[Fluvoxamine in the treatment of anxiety-depressive spectrum disorders]

The RSCI and PubMed search databases have requested publications over the past 40 years on the search queries «fluvoxamine», «anxiety-depressive disorders», «anxiety», «depression», «comorbidity», devoted to the effectiveness of fluvoxamine in various variants of disorders of the anxiety-depressive spectrum, anxiety depressions. The data of the above studies indicate that fluvoxamine (Zovart San) in doses of 50-300 mg / day is a highly effective remedy for the treatment of not only anxiety depressions and genesis (psychogenic, organic, mixed, autochthonous-endogenous) and severity (up to psychotic), but also a wider range of anxiety-depressive disorders, including adaptation disorders, obsessive-compulsive disorder, somatized, dysmorphic, insomniac symptom complexes and eating disorders. A wide range of clinical effects of fluvoxamine is due to its main and additional mechanisms of action: blockade of serotonin reuptake, σ1-agonist activity and the effect on the metabolism of melatonin and neurosteroids catabolism.

[Optimization of treatment of depression with administration of ethylmethylhydroxypyridine succinate (Mexicor)]

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.

Obsessive-compulsive disorder during the SARS-CoV-2 pandemic (case report)

The novel coronavirus 2019 (COVID-19) pandemic has affected not only the somatic health of people but also their mental health and the organization of mental health care. Self-isolation, quarantine, extensive media coverage of the situation, a large amount of inaccurate information, and conflicting recommendations – all this has led to an increase in admission of patients who have not previously had mental illness to psychiatrists. As a confirmation of the influence of the above factors on the population's mental health, we present a case report of a 25-year-old patient who first came to a psychiatric clinic due to the obsessive-compulsive disorder that developed due to the pandemic.

[About the causes and therapy of depressive disorders in COVID-19]

Brief information about the causes of depressive disorders in COVID-19 and general strategies of their treatment is presented. According to the biopsychosocial model of the development of mental diseases, depressive disorders in COVID-19 develop due to the toxic effect of the coronavirus on nervous system and other organism systems, possible side-effects of COVID-19 therapy, the psychogenic effect of excessive and inaccurate information about the coronavirus infection and the consequences of its spread, adverse social changes during the pandemic. If infection with the SARS-CoV-2 did not develop, depressive disorders may arise due to psychogenic information and negative social influences. If coronavirus infection is present, depressive disorders can manifest during the acute period of COVID-19 and after recovery from COVID-19. Depressive disorders may occur for the first time in a patient with COVID-19 or infection can aggravate depression that has been in remission. Care should consistently include psychosocial activities, psychocorrection and psychopharmacotherapy. For the prevention of onset of depressive disorders, it is better to implement social-hygienic and psychological-pedagogical measures. Psychotherapy and psychopharmacotherapy become more important in the development of clinically expressed depressive disorders.