[Peculiarities of treatment with antidepressants in patients with schizoaffective disorder in the interictal period]. / Osobennosti terapii antidepressantami bol'nykh shizoaffektivnym rasstroistvom v mezhpristupnom periode.

OBJECTIVE: To investigate the effect of therapy with various classes of antidepressants on the quality of remission and adherence to therapy in patients with schizoaffective disorder (SAD) in remission. MATERIAL AND METHODS: We examined 87 outpatients, including 29 men (33.33%), 58 women (66.67%) diagnosed with SAD according to ICD-10 criteria (item F25), in whom 341 cases of remission were studied. The average age of the patients was 41.40±12.56 years. Cases of remission in patients receiving therapy with nonselective monoamine reuptake inhibitors (NSMRIs) were included in group 1 (n=228), cases of remission formed on therapy with selective neuronal reuptake inhibitors (SNRI) were included in group 2 (n=113). Clinical follow-up and statistical methods were used. RESULTS: In both groups, mood disorders in remission were represented by subdepression. Delusional disorders at the stage of remission were almost 7 times more common in group 1 (12.28%), compared with group 2 (1.77%). The duration of the interictal period in patients treated with NSMRIs was higher (504.0±60.67 days) compared with patients receiving SNRI (176.46±17.88 days). In group 2, residual affective-delusional symptoms in remission were significantly less common. Cases of refusal from therapy in group 2 were 12 times less frequent, which indicates a greater adherence to therapy in patients receiving SNRI. CONCLUSION: It is possible to recommend treatment with NSMRIs for patients with depressive affect in the structure of SAD to increase the duration of the interictal period. At the same time, for patients with SAD in the presence of delusional and affective-delusional symptoms, it is preferable to prescribe SNRI.

[The trial of the efficacy and safety of sequential therapy with Mexidol forte 250 in acute and early recovery stages of hemispheric ischemic stroke]. / Issledovanie effektivnosti i bezopasnosti lekarstvennogo preparata Meksidol FORTE 250 v ramkakh posledovatel'noi terapii u patsientov s polusharnym ishemicheskim insul'tom v ostrom i rannem vosstanovitel'nom periodakh.

OBJECTIVE: To evaluate the efficacy and safety of sequential therapy with mexidol (solution for intravenous and intramuscular injections) and mexidol forte 250 (coated tablets) in acute and early recovery stages of hemispheric ischemic stroke. MATERIAL AND METHODS: The changes in scores on the modified Rankin Scale (mRs) (primary endpoint), the National Institute of Health Stroke Scale (NIHSS), the Bartel Index (BI), the Montreal Cognitive Assessment (MoCa), the Beck Depression Inventory (BDI), the EuroQol Quality of Lifes Scale ( EQ-5D) were assessed in the end of treatment (secondary endpoint). RESULTS AND CONCLUSION: Prolonged and sequential therapy with mexidol at the dose 500 mg daily during 14 days (saturation phase) and mexidol forte 250 at the dose of 250 mg three times a day during 60 days (maximum therapeutic effect) provides additional opportunities for a more complete recovery in acute and early recovery stages of hemispheric ischemic stroke (increases quality of life, improves movement and cognitive functions).

[Depression and it's treatment in patients with schizoaffective disorder]. / Depressiia i ee lechenie u bol'nykh s shizoaffektivnym rasstroistvom.

AIM: To study the influence of depression on the quality of remission in patients with schizoaffective disorder (SAD) and develop recommendations for anti-relapse therapy. MATERIAL AND METHODS: Eighty-nine outpatients with the diagnosis of SAD were examined, in whom 348 remission cases were studied. In accordance with the characteristics of the episodes, the patients were divided into 2 main groups: patients with only depressive manifestations (group 1) and patients with affective disorders of both poles (group 2). Clinical-psychopathological, clinical-anamnestic, clinical-follow-up and statistical methods were used. RESULTS AND CONCLUSION: The type of SAD did not have a significant effect on the duration of remission and the duration of subsequent hospitalization. Patients of group 2 had residual symptoms in remission almost 2 times less often and the level of affective-delusional disorders in this group was higher compared to group 1. In both groups, affective symptoms are represented by subdepression. Patients without residual symptoms had a longer remission compared to patients with subdepression. Subdepressive disorders are associated with lower treatment adherence. Prescribing anti-relapse treatment of SAD, one should consider not only the current state and features of the last episode, but also the features of previous episodes. Patients with depressive episodes are characterized by subdepressive residual symptoms in remission. For patients with different variants of affective disorders in SAD, emotional disorders in remission are as specific as elements of affective-delusional disorders. Anti-relapse therapy should include neuroleptics and normothymics. In case of residual depressive symptoms, the authors recommend the addition of antidepressants.

[Differentiated approach to the therapy of endogenous anxious depression].

The paper presents a study devoted to endogenous depression with a pronounced element of anxiety. The subjects, 66 patients, received antidepresive therapy with either amitriptyline or remeron. The study lasted 6 months, during which the symptoms were assessed using Hamilton Depression and Anxiety Scales. Three variants of anxious depressive conditions were revealed: anxious melancholic, anxious hypochondriac and anxious adynamic ones. Amitriptyline proved to be more efficient in treatment of patients with anxious melancholic depression. No difference in time to and the degree of symptom reduction was observed between amitriptyline and remeron in patients with anxious adynamic depression. Remeron proved to be more efficient in patients with anxious hypochondriac depression.