Rational pharmacotherapy of depression, complicated by neurological symptoms: chronic pain syndrome and insomnia
A.V. Kuchaeva, M.L. Maximov

Kazan State Medical Academy

Aim: to study the effect of psycholeptics in patients with depression complicated by neurological symptoms for psychopharmacotherapy optimization.
Patients and Methods: 50 patients were involved in the retrospective study with a diagnosis of non-psychotic recurrent depressive disorder, current episode of moderate severity, with neurological symptoms (F33.11 ICD-10), hospitalized in SAHI (State Autonomous Healthcare Institution) «Behterev Republican Clinical Psychiatric Hospital of the Ministry of Health of the Republic of Tatarstan» (Kazan), 2018. Dosing of neuroleptics was analyzed using Defined Daily Doses (DDD), certain Anatomical Therapeutic Chemical (ATC) Classification. Patients received the following treatment: antidepressant drugs, tranquilizers, neuroleptics, bromides, non-steroidal anti-inflammatory drugs or combinations thereof. Hamilton Depression Rating Scale (HDRS) was used to determine the severity of depression in follow-up, to measure pain intensity — Wong-Baker Faces Pain Scale, to evaluate sleep quality — Leeds Sleep Questionnaire, to assess the treatment of depression with chronic pain syndrome and insomnia — Cost Minimization Method.
Results: the most effective in depression, with chronic pain syndrome and insomnia, is the combination of amitriptyline, sulpiride and bromkamphora (Dobrocam) at the Defined Daily Doses (DDD) according to neurologists.
Hospital treatment of patients with chronic insomnia with amitriptyline, phenazepamum and bromkamphora (Dobrocam) reduced the average time duration of hospitalization, improved the quality of patients’ life, reduced frequency of seeking neurological care. Administering of bromocamphora reduced the heart rate in the treatment of insomnia in patients with the studied depression, while with the use of other studied sedatives (amitriptyline, sulpiride, phenazepamum) it was increasing.
Monotherapy of insomnia with bromkamphora (Dobrocam) was cheaper than other drugs in studied depression with neurological symptoms.
Conclusion: the results of the study allow us to recommend the following studied drugs: amitriptyline, sulpiride, phenazepamum, bromkamphora (Dobrocam) in the treatment of depression, complicated by neurological symptoms.

Key words: depression, chronic pain, age, occupational adaptation, insomnia, sedatives, rational pharmacotherapy.
For citation: Kuchaeva A.V., Maximov M.L. Rational pharmacotherapy of depression, complicated by neurological symptoms: chronic pain syndrome and insomnia // RMJ. 2018. № 12(I). P. 10–15.