№ 4S (2016)

The article describes the range of cognitive impairments that occur in clinical practice, their importance in the daily livings of patients, and associated recovery problems. The place of memantine in the treatment of cognitive disorders of varying severity and different etiologies is discussed. The possibilities of the use of original memantine and generic drugs are considered.

Currently, hormone therapy of epileptic syndromes with prolonged spike-wave activity during sleep is a promising developing area in epileptology. Some clinical studies and global meta-analyzes inevitably confirm efficacy of hormones when success can not be achieved using anti-epileptic drugs. However, unified approaches to the choice of the drug and schemes of its administration are not been developed until now. This article discusses the possible mechanisms of action of steroids. Indications for hormonal treatment, data on efficacy and tolerability are presented. Based on own author’s experience, protocol of differentiated tactics of hormonal treatment of epileptic syndromes with prolonged spike-wave activity during sleep is suggested. The chosen strategy allows to achieve a positive effect in reducing the number of seizures and prevent the development of severe neurocognitive deficits in 70-80% of patients.

The prevalence of anxiety disorders (AD) among child and adolescent population varies from 9 to 32% and tends to increase during the transition from the younger age groups in the older ones. However, ADs remain undiagnosed in many patients, which lead to the lack of specialized care and pharmacotherapy. The article discusses the features of the childhood age-related fears, clinical manifestations of ADs, including separation AD of childhood, selective mutism, phobic AD of childhood, social AD of childhood, generalized AD of childhood, panic disorder, and agoraphobia. Tenoten kid is a promising drug for the treatment of ADs. In a multicenter, double-blind, placebo-controlled randomized trial of efficacy and safety of Tenoten Kid for 12 weeks in 98 children and adolescents with ADs aged 5 to 15 years, according to assessment of anxiety using scales developed by G.P. Lavrentieva and TM Titarenko, and SCAS, and anxiety test developed by R.Tammil et al. for children 5-7 years, more pronounced regress of symptoms during treatment with Tenoten Kid compared to placebo was registered in 5-7-year-old patients in terms of «social phobia» and «physical injury fear», in 8-15-year-old patients - in terms of «panic attacks and agoraphobia», «separation anxiety» and «social phobia». The anxiolytic activity of the drug was significantly more pronounced in 5-7 year-old children, which confirms the need for early diagnosis and treatment of ADs in children.

In gastroenterological practice, actual psychosomatic disorders (36% of hospital patients in need of psychiatric counseling) can be differentiated as: a) somatogenic and psychogenic mental disorders on the background of current gastroenterological diseases (37%); b) somatized mental disorders (47%); c) psychiatric disorders, comorbid to somatic diseases (16%). Long-term experience confirms the effectiveness of interdisciplinary collaboration of gastroenterologists and psychiatrists, allowing to exhaustively assess the condition of the patient, justify the optimal treatment tactics depending on the specificity of psychosomatic relations in the individual clinical manifestation of the disease.

The study was aimed to the comparative evaluation of the efficacy and safety of monotherapy with one of the new generation antidepressants and combined therapy with the use of similar antidepressants and citicoline for the treatment of depression in elderly patients. The study included patients of gerontopsychiatric hospital aged 60 to 79 years with mild to moderate depression. Citicoline was administered intravenously using courses of intravenous infusions, after that the drug was administered per os in the form of a solution. For the evaluation of the therapeutic efficacy (in accordance with a specially designed protocol), standardized rating scales were used. The results led to the following conclusion: the use of combination therapy allows to achieve more rapid development of therapeutic response and a more pronounced effect than monotherapy with antidepressant.

Lamotrigine is an effective drug for the treatment of bipolar affective disorder with predominant antidepressive activity. It is effective in the acute episode of depression, but also has a great importance for the long-term maintenance treatment of patients with predominantly depressive symptoms. Advantages of lamotrigine over other mood stabilizers, especially with prolonged use, include its high safety, including for children, the elderly patients and pregnant women.