[Experience in application of various antidepressants in gerontology].

The article presents data on the effectiveness of comorbide therapy with amlodipine and antidepressants of various groups in patients more than 65 years old suffering from coronary artery disease (CAD), arterial hypertension (AH), and comorbide depression. Eighty-eight patients with stable FC I-III stenocardia, accompanied by AH and comorbide depression, were examined. The patients were divided into three groups. Patients in group I (n = 21) received amlodipine therapy in a dose of 2.5 to 5 mg/day with amitriptyline in a dose of 25 mg/day. Group II patients (n = 25) received tianeptine in a dose of 25 mg/day in addition to amlodipine in a dose of 2.5 to 5 mg/day. Group III patients (n = 20) were treated with a combination of amlodipine 2.5 to 5 mg/day with sertraline in a dose of 50 mg/day. The comparison group consisted of 22 patients who received monotherapy in a dose of 2.5 to 5 mg/day. The study revealed that all these combinations with different antidepressants significantly lowered the average depression score and significantly improved the quality of life, unlike amlodipine monotherapy. The best combination was amlodipine plus tianeptine, which did not only demonstrate antidepressive and anxiolytic effects, but also led to improvement in prognostically significant parameters of cardiac rhythm variability in elderly patients with comorbide depressive disorders underlied by stable stenocardia and arterial hypertension.

[Effects of therapy with various groups of antianginal agents on life quality of the elderly with coronary heart disease and comorbid depression].

The purpose of the work was to study effects of antianginal agents of various groups on the psychoemotional status and life quality (LQ) of elderly patients with coronary heart disease (CHD) and concomitant depression. The subjects of the study were 70 patients (35 men and 35 women) with stable angina and depression. The subjects were divided into 3 groups. The 20 patients of group I were administered nitrates, the 32 patients of group II--beta-adrenoblockers, and the 18 patients of group III--a Ca antagonist. The control group consisted of 27 patients without anxious depression. The treatment led to significant reduction of weakly attack frequency and weakly sublingual nitroglycerine consumption in all the three groups. Significant reduction of average depression score and personal anxiety was noted in group III; decrease of situational anxiety level was observed in group I. There was no change of the psychoemotional status in group II. Examination of patients with depression showed that their LQ, according to Nottingham Health Profile questionnaire, was significantly lower than that of patients without depression. In spite of more pronounced antianginal effect of beta-adrenoblockers, LQ in this group did not differ significantly from that in other groups. There was significant improvement of LQ in group I and III. The latter demonstrated even more prominent changes, consisting in positive dynamics of the emotional status and improvement of sleep. Despite antianginal agents, LQ of patients with depression remained significantly worse than that of patients who did not have depression prior to the therapy. Thus, correction of concomitant depression will lead not only to improvement of LQ, but perhaps, also to improvement of the prognosis of patients with CHD.