We have obtained evidence ...

   Us obtained data supporting the therapeutic activity of moclobemide for complex syndromes observed in the prolonged anxiety and somatization of depressive disorder (mean duration of 24 to 50 months). identifies some patterns of actions that are important for selecting appropriate therapeutic tactics and explain the effect of patient characteristics drug. moclobemide uniformly suppresses all manifestations of this type of depression, namely, depressed mood (depression, sadness, gloomy despondency, hopelessness, loss of ability to experience pleasure, increased irritability, tearfulness, a tendency to exhibit primitive reactions), decreased self-esteem (the consciousness of their helplessness, worthlessness), with repetitive negative thoughts, and sometimes with a sense of hopelessness and even suicidal mood, somatization manifestations (sleep disorders violation of his rhythm and depth, anorexia, loss of appetite, familiar taste, weight loss, violation of normal rhythm of sleep and wakefulness, loss of sexual function, chest pain or other painful sensations, arising out of touch with real medical conditions cardialgia, tsefalgii, stomachodynia, back pain and in the genital area, a feeling of deep bodily distress, weakness, lethargy), and the symptom of anxiety, including the expectation of an unfavorable outcome both in relation to these events, and in the future, the emergence in exacerbations of paroxysmal states with a sense of catastrophe, fear of an incurable disease, fear of death, the multiple manifestations of autonomic dysfunction. In analyzing the results of moclobemide therapy revealed that the reduction of anxiety manifestations (at most) and somatized (to a lesser degree) a few ahead of the actual reduction in symptoms of depression in the first week of treatment. In this case, anxiety can even increase somewhat in the early days, although significantly reduced, and then going dezaktualizatsiya fear of impending death and other phobic symptoms. The reverse development somatized manifestations of depression in the first all subject to the reduction of disturbances, disturbances in appetite, autonomic symptoms, abnormal sensations, reduced body weight. Actually mood recovered gradually, not earlier than 3 4 weeks of treatment. predictors developed therapeutic activity of moclobemide according to which: 1) a distinct therapeutic effect was seen in the first 2 Weeks, and 2) reduction of psychopathologic components of major-resistant depression (depression, anxiety, somatization) should occur almost simultaneously, and 3) a small efficiency or lack of clinical effect observed in the prevalence of depression in the film pretentious senestopathic sensations or manifestations overvalued hypochondria, obsessions. Modern therapeutic strategy to ensure the achievement of therapeutic effect and to overcome resistance to therapy for depression somatized requires more daily doses of moclobemide 450 mg or more.