[Clinical features of asthenia in the context of adjustment disorders]. / Klinicheskie osobennosti astenii v ramkakh rasstroistv adaptatsii.

OBJECTIVE: To study asthenic symptoms in patients with adjustment disorders and to assess the efficacy of cytoflavin in their treatment. MATERIAL AND METHODS: The study included 100 patients, aged 20 to 43 years, with a diagnosis of adjustment disorder. Clinical, neurophysiological and parametric methods were used. An asthenic state scale, the Multidimensional Fatigue Inventory (MFI-20), a digital rating scale (a 10-point variant) and the Headache Impact Test (HIT-6), the Psychological Stress Measure (PSM-25), the Cognitive Emotion Regulation Questionnaire, the Test of Variables of Attention (TOVA) were administered. Cytoflavin was used in a dose of 2 tab. 2 times a day for 25 days for the treatment of patients from the study group. RESULTS: In the study group, 48.0% of patients had a pronounced degree of asthenia, and 52% had a moderate one. The clinical improvement was achieved in 73.0%. In the subgroup with moderate asthenia, the improvement was recorded in 88.5% of cases, in the subgroup of patients with severe asthenia in 56.3% of patients. There was a significant decrease in the severity of indicators on the scales of general asthenia, decreased activity and mental asthenia; a significant decrease in the integral indicator of mental tension, a significant improvement in the indicator of attention, a decrease in the frequency and intensity of headache. The improvement in the functional state of the brain in the form of a decrease in the power of the alpha rhythm in the anterior cerebral cortex was shown. CONCLUSION: The results of the study allow us to conclude that the use of cytoflavin is effective in the treatment of adjustment disorders.

[Cognitive control impairment in adult with attention deficit/hyperactivity disorder]. / Narusheniia kognitivnogo kontrolia pri sindrome defitsita vnimaniia u vzroslykh.

AIM: To study cognitive impairment in adults with attention deficit hyperactivity disorder (ADHD) and assess the efficacy of cerebrolysin in the treatment of such patients. MATERIAL AND METHODS: Thirty-eight patients with ADHD, aged from 18 to 45 years were enrolled in the study. Along with general neurological examination, several ADHA-specific scales and tests (ASRS-V1-1, SFQ, BIS, the Emotional Intelligence Self-Evaluation, TOVA) were administered. RESULTS AND CONCLUSION: There was a significant increase in inattention and impulsivity in comparison with the control group, which can be regarded as a decrease in cognitive control. The results of the study showed that cerebrolysin was an effective tool for improving cognitive control in adult patients with ADHD (a significant improvement was noted in 42.1% of patients, improvement in 31.6% of patients).

[Between depression and fibroniyalgia: the fate of the antidepressant].

The authors present the information about one of the least studied antidepressants- milnacipran. Recommendations of its clinical use have been long based on incorrect conceptions of its pharmacological properties. Currently, milnacipran is considered as ancirepinephrine and serotonin (to a lesser degree) reuptake inhibitor and NMDA receptor blocker. Milnacipran can be successfully used in apatic, asthenic, adynamic and anhedonic depressions as well as in fibromyalgia in patients with marked fatigability and pain. However the recommendations for the latter are not registered in Russia (maybe due to the differences in the diagnosis of fibromyalgia which is traditionally more often diagnosed as neurasthenia).

[Pharmacotherapy and dementia]. / Farmakoterapiia i dementsiia.

The review considers treatment aspects of dementia in Alzheimer's disease (DAD), vascular dementia (VD) and some other forms of dementia. Pathogenetic pharmacotherapy of DAD aims to maintain the activity of cholinergic neurons with anticholinesterase drugs including donepezil, which is used most often. The main objective of VD treatment is prevention of new cerebral infarctions using cardiotropic medications, antiaggregants, anticoagulants, hypotensive drugs and statins. In Russia, patients with DAD and VD receive polymodal drugs as well. These drugs have been included in the list of antidementia medications due to their wide use in treatment of discirculatory encephalopathy and chronic brain ischemia.

[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.