EVALUATION OF THE EFFICACY OF DEPRESSIVE DISORDERS PHARMACOTHERAPY USING QUANTITATIVE PHARMACO-EEG

Timely diagnosis and efficacious pharmacotherapy of depressive disorders are of immediate concern to the medical practice. The quantitative pharmaco-electroencephalography method enables differential evaluation of the affective disorder treatment efficacy. The aim of the study was to perform comparative evaluation of pharmacological  activity of two treatment regimens for moderate somatization disorders in patients with gastrointestinal pathology: monotherapy with fluoxetine — an antidepressant  of the selective serotonin  reuptake  inhibitors  class, and combination  therapy  with melatonin-containing medicine.  Methods: the severity of the depressive disorder and the efficacy of the treatment regimens were assessed using the Hamilton Depression Rating Scale (HDRS-17). The quantitative  pharmaco-electroencephalography (pharmaco-EEG) was used both before and during the treatment to analyse the effect of the medicinal products on the functional state of the brain in the patients with depressive disorder. Results: it was shown that the combination  of fluoxetine and melatonin  results in a more rapid regression of depressive symptoms according to the HDRS-17 scale. The quantitative pharmaco-EEG method helped to reveal specific differences between the effect of fluoxetin as monotherapy and in combination  with melatonin  on the bioelectrical activity on the patients brain. Conclusions: the analysis of the relative power of the patient brain rhythms by pharmaco-EEG demonstrated a more rapid restoration  of normal EEG rhythms in the patients who received the combination  of fluoxetine and melatonin, than in those patients who received fluoxetine monotherapy which did not result in complete remission of the existing depressive episode in a number of patients after the 42-day treatment course.

1. Tomenson B, Essau C, Jacobi F, Ladwig KH, Leiknes KA, Lieb R, et al. Total somatic symptom score as a predictor of health outcome in somatic symptom disorders. Br J Psychiatry. 2013;203(5):373–80. https://doi.org/10.1192/bjp.bp.112.114405

2. Safronenko AV, Maklyakov YuS, Soboleva SYa. Ways of increasing the efficiency of treating patients with arterial hypertension. Vestnik novykh meditsinskikh tekhnologiy = Journal of New Medical Technologies. 2011;18(4):73–5 (In Russ.)

3. Sobennikov VS, Prokopieva ML, Sobennikova VV. To the problem of somatic depression (review). Psikhicheskie rasstroystva v obshchey meditsine = Mental Illness in General Health Care. 2013;(3):18–21 (In Russ.)

4. Aslanov AM, Kolmakova TS. The content of steroid hormones in patients with a different course of cholelithiasis. Kubansky nauchny meditsinskiy vestnik = Kuban Scientific Medical Bulletin. 2016;(6):10–13 (In Russ.)

5. Smulevich AB, Dubnitskaya EB. Depression — topical problems of systematics. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova = S.S. Korsakov Journal of Neurology and Psychiatry. 2012;112(11):11–20 (In Russ.)

6. Wenthur CJ, Bennett MR, Lindsley CW. Classics in chemical neuroscience: Fluoxetine (Prozac). ACS Chem Neurosci. 2014;5(1):14–23. https://doi.org/10.1021/cn400186j

7. Mosolov SN. Biological mechanisms of the development of recurrent depression and the action of antidepressants: new data. Psikhofarmakoterapiya depressii = Psychopharmacotherapy of Depression. 2011;(15):1–14 (In Russ.)

8. Mendel VE, Mendel AG. Melatonin: a role in the body and therapeutic possibilities. experience of using melaxen in russian medical practice. Russkiy meditsinsky zhurnal = Russian Medical Journal. 2010;18(6):336–41 (In Russ.)

9. Bochkarev VK. Electroencephalographic studies in borderline mental states. In: Bochkarev VK, Panyushkina SV. Borderline Mental Disorders. Moscow: Meditsina; 2000. P. 120–33 (In Russ.)

10. Itil TM. The discovery of psychotropic drugs by computer analyzed cerebral bioelectrical potentials (CEEG). Drug Dev Res. 1981;1(4):373– 407. https://doi.org/10.1002/ddr.430010407

11. Gantsgorn EV, Khloponin DP, Maklyakov YuS. Survival analysis and spatial-frequency distribution of EEG-indices in rats’ global cerebral ischemia. Kubansky nauchny meditsinsky vestnik = Kuban Scientific Medical Bulletin. 2017;(2):43–9 (In Russ.)

12. Bazanova OM, Aftanas LI. Individual measures of electroencephalogram alpha activity and non-verbal creativity. Neurosci Behav Physiol. 2008;38(3):227–35. https://doi.org/10.1007/s11055-008-0034-y

13. Kudelina OM, Khloponin DP, Maklyakov YuS, Zaika VG, Gantsgorn EV. Evaluation efficiency of modern antidepressants by means of quantative pharmaco-EEG. Research Result: Pharmacology and Clinical Pharmacology. 2016;2(4):12–20. https://doi.org/10.18413/2500-235X-2016-2-4-12-20