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Catatonia is a common syndrome among psychiatric patients, diagnosed in 20-43% of cases. Treatment methods for patients with catatonia are limited to the use of benzodiazepines and ECT in the acute period, and the problem of anti-relapse and maintenance therapy remains one of the most difficult. Currently, transcranial magnetic stimulation is a promising approach in the treatment of catatonia. The purpose of the study was to evaluate the possibility of using the method of transcranial magnetic stimulation of the brain in patients with schizophrenia in remission with residual catatonic symptoms. Material and methods. 50 patients diagnosed with schizophrenia and residual catatonic symptoms were examined by clinical and psychometric methods and divided into 2 groups (therapeutic and comparison groups) to prospectively evaluate the effectiveness of transcranial magnetic stimulation for 4 weeks. Results. Transcranial magnetic stimulation of the DLPFC on the left in patients with residual catatonia TMS turned out to be effective and safe a tendency was revealed to reduce psychomotor impairments that made up the clinical picture before the start of stimulation, along with an improvement in basic cognitive functions. Conclusions. Augmentation of standard psychopharmacotherapy protocols with TMS is effective for the correction of psychomotor symptoms.

The problem of the safety of antiepileptic therapy due to the duration of treatment and the need for regular intake of antiepileptic drugs (AEDs) is extremely significant. Adverse reactions (ADRs) may outweigh any positive effect of therapy associated with seizure reduction. The purpose of the study: to analyze the frequency and structure of ADRs of AEDs. Materials and Methods: The work was carried out within the framework of comprehensive research on the topic No. 210-16 "Epidemiological, genetic and neurophysiological aspects of diseases of the nervous system (central, peripheral and vegetative) and preventive medicine" (registration number 0120.0807480). Results: The frequency of ADRs against the background of third-generation AEDs was not inferior to that against the background of receiving second-generation AEDs, while the structure of ADRs was different: third-generation AEDs had a higher incidence of ADRs from the central nervous system, including a worsening of the course of epilepsy. The ratio of the chances of valproic acid accumulation with the achievement of toxic concentration in the blood and the development of un-desirable side effects in poor metabolizers (carriers of the polymorphism of CYP2C9*2 or CYP2C9*3) the gene encoding the cytochrome P450 isoenzyme 2C9 of the liver is 5.94 and 4.27, respectively. Conclusion: A personalized approach to ensuring the safety of valproic acid preparations based on taking into account the carriage of polymorphisms of the CYP2C9 gene allows to reduce the incidence of ADRs in patients receiving valproic acid preparations from 59.28% to 10.78%. The introduction of a personalized approach to the administration of valproates to patients suffering from epilepsy in the Krasnoyarsk Territory did not lead to an increase in direct costs.

Suicide is a serious public health problem. A deeper understanding of the underlying mechanisms and processes that lead to suicidal behavior is crucial for the development of effective preventive strategies. The study and identification of biomarkers will help in understanding the underlying processes or changes associated with suicide, however, studies linking biomarkers to suicide are limited and fragmented. Objective- To study the genetic associations of the polymorphic variant of the DRD2 gene (rs1800497) with forms of suicidal behavior in patients with alcohol dependence. Materials and methods: The association of polymorphic variants of the gene DRD2 (rs1800497) was analysed in patients with alcohol dependence syndrome, with a history of suicidal behavior and without it, living in the Republic of Bashkortostan, who were treated at the Republican Narco-logical Dispensary in the period from 2019 to 2021. Results: the presence of suicidal tendencies was detected in 39% of patients (136/344).  30% (42/136) were classified as patients with ex-ternal and internal forms of suicidal behavior, 70% (94/136) had only internal forms of suicidal behavior. Carriages of the CC and TT genotypes of the DRD2 gene (rs1800497) are characterized by a lower frequency of occurrence of all forms of suicidal behavior than carriages of СТ genotype. Also, carriages of the CC genotype of the DRD2 gene (rs1800497) are characterized by a lower frequency of occurrence of external forms of suicidal behavior than carriages of СТ and TT genotypes. Conclusions. The data we present indicate the possible contribution of genetic factors to the risk of suicidal behavior in individuals with alcohol dependence syndrome. There is a need for further research to explain the relationships between the circadian rhythm system, alcohol use disorders and suicidal behavior.

This article presents a clinical case of Alzheimer’s disease with a debut as primary progressive aphasia syndrome. Insufficient use of routine magnetic resonance imaging in this case in the diagnosis of neurodegenerative diseases and the advantage of such additional neuroimaging methods as positron emission tomography, functional magnetic resonance imaging with a scale assessment of atrophic changes. Additional neuroimaging techniques have been shown to significantly improve the early detection of pathological changes in brain structures and to reveal the location of functional areas involved in the neurodegenerative process.

Pharmacogenetic testing (PGx) is an important diagnostic tool for achieving an optimal balance between the effectiveness and safety of psychotropic drugs, especially those requiring long-term use. The most prescribed medications in psychiatric practice are antipsychotics (APs). Despite the long period of use of APs, their safety profile remains insufficiently high. Due to the high incidence of adverse drug reactions (ADRs), from the central nervous system (CNS) and other organs and tissues of the human body. Therapeutic drug monitoring can help predict and diagnose AP-induced ADRs only if the patient is receiving APs. PGx helps to individually select an AP, its dose and clarify the risk of ADRs before prescribing an AP, or at the start of therapy. This explains the importance of PGx in psychiatrist practice. However, to date, most practicing psychiatrists rarely use predictive PGx or do not use this method. PGx is more often prescribed in the case of a long history of un-successful AP-therapy, or in the case of the development of serious ADRs, the risk of which could be significantly reduced if predictive PGx was used. This case report of PGx in a 56-year-old woman with severe bipolar disorder demonstrates that the trajectory of ADRs and socialization could be significantly improved if this method was prescribed before the initiation of APs, rather than in the event of the development of serious ADRs.