[Apathy syndrome in depressed patients previously treated with selective serotonin reuptake inhibitors]

Apathy, anhedonia and cognitive dysfunction: common symptoms of depression and neurological disorders

Depression is one of the most common mental disorders in neurological practice. Among other symptoms of depression, a symptom complex represented by apathy, anhedonia, and cognitive impairment plays an important role. This review presents the clinical characteristics of the symptoms described above and discusses modern neurochemical and neuroimaging concepts of their pathogenesis. The problem of pathogenetically substantiated therapy of depression with a predominance of apathy, anhedonia and cognitive impairment is discussed. Fundamental and clinical arguments are presented in favor of the high efficacy of vortioxetine in depression with a predominance of apathy, anhedonia, and cognitive impairment. 

[Long-term maintenance therapy of depressive disorders with antidepressants: experience of using agomelatin]

The article presents the literature data that determine the place of antidepressants in the relief and maintenance therapy for recurrent depression (RD) and depression in the framework of bipolar affective disorder (BPAD) and provides a justification for their use in the presence of residual depressive symptoms during remission. There are several ways to achieve complete remission: determination of the nature of residual symptoms; identification of adverse side-effects that have occurred as a result of the therapy; the establishment of those symptoms that are subjectively perceived by the patient as interfering with his/her full life. The data on the effective use of agomelatin for maintenance therapy, both as monotherapy and in combination with other antidepressants, anticonvulsants and neuroleptics, in RD and BPAD are presented. The authors have analyzed the case histories of 29 outpatients with depressions of various origins (RDD, BPAD, prolonged psychogenic depression, organic affective disorder), who received agomelatin as part of complex and monotherapy for a long time (1 to 13 years), and justified the predictors of its efficacy.