Our brain is dominated by nerve cells - neurons (neurons). To communicate with each other, transmit information, they use biochemical substances - mediators (neuromediators). Depending on which mediator affects the cell, we can say whether the cell will be excited or suppressed.

For example, the mediator dopamine is an excitatory mediator. If its amount in certain brain structures increases, then these structures will begin to work excessively, causing effects that are absent in a normal person. For example, an increase in dopamine in the mesocortical system (One of the areas of the brain responsible for transmitting information from the visual and auditory organs to the cerebral cortex for analysis) leads to the appearance of hallucinations. That is, to suppress hallucinations, you need to turn off dopamine receptors.

Another example, serotonin is an excitatory mediator, which, when its amount in the limbic system (mood system) decreases, causes depressive symptoms: apathy, weakness, fatigue, indifference. So, by increasing the level of serotonin with the help of antidepressants, we reduce depression.

Another example. The mediator Gamma-aminobutyric acid (GABA) is an inhibitory mediator. If it increases, then all systems will slow down. This can help if there is a special focus of excitation in the brain that interferes with the brain's work. An increase in GABA suppresses this focus. The focus of excitation in this case is called the focus of epilepsy. Also, an increase in the inhibitory mediator accelerates the onset of sleep, since the brain slows down faster.

Note: the information here is given in a very overview format so that it is understandable. Do not nitpick and criticize.

Many conditions, such as depressive syndrome, manic syndrome, panic disorder, anxiety disorder, etc. are diseases that require at least 3 months to treat. Usually, these ailments are treated in one or two years of drug therapy, after which a complete remission can be achieved, that is, the absence of subsequent relapses and complete recovery.

In reality, 85% of schizophrenias end favorably with long periods of remission. 15% achieve stable remission in the first five years of treatment. In our add-on, this is implemented a little differently.

In our add-on, all diseases can be cured with a certain chance with a certain drug, which is written in the description of the disease. The exception is schizophrenia, which is treated in a special way (You will see this below).

In reality, some patients may be resistant to specific neuroleptics or antidepressants. Some drugs help some people, others - others.

In our addon, this mechanism is implemented for neuroleptics and antidepressants: Aripiprazole, sulpiride, quetiapine, risperidone, imipramine, sertraline, duloxetine, paroxetine. The probability that the patient will be resistant to these drugs is 75% for each.

If a specific drug does not help the patient, another similar drug is prescribed. If all the drugs described earlier do not help the patient, clozapine or flupentixol or clomipramine are prescribed.

The patient may complain of side effects after using the drug.

Side effects:
- Late dystonia
- Disorientation
- Headache
- Excitement
- Nausea

They require treatment with regular simple drugs, only a single dose is needed.

To treat the clinical conditions described below, taking the drugs is required regularly:

Associated clinical conditions:
- Malignant neuroleptic syndrome
- Drug-induced encephalopathy
- Vegetative-vascular dystonia
- Focal epilepsy
- Diabetes insipidus
- Tachyarrhythmia
- Osteoporosis
- Hypothyroidism

Schizophrenia
A disease characterized by the breakdown of thought processes and emotional reactions. It is a psychosis. The patient may experience hallucinations; he may have delusional ideas; he may complain of a depressed mood if a complication arises - depression.
Complications of this disease:
1. Depression (Chance 0.01% every second)
2. Anxiety disorder (Chance 0.01% every second)
The main criteria for diagnosis:
1. Feeling of auditory or visual hallucinations.
2. Feeling that others can read the patient's thoughts.
3. Feeling of being watched (delusional idea).
4. Feeling that thoughts do not belong to the patient.
To make a diagnosis, there must be a match for at least 1 point.
Treatment - neuroleptics quetiapine, risperidone, sulpiride, aripiprazole, clozapine, flupentixol.

Depression
Depression is a syndrome characterized by a decrease in mood and psychomotor retardation.
Criteria for diagnosis:
1. The patient feels a depressed or depressed mood.
2. The patient has begun to think slowly.
3. The patient has begun to perform tasks slowly and move slowly.
All three criteria must be met to establish the diagnosis.
Treatment - antidepressants of various groups.
A drug that can cause complete remission: clomipramine with a 25% chance.

Mania
A manic episode is a condition that opposes depression. During this state, all processes in the patient are accelerated: thinking, speech, movements; mood is greatly elevated.
To diagnose Mania, at least one of the following criteria must be met:
1. The patient feels more energetic.
2. The patient feels that his thoughts have become faster.
3. The patient notices that his mood is too good.
Treatment: neuroleptic quetiapine, mood stabilizers (also known as anticonvulsants).
A drug that can cause complete remission: quetiapine with a 25% chance.

Anxiety disorder
Anxiety disorder is a mental condition characterized by pathologically increased and unreasonable anxiety.
Complications of this disease:
1. Depression (Chance 0.01% every second)
To diagnose, at least one of the criteria must be met:
1. The patient has become very anxious.
2. The patient feels that something bad is about to happen.
3. The patient believes that the world will soon die.
Anxiolytics or the antidepressant sertraline are used for treatment.
A drug that can cause complete remission: diazepam with a 25% chance.

Panic disorder
Panic disorder is a disease characterized by frequent episodes of causeless panic (panic attacks).
Complications of this disease:
1. Depression (Chance 0.01% every second)
The patient complains of the following symptoms:
1. The patient began to feel that his pulse was sharply accelerating.
2. The patient began to often experience panic for no reason.
3. The patient often feels that he can suddenly die.
To treat the disorder, the beta-blocker propranolol, anti-anxiety drugs (Anxiolytics) and the antidepressant sertraline are used.
A drug that can cause complete remission: sertraline with a chance of 25%.

Delusional disorder
Delusional disorder is a condition characterized by the patient having a persistent delusional belief or vision for more than three months without any other psychotic symptoms (i.e. without hallucinations).
Complications of this disease:
1. Mania (Chance 0.01% every second)
To make a diagnosis, it is necessary to have such ideas as:
1. The patient feels that he is being watched.
2. The patient believes that the world is run by aliens.
3. The patient is convinced that the world is taken over by Freemasons.
Treatment consists of prescribing the neuroleptics risperidone or quetiapine. Clozapine and flupentixol may help.
Drug capable of causing complete remission: clozapine with a 25% chance

Tardive dystonia
Tardive dystonia is a symptom complex that occurs with long-term treatment with neuroleptics. This type of dyskinesia (Random movement of individual muscles) is the most dangerous, as it is very difficult to treat.
Complications of this disease:
1. Mania (Chance 0.01% every second)
To establish this diagnosis, the following criteria must be met:
1. The patient feels convulsive contractions throughout the body.
2. The patient feels that his facial muscles are tense.
3. The patient feels that the chewing muscles are seized by a spasm.
Levodopa + carbidopa (Nakom) or biperiden are used for treatment
A drug that can cause complete remission: nacom with a 25% chance

Migraine
Migraine is a syndrome accompanied by severe headache with a significant deterioration in performance, with a special form of manifestation. Migraine is more complex than a simple headache and has a different nature and pronounced symptoms.
A patient with migraine is bothered by the following symptoms:
1. The patient feels a one-sided severe headache.
2. The patient notices darkening in the eyes.
3. The patient feels severe weakness.
Treatment consists of using naproxen or ergotamine; the antidepressant imipramine can be used.
A drug that can cause complete remission: imipramine with a 25% chance

Aripiprazole is an antipsychotic drug used to treat psychosis. The patient may have resistance to this drug.

Side effects:
- Nausea (5%)
- Headache (5%)
- Disorientation (1%)
- Agitation (1%)
- Tardive dystonia (1%)

Sulpiride is an antipsychotic drug used to treat psychosis. The patient may have resistance to this drug.

Side effects:
- Nausea (1%)
- Headache (1%)
- Disorientation (5%)
- Agitation (1%)
- Late dystonia (10%)

Quetiapine is a neuroleptic that helps to cope with psychosis. It is indicated for mania. The patient may have resistance to this drug.

Side effects:
- Nausea (5%)
- Headache (15%)
- Disorientation (1%)
- Agitation (5%)
- Tardive dystonia (1%)

Risperidone is an antipsychotic that helps to cope with psychosis. The patient may have resistance to this drug.

Side effects:
- Nausea (15%)
- Headache (1%)
- Disorientation (1%)
- Agitation (1%)
- Late dystonia (5%)

Clozapine is a potent neuroleptic used to treat schizophrenia and delusional disorder. It does not cause side effects when administered intravenously.

Flupentixol is a new neuroleptic that does not cause side effects and is always effective in schizophrenia, delusional disorder and depression. It is very expensive.

Imipramine- is an antidepressant that helps reduce and treat depression symptoms. The drug is also effective in treating migraines. The patient may have resistance to this drug.

Sertraline- is an antidepressant that helps reduce and treat depression symptoms. The drug is also indicated for anxiety disorder and panic disorder. The patient may have resistance to this drug.

Duloxetine is an antidepressant that helps reduce and treat depression. The patient may have resistance to this drug.

Paroxetine is an antidepressant that helps reduce and treat depression. The patient may have resistance to this drug.

Amitriptyline is an antidepressant that helps reduce and treat depression.

Clomipramine- an antidepressant that helps relieve depression. Does not cause side effects, is administered intravenously.

Lamotrigine- anticonvulsant drug, which, however, can also remove the side effect - disorientation. It is also a mood stabilizer and treats mania.

Gabapentin- anticonvulsant drug, used as a mood stabilizer (mood stabilizer) and treats mania. It can remove disorientation.

Valproic acid is an anticonvulsant drug used to normalize mood and treat manic syndrome. It can remove the symptom of disorientation.

Diazepam - anti-anxiety drug, anxiolytic. The drug increases the inhibitory mediator GABA in the brain and thus inhibits it.
Indications: anxiety, panic disorder; agitation.

Alprazolam - anti-anxiety drug, anxiolytic. The drug increases the amount of the inhibitory mediator GABA and is used as an anxiolytic (Anti-anxiety).
Indications: anxiety, panic disorder; agitation.

Hydroxyzine - anti-anxiety agent, anxiolytic. Very mild tranquilizer.
Indications: anxiety, panic disorder; agitation.

Biperiden is an anticholinergic that suppresses the side effects of neuroleptics - late dystonia and neuroleptic malignant syndrome.

Nakom - the drug helps to cope with muscle cramps, but only if they are caused by neuroleptics. It is indicated for late dystonia.

Bromocriptine - the drug increases dopamine in the areas of the brain responsible for regulating autonomous, habitual or precise movements. Helps to cope with the consequences of taking neuroleptics: stops malignant neuroleptic syndrome.

Ibuprofen is a pain reliever that helps relieve mild headaches.

Ergotamine is a drug that enhances the effect of serotonin on blood vessels, causing them to narrow in the brain and reducing pain during migraines.

Naproxen is a special anti-inflammatory drug used to treat severe pain (including migraine pain). It can also relieve common headaches.

Kalcemin is a combination drug that includes vitamin D and calcium, which is necessary for the growth and life of bones. The drug is used for osteoporosis, when bone tissue becomes depleted of calcium and vitamin D.

Metformin - the drug helps reduce blood glucose by activating receptors that are responsible for the absorption of glucose from the blood into the body's cells. It is used for diabetes insipidus.

Thyroxine - the drug replaces the body's hormone - thyroxine, which is responsible for the basic metabolism in the body; is responsible for its temperature and metabolism. The drug is used for hypothyroidism, that is, a decrease in the function of the thyroid gland.

Meldonium - a drug that can combat all types of side effects from taking psychoactive substances. Suppresses nausea, disorientation, headache and agitation. This drug is used to treat drug-induced encephalopathy (But it helps twice as badly as nootropics)

Pyritinol - the drug improves brain metabolism and improves blood flow to it. Promotes healing of brain damage. It is used for vegetative-vascular dystonia. It is also used to detoxify the brain in case of toxic damage

Dexamethasone - a drug that improves cerebral circulation. Promotes detoxification of the brain in case of toxic damage. It is used for encephalopathy.

Cerebrolysin is a drug that improves cerebral circulation. Promotes brain detoxification in case of toxic damage. Used for encephalopathy.

Metoclopramide is an antiemetic drug that can relieve nausea and vomiting.

Propranolol is a beta blocker that is usually used as a heart medication, but it can block adrenergic receptors (K adrenaline) in the brain and thus reduce the symptoms of panic disorder.

Treatment of schizophrenia
Schizophrenia is a polymorphic disease characterized by the process of disintegration of thinking and emotional reactions. The condition is chronic; often requires taking neuroleptics for a long course or even for life. However, using the drugs listed below, you can completely cure a person of schizophrenia with a 10% chance.

Treatment regimen:
The first stage - stable remission, that is, the absence of symptoms. First, it is necessary to select a drug that will relieve the symptoms.
The second stage - give this drug (Helping with schizophrenia for a specific patient), take it a few seconds before the start of the next stage.
Stage Three - sequential administration of neuroleptics: Thioridazine, Chlorpromazine, Zuclopenthixol, Amisulpiride - with a mandatory interval of 30 seconds between doses.
Stage Four - waiting for schizophrenia symptoms to understand whether the treatment goal has been achieved.

Side effects of drugs (All together):
- Nausea (5%)
- Headache (5%)
- Disorientation (5%)
- Agitation (5%)
- Late dystonia (5%)

Transcranial magnetic stimulation
A relatively safe method of treatment mental illnesses. This method is rarely used in modern medicine. They resort to this method of treatment only when the drugs do not work as they should, or if urgent remission of the disease is required.

The essence of the method is that electromagnetic waves of a certain frequency affect the brain, stimulating its activity and thereby achieving a therapeutic effect.

Therapy with such a device is effective against schizophrenia and depression.

Side effects of TMS:
- Nausea (10%)
- Vegetative-vascular dystonia (10%)
- Disorientation (20%)

The probability of stopping schizophrenia is 90%.
The probability of complete remission of schizophrenia is 30%.
The probability of stopping depression is 90%.
The probability of complete remission of depression is 30%.

Electroconvulsive therapy
An old, but still used method of treating psychopathologies. The essence is to conduct a current with an amplitude of 130 to 180 volts through the patient's brain. The method has proven itself well for the treatment of severe disorders that do not respond to drug therapy. Also, ECT is used if it is necessary to urgently achieve remission of the disease. The number of side effects is higher than with magnetic stimulation, but still there are not so many reactions, given that now the method has been successfully improved and made almost safe for the patient.

Effective against schizophrenia, mania and depression. Also used against malignant neuroleptic syndrome.

Side effects of ECT:
- Nausea (20%)
- Headache (20%)
- Disorientation (20%)
- Migraine (10%)
- Focal epilepsy (10%)

Probability of relieving schizophrenia: 90%.
Probability of complete remission of schizophrenia: 50%.
Probability of relieving depression: 90%.
Probability of complete remission of depression: 50%.
Probability of relieving mania: 90%.
Probability of complete remission of mania: 50%.
Probability of relieving neuroleptic malignant syndrome: 90%.
Probability of complete remission of neuroleptic malignant syndrome: 50%.

Superdose therapy
The safest, but less effective method of treating depression is therapy with super-high doses for a short period of time, followed by an abrupt withdrawal of all drugs. This is a type of "shock" therapy for the brain.

The procedure is as follows: the patient refuses all previously used drugs, after 5 minutes they are given 5 amitriptyline and 8 biperiden in 10 seconds, after which they are left without any drug interactions.

Probability of depression relief: 50%.
Probability of complete remission of depression: 20%.

Note
All pathologies presented in this section appear when taking antidepressants or neuroleptics with a 5% chance. This percentage is the same for all drugs. The exception is the drug flupentixol (it does not cause any disease).

Focal epilepsy
Long-term use of some neuroleptics or antidepressants can lead to activation of epileptic foci, which are located in specific lobes of the brain. Seizures caused by such foci are not always tonic-clonic (when the patient shakes in convulsions); in our case, the seizures are focal and are accompanied by sensory hallucinations. This is called a sensory focal seizure.
It occurs against the background of taking any neuroleptics.
The following symptoms are required to make a diagnosis:
1. The patient feels darkening in the eyes.
2. The patient feels goosebumps on the body.
3. The patient feels as if he is being shocked with electricity.
Treatment: anticonvulsants (Valproic acid, Lamotrigine, Gabapentin)
A drug that can cause complete remission: valproic acid with a 10% chance

Osteoporosis
Taking neuroleptics is often accompanied by an increase in the hormone prolactin. This hormone can destroy bone tissue, causing it to become fragile. This condition is called osteoporosis.
It occurs against the background of taking any neuroleptics.
To establish a diagnosis, the patient must have the following symptoms:
1. The patient feels pain in the spine.
2. The patient feels pain in the lower back.
Treatment: Vitamin D + calcium (Drug Calcemin)
Drug Capable of Inducing Complete Remission: Calcemin with a 10% Chance

Vegetative-vascular dystonia
Antipsychotics are drugs that disrupt the functions of the autonomic (vegetative) nervous system. This is manifested by periodic fainting spells that go away on their own, but bother the patient regularly.
It occurs against the background of taking any neuroleptics and antidepressants.
Symptoms that patients present:
1. The patient feels darkening in the eyes.
2. The patient feels nausea.
3. The patient feels weak.
Treatment: pyritinol
A drug that can cause complete remission: pyritinol with a 10% chance

Diabetes insipidus
Some medications increase blood sugar levels, which leads to the development of diabetes insipidus, since insulin (a hormone that absorbs glucose) is produced in sufficient quantities. It is believed that the disorder occurs when the body's tissues become resistant to the penetration of sugar, as a result of which it remains in the blood.
It occurs against the background of taking any neuroleptics and antidepressants.
To make this diagnosis, the following symptoms are required:
1. The patient feels like he needs to eat all the time.
2. The patient feels numbness in his arms and legs.
3. The patient feels like he gets tired quickly.
Treatment: Metformin
A drug that can cause complete remission: Metformin with a 10% chance

Tachyarrhythmia
Many psychiatric drugs cause rapid and increased heart rate. A pulse rate above 90 is called tachycardia. If the condition is persistent, a diagnosis of tachyarrhythmia is made.
It occurs against the background of taking any neuroleptics.
The following symptoms are required to establish a diagnosis:
1. The patient feels that his heart is beating faster.
2. The patient feels that his heart is beating faster.
3. The patient feels anxiety and fear.
Treatment: propranolol

Hypothyroidism
Drugs used in psychiatry sometimes affect the thyroid gland, causing it to produce less thyroxine and other hormones. This condition is called hypothyroidism.
It occurs when taking any neuroleptics.
To make a diagnosis, the following symptoms are needed:
1. The patient feels like his body is burning.
2. The patient feels depressed.
3. The patient gets tired very quickly.
Treatment is carried out with the drug - thyroxine
A drug that can cause complete remission: thyroxine with a 10% chance

Malignant neuroleptic syndrome
Neuroleptics cause blockade of dopamine receptors, which leads to a huge mass of side effects. One of these is severe malignant neuroleptic syndrome, which is dangerous for patients.
It occurs against the background of taking any neuroleptics.
To make this diagnosis, the following symptoms must be present:
1. The patient feels like he is thinking more slowly.
2. The patient feels like his body is hot.
3. The patient experiences spasm of the masticatory muscles.
Treatment consists of prescribing bromocriptine or biperiden.
A drug that can cause complete remission: bromocriptine with a 10% chance.

Drug-induced encephalopathy
Long-term and multiple use of various psychiatric drugs leads to brain damage. To reduce the likelihood of such a complication, drugs should be taken in the lowest possible dosages; you should also avoid prescribing several drugs of the same group at once.
Symptoms of encephalopathy:
Early stage:
1. Darkening of the eyes.
2. The patient feels that it is difficult to think.
3. The patient feels tension in the head.
Middle stage:
4. Slight blurring of vision.
5. Hallucinations.
Late stage:
6. Severe double vision and blurring of vision.
7. Inability to walk.
Dexamethasone, cerebrolysin, pyritinol, meldonium are used to treat encephalopathy.
The disease will pass as the toxic effect on the brain decreases.
A tactic that can be used is to administer multiple psychiatric drugs, then administer drugs to treat encephalopathy, wait for the encephalopathy symptoms to subside, and then administer multiple psychiatric drugs again if needed.