Цель исследования. Представить читателю подробный обзор касательно эпидемиологии, факторов риска, этиологических причин и патогенетических механизмов развития ортостатической гипотензии в психиатрии. Показать, каким образом ортостатическая гипотензия в психиатрии может быть источником дополнительных психических проблем, или причиной развития резистентности к проводимому психотропному лечению. Представить несколько интересных клинических случаев ортостатической гипотензии в психиатрии, включая наш собственный.

Методология проведения работы. Мы провели поиск в поисковых системах PubMed, Google Scholar, Science Direct, Web of Science с использованием ключевых слов «orthostatic hypotension» в сочетании с наименованиями различных психических патологий и психотропных препаратов. Найденные поиском статьи были проанализированы нами на предмет релевантности по отношению к тематике планируемой статьи. Затем мы представили результаты этого анализа в настоящем обзоре.

Результаты. В процессе составления настоящего обзора нами найдены литературные данные, убедительно свидетельствующие о том, что ортостатическая гипотензия в психиатрии является не просто «ещё одним побочным эффектом», но нередким источником таких дополнительных психических проблем, как депрессия, тревога, патологическая сонливость, ухудшение когнитивного функционирования пациентов, усиление экстрапирамидных побочных эффектов терапии. Кроме того, найденные нами литературные данные свидетельствуют также о том, что ортостатическая гипотензия в психиатрии может также быть одной из причин резистентности к проводимой терапии.

Нами также найдены литературные данные о факторах риска развития ортостатической гипотензии в психиатрии. Эти данные позволяют стратифицировать пациентов по группам риска, и заранее предпринять соответствующие меры по профилактике или минимизации риска возникновения этого осложнения в уязвимых группах. Затем нами представлены клинические случаи, иллюстрирующие вышеуказанные тезисы, в том числе один случай из нашей собственной практики.

Область применения результатов. Полученные нами результаты свидетельствуют о том, что проблему ортостатической гипотензии в психиатрии ни в коем случае нельзя игнорировать или недооценивать. Она заслуживает своевременного и проактивного выявления и энергичной коррекции. Это связано с тем, что ортостатическая гипотензия не только снижает качество жизни пациента и его комплаентность к лечению, но и служит источником дополнительных психических проблем, таких, как депрессия, тревога, когнитивные нарушения, чрезмерная сонливость. Она даже может быть причиной резистентности к психотропной терапии.

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