[Assessment of the high cost drug program on an example of the interferon treatment of multiple sclerosis].

Currently in Russia, there is a rather complicated situation with the distribution of expensive disease modifying drugs (DMD) purchased by the state for treatment of patients with multiple sclerosis. In this regard, it is necessary to carry out a serious organizational work in the direction of assessment of equivalence of biosimilars and original drugs concerning, first of all, efficacy and safety. Also, there is a problem of the replacement of one biosimilar by another in connection with organizational problems of shipping DMD to country regions. We present the results of the sociological research on the assessment of expensive drug provision by patients. The research has been carried out in 35 regions of the country. Based on these results, a strategy of the development of the program of provision with DMD should be developed all over the country.

[Fluvoxamine, amitriptyline and transcranial electrostimulation of the brain in the treatment of chronic daily headache].

Efficacy of antidepressants fluvoxamine, amitriptyline and transcranial electrostimulation of the brain in the treatment of chronic daily headache has been studied. Amitriptyline had the highest effect in dosage 50 mg daily but was not well tolerated by patients that resulted in that only 50% of them finished the study. Fluvoxamine had high efficacy and good tolerability in the treatment of chronic daily headache and medication overuse headache. Small dosages of amitriptyline and fluvoxamine potentiated the analgesic effect of transcranial electrostimulation of the brain. The combination of antidepressants with transcranial electrostimulation of the brain alleviated the negative effect of the withdrawal of overused analgesics and may be recommended for out-patient use.

[The efficacy of different anticonvulsants in chronic daily headache].

Efficacy of 4 medications--topiramate, valproate, gabapentine and carbamazepine--was studied in 180 patients: 84 with chronic migraine, 63 with chronic headache of tension and 33 with a combination of the above types of headache. Mean age of the patients was 40,4+/-11,7 (from 19 to 65 years), most patients were female (n=152). The treatment was conducted during 12 weeks with assessment of efficacy every 2 weeks and 4 weeks after the end of the treatment. The response was high for all anticonvulsants, with the highest efficacy in chronic migraine. Among antidepressants used topiramate proved to be most effective. The use of anticonvulsants allows the reduction of the dosage of analgetics as much as twice and the complete withdrawal of the latter in 20% of cases.

[Antidepressants with different action mechanisms in the treatment of chronic daily headache].

Efficacy and safety of the following antidepressants: amitryptiline (tricyclic antidepressant), escitalopram (selective inhibitor of serotonin reuptake), milnacipran (selective inhibitor of serotonin and noradrenalin reuptake) and maprotiline (selective inhibitor of noradrenalin reuptake) have been compared during the treatment of 120 patients with chronic daily headache. A positive effect was found for all drugs, in particular in the presence of depressive and anxiety symptoms. Most effective proved to be milnacipran and amitryptiline. Escitalopram and milnacipran were more tolerable and had less side-effects. The authors suggested that the combination of noradrenergic and serotoninergic components appears to be most effective in treatment of chronic daily headache.

[Levels of unified metabolites and thyroid hormones in blood and oral fluid of children with minimal brain dysfunction]. / Soderzhanie unifitsirovannykh metabolitov i tireoidnykh gormonov v krovi i rotovoi zhidkosti detei s minimal'noi disfunktsiei mozga.

Minimal brain dysfunctions in children with various perinatal complications are accompanied by metabolic imbalance manifested by decreased total protein content, the tendency to reduced triglycerides, increased cholesterol concentrations in the oral fluid, the trend to hypoproteinaemia, hypoglycaemia, hypotriglyceridaemia. The most significant changes in the redox systems alpha-ketoglutarate-glutamate, oxaloacetate-malate, pyruvate-lactate, dioxyacetone phosphate-alpha-glycerophosphate in biological fluids were revealed in cases of antenatal alcoholisation. A certain correlation was found between anemia in pregnant women and hypothyroidal background in children. In addition, a high level of free and total thyroxine, that of total triiodthyronine were found in the oral fluid. Hypophysis--thyroid dysregulation in children with minimal brain dysfunction associated with gestosis in their mothers during pregnancy, was manifested by decreased content of total and free T4 and T3 in blood serum and increased level of the thyroid-stimulating hormone.