Ivanets N N, Kinkulkina M A, Tartynskiy K M, Krenkel G L
Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2018;118(4):65-69. doi: 10.17116/jnevro20181184165-69.
To develop therapeutic programs for treatment of depression with panic attacks on the basis of their clinical and psychopathological features.
A total of 100 in- and outpatients, aged from 18 to 60 years, with depression of mild and moderate severity with panic attacks were studied. The investigation was carried out using clinical, psychopathological and psychometric (the Atypical Depression Diagnostic Scale (ADDS), the Montgomery-Asberg Depression Rating Scales (MADRS), and the Sheehan Anxiety Rating Scale (ShARS)) methods. The patients were assessed on admission, on the 1, 2, 4 and 8 weeks with subsequent processing and defining standard indicators. Three therapeutic groups were formed: the 1 group received therapy combining an antidepressant and a tranquilizer; the 2 group an antidepressant, a tranquilizer and a mood stabilizer; and the 3 group an antidepressant, a tranquilizer and an antipsychotic agent. The time course of expression of the signs of depression, anxiety and frequency of panic attacks was analyzed.
The highest efficacy in the form of reduced signs of depression and anxiety was observed in the 3 group on the 1 week of therapy. No significant differences in reduction of depression and anxiety were found between the 1 and 2 groups. In the 1 therapeutic group, there was an increase in the frequency of panic attacks together with the reduction in their expression and decrease in the severity of depression as compared to the 2 and 3 groups. At the same time the 3 therapeutic group was characterized by a maximally expressed decrease in the frequency of panic attacks already on the 1 week of therapy.
The study has shown that the use of antipsychotic drugs in addition to therapy with antidepressants and tranquilizers is the most effective way to stop depression.
根据伴有惊恐发作的抑郁症的临床和精神病理学特征，制定治疗方案。
对100例年龄在18至60岁之间、患有轻度和中度抑郁症并伴有惊恐发作的门诊和住院患者进行研究。采用临床、精神病理学和心理测量（非典型抑郁症诊断量表（ADDS）、蒙哥马利-阿斯伯格抑郁评定量表（MADRS）和希恩焦虑评定量表（ShARS））方法进行调查。在患者入院时、第1、2、4和8周进行评估，随后进行处理并确定标准指标。形成了三个治疗组：第1组接受抗抑郁药和镇静剂联合治疗；第2组接受抗抑郁药、镇静剂和情绪稳定剂治疗；第3组接受抗抑郁药、镇静剂和抗精神病药物治疗。分析了抑郁、焦虑症状的表达时间进程以及惊恐发作的频率。
在治疗第1周时，第3组观察到抑郁和焦虑症状减轻的疗效最高。第1组和第2组在抑郁和焦虑减轻方面未发现显著差异。与第2组和第3组相比，在第1治疗组中，惊恐发作频率增加，同时其表达减少，抑郁严重程度降低。与此同时，第3治疗组的特点是在治疗第1周时惊恐发作频率就出现了最大程度的降低。
研究表明，在使用抗抑郁药和镇静剂治疗的基础上，加用抗精神病药物是治疗抑郁症最有效的方法。
