Клинический разбор в общей медицине (May 2024)
Experience in the treatment of depressive disorders with vortioxetine after hysterectomy
Abstract
Relevance. Antidepressants are widely used in clinical practice for neurological disorders. Vortioxetine refers to the latest generation of drugs, the appointment of which is appropriate for depressed patients after hysterectomy. Objective: to evaluate the effectiveness of vortioxetine in combination with menopausal hormone therapy in correcting depressive symptoms after hysterectomy. Materials and methods. 136 patients with depressive disorder after hysterectomy (average age 44.7±1.3 years) were examined and treated, who were divided into two groups. The main group consisted of 74 (54.4%) patients who were prescribed divigel with vortioxetine in combination. The control group included 62 (45.6%) patients who used only divigel. All underwent clinical and laboratory monitoring, psychological assessment on the Hamilton Depression scale (HDRS-21). Results. In the main group according to the Hamilton scale (HDRS-21), 26 (35.1%) patients showed mild depression, 48 (64.9%) moderate depression, in the control group 20 (32.2%) and 42 (67.8%) respectively. Against the background of complex therapy, a decrease in the indicators of the mental and somatic component was revealed. After a month, 16 (21.7%) patients of the main and 22 (35.4%) of the control group complained of depression, depression, a sense of self-worth, 21 (28.3%) and 27 (43.5%) of guilt, 9 (12.1%) and 11 (17.8%) slow thinking, 25 (33.8%) and 29 (46.8%), respectively, for a decrease in motor activity. Before the start of treatment, 49 (66.2%) patients of the main and 40 (64.5%) control groups complained of headache of varying intensity, 11 (14.9%) and 8 (13.0%) of pain in the lumbar region, 17 (23.0%) and 15 (24.1%), respectively, of body aches and soreness in small joints. During the first month of treatment, pain in the lumbar region decreased, followed by headaches, and soreness in the body and joints lasted longer. Conclusions. Against the background of taking an antidepressant in the examined patients, positive dynamics of the disease was noted, both in the subjective assessment of the condition and in the objective result of psychological symptoms. Vortioxetine, which has high clinical efficacy and good tolerability, can be recommended in the treatment of depression after hysterectomy.
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