Selective serotonin reuptake inhibitors in therapy of different clinical types of endogenous depressions

In order to specify differential indications for the use of selective serot onin reuptake inhibitors (SSRI) their therapeutic effect was investigated i n apathic-adynamic, melancholic and anxious depressions. Group of 151 patie nts received monotherapy with one of SSRI-drugs: citalopram - 22 patients ( mean daily dosage - 27,4 mg), paroxetine - 47 patients (23 mg), sertraline - 19 patients (107 mg), fluvoxamine - 28 patients (162 mg), fluoxetine - 35 patients (20 mg). The state of the patients was estimated 5 times during 4 2 days of therapy by clinical estimations and according to Hamilton Depress ion Scale (HAM-D). Therapeutic effects of the drugs were determined accordi ng to the degree of reduction of the total HAM-D scores and they were consi dered as "significant" (a reduction of the scores by 50% and more), "modera te" (by 21-49%), and "insignificant" (by 1-20%), Positive antidepressive ef fect, including "significant" was obtained in the case of the use of all th e drugs studied. Differential evaluation of the three components of antidep ressive activity (thymoleptic, sedative-anxiolytic, and stimulative) accord ing to the degrees and data of expression of drugs' therapeutic effect has allowed to determine indications for the therapy of endogenous depressions by each of SSRI: to recommend cytalopram for the treatment of various types of depressive states mainly, for anxious and apatho-adynamic types; paroxe tin - for treatment of melancholic depressions as well as for anxious and a patho-dynamic ones; sertralin - for depression with anxiety and fobic disor ders; fluvoxamine - for melancholic and anxious depression; fluoxetine - fo r apatho-adynamic depressions.