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EVALUATION EFFICIENCY OF MODERN ANTIDEPRESSANTS BY MEANS OF QUANTATIVE PHARMACO-EEG

Introduction. Currently, topicality the problem of diagnosis and treatment of depressive disorders (DD) in medical practice is not in doubt. The drugs of choice in the treatment of this affective disease are the selective serotonin reuptake inhibitors (SSRIs). One of the best known and widely used today of representatives a number of SSRIs is fluoxetine. An example perspective way to improve the pharmacotherapy of depression is to combine SSIRs with representatives of other groups of drugs. Great interest from this point of view is the hormone of pineal gland - melatonin (MT), which is an important element of the non-specific antistress system of body. One more potentially significant vector of perfecting therapy is searching/development of the new, more potent and fast-acting antidepressants. In this respect, the attention of researchers attracts agonist to MT1- and MT2-receptors and antagonist to 5-HT2C-receptors - valdoxan. Materials and methods. In this study, by means of quantitative pharmaco-EEG (QPEEG) was performed a comparative evaluation of pharmacological activity of valdoxan, fluoxetine and combination of fluoxetine with melaxen during rat's experimental depression (ED) and depressive disorder (DD) in patients. Pharmacoeconomic analysis was performed by the method of "cost/effectiveness". Results and discussion. It was established that reception of valdoxan and combined fluoxetine with melaxen promotes a more rapid normalization of bioelectric activity of brain than at fluoxetine usage separately. So, on the EEG at rats with ED was registered significant increase of theta-rhythm activity, which dominates in the norm, and at patients with DD this regime of pharmacotherapy normalized the distribution of the alpha-rhythm and reduced slow-wave activity. Conclusions. Evaluation efficiency of the above regimes of pharmacotherapy of depressive frustration showed, that the application of valdoxan, and also combination fluoxetine+melaxen favorably affects the course of the disease and contributes to a more rapid normalization of bioelectric activity of brain than fluoxetine in isolation, both experimentally and clinically.

Ключевые слова: depression, rats, patients, valdoxan, fluoxetine, melaxen, pharmaco–EEG.

Иллюстрации

Table 1The comparative characteristic of RVP (%) of EEG rhythms of rats at reference state and at the ED

Table 2. The comparative characteristic of RVP (%) of EEG rhythms of rats of groups F, V and F+M on the 7th day of introduction.

Table 3. The comparative characteristic of RVP (%) of EEG rhythms of rats of groups F, V and F+M  on the 14th day of introduction.

Figure 1. Distribution of RVP of EEG rhythms of rats for the 21st day of introduction of fluoxetine.

Note to figures 1-3: on an axis of ordinates – RVP (%), on an abscissa axis – groups of rats and an EEG rhythms in SSC and HC; *at p<0.05 as compared to animals of group C; ** - at p<0.01 as compared to animals of group C; # -at p<0.05 as compared to animals of group D; # # -at p<0.01 as compared to animals of group D

Figure 2. Distribution of RVP of EEG rhythms of rats for the 21st day of introduction of valdoxan.

Figure 3. Distribution of RVP of EEG rhythms of rats for the 21st day of introduction of combination of fluoxetine with melaxen.

Table 4. The comparative characteristic of RVP (%) of EEG rhythms at healthy people and patients with a DD.

Figure 4. Distribution of RVP of EEG rhythms at patients for the 42nd day of introduction of fluoxetine.

Note to figures 4-6: on an axis of ordinates – RVP (%), on an abscissa axis – the field of registration of EEG rhythms; * at p<0.05 as compared to group C; ** - at p<0.01 as compared to group C; # - at p<0.05 as compared group D; # # - at p<0.01 as compared to group D.

Figure 5. Distribution of RVP of EEG rhythms at patients for the 42nd day of introduction combination of fluoxetine with melaxen.

Figure 6. Distribution of RVP of EEG rhythms at patients for the 42nd day of valdoxan.

Table 5. Dynamics of RVP (%) of α-rhythm in patients comparison groups in the occipital region of the brain

Figure 7. Cost-effectiveness of pharmacotherapy course at patients surveyed groups on RVP of a α-rhythm of the brain.

Note: on an axis of ordinates – the drug cost per course of treatment (rub.) / RVP (%) α-rhythm on the 28th and 42th days of observation. On an abscissa axis – the period of observation.

DOI: 10.18413/2500-235X-2016-2-4-12-20
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