An open, non-comparative clinical study was performed to assess the efficacy and safety of tianeptine (Coaxil) in Parkinson's disease (PD). A total of 18 patients with PD were used whose clinical state increased moderately severe and more profound depression (assessed on the Hamilton and Beck scales). After three months of treatment, depression on the Hamilton depression scale was decreased by 34% and on the Beck scale by 31% compared with baseline data ((p) < 0.05). Improvements in mental status were noted in 14 of 18 patients (77%); eight patients (44%) showed more than 50% reductions on the Hamilton scale. Analysis of the structure of depressive symptomatology showed that improvement occurred because of decreases in anxiety and the severity of somatoform symptoms and, to a lesser extent, in melancholy and sleep disturbance. There was no significant change in apathy. The decrease in the severity of depression was accompanied by an improvement in the quality of life. The efficacy of Coaxil was greater in patients with less marked depressive and motor symptoms, shorter durations of illness, and less marked cognitive impairments. Coaxil was well tolerated by the patients. The data obtained here provide grounds for recommending the use of Coaxil in the treatment of depression in PD.
Dementia is an important medical problem with the prevalence and significance growing year after year. Improvement of diagnostic methods facilitates early diagnosis and treatment. This year marks the 20th anniversary of memantine, one of the basic anti-dementia drugs, registration in Russia. It provided conditions for more efficient care of patients with dementia and development of memory clinics in Moscow and major regions of Russia used modern investigation technology and neuropsychological testing. Many multi-central studies involving 1250 patients with cognitive impairment were conducted A great number of educational activities, social projects that helped to increase awareness of dementia issues in medical community as well as society in general were implemented. Total screening programs for identification of cognitive impairment are being introduced, psychological support programs for caregivers of dementia patients are being implemented.
Anti-NMDA-R encephalitis is a relatively frequent form of autoimmune encephalitis. Initial clinical features of anti-NMDA-R encephalitis resemble those of schizophrenia exacerbation which resulted in hospitalization of patients to mental care facilities. Taking into account high lethality and potential curability, detection of this condition is an important clinical problem. The authors describe a case report of encephalitis with NMDA-R antibodies. This report is the first in the domestic literature. The difficulties of timely diagnosis, diagnostic criteria and treatment algorithm are presented.
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