psychiatryПСИХИАТРИЯPsychiatry (Moscow) (Psikhiatriya)1683-83192618-6667FSBSI “The Mental Health Research Centre”; LLC «Publisher «MIA»10.30629/2618-6667-2020-18-3-95-107psychiatry-515Research ArticleНАУЧНЫЕ ОБЗОРЫSCIENTIFIC REVIEWSСовременные представления о терапии депрессивных расстройств позднего возрастаLate-Life Depression Treatment: the State of the Arthttps://orcid.org/0000-0002-3509-1622СафароваТ. П.SafarovaT. P.

Сафарова Татьяна Петровна, кандидат медицинских наук, отдел гериатрической психиатрии

Москва

Tatiana P. Safarova, MD, PhD, Cand. of Sci. (Med.), the Geriatric Psychiatry Department

Moscow

saftatiana@mail.ruФГБНУ «Научный центр психического здоровья»РоссияFSBSI “Mental Health Research Centre”Russian Federation20201909202018395107Copyright © Сафарова Т.П., 20202020Сафарова Т.П.Safarova T.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.journalpsychiatry.com/jour/article/view/515Цель

Цель: представить обзор отечественных и зарубежных современных исследований, освещающих вопросы терапии депрессий позднего возраста.

Материалы и метод

Материалы и метод: с помощью ключевых слов «депрессивные расстройства», «поздний возраст» «психофармакотерапия» проводился поиск научных статей в базах данных MedLine, PubMed за период 2000–2020 гг.

Обсуждение и выводы

Обсуждение и выводы: вариабельность многочисленных факторов старения у депрессивных больных позднего возраста приводит к значительной гетерогенности гериатрических депрессий и трудностям подбора терапии. В современной литературе, посвященной терапии депрессий позднего возраста, существуют довольно разнородные рекомендации по поводу выбора различных препаратов, рекомендуемых дозировок, длительности проведения терапии и времени замены препаратов в случае их неэффективности. Мировая тенденция перехода к персонифицированной терапии психических болезней требует идентификации у больных предикторов терапевтического ответа. Накоплены значительные данные по потенциальным предикторам терапевтического ответа на антидепрессанты у больных молодого и среднего возраста с использованием клинических, нейробиологических, нейрокогнитивных и генетических параметров. Поиск предикторов терапевтического ответа особенно важен в позднем возрасте, поскольку подбор адекватной антидепрессивной терапии связан не только с эффективностью, но и безопасностью лечения пожилых пациентов. На сегодняшний день наши знания в области разработки проблемы предикции терапевтического ответа в этой группе пациентов остаются достаточно ограниченными и требуют дальнейшего изучения.

Purpose

Purpose: to present an overview of domestic and foreign current research covering the treatment of late-life depression.

Materials and method

Materials and method: the keywords “depressive disorder”, “late age”, “psychopharmacotherapy” were used to search for scientific articles in the databases MedLine, PubMed for the period 2000–2020.

Discussion and conclusions: the variability of multiple aging factors in depressive patients of late age leads to significant heterogeneity of geriatric depressions and difficulties in selection of therapy. In the current literature on the treatment of late-life depression, there are quite heterogeneous recommendations on the choice of different drugs, recommended dosages, duration of therapy and time to replace drugs if they are ineffective. The global trend of transition to personalized therapy of mental diseases requires identification of predictors of therapeutic response in patients. Significant data has already been accumulated on potential predictors of therapeutic response to antidepressants in young and middle-aged patients using clinical, neurobiological, neurocognitive and genetic parameters. The search for predictors of therapeutic response is especially important in late life, since the selection of adequate antidepressant therapy is associated not only with the effectiveness, but also with the safety of treatment of elderly patients. To date our knowledge of the problem of predicting the therapeutic response in this group of patients remains very limited and requires further study

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The authors declare that there are no conflicts of interest present.