Augmented antipsychotic therapy with pantogam active in patients with schizophrenia

Objective — to study the efficacy of the GABA-ergic drug pantogam active (D-, L-gopantenic acid) in patients with schizophrenia treated with typical neuroleptics and to assess the rate of treatment response and tolerability of the drug. Material and methods. A sample consisted of 70 patients with schizophrenia stratified into main (n=35) and control (n=35) groups. All patients received one of typical antipsychotics (haloperidol, zuclopenthixol, promazine or perphenazine). Patients of the main group received in addition pantogam active in dose of 1200-1800 mg daily. The maximum allowed dose of 1800 mg daily was used in 62.9% of the patients. Results and conclusion: The long-term combined therapy with the addition of D-, L-gopantenic acid (pantogam activ) allowed to achieve clinical improvement earlier (on 8th week in the main group versus 16th week in the control group). The frequency and severity of secondary negative symptoms associated with antipsychotic therapy were decreased as well. The high efficacy and tolerability of the combined therapy allow to improve quality of life in patients with schizophrenia and their compliance to treatment as well as to reduce costs of medical care. © 2015, Media Sphera. All Rights Reserved

Antidepressant therapy in patients with cardiovascular diseases

Depression is the most common form of mental illness in patients with cardiovascular diseases (CVD). Depression and CVD can worsen the clinical and dynamic characteristics of each other. The timely detection and adequate psychopharmacotherapy of depressive states in patients with CVD are of great clinical, therapeutic, and prognostic importance. Anti-antidepressant therapy promotes a more pronounced somatic stabilizing effect in patients with CVD. Adverse events to the use of antidepressants in patients with CVD may be associated with their negative effect on the hepatic cytochrome CYP450 isoenzymes involved in the metabolism of various drugs. The authors' own data of clinical psychopharmacotherapeutic studies and the results of meta-analyses indicate the high efficiency and good tolerability of agomelatine, an antidepressant with an innovative mechanism of action, in a wide range of patients. © 2019 Ima-Press Publishing House. All rights reserved

Опыт применения вальдоксана при депрессиях, протекающих с когнитивными нарушениями

Objective. To investigate the efficacy and tolerability of monotherapy with agomelatine (valdoxan) in depressive patients with marked cognitive impairment. Material and methods. Thirty-five patients (women 77.1%) were recruited to participate in the study. Mean age of patients was 48.9±3.5 years. The following scales and cognitive tests were used: HAM-21, CGI, HADS, MMSE, the Stroop task, the Rey test, RAVLT. Effective therapeutic doses of valdoxan were 25mg per day in 77.1% of patients, 50 mg per day beginning from week 2 in 22.9%. Cognitive impairment was found in astheno-apathic depression (51.4%), anxiety-hypochondriacal depression (28.6%), anhedonic depression (5.7%). Results. The results showed that 74.3% of patients were responders and 51.4% were in remission. The dynamic of cognitive impairment demonstrated the positive effect of treatment with agomelatine (valdoxan). Beneficial safety profile of valdoxan was confirmed. Conclusion. Valdoxan is the effective and relatively safe antidepressant; it can be recommended for treatment of depression with cognitive impairment in therapeutic doses for at least 6 weeks.Цель исследования. Оценка эффективности и переносимости монотерапии вальдоксаном (агомелатин) у больных депрессией с выраженными когнитивными нарушениями. Материал и методы. В исследование были включены 35 пациентов, из которых 77,1% были женщины (средний возраст — 48,9±3,5 года). Использовали шкалы Гамильтона (HAM-21), общего клинического впечатления (CGI), госпитальный опросник тревоги и депрессии (HADS), шкалу MMSE, когнитивные тесты (тест Струпа, тест Рея на слухоречевое заучивание, RAVLT). Эффективная терапевтическая доза препарата составила 25 мг/сут у 77,1% пациентов, 50 мг/сут начиная со 2-й недели — у 22,9% пациентов. Когнитивные нарушения отмечались при астено-апатических (51,4% наблюдений), тревожно-ипохондрических (28,6%), ангедонических (5,7%) депрессиях. Результаты. Респондерами оказались 74,3% пациентов. У 51,4% больных на момент завершения исследования констатировано развитие ремиссии. Динамика когнитивных функций свидетельствует о достоверном положительном эффекте терапии. Подтвержден благоприятный профиль безопасности препарата. Заключение. Вальдоксан является эффективным и относительно безопасным препаратом, который может быть рекомендован для лечения депрессий, сопровождающихся когнитивными нарушениями, в терапевтических дозах курсом не менее 6 нед

Augmented antipsychotic therapy with pantogam active in patients with schizophrenia

Objective — to study the efficacy of the GABA-ergic drug pantogam active (D-, L-gopantenic acid) in patients with schizophrenia treated with typical neuroleptics and to assess the rate of treatment response and tolerability of the drug. Material and methods. A sample consisted of 70 patients with schizophrenia stratified into main (n=35) and control (n=35) groups. All patients received one of typical antipsychotics (haloperidol, zuclopenthixol, promazine or perphenazine). Patients of the main group received in addition pantogam active in dose of 1200-1800 mg daily. The maximum allowed dose of 1800 mg daily was used in 62.9% of the patients. Results and conclusion: The long-term combined therapy with the addition of D-, L-gopantenic acid (pantogam activ) allowed to achieve clinical improvement earlier (on 8th week in the main group versus 16th week in the control group). The frequency and severity of secondary negative symptoms associated with antipsychotic therapy were decreased as well. The high efficacy and tolerability of the combined therapy allow to improve quality of life in patients with schizophrenia and their compliance to treatment as well as to reduce costs of medical care. © 2015, Media Sphera. All Rights Reserved

Опыт применения вальдоксана при депрессиях, протекающих с когнитивными нарушениями

Objective. To investigate the efficacy and tolerability of monotherapy with agomelatine (valdoxan) in depressive patients with marked cognitive impairment. Material and methods. Thirty-five patients (women 77.1%) were recruited to participate in the study. Mean age of patients was 48.9±3.5 years. The following scales and cognitive tests were used: HAM-21, CGI, HADS, MMSE, the Stroop task, the Rey test, RAVLT. Effective therapeutic doses of valdoxan were 25mg per day in 77.1% of patients, 50 mg per day beginning from week 2 in 22.9%. Cognitive impairment was found in astheno-apathic depression (51.4%), anxiety-hypochondriacal depression (28.6%), anhedonic depression (5.7%). Results. The results showed that 74.3% of patients were responders and 51.4% were in remission. The dynamic of cognitive impairment demonstrated the positive effect of treatment with agomelatine (valdoxan). Beneficial safety profile of valdoxan was confirmed. Conclusion. Valdoxan is the effective and relatively safe antidepressant; it can be recommended for treatment of depression with cognitive impairment in therapeutic doses for at least 6 weeks.Цель исследования. Оценка эффективности и переносимости монотерапии вальдоксаном (агомелатин) у больных депрессией с выраженными когнитивными нарушениями. Материал и методы. В исследование были включены 35 пациентов, из которых 77,1% были женщины (средний возраст — 48,9±3,5 года). Использовали шкалы Гамильтона (HAM-21), общего клинического впечатления (CGI), госпитальный опросник тревоги и депрессии (HADS), шкалу MMSE, когнитивные тесты (тест Струпа, тест Рея на слухоречевое заучивание, RAVLT). Эффективная терапевтическая доза препарата составила 25 мг/сут у 77,1% пациентов, 50 мг/сут начиная со 2-й недели — у 22,9% пациентов. Когнитивные нарушения отмечались при астено-апатических (51,4% наблюдений), тревожно-ипохондрических (28,6%), ангедонических (5,7%) депрессиях. Результаты. Респондерами оказались 74,3% пациентов. У 51,4% больных на момент завершения исследования констатировано развитие ремиссии. Динамика когнитивных функций свидетельствует о достоверном положительном эффекте терапии. Подтвержден благоприятный профиль безопасности препарата. Заключение. Вальдоксан является эффективным и относительно безопасным препаратом, который может быть рекомендован для лечения депрессий, сопровождающихся когнитивными нарушениями, в терапевтических дозах курсом не менее 6 нед

Терапия депрессивных расстройств, протекающих с цирканнуальными ритмами

Studies of efficacy of agomelatine in treatment of depressions with seasonal rhythm in the framework of BAD are almost lacked. This is the study of efficacy and tolerability of agomelatine in treatment of depressions with circannual rhythms in the framework of BAD (n=35) and SAD (n=35). Agomelatine was effective in 82.9% patients with SAD and in 71.4% patients with BAD. Predictors of inefficacy in both groups were lack of circadian rhythm and inefficacy of previous treatment. Predictors of inefficacy in SAD patients were monopolar progress of disease, elongation of depressive phases, schizotypal disorder; in BAD patients - less of 5 previous seasonal depressive phases, lack of improvement in first two weeks of treatment, sadness and anxiety. Agomelatine has favorable profile of safety and tolerability.Исследования эффективности агомелатина при лечении депрессий с сезонным ритмом в рамках биполярного аффективного расстройства (БАР) практически отсутствуют. Проведено исследование эффективности и переносимости монотерапии агомелатином (препарат Вальдоксан) депрессий, протекающих с сезонными цирканнуальными ритмами в рамках сезонного аффективного расстройства - САР (n=35) и БАР (n=35). В ходе данной работы установлен достоверный выраженный тимолептический эффект агомелатина у 82,9% пациентов с САР и 71,4% больных БАР. Предикторами неэффективности в обеих группах являлись: отсутствие суточного ритма, неэффективность предшествующих курсов терапии; у пациентов с САР - монополярное течение, увеличение от года к году длительности сезонных депрессий и их реализация в рамках шизотипического расстройства; у больных БАР - менее 5 сезонных обострений в анамнезе, отсутствие положительных изменений в состоянии в течение первых 2 нед приема препарата, наличие в структуре депрессии тоскливого или тревожного аффекта. Препарат обладает благоприятным профилем переносимости и безопасности

Optimization of the treatment of anxiety disorders with selank

Objective. To compare the efficacy and tolerability of monotherapy with phenazepam to complex treatment with the peptide preparation selank and phenazepam in patients with anxiety disorders. Material and methods. Authors explored the anxiolytic effect and tolerability of monotherapy with phenazepam (30 patients) and complex treatment with selank and phenazepam (40 patients) in anxiety-phobic, hypochondriac and somatoform disorders (ICD-10 items F40.2-9, F41.1-9, F45.0-2). Therapeutic effect was assessed clinically and with HDRS, CGI and Spilberger scales. Tolerability was evaluated using the UKU scale. Stroop test and verbal fluency test were used. Quality of life was assessed with the SF-36. Results. The positive effect of phenazepam was achieved earlier in the optimization of treatment with selank on HDRS. The combined treatment decreased the level of undesirable side-effects of phenazepam (attention and memory impairment, asthenia, sedation, increase in sleep duration, sexual disturbances, emotional indifference and orthostatism) during the course of treatment and after the tranquilizer withdrawal. Taken together, the therapeutic efficacy and reduction of side-effects had a positive impact on the quality-of-life of the patients treated with selank as add-on to phenazepam. Conclusion. The results extend therapeutic possibilities of treatment of anxietyspectrum disorders with the combination of benzodiazepine tranquilizers and selank. © 2015, Media Sphera. All rights reserved

Optimization of the treatment of anxiety disorders with selank

Objective. To compare the efficacy and tolerability of monotherapy with phenazepam to complex treatment with the peptide preparation selank and phenazepam in patients with anxiety disorders. Material and methods. Authors explored the anxiolytic effect and tolerability of monotherapy with phenazepam (30 patients) and complex treatment with selank and phenazepam (40 patients) in anxiety-phobic, hypochondriac and somatoform disorders (ICD-10 items F40.2-9, F41.1-9, F45.0-2). Therapeutic effect was assessed clinically and with HDRS, CGI and Spilberger scales. Tolerability was evaluated using the UKU scale. Stroop test and verbal fluency test were used. Quality of life was assessed with the SF-36. Results. The positive effect of phenazepam was achieved earlier in the optimization of treatment with selank on HDRS. The combined treatment decreased the level of undesirable side-effects of phenazepam (attention and memory impairment, asthenia, sedation, increase in sleep duration, sexual disturbances, emotional indifference and orthostatism) during the course of treatment and after the tranquilizer withdrawal. Taken together, the therapeutic efficacy and reduction of side-effects had a positive impact on the quality-of-life of the patients treated with selank as add-on to phenazepam. Conclusion. The results extend therapeutic possibilities of treatment of anxietyspectrum disorders with the combination of benzodiazepine tranquilizers and selank. © 2015, Media Sphera. All rights reserved

Depressions with eating disorders: clinical manifestations and therapy [Депрессии с расстройствами пищевого поведения: клинические проявления и терапия]

Depression is a common comorbid diagnosis in patients with eating disorders (EDs). The development of pathogenetic therapy for depression with EDs is far from being completed. The objective of the psychopharmacotherapeutic study was to evaluate the efficacy and tolerability of melatonergic monotherapy with the antidepressant agomelatine (25–50 mg/day at night) for depressions with two ED variants: hyperphagic (n=32) and hypo- and aphagic (n=31) EDs. Patients and methods. The investigation enrolled patients of both sexes, aged 18 to 65 years. The investigators performed clinical psychopathological and experimental psychological studies, as well as psychometric examination using the 21-item Hamilton Depression Rating Scale (HDRS-21), the Clinical Global Impression (CGI), the Supplemental Hospital Offset Payment Program (SHOPP), the Dutch Eating Behavior Questionnaire (DEBQ), and statistical data processing. Results and discussion. There was a significant pronounced antidepressant effect of 6-week agomelatine therapy for depressions occurring with different ED variants both in the pattern of the depressive symptom complex and in that of concurrent with and preceding the latter. At the same time, the efficacy of the drug did not depend on the clinical presentations of the leading hypothymic syndrome, the variants of EDs, and the duration of actual depression. However, by the end of the study period, a larger effect was achieved in the therapy for depressions with the hyperphagic variant of EDs, as well as in patients with EDs manifesting in the pattern of depressive symptom complex. Agomelatine has a favorable tolerance profile. BMI tends to become normal in patients with different variants of EDs during the therapy. The adverse events are transient and/or unclear; they do not require therapy discontinuation. Conclusion. Agomelatine is an effective and relatively safe drug that can be recommended to treat depressions concurrent with EDs in therapeutic dosages for at least 6 weeks. © 2020 Ima-Press Publishing House. All rights reserved