nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-0-0-nnp-1432Research ArticleCLINICAL OBSERVATIONSКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯPost-stroke depression and the abilities of antidepressants to enhance the effectiveness of neurorehabilitationПостинсультная депрессия и возможности антидепрессантов в повышении эффективности нейрореабилитацииКотовС. В.KotovS. V.

Сергей Викторович Котов, заведующий кафедрой неврологии, профессор, доктор медицинских наук

129110, Москва, ул. Щепкина, 61/2, корп. 1

Sergei Viktorovich Kotov

61/2, Shchepkin St., Build. 1, Moscow 129110

kotovsv@yandex.ruИсаковаЕ. В.IsakovaE. V.

Ведущий научный сотрудник неврологического отделения, доктор медицинских наук

129110, Москва, ул. Щепкина, 61/2, корп. 1

61/2, Shchepkin St., Build. 1, Moscow 129110

isakovael@mail.ruЕгороваЮ. В.EgorovaYu. V.

Аспирантка кафедры неврологии

129110, Москва, ул. Щепкина, 61/2, корп. 1

61/2, Shchepkin St., Build. 1, Moscow 129110

pjv90@mail.ruГБУЗ МО «Московский областной научно-исследовательский клинический институт им. М.Ф. Владимирского»РоссияM.F. Vladimirsky Moscow Regional Research Clinical InstituteRussian Federation202018092020126110116Copyright © Kotov S.V., Isakova E.V., Egorova Y.V., 20202020Котов С.В., Исакова Е.В., Егорова Ю.В.Kotov S.V., Isakova E.V., Egorova Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/1432

Stroke is the leading cause of disability in adults. Depression after a stroke is detected in one third of patients, complicating physical rehabilitation, worsening functional outcome, increasing mortality rates. The question of the use of antidepressants in the treatment of post-stroke depression is currently not completely resolved, there is no consensus on the most optimal drug. The drugs of choice are selective serotonin reuptake inhibitors, the use of tricyclic antidepressants is possible. A number of clinical studies indicate the effectiveness of selective serotonin reuptake inhibitors in the treatment of post-stroke depression, including through mechanisms including increased neuroplasticity and stimulation of neurogenesis, while others disprove their effectiveness. The article presents a clinical case of the use of vortiroxetin in the patient’s neurorehabilitation in the early recovery period of a stroke, its safety and positive effect are shown.

Инсульт является основной причиной инвалидности во взрослой популяции. Депрессия после инсульта выявляется у трети больных, затрудняя физическую реабилитацию, ухудшая функциональный исход, увеличивая показатели смертности. Вопрос использования антидепрессантов при лечении постинсультной депрессии на сегодняшний день окончательно не решен, нет единого мнения о наиболее оптимальном препарате. Препаратами выбора являются селективные ингибиторы обратного захвата серотонина, возможно использование трициклических антидепрессантов. Ряд клинических исследований свидетельствуют об эффективности селективных ингибиторов обратного захвата серотонина при лечении постинсультной депрессии, в том числе за счет механизмов, включающих повышение нейропластичности и стимуляцию нейрогенеза, другие опровергают их эффективность. В статье представлен клинический случай применения вортиоксетина в нейрореабилитации пациентки в раннем восстановительном периоде инсульта, показаны его безопасность и положительное влияние.

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