Psychosomatic disorders in the therapist's practice

Many patients at the polyclinic complain of symptoms that cannot be explained by the presence and/or exacerbation of any somatic disease. For example, “cardialgia of non-cardiac origin” is widespread. In foreign literature, such conditions are referred to as “symptoms that are medically unexplained”; in our country, another definition is adopted – vegetative dystonia syndrome. Such patients often undergo expensive examinations, undergo consultations with various specialists, and receive ineffective treatment, which, as a rule, does not lead to a positive result, causing dissatisfaction among both patients and doctors. The optimal treatment strategy includes individually selected psychotherapy in combination with medicinal and non-medicinal methods of treatment and prevention. Therapy of clinically expressed anxiety by a non-psychiatrist is possible with the use of psychotropic drugs. The article discusses anxiolytics of various mechanisms of action, including the atypical benzodiazepine tranquilizer tophizopam, which has a number of advantages over other tranquilizers: lack of sedation, muscle relaxation and cognitive impairment, effectiveness in somatovegetative symptoms of anxiety, safety for daily use, and the presence of a mild stimulating effect.