In recognition of depression ...

In recognition of depression is expedient to focus on the following clinical signs: - mnestiko-intellectual disorders: memory disorders in amnestic episodes of disorientation, impaired concentration and cognitive processes, reducing criticism, the capacity for abstraction - the idea of ??a nihilistic content (failure to perform food putrefaction of the internal organs) with the prevalence of depressive disorders in the structure of anxious-hypochondriac of the spectrum - resistance to pharmacotherapy. Considered psychopathological features of NA (prevalence in the structure of depression and anxiety disorders somatovegetative) are responsible for the high sensitivity of patients, even a slight worsening of bodily discomfort. Accordingly, the appointment timolepticheskoy therapy in such patients is associated with certain difficulties. So, when choosing a drug has to consider not the intensity timolepticheskogo action (as in severe depression) and its selectivity with respect to the individual structures of pathological affect, and the minimum severity of behavioral toxicity and side effects [AB Smulevich, MA Morozova, 1997]. In connection with this appointment patients with ND conventional pharmacotherapy with tricyclic antidepressants (TCA), having along with antidepressant side effects (orthostatic hypotension, sinus tachycardia, slow conduction of the heart) [VA Of Eden, 1988; SN Mosolov, 1995; Reference Vidal, 1997; A. Stoudemire, 1990; British National Formulary № 31, 1996] and the adverse effects of interactions considered timoleptikov with somatotropic drugs often leads to therapeutic effect [AB Smulevich et al., 1997]. Of particular importance in the treatment of NB gain antidepressants, combining soft timoleptichesky effect with good tolerability (pirazidol, Prozac, coaxil, etc.). The latter, especially in cases of severe somatic pathology in the elderly, as well as the phenomena of intolerance to these medication can easily be replaced with drugs, not only does not violate the functions of internal organs, but also have a synergistic psycho and somatotropic effect. Among such funds - SAMe in clinical activity which combines timolepticheskoe and hepatotropic action (shown at the phenomena of cholestasis, liver cirrhosis, chronic active hepatitis, cystic fibrosis). Finally, in consideration of depressive disorders as the drug of choice may be used neuroleptics sulpiride (Eglon), and teralen. The first of these, along with timoneyrolepticheskoy and anxiolytic activity has a positive effect on the pathological processes of the gastrointestinal tract (stomach ulcer and duodenal ulcer, Crohn's disease operated stomach). Second, having anxiolytic properties and reducing the influence of somatization on the manifestations of anxiety and depression, gives a distinct anti-hypertensive and anti-histamine effect.