TREATMENT OF ANXIODEPRESSIVE DISORDERS IN PATIENTS WITH CARDIOVASCULAR DISEASES

Abstract

Sixty patients at the age of 43 to 79 years with anxiodepressive symptoms with comorbid cardiovascular disease have been examined after admission to psychotherapeutic department. Patients have been divided into two groups. The first group including 30 patients were treated by the tricyclic antidepressant amitriptyline with the average daily dose of 34.4 ± 12.9 mg. The 30 patients from the second group were treated by antidepressants of the selective serotonin reuptake inhibitors group. The sociodemographic characteristics in both groups did not differ significantly; the severity of cardiovascular disease, additional somatic and other diseases were certainty lower in the first group than in the second (p < 0.05). Examination of the patients with the use of Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale (HDRS and HARS) was carried out three times: at admission, in 1 week and in 4 weeks. At the time of admission, anxiety and depression in the first group were more expressed (p < 0.05) than in the second due to frequent psychogeny. The treatment scheme included tranquilizers, neuroleptics, neurometabolic drugs, basic cardiotropic therapy and psychotherapy. After 4 weeks anxiodepressive symptoms were more than 50 % reduced in both groups: 61 % in the first group and 50.7 % in the second group by the HDRC scale; 65.9 % in the first group and 59.8 % in the second group by the HARS scale. It has been shown that the small doses of antidepressant including amitriptyline involved in the complex treatment scheme were efficient and did not cause cardiotoxic effect.