[Long-term maintenance therapy of depressive disorders with antidepressants: experience of using agomelatin]. / Dlitel'naya podderzhivayushchaya terapiya depressivnykh rasstroistv antidepressantami: opyt primeneniya agomelatina.

The article presents the literature data that determine the place of antidepressants in the relief and maintenance therapy for recurrent depression (RD) and depression in the framework of bipolar affective disorder (BPAD) and provides a justification for their use in the presence of residual depressive symptoms during remission. There are several ways to achieve complete remission: determination of the nature of residual symptoms; identification of adverse side-effects that have occurred as a result of the therapy; the establishment of those symptoms that are subjectively perceived by the patient as interfering with his/her full life. The data on the effective use of agomelatin for maintenance therapy, both as monotherapy and in combination with other antidepressants, anticonvulsants and neuroleptics, in RD and BPAD are presented. The authors have analyzed the case histories of 29 outpatients with depressions of various origins (RDD, BPAD, prolonged psychogenic depression, organic affective disorder), who received agomelatin as part of complex and monotherapy for a long time (1 to 13 years), and justified the predictors of its efficacy.

[Bipolar affective disorder: gender differences in the course and treatment]. / Bipoliarnoe affektivnoe rasstroistvo: gendernye osobennosti techeniia i terapii.

Bipolar affective disorder (BAD) according to the latest international classifications (ICD-10, DSM-5) is recognized as its own disease, characterized by episodes of mania (or hypomania), hyperthymic personality and (or) a genetic predisposition to BAR in contrast to recurrent depressive disorder (RD). The history of development and classification of manic depressive disorder (MDD), difficulties of differential diagnosis between BAD and RD are presented in this literature review. It considers the clinical features of the course of BAR in men and women and also gender-specific therapy. Gender differences in the clinical picture, course and treatment of BAD are discussed. Attention is drawn to the differences in effectiveness and tolerability of antidepressants in men and women. It is concluded that identifying the gender particularities is important for treatment and prevention optimization.

[Comparative evaluation of depressive disorders in women and men]. / Osobennosti depressivnykh rasstroistv u zhenshchin i muzhchin.

AIM: To study clinical characteristics of depression in women and men. MATERIAL AND METHODS: One hundred and twenty women, aged from 18 to 65 years, and 67 age-matched men with the diagnosis of recurrent depressive disorder (RDD) (ICD-10 F33) were examined using a specially developed survey. RESULTS: Differences in the clinical picture and course of RDD in women and men were found. RDD in women develops at an earlier age, the number of attacks is greater but remissions are longer. However, complete remission is achieved more frequently in men. Most typical effect in the structure of depression in women is anxiety whereas melancholy prevails in men. Daily mood fluctuations and suicidal thoughts are characteristic of women. Motor retardation and decreased motivation are more frequent in men. Ideas of self-blame, avoidance of contacts with other people, adynamia, persistent sense of fatigue are more common in women. Sleep disorders are equally common in men and women but falling asleep disturbance and lack of sleep feeling are more common in women. Somatic symptoms of depression are generally more common in men as well as concomitant diseases of cardiovascular, respiratory and genitourinary systems. Men are more likely to abuse alcohol and other psychoactive substances. CONCLUSION: The identified characteristics of depression in women and men allow more accurate diagnosis and treatment recommendations.

[The differential diagnosis and treatment of depressive disorders in climacteric transition]. / Depressii u zhenshchin, manifestiruiushchie v period klimakteriia.

AIM: To study clinical symptoms of menopause depression, develop differential diagnostic criteria and consider treatment aspects. MATERIAL AND METHODS: One hundred and fifty women, aged 41-65 years, with mental disorders developed in different periods of menopause (perimenopause, menopause and post menopause) were studied. RESULTS AND CONCLUSION: Four types of depression were diagnosed: climacteric (n=46), psychogenic (n=35), endogenic (n=42) and involutional (n=27). Clinical characteristics of each type are presented in the aspect of correlations between psychopathological and climacteric (somatic) symptoms. Therapy of the depressions is discussed in light of literature on psychopharmacological, hormonal treatment and psychotherapy. The efficacy of antidepressants, in particular valdoxan (agomelatine), is highlighted.