[Multi-center open comparative randomized study of efficacy and safety of Akatinol Memantine 20 mg (single-doses) vs Akatinol Memantine 10 mg (double-doses) in patients with vascular dementia]. / Mnogotsentrovoe otkrytoe sravnitel'noe randomizirovannoe issledovanie effektivnosti i bezopasnosti primeneniya preparata Akatinol Memantin, 20 mg (odnokratnyi priem) v sravnenii s preparatom Akatinol Memantin, 10 mg (dvukratnyi priem) u patsientov s sosudistoi dementsiei.

OBJECTIVE: Evaluation of the efficacy and safety of the drug Acatinol Memantine, 20 mg (once daily) in comparison with the drug Acatinol Memantine, 10 mg (twice daily) in patients with moderate to moderate severe vascular dementia. MATERIAL AND METHODS: The study included 130 patients aged 50-85 years of both sexes with instrumentally and clinically confirmed vascular dementia. The patients were randomized into 2 groups. Group I consisted of 65 patients receiving Akatinol Memantine, 20 mg once daily, group II - 65 patients receiving Akatinol Memantine, 10 mg twice daily for 24 weeks. Clinical, parametric and statistical research methods were used. The Alzheimer's disease assessment scale, the cognitive subscale (ADAS-cog), the short mental Status Assessment Scale (MMSE) and the general clinical impression scale for patients condition and illness severity (CGI-C and CGI-S) and the Hamilton Depression Rating scale (HAM-D) were used. Adverse events were collected and analyzed. RESULTS: At week 24, both groups showed statistically significant positive change in ADAS-cog total score: in group I the total score was 27.2±8.76 points (absolute difference from baseline 3.5 points; p<0.01), and in group II - 26.1±7.86 points (absolute difference from baseline 2.5 points; p<0.01) with no statistically significant differences between groups. Evaluation of secondary efficacy criteria (change in ADAS-cog total score at week 12 and MMSE at weeks 4, 12, and 24) also revealed statistically significant benefit in both groups compared to baseline with no significant differences between groups. Statistically significant improvement was noticed on CGI-S and CGI-C scales in both groups. Akatinol Memantine was safe and well tolerated in both groups. CONCLUSION: The study showed no lesser efficacy and safety of Akatinol Memantine, 20 mg (once daily) compared to Akatinol Memantine, 10 mg (twice daily) in patients with moderate and moderately severe vascular dementia.

[Optimization of treatment of depression with administration of ethylmethylhydroxypyridine succinate (Mexicor)]. / Optimizatsiya lecheniya depressii naznacheniem etilmetilgidroksipiridina suktsinata (Meksikor).

OBJECTIVE: To investigate the therapeutic efficacy and tolerability of Mexicor as an adjuvant in the treatment of depression with SSRI antidepressants. MATERIAL AND METHODS: The study included 100 patients, aged 18-50 years, with verified depression of mild (n=32) or moderate (n=68) severity. Patients (n=50) of the main group, along with basic antidepressant therapy with SSRIs, received Mexicor at a dose of 600 mg/day, in the comparison group (n=50) - only SSRIs. Clinical-psychopathological, psychometric, using the HDRS-21 scale, CGI, HADS, fluency test of speech responses and the Stroop test, statistical research methods were used. RESULTS: The reduction of depressive symptoms on the HDRS-21 scale, starting from the fourth week, was statistically significantly superior to that in the comparison group (p<0.001), the reduction in the severity of the condition on the CGI scale in the main group was also significantly greater than in the comparison group (17.3% and 9.6% respectively, p<0.05). A significant improvement in speech fluency was found in the main group (p<0.05). Adverse events in the main group were significantly less common (p<0.001). CONCLUSION: Administration of Mexicor together with SSRIs leads to improved efficacy and tolerability of antidepressant therapy, and in the future, Mexicor may be recommended as an adjuvant in SSRI therapy for depression.

[Clinical aspects of the use of imidazopyridine derivatives in the treatment of sleep disorders associated with post-COVID syndrome]. / Klinicheskie aspekty primeneniya preparatov gruppy imidazopiridinov v terapii narushenii sna, assotsiirovannykh s postkovidnym sindromom.

In 2019, a pandemic caused by the SARS-CoV-2 virus began. The fight against COVID-19 required the introduction of a number of restrictive measures, in particular the introduction of quarantine for the population and isolation of the sick, which, along with the direct effect of the virus on the nervous system, led to a significant spread of sleep disorders. In this regard, questions have become relevant about the choice of drugs for the correction of sleep disorders, about which sleeping pills will be safe in conditions of acute illness and during the recovery period after COVID-19. The article discusses the prevalence and therapy of insomnia in patients with acute COVID-19 and in patients with postcovid syndrome. The pharmacological effects and safety of zolpidem, a non-benzodiazepine short-acting hypnotic drug belonging to the class of imidazopyridines, which is used in short courses for both acute and transient insomnia and chronic insomnia, are described. The data on the ability of zolpidem to improve memory after a night's sleep are given. The possibility of its use in acute COVID-19 and postcovid syndrome is being evaluated.

[Astenic disorders within the framework of post-covid syndrome]. / Astenicheskie rasstroistva v ramkakh postkovidnogo sindroma.

The direct neurotropic and neurotoxic effect of the SARS-CoV-2 virus on the central nervous system, as well as the stressful effect of various factors of the COVID-19 pandemic, contribute to the development of the so-called post-COVID syndrome. The clinical picture of the syndrome includes asthenic, anxiety-asthenic, and depressive manifestations. When prescribing psychopharmacotherapy to patients who have undergone COVID-19, it is recommended to assess the potential benefits and risks in the aspect of using drugs not only with therapeutic antiasthenic and anxiolytic properties, but with minimally expressed undesirable effects and adverse drug interactions.

[Treatment of depression with cognitive impairment]. / Opyt primeneniia val'doksana pri depressiiakh, protekaiushchikh s kognitivnymi narusheniiami.

AIM: 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.

[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.

[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.

[New possibilities of pharmacotherapy in cardiovascular patients with mental disorders].

OBJECTIVE: To study the efficacy and tolerability of the drugs pantogam active and phenotropil in mild neurotic, somatoform, stress-induced and depressive disorders developed in patients with cardiovascular diseases. MATERIAL AND METHODS: The effect of pantogam active was assessed in an open study. The main group of patients (n=35) treated with phenotropil during 12 weeks was compared to the comparison group (n=35). Patient's status was evaluated using psychometric (CGI, HDRS etc) and adverse effect scales. RESULTS AND СONCLUSION: Statistically significant results demonstrated the advantages of pantogam active has advantage on a number of values. The treatment effect of pantogam active gradually increased while the effect (in particular anxiolytic one) of phenotropil decreased after 4-8 weeks of treatment. The tolerability of both drugs was satisfactory.

[Hypochondria circumscripta (to the problem of coenesthesiopathic paranoia)].

Hypochondria circumscripta manifests in patients with paranoial personality and signs of somatopsychic accentuation. A sample included 11 patients (6 men, 5 women, mean age 54 years) who referred to dermatologists or had been admitted to gastroenterological and psychiatric units. Pathokinesis of hypochondria circumscripta comprises three stages: idiopathic algias, overmastering sensations and possession of pain. In the latter stage, delusional behavior targeted to the elimination of a part of the body, which is perceived as the source of pain, develops. Psychopathological disorders are realized in limits of coenesthesiopathic spectrum without tendency to interpretive delusion manifestation as well as transformation to systematic delusion of persecution during the disease course. As a consequence of above mentioned peculiarities of psychopathological structure, the stage of possession of pain may be designated as coenesthesiopathic paranoia. Because of the small sample, the findings can be considered as preliminary ones.

[Isolation and study of the antibiotics produced by a culture of Str. iverini (Gause et al., 1957) Pridham et al., 1958]. / Vydelenie i izuchenie antibiotikov, produtsiruemykh kul'turoi Str. iverini (Gause et al., 1957) Pridham et al., 1958.

An antibiotic complex consisting of echinomycin and triostin A was isolated from Str. iverini (Gauze et al., 1957) Pridham et al., 1958. Hydrolysis of the antibiotics resulted in formation of an aglycone identified with quinoxaline carboxylic acid. The UV spectrum of the aglycone and the antibiotics of the echinomycin-triostin group was studied.

[New anthracycline antibiotics taurimycins A and B produced by a Str. tauricus No. 7036-1 culture]. / Novye antratsiklinovye antibiotiki tavrimitsiny A i B, produtsiruemye kul'turoi Str. tauricus No. 7036-1.

Taurimycins A and B are new anthracycline antibiotics belonging to the group of glycosides. They were isolated from the mycelium of culture 7036-1 classified with Str. tauricus. The empiral formula of taurimycin A is C14H51O16N,M+813. The empirical formula of taurimycin B is C41H49O16N,M+811. The absorption maxima in the UV spectra of the antibiotics (in alcohol solutions) were observed at 235, 257, 292, 466, 482, 494, 515 and 527 nm. The IR spectra showed absorption bands at 3450, 2945, 2870, 1740 and 1610 cm-1. Hydrolysis of the antibiotics with hydrochloric acid resulted in formation of an aglycone identified as epsilon-pyrromycinone.

[Identification of the antibiotic formed by a Str. canulus 106/78 culture with antibiotic CC-1065]. / Identifikatsiia antibiotika, obrazuemogo kul'turoi Str. canulus 106/78, s antibiotikom CC-1065.

An antibiotic with a melting point of at least 340 degrees C, [alpha]D + 100 degrees (c 1 per cent in dimethylformamide) was isolated from the mycelium of Str. canulus 106/78. Calculated (%): C 60.63, H 4.69, N 13.6. The UV spectrum of the antibiotic (in methanol solution) showed the terminal absorption, shoulder at 265 nm and maximum at 375 nm. In dimethylformamide solution the UV absorption maximum was observed at 370 nm with E1 1% cm 845. The IR, FMR and 13C-NMR spectra of antibiotic 106 are analogous to the respective spectra of antibiotic CC-1065 which is indicative of their identity.

[New antibiotic, cinropeptin, from a culture of Act. cineraceus]. / Novyi antibiotik tsinropeptin iz kul'tury Act. cineraceus.

Cinropeptin, a new antibacterial antibiotic, was isolated from the mycelium of a culture classified as belonging to Act. cineraceus. Its empirical formula is C50H63N11O12S6, [alpha]D--169.4 degrees (C 0.36, CHCl3). The UV absorption maxima of the antibiotic in an alcoholic solution were observed at 218, 232, 304 and 365 nm. The IR absorption bands were recorded at 3370, 1660, 1600, 1530, 1140 and 1100 cm-1. Cystin, glycine and methylamine were detected in the acid hydrolysate of cinropeptin. Study on the products of the antibiotic partial oxidation with performic acid and comparison of the sulfur percentage and molecular weight showed that the molecule of cinropeptin contained 3 residues of cystin.

[A new antibiotic, corallomycin, from an Act. longispororuber]. / Novyi antibiotik korallomitsin iz kul'tury Act. longispororuber.

A new antibiotic named corralomycin (C34H28O9) was isolated from the mycelium of culture 6795-38 classified as belonging to Act. longispororuber. The maximum UV absorption spectra of the antibiotic in an alcohol solution were observed at the wavelengths of 228, 268 and 420 nm, the absorption bonds of 3400, 2980, 2865, 1710, 1625, 1595, 1165, 880 and 780 cm(-1) were recorded in the IR spectrum. Two acetyl derivatives of corallomycin, i.e. diacetate (C38H32O11) and tetraacetate (C42H36O13) were prepared.