[Teraligen in the complex treatment of anxiety-phobic, behavioral and depressive syndromes in children and adolescents with schizotypal disorder]. / Teralidzhen v kompleksnoi terapii trevozhno-fobicheskikh, povedencheskikh i depressivnykh narushenii u detei i podrostkov s shizotipicheskim rasstroistvom.

OBJECTIVE: To determine the frequency of prescribing and the main therapeutic targets of Teraligen in the treatment of Schizotypal disorder (STD) in childhood and adolescence. MATERIAL AND METHODS: The sample consisted of 151 patients aged 7 to 16 years with a diagnosis of STD (F 21), of which 31.1% (n=47) of female patients and 68.9% (n=104) of male patients who received inpatient or outpatient treatment at the FSBI NCPZ from 2008 to 2020. The study was conducted by clinical-psychopathological, clinical-catamnestic, and statistical methods. RESULTS: Teraligen was prescribed by psychiatrists to patients with STD in 74.2% of cases, of which in 46.4% of cases patients received Teraligen even before the diagnosis of STD in connection with complaints of neurotic disorders (anxiety, fears and sleep disorders) (n=30), as well as in connection with autistic-like behavior (n=22). At the time of follow-up, 55% (n=83) of patients received Teraligen, of which 63.9% (n=53) of patients were prescribed it for the first time. The applied schemes of prescribing Teraligen for the treatment of anxiety-phobic, depressive and behavioral syndromes within the framework of the STD in a relatively age-related aspect are presented. CONCLUSION: The high frequency of prescribing Teraligen by psychiatrists and neurologists to children and adolescents with STD at different stages of observation is shown, which reflects the confidence of specialists in this drug. Teraligen has demonstrated a multidimensional pharmacological effect, including a mild antipsychotic effect, providing reduction of a wide range of psychopathological symptoms, with good tolerability and drug interaction. The study of the possibilities of Teraligen, both for monotherapy and for augmentation of the treatment of mental pathology in childhood, remains relevant.

[Clinical and pathopsychological features of youth depression with attenuated schizophrenic symptoms]. / Klinicheskie i patopsikhologicheskie kharakteristiki yunosheskikh depressii s attenuirovannymi simptomami shizofrenicheskogo spektra.

OBJECTIVE: To determine the clinical and pathopsychological features of youth depressions with attenuated schizophrenic symptoms (ASS), and their significance for early differential diagnostic and nosological assessment. MATERIAL AND METHODS: Twenty young patients (19.7±3.7 years) with the first depressive episode with attenuated schizophrenic symptoms (ASS) (ICD-10 items F32.1, F32.2, F32.3) (basic group) were divided into subgroup 1 with attenuated positive symptoms - APS (19.3%) and subgroup 2 with attenuated negative symptoms - ANS (45.1%). Eleven young patients (19.4±2.9 years) with the classic depressive episode without ASS (ICD-10 items F32.1, F32.2) were included in a control group. Psychometric scales HDRS, SOPS, SANS, pathopsychological methods and Adult Personality Traits Questionnaire (APTQ) were used. RESULTS: Statistically significant differences in the severity of depression were not found. A higher SOPS total score (p=0.006) and a greater severity of negative symptoms on SANS (p=0.006) were detected in patients of clinical groups compared with the comparison group. Distortion of the generalization process was detected in 60% of cases, impairments of immediate memorization were found in 30%, and the non-constructive nature of associations in 10%. Indirect data on greater emotional integrity of patients from the comparison group was obtained. CONCLUSION: The presence of similar clinical and psychological abnormalities in the youth depressions with ASS allows us to attribute these phenomena to the possible risk factors for the development of schizophrenia.

[Clinical-psychopathological aspects of therapeutic effects of agomelatine (valdoxan) and its place in perfection of methods of therapy of postschizophrenic depressive disorders]. / Kliniko-psikhopatologicheskie aspekty osobennostei terapevticheskogo deistviia agomelatina (val'doksana) i ego mesto v usovershenstvovanii metodov terapii postshizofrenicheskikh depressii.

AIM: To determine a therapeutic effect of agomelatine (valdoxan) on post-schizophrenic depression (PSD), taking into account its psychopathological structure. MATERIAL AND METHODS: A total of 33 patients of both sexes (average age was 32.1 yrs) with symptoms of post-schizophrenic depression (F20.4 according to ICD-10) were examined by using clinical and psychometric methods in the dynamics of shift-like schizophrenia. HAMD-17, PANSS and CGI-S scales were applied. All the patients were subdivided into groups: mild, moderate and severe depressions. Valdoxan was used at a dose of 25-50 mg/day for 28 days along with preceding antipsychotic therapy at maintenance doses. Evaluation of the efficacy of treatment was carried out according to percentage reduction of average total score (ATS) in dynamics. RESULTS: A significant effect of valdoxan, with 73.5% of PANSS score reduction and quicker response to treatment, was identified. Therapeutic effect of valdoxan on separate components of PSD was uneven. The decrease of depressive disorders per se assessed by HAМD-17 and PANSS G-subscale was equally high (78.4 and 78.2%, respectively). Therapeutic reduction of negative disorders according to PANSS N-subscale was the lowest, at the level of 'good' effect (53.6%). In 27.3%, negative disorders were irreversible and were assessed as schizophrenic defect; in 72.7% of patients they were diagnosed as 'secondary' negative symptoms in atypical depression. In the subgroups of mild, moderate, and severe depression, the reduction of negative disorders was 62.4; 44.2 and 60.8%, respectively, and that of total PANSS score were 81.5; 66.1, and 78.6%, i.e. there was no correlation between these variables. CONCLUSION: Agomelatin (valdoxan) is an effective medication for optimization of methods of PSD treatment, providing the therapeutic effect at the level of significant or complete reduction of symptoms. The quality (depth) and rate of formation of response in the dynamics of course treatment are determined not by the severity of depressive disorders in PSD structure, but by the ratio between negative (deficit) symptoms and 'secondary' symptoms, reflecting the degree of progression of the main disease.

[A differential approach to the improvement of prevention and correction of neuroleptic side extrapyramidal disorders with pantogam activ in patients with schizophrenia]. / Differentsirovannyi podkhod k usovershenstvovaniyu metodov preduprezhdeniya i korrektsii neirolepticheskikh pobochnykh ekstrapiramidnykh rasstroistv preparatom pantogam aktiv u bol'nykh shizofreniei.

AIM: To assess the efficacy and safety of pantogam active (PA) in prevention and correction of neurological side-effects during the course neuroleptic treatment of acute endogenous psychoses. MATERIAL AND METHODS: Eighty schizophrenic patients (mean age 33 years) with acute psychosis were examined. All patients received 28-day course treatment with typical and atypical neuroleptics. Two equal groups were studied: patients of the first group were treated with trihexyphenidyl (THP) in dose of 0,002-0,012 mg and patients of the second group received in addition PA in dose 0,9 mg/day. Clinical-observation, psychometric scales (PANSS, CGI-S, UKU) were administered at baseline and in 1st,3rd,7th, 14th, 21st, 28st day. RESULTS: PA in the combination with THP improved tolerability to neuroleptic therapy in whole and exerted the better correction effect on neuroleptic extrapyramidal disorders (EPD) compared to THP monotherapy. The number of patients with ERD was reduced by 1.5 times and prevention of EPD was observed 3 times more frequent in the group treated with PA. In the THP group, other adverse effects (AE) were 1,7 times more frequent and the total AE score was 2,5 times greater compared to the PA group (131 vs 50). Correction and preventive effects of the combined treatment on the clinically severe symptoms of EPD (akathisia, muscle dystonia) were more frequent in patients treated with typical neuroleptics. A less amount of THP (by 1,2 times) was used to stop EPD in the PA group. CONCLUSION: PA in the combination with THP has demonstrated the clear neuroprotective effect on the development, frequency and clinical presentations of neurological side-effects. The РА can be recommended as a drug of choice for correction and prevention of neuroleptic side-effects, it promotes their tolerability and improves quality of life during the course treatment.

[Clinical and therapeutic perspectives of agomelatine (valdoxan) in the treatment of anhedonia in patients with endogenous depressions].

OBJECTIVE: To analyze the therapeutic effect of valdoxan on symptoms of anhedonia in patients with endogenous depressions and to develop indications for its use. MATERIAL AND METHODS: Authors examined 30 women, mean age 35,9 years with anhedonic depression (ICD-10 items F31.3-4, F33.1-2, F20.4). Valdoxan was administered in average daily dose from 25.8 to 45.8 mg during 30 days. Patient's status was assessed on 0, 7, 14 and 30th days, using clinical and psychometric (HAMD-21, HADS, SHAPS and UKU scales) methods. The reduction of scores was used as a measure of therapeutic effect designated as «mild¼, «moderate¼, «good¼ and «marked¼. RESULTS: Antianhedonic effect of valdoxan on 30th day was superior to thymoleptic and anxiolytic effects of this drug (91.5 versus 82.2 and 76.9%). The marked effect was identified already on 14th day and enhanced to 30th day. The best effect was seen in depression of moderate severity. Single autonomic side-effects of the treatment were observed. CONCLUSION: The course treatment of anhedonic depressions with valdoxan should be considered as preferable and highly effective method that provides a dominative antianhedonic effect in the spectrum of antidepressive properties of the drug. Good and marked effects have been achieved in 96.7% of patients. The intensity and rate of its formation, good tolerability allow to tailor indications of valdoxan basing on the psychopathological characteristics of gedonic disorders.