Elena Shipilova1, Tatiana Safarova2, Olga Yakovleva2
1FSBSI Mental Health Research Centre, Department of Geriatric Psychiatry, Moscow, Russia
2FSBSI Mental Health Research Centre, Moscow, Russia
The prevalence of unipolar depression among geriatric in- and out-patients ranges from 10% to 38%. Bipolar depression occurs approximately in 4%-17% patients at psychogeriatric units. Both types of late-life depression are associated with comorbid metabolic and vascular cerebral dysfunction, cognitive decline, treatment resistance, drug hypersensitivity. Therefore, it is relevant to use a neuroprotective agent in a complex treatment of unipolar and bipolar depression in the elderly.
Aim: The aim was to compare effectiveness of a complex antidepressive treatment with Actovegin® of late-life unipolar and bipolar depression and a control group without neuroprotective augmentation.
Materials and methods: 21 depressive in-patients (33.3% male (n=7), 66.7% female (n=14)) of the geriatric units of MHRC aged 60 and older with unipolar depression (F32, F33 according to ICD-10; n=12; 57.1%) and bipolar depression (F31 according to ICD-10; n=9; 42.9%) were enrolled in the main group of an 8-week study. Main group received Actovegin® 200mg (5mL) intramuscularly in addition to antidepressive therapy (venlafaxine or fluvoxamine; combined with mood stabilizer for bipolar patients). The control group (n=21) received the same medications without augmentation. Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HARS), Clinical Global Impression Scale (CGI) and Mini-Mental State Examination (MMSE) were used for psychometrical assessment.
Results: A complex treatment with Actovegin® showed more rapid and significant reduction of depressive symptoms and more rapid therapeutic response compared to the control group without neuroprotective augmentation. No significant differences between unipolar and bipolar subgroups were found out. Patients, who received multimodal antidepressive treatment with Actovegin® showed marked cognitive improvement by contrast with the control group.