Алгоритм назначения антидепрессантов в реальной клинической практике

Путилина М.В. Алгоритм назначения антидепрессантов в реальной клинической практике. Consilium Medicum. 2018; 20 (9): 101–107. DOI: 10.26442/2075-1753_2018.9.101-107

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Putilina M.V. Algorithm of antidepressants use in clinical practice. Consilium Medicum. 2018; 20 (9): 101–107. DOI: 10.26442/2075-1753_2018.9.101-107

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Аннотация

По данным Всемирной организации здравоохранения, тревожно-депрессивные расстройства (ТДР) и инсульт входят в десятку самых значимых проблем здравоохранения. Симптомы тревоги или субсиндромальные ТДР регистрируются у 76% населения планеты. Депрессия, с которой сталкиваются врачи-интернисты в повседневной практике, чаще всего протекает в скрытой, атипичной форме, маскируясь разнообразными психовегетативными, алгическими, соматическими проявлениями. Болевой синдром всегда сочетается с жалобами психопатологического и психовегетативного характера. Базовыми препаратами терапии являются антидепрессанты. Препараты показаны не только когда вегетативные расстройства являются проявлением депрессии, но и когда они протекают в рамках тревожных и тревожно-фобических расстройств, даже если очевидной депрессии не выявляется.

Ключевые слова: депрессия, генерализованное тревожное расстройство, нейропатическая боль, антидепрессанты, эффективность, безопасность.

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According to the World Health Organization data mixed anxiety and depressive disorder (MADD) and stroke are one of the ten most important healthcare problems. Anxiety symptoms and subsyndromal MADD are found in 76% of the world's population. Depression that internal medicine specialists come across in everyday practice mostly exists in an atypical latent form and is masked with various psychovegetative, algesic and somatic manifestations. Pain syndrome is always combined with various psychopathologic and psychovegetative complaints. The basis therapy includes antidepressant medications that are indicated not only when autonomic disturbances are symptoms of depression but also when they are a part of anxiety and anxiety-phobic disorders even if there is no evident depression.

Key words: depression, generalized anxiety disorder, neuropathic pain, antidepressants, effectiveness, safety.

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Авторы

М.В.Путилина

ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И.Пирогова» Минздрава России. 117997, Россия, Москва, ул. Островитянова, д. 1
profput@mail.ru

________________________________________________

M.V.Putilina

N.I.Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation. 117997, Russian Federation, Moscow, ul. Ostrovitianova, d. 1
profput@mail.ru

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