[Agomelatine in the treatment of major depressive disorder: assessment of the efficacy and tolerability]. / Agomelatin pri lechenii bol'shogo depressivnogo rasstroistva: otsenka éffektivnosti i perenosimosti.

Agomelatine is an antidepressant agent with an innovative unique pharmacodynamic profile, including melatonergic receptor agonism (MT1 / MT2) and antagonistic effects on serotonergic 5-HT2C receptors. According to the results of meta-analyzes of clinical studies of the acute phase of a major depressive disorder, the antidepressant effect of agomelatine itself is significantly higher than that of placebo, but somewhat inferior to a number of other antidepressants (especially SSRIs and venlafaxine). To date, there is some uncertainty regarding the efficacy of agomelatine for the prevention of recurrence of MDD and its hepatotoxicity profile. In this regard, agomelatine is not considered as a drug of first choice in treatment of MDD. However, the heterogeneous clinical manifestations of MDD and the unique mechanism of action of agomelatine with the ability of the drug to have a modulating effect on sleep, make it possible to effective use it for treating such disorders. In addition, agomelatine has a more favorable safety profile, which allows considering it as a drug of choice in patients who have contraindications to other antidepressants or in the absence of therapeutic response to another antidepressant therapy.

[The efficacy of remaxol as a hepatoprotective agent in long-term psychopharmacotherapy]. / Primenenie remaksola v kachestve gepatoprotektora pri dlitel'noi psikhofarmakoterapii.

AIM: Evaluation of the efficacy of psychopharmacotherapy with the hepatoprotector remaxol. MATERIAL AND METHODS: A study was conducted on 60 male patients diagnosed with 'Paranoid schizophrenia, continuous progression type course' who received therapy for the underlying disease with traditional antipsychotics in a psychiatric inpatient setting. During the 12 days of the study, 30 patients (main group) received neuroleptic therapy in combination with intravenous infusions of remaxol (400.0 ml), the remaining 30 patients (control group) received 'active placebo' (0.9% sodium chloride solution, 400.0 ml). RESULTS AND CONCLUSION: A decrease in the frequency and severity of astheno-vegetative, dyspeptic, hemorrhagic, cholestatic syndromes and hepatomegaly was shown. The absence of side-effects along with an improvement in the general well-being of the patients is extremely important in long-term psychopharmacotherapy of psychiatric patients.

[The differences in the estimation of depression severity by psychiatrists and patients during the combined treatment with agomelatine (a multicenter study "EMOTSIA")]. / Razlichiya v otsenke tyazhesti depressii vrachami i patsientami v protsesse kombinirovannoi terapii agomelatinom (mul'titsentrovoe issledovanie «EMOTsIYa¼).

AIM: To compare the prognosis of depression severity estimated by the physician and by the patient based on the treatment outcome. MATERIAL AND METHODS: One hundred and seven patients with depression were examined. Mental status was assessed with HАМ-D, SHAPS, CGI-S, CGI-I, PGI-S, PGI-I and VAS. A data analysis was performed. RESULTS: There were differences in the estimation of depression severity by psychiatrists and patients. Moreover, the scores on HАМ-D and CGI-S were not consistent when assessed by psychiatrists. As the severity of depression decreased and patient's state improved during the treatment with agomelatine (valdoxan), the assessments of the changes by the psychiatrist and the patient became similar. CONCLUSION: Agomelatine (valdoxan) is effective and tolerable in the treatment of depression of any severity. The differences between the psychiatrist's and patient's estimation of the depression severity at baseline using different psychometric scales can level the prognostic value of treatment outcome.

[Modern approaches to the synchronization of circadian rhythms in treatment of depression].

In this review, we have analyzed the association between chronobiological disorders and depressive symptoms, and outlined new antidepressant therapeutic strategies aimed at restoring normal functioning of the circadian system. It is specifically noted that the drug valdoxan, an agonist of melatonin receptors and selective antagonist of serotoninergic 5-HT2C receptors has chronobiotic,antidepressive and anxiolytic action. In its antidepressive effect, valdoxan is comparable to venlafaxine, fluoxetine and sertraline.Recurrences of depression is noted in fewer patients (23,9 %) treated with valdoxan compared to placebo (50,0 %). The drug improves sleep quality as well. As the drug does not cause the increase in serotonin levels, it has considerably less side-effects of the gastrointestinal tract, sexual sphere, or metabolic processes, characteristic of many other antidepressants.