Ivanov S V, Voronova E I
Mental Health Research Centre, Moscow, Russia.
Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2021;121(5. Vyp. 2):106-112. doi: 10.17116/jnevro2021121052106.
A review of works devoted to the problem of psychopharmacotherapy of depression in general medical practice is presented. The issues of its comorbidity with somatic and neurological diseases, as well as multimorbidity are discussed. Both direct and side-effects of antidepressants, which are important for effective therapy of not only affective disorders proper, but also the symptoms of the leading pathology, are considered in detail for individual organs and systems. The analysis of the preferred pharmacological classes of antidepressants, which are drugs of first choice, taking into account the somatic condition of the patient, is carried out, and drugs are indicated, the appointment of which is undesirable for the treatment of a patient with a certain disease. The presented results are aimed both at increasing the efficiency of therapy for patients with general medical level of health care, and at increasing the safety of treatment of psychiatric patients with concomitant somatic disorders.
本文对普通医疗实践中抑郁症心理药物治疗问题的相关著作进行了综述。讨论了其与躯体疾病和神经系统疾病的共病问题以及多重疾病问题。详细考虑了抗抑郁药对各个器官和系统的直接作用和副作用，这些作用不仅对有效治疗情感障碍本身很重要，而且对主要病理症状的治疗也很重要。在考虑患者躯体状况的情况下，对首选的抗抑郁药药理学类别进行了分析，并指出了某些药物不适用于特定疾病患者的治疗。所呈现的结果旨在提高普通医疗保健水平患者的治疗效率，并提高伴有躯体疾病的精神病患者的治疗安全性。
