No 7 (2010)

The principal stages of formation of modern psychopharmacology are presented. It is emphasized that psychotropic drugs have produced a revolution in psychiatry, have created the prerequisites for the development of so-called biological psychiatry, and have contributed to the restructuring of mental illness and organization principles of medical care of psychiatric patients. The article is dedicated to the general characteristics of clinico-pharmacological action of psychopharmacological drugs and approaches to its fundamental analysis.

The general principles for the use of modern antidepressant drugs, data for the comparative effectiveness of various antidepressants with emphasis on selective serotonin reuptake inhibitor citalopram are presented. The article discusses the selection criteria of antidepressants in the light of the peculiarities of their metabolism, drug interactions, and suicidal risk. The results of monotherapy with citalopram (drug Pram) in patients with symptoms of generalized anxiety or social anxiety disorder are presented. The findings confirm the justification for the choice of citalopram (drug Pram) as a drug for long-term therapy due to its efficacy and high tolerability. Drug with a pronounced therapeutic effect at a dose of 20-40 mg per day is effective in major manifestations of generalized and social anxiety.

This article discusses mechanisms of action and clinical effect of calcium channel blocker nimodipine. It is emphasized that to date this drug is used for subarachnoid hemorrhage, ischemic stroke and dementia of different genesis (vascular and primary degenerative). This drug has not only symptomatic action, improving the cognitive and behavioral function in patients with dementia, but also impact on the mechanisms of development of cognitive disorders. Side effects during therapy are rare, and it seems particularly important for of elderly and senile patients.

One of the most common complications of diabetes mellitus (DM) is a polyneuropathy (PNP). The article presents statistical data, classification of diabetic neuropathy, diagnostic criteria, pathogenesis and principles of treatment of this complication of DM. The blood glucose level control and metabolic therapy with α-lipoic (thioctic) acid are major pathogenetic-based methods of treatment of DM. Thiogamma is effective, safe and easy to use form of α-lipoic acid, which can be administered for the treatment of different categories of patients with DM, including children, and patients with different forms of diabetic PNP.

Modern medical studies pay great attention to the issues of relation between mental and somatic pathology, particularly in cardiology. A great number of comorbid mental and somatic disorders were recognized. Mental illnesses, most often found in cardiac patients were defined. The combined use of psychotropic and cardiotropic drugs in the treatment of cardiac patients was well-founded.

The article presented the results of clinical study aimed to examination of clinical efficacy, tolerability and safety of Neurodiclovit (diclofenac + B group vitamins) in an outpatient neurology practice in 60 patients with acute pain syndrome secondary to herniation of intervertebral disk. It is shown that Neurodiclovit is effective and safe drug for patients with acute pain syndrome, caused by degenerative and inflammatory lesions of the spine. Diclofenac only was surpassing Neurodiclovit for efficacy, safety and tolerability.

The content of proinflammatory cytokines, the prevalence and severity of depression in patients with chronic heart failure were explored. It was noted that the morphological and functional parameters of the myocardium and the content of cytokines are related. Increased content of interleukin-1β, interleukin-6 and tumor necrosis factor α, and depressive disorders were detected significantly more frequently in patients with left ventricular hypertrophy in comparison with patients with normal geometry of the myocardium. Maximum production of proinflammatory cytokines and the greatest severity of depression occurred in patients with a pronounced decrease in myocardial contractility.

Binswanger's disease (BD) is characterized by progressive dementia, accompanied by episodes of focal neurological symptoms. It is believed that disintegration of cortex and underlying formation of the brain, as well as various areas of the cortex to each other are customary for BD. In 1894, Otto von Binswanger due to analysis of 6 cases of vascular dementia from a clinical and morphological perspective first described the disease in detail.