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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">bekhterev</journal-id><journal-title-group><journal-title xml:lang="ru">Обозрение психиатрии и медицинской психологии имени В.М.Бехтерева</journal-title><trans-title-group xml:lang="en"><trans-title>V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2313-7053</issn><issn pub-type="epub">2713-055X</issn><publisher><publisher-name>V. M. BEKHTEREV  NATIONAL  RESEARCH  MEDICAL  CENTER  FOR  PSYCHIATRY  AND  NEUROLOGY                           OF    THE  RUSSIAN  FEDERATION   MINISTRY  OF  HEALTH</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.31363/2313-7053-2025-1-1094</article-id><article-id custom-type="elpub" pub-id-type="custom">bekhterev-1104</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>В ПОМОЩЬ ПРАКТИКУЮЩЕМУ ВРАЧУ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>GUIDELINES FOR THE PRACTITIONER</subject></subj-group></article-categories><title-group><article-title>Тразодон в терапии химических зависимостей</article-title><trans-title-group xml:lang="en"><trans-title>Trazodone in the treatment of chemical addictions</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7148-4485</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Асадуллин</surname><given-names>А. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Asadullin</surname><given-names>A. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Асадуллин Азат Раилевич—д.м.н., профессор кафедры наркологии</p><p>109390, г. Москва, ул. Люблинская, 37/1;</p><p>профессор кафедры психиатрии, наркологии и психотерапии</p><p>Республика Башкортостан, 450008, г. Уфа, ул. Ленина, 3;</p><p>профессор кафедры психиатрии, наркологии, психотерапии и клинической психологии</p><p>410012, г. Саратов, ул. Большая Казачья, 112;</p><p>профессор кафедры психиатрии и наркологии</p><p>Узбекистан, 100109, г. Ташкент, ул. Фаробий, 2</p></bio><bio xml:lang="en"><p>Azat R. Asadullin</p><p>Moscow;</p><p>Ufa;</p><p>Saratov;</p><p>Tashkent, Uzbekistan</p></bio><email xlink:type="simple">droar@yandex.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4053-6232</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ахметова</surname><given-names>Э. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Akhmetova</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ахметова Эльвина Аслямовна—к.м.н., доцент кафедры психиатрии, наркологии и психотерапии</p><p>Республика Башкортостан, 450008, г. Уфа, ул. Ленина, 3;</p><p>научный сотрудник отделения терапии стационарных больных с аддиктивными расстройствами</p><p>192019, г. Санкт-Петербург, ул. Бехтерева, д. 3</p></bio><bio xml:lang="en"><p>Elvina A. Akhmetova</p><p>Ufa;</p><p>Saint Petersburg</p></bio><email xlink:type="simple">aea1202@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-9994-8656</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ефремов</surname><given-names>И. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Efremov</surname><given-names>I. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ефремов Илья Сергеевич—к.м.н., врач-психиатр</p><p>Республика Башкортостан, 450093, г. Уфа, ул. Аксакова, д. 7</p></bio><bio xml:lang="en"><p>Ilia S. Efremov</p><p>Ufa</p></bio><email xlink:type="simple">efremovilya102@gmail.com</email><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4516-3324</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гасенко</surname><given-names>К. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Gasenko</surname><given-names>K. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Гасенко Ксения Александровна—врач-психиатр, заведующая отделением психосоциальной реабилитации</p><p>644070, г. Омск, ул. Куйбышева, 28</p></bio><bio xml:lang="en"><p>Ksenia A. Gasenko </p><p>Omsk</p></bio><email xlink:type="simple">ksenia.gasenko@yandex.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6080-7293</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Борукаев</surname><given-names>Р. Р.</given-names></name><name name-style="western" xml:lang="en"><surname>Borukaev</surname><given-names>R. R.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Борукаев Рустам Русланович—к.м.н., медицинский советник</p><p>109028, г. Москва, ул. Серебряническая наб., 29</p></bio><bio xml:lang="en"><p>Rustam R. Borukaev</p><p>Moscow</p></bio><email xlink:type="simple">rustam.borukaev@angelinipharma.com</email><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-0785-7288</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Колыванова</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Kolyvanova</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Колыванова Ирина Валерьевна—региональный медицинский советник</p><p>109028, г. Москва, ул. Серебряническая наб., 29</p></bio><bio xml:lang="en"><p>Irina V. Kolyvanova</p><p>Moscow</p></bio><email xlink:type="simple">irina.kolyvanova@angelinipharma.com</email><xref ref-type="aff" rid="aff-5"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0529-4525</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Крупицкий</surname><given-names>Е. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Krupitsky</surname><given-names>E. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Крупицкий Евгений Михайлович—д.м.н., профессор, заместитель директора по научной работе, директор Института аддиктологии;</p><p>директор Института фармакологии им. А.В. Вальдмана</p><p>г. Санкт-Петербург,  ул. Льва Толстого, д. 6-8</p></bio><bio xml:lang="en"><p>Evgeny M. Krupitsky</p><p>Saint Petersburg</p></bio><email xlink:type="simple">kruenator@gmail.com</email><xref ref-type="aff" rid="aff-6"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ДПО «РМАНПО»;&#13;
ФГБОУ ВО «Башкирский государственный медицинский университет»;&#13;
ФГБОУ ВО «Саратовский Государственный медицинский университет имени В.И. Разумовского»;&#13;
Ташкентская Медицинская Академия</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Medical Academy of Continuous Professional Education;&#13;
Bashkir State Medical University;&#13;
Saratov State Medical University named after V.I. Razumovsky;&#13;
Tashkent Medical Academy</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБОУ ВО «Башкирский государственный медицинский университет»;&#13;
ФГБУ «НМИЦ ПН им. В.М. Бехтерева»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Bashkir State Medical University;&#13;
Bekhterev National Research Medical Center</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>Психологический центр "Мастерская психотерапии"</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Psychological Center "Psychotherapy Workshop"</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>БУЗОО КПБ им. Н.Н. Солодникова</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Solodnikov BUZOO CPB</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-5"><aff xml:lang="ru"><institution>ООО «Анджелини Фарма Рус»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>OOO "Angelini Pharma Rus"</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-6"><aff xml:lang="ru"><institution>ФГБУ «НМИЦ ПН им. В.М. Бехтерева»;&#13;
ФГБОУ ВО «ПСПбГМУ им. И.П. Павлова»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Bekhterev National Research Medical Center;&#13;
Pavlov State Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>28</day><month>03</month><year>2025</year></pub-date><volume>59</volume><issue>1</issue><fpage>81</fpage><lpage>89</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Асадуллин А.Р., Ахметова Э.А., Ефремов И.С., Гасенко К.А., Борукаев Р.Р., Колыванова И.В., Крупицкий Е.М., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Асадуллин А.Р., Ахметова Э.А., Ефремов И.С., Гасенко К.А., Борукаев Р.Р., Колыванова И.В., Крупицкий Е.М.</copyright-holder><copyright-holder xml:lang="en">Asadullin A.R., Akhmetova E.A., Efremov I.S., Gasenko K.A., Borukaev R.R., Kolyvanova I.V., Krupitsky E.M.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.bekhterevreview.com/jour/article/view/1104">https://www.bekhterevreview.com/jour/article/view/1104</self-uri><abstract><p>Тразодон—это антидепрессант, одобренный FDA для терапии депрессии. Однако, он используется специалистами по охране психического здоровья для лечения множества психиатрических и медицинских состояний, в том числе, при неодобренных FDA показаний, таких как расстройства, связанные с употреблением психоактивных веществ (ПАВ). Проблема зависимости от ПАВ является важным аспектом современного психиатрического лечения. Так, среди всех факторов риска, связанных с преждевременной смертью, употребление табака и алкоголя занимает второе и седьмое место соответственно. Высокий вклад в преждевременную смертность привносит прямое воздействие ПАВ, а также их негативное воздействие на здоровье. Поэтому, вопрос соответствующего терапевтического лечения расстройств, связанных с употреблением ПАВ остается важным и актуальным. Тразодон проявляет антагонизм к серотонинергическим рецепторам (рецепторам 5-HT2) и одновременно является ингибитором обратного захвата серотонина, продемонстрировал эффективность у лиц, зависимых от алкоголя, бензодиазепинов, опиатов и иных зависимостей. Хотя механизм действия тразодона в организме очень сложен и еще не до конца изучен, его преимуществом является относительно небольшая группа побочных эффектов. Тем не менее, тразодон может являться препаратом выбора по той причине, что улучшение депрессивных состояний и проблем со сном у пациентов потенциально снижает риск рецидива зависимости от ПАВ.</p></abstract><trans-abstract xml:lang="en"><p>Trazodone is an FDA-approved antidepressant used to treat depression. However, mental health professionals also use it to treat various psychiatric and medical conditions, including substance use disorders, which have FDA- not approved indications. The problem of addiction to these substances is an important part of modern psychiatric care. Among all the risk factors for premature death, tobacco use ranks second, while alcohol use ranks seventh. Direct exposure to these substances and their negative health effects contribute significantly to premature mortality. Thus, the issue of proper treatment for disorders associated with their use remains important and relevant. Trazodone has been shown to have antagonistic effects on serotonin receptors (5-HT2) and is also a serotonin reuptake inhibitor. It has been demonstrated to be effective in individuals with alcohol, benzodiazepine, and opiate addictions, as well as other dependencies. Although the exact mechanism of trazodone’s action in the body has not been fully understood, its advantage lies in its relatively low number of side effects compared to other medications. Despite this, trazodone may be a suitable option for improving depressive symptoms and sleep issues in patients, potentially reducing the risk of relapsing into substance abuse.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>тразодон</kwd><kwd>коморбидность</kwd><kwd>депрессия</kwd><kwd>алкоголизм</kwd><kwd>антидепрессанты</kwd><kwd>инсомния</kwd></kwd-group><kwd-group xml:lang="en"><kwd>trazodone</kwd><kwd>comorbidity</kwd><kwd>depression</kwd><kwd>alcoholism</kwd><kwd>antidepressants</kwd><kwd>insomnia</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Статья спонсируется компанией «Анджелини».</funding-statement><funding-statement xml:lang="en">The article is sponsored by Angelini Pharma Rus LLC.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Винникова М. А., Комаров С. Д. 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