood pressure are not mentioned at all.
Normotimics are not mentioned at all (and they are also needed and shown in PTSD, because there is impulsivity, and aggressiveness, and sharp mood swings, and suicidality that requires lithium; in addition, many PTSD who survived, say, shell shock suffer also post-traumatic epilepsy).
Antipsychotics are not mentioned at all (meanwhile, within the framework of PTSD, there are also transient psychotic symptoms, and aggressiveness, and antipsychotics are needed).
Nightmares – doxazosin, prazosin, clonidine at night – are not mentioned at all. Beta blockers are not mentioned at all. Topiramate, which has proven to help with PTSD flashbacks, is not mentioned at all.
Lamotrigine, which reliably helps with depersonalization-derealization in the context of PTSD, is not mentioned at all. Valproate, which helps with panic attacks and anxiety in PTSD (and unlike benzodiazepines, is not addictive) is not mentioned at all.
In accordance with paragraph 4 of Part 1 of Article 37 of Federal Law No. 323-FZ dated November 21, 2011 “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation” and subparagraph 5.2.18 of paragraph 5 of the Regulation • of the Ministry of the Russian Federation, approved by the Decree of the Government of the Russian Federation dated June 19, 2012 No. 608, I order:
1. Approve the medical standard
helping adults with
post-traumatic stress disorder (diagnosis and treatment) according to the appendix.
2. Recognize as invalid:
order of the Ministry of Health of the Russian Federation dated December 20, 2012 No. 1223 “On approval of the standard of primary health care for neurotic, stress-related and somatoform disorders, post-traumatic stress disorder in an outpatient setting B (dispensary department, office)” of a neuropsychiatric dispensary (registered by the Ministry of Justice of the Russian Federation on March 20, 2013, registration No. 27788);
order of the Ministry of Health of the Russian Federation dated December 20, 2012 No. 1234n “On approval of the standard for specialized medical care for neurotic, CO stress-related somatoform and disorders, post-traumatic stress disorder” (registered by the Ministry of Justice of the Russian Federation on March 6, 2013, registration No. 27535)
But they did not forget to register air exposure, helium exposure, contrast showers, and baths. Fucking govnalijen and stuffed here. For some reason they stuffed tiapride. Tofisopam, which has an extremely weak evidence base, was stuffed. Shivnarax was shoved. Stresam was stuffed (sht? although I appreciate it as an anxiolytic, but what does it do in the standard treatment for PTSD?).
