CAMAGÜEY.- The title of this Medical Consultation corresponds to an exhortation of Dr. Pablo Hernández Figaredo, Second Degree Specialist in Psychiatry, Assistant Professor and Consultant, Master in Social Psychiatry, from the René Vallejo Psychiatric Hospital, in this city, and also the president of the Camagüey Chapter of the Cuban Society of Psychiatry, to whom we turn in search of his criteria, especially due to the imbalances that we may suffer in times of pandemic.

The appearance of the SARS-CoV-2 coronavirus that causes COVID-19 around 18 months ago in Cuba is closely linked to stress, uncertainty and insecurity, sadness, depression, and sleep disorders, because they inevitably take over of not a few people, those who in extreme situations go to the consumption of psychotropic drugs.

- What do you think of the use or abuse of the consumption of psychotropic drugs?

—As a health professional, I understand that the use of psychotropic drugs has no drawbacks as long as it has been prescribed by a doctor, since he knows for what purposes it is done, the approximate time of treatment and the contraindications in each case.

“Abuse is something very different, it would be understood as inappropriate, excessive and continuous use, with its corresponding physical, psychological and even social damage. Half a millennium ago, Paracelsus, a Swiss doctor, expressed a basic principle of toxicology, and that is that the dose differentiates a poison from a medicine. If it is known that the dose makes the poison, it is necessary to be very attentive to avoid problems.

"And another risk about the use of these drugs without a prescription is that some interact with other drugs that people consume or have diseases to which they are contraindicated."

—How are the families of psychotropic drugs divided?

—Psychotropic drugs, which are popularly known as “nerve pills”, are divided according to the effect they produce into anxiolytics, antidepressants, neuroleptics, normothymics, hypnotics, among others. Benzodiazepines belong to the family of anxiolytics, that is, they are indicated when anxiety symptoms appear.

- Of those mentioned, which are the most addictive?

—First, it is pertinent to clarify that there are clinical symptoms and entities that require long periods of treatment, hence the importance of medical prescription. In these cases, the suppression or reduction of the drug depends on the evolution and will always be a decision of the physician with the consent of the patient. Now, when a treatment is maintained for longer than indicated by desire of the latter, it can happen that it becomes "hooked" and it is difficult for you to stop ingesting it. This is when the addiction diagnosis must be assessed. One of the most widely used psychotropic drugs in the world today is Xanax, which is the commercial name of Alprazolam, it can produce dependence in a short time.

—It is normal that those affected want to resolve as soon as possible, hence they medicate themselves or seek specialized help so that the pills are indicated, would this always be the solution or are there other possibilities to find improvement?

—Psychotropic drugs made their appearance in the middle of the previous century, and before that it was very common to use decoctions, linden, or that handy action to fall asleep: “counting sheep”. It is true that you cannot go against the times, but it is also clear that there are a good number of situations that cannot be solved with medication. Tensions and daily stress require another coping, why go to a psychotropic drug if not indicated by a doctor?

"It is very convenient for anyone, whether they have mental concerns or not, to know a breathing and relaxation technique, to apply what is known in relation to sleep hygiene, all of which will help the individual to maintain their mental health and to better cope with situations. stressful. I always comment that the only country in the world where there is a television program called La Dosis Exacta is ours, because here we are used to self-medicating. It is very normal to hear that the neighbor felt better with some pills and gives them to another with similar discomfort, and so when she comes to see she is taking something that could be poison for that other one.

—If the drug (s) was inevitably consumed, at what time and how would it be advisable to suspend them.

—There are medications that can be stopped suddenly, others cannot. This is not known to the patient and sometimes, because it took time for improvement to appear, a treatment that could begin to take effect is suspended. Well, some do it after the second or third week. Other times it is the patient who does not want to stop taking it and tells you: "I have felt so good", when he no longer needs it. I insist that the indication of the drug, the reduction or the suppression, have to be evaluated by the doctor ”.

—Of addiction, what would be the prognosis for these people?

—When self-labeling does not occur, that is, when the problem is not recognized and help is rejected, higher and higher doses will be required to achieve the desired effect and in this way the person will be immersed in a vicious circle of consumption.

"The good news is that when that person recognizes that they have this problem and cooperates with the cessation treatment, the prognosis will be good."

—A general advice, especially in times of COVID-19 ...

—This is a question that has as many answers as people can answer it, because there are no “recipes” for this, but each one knows what is good for him and what worries or stresses him. However, in any season, through thick and thin, I think staying positive will help a lot. Look at what difficult moments we have had to live; however, with pessimism or defeatist attitudes we will not solve anything. 'At bad times, good face'.

“It is opportune to use time in a useful way when we have to make life more homelike. Exercising at home, now that 'I don't have time' thing doesn't work. Read the books that have been waiting for us for that same lack of time. Stay out of fake news and avoid information overload. When the news and the world we live in are not very pleasant, we are obliged to embellish them with hope and optimism ”.

Translated by Linet Acuña Quilez