Depression in neurological practice: prevalence, diagnosis, treatment standards and new options for pharmacotherapy

Abstract

Depression is the third most common cause of disability in the world's population. Depressive disorders are widespread in patients observed by psychiatrists, neurologists, as well as general practitioners. Comorbid depression worsens the course and prognosis of somatic and neurological diseases. Training, psychotherapy and pharmacotherapy form the basis of the current approach in the treatment of depression. Over the past several decades, the common pharmacological treatments for depression have been antidepressants with different mechanisms of action. However, antidepressant therapy has several disadvantages. The therapeutic effect of antidepressants occurs only 2--4 weeks after the start of treatment. Limitations in the use of antidepressants are not seldom due to contraindications or persistent side effects. Meanwhile, about 2/3 of patients taking antidepressants do not achieve the clinical effect, hence the need to find a drug which could be associated with a better antidepressant efficacy. Acetyl-L-carnitine is an active L-carnitine metabolite with antidepressive action, good tolerability and safety. The article tells about pre-clinical trials of acetyl-L-carnitine (ALC) in cell-based models and animal models, the results of randomized, placebo-controlled studies of ALC efficacy in the treatment of depression and depressive symptoms.

Keywords

• депрессия
• лечение
• психотерапия
• когнитивно-поведенческая терапия
• ацетил-l-карнитин
• depression
• treatment
• psychotherapy
• cognitive-behavioral therapy
• acetyl-l-carnitine