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This review discusses the importance of the main psychoemotional risk factors for the development of chronic noncommunicable diseases. Current data on the prevalence of anxiety and depressive disorders in patients with cardiovascular disease (CVD) are presented. Data on the relationship between the development of psychoemotional disorders and CVD are summarized and the prospects for managing such patients within the framework of interdisciplinary cooperation are discussed. The main pathogenetic mechanisms for the development of complications, including CNS damage in COVID-19, are considered. The significance of the selection of pathogenetic therapy for patients with comorbid somatic and mental diseases in the context of the COVID-19 pandemic is discussed. Results from multicenter placebo-controlled studies of the use of fl uvoxamine in patients with COVID-19 of varying severity are addressed.

Introduction. Given due regard to the urgency of the issue of pharmaceutical support in neurorehabilitation after stroke, an open multicenter study was designed and conducted.Aim. To evaluate the efficacy and safety of therapy with Brainmax®, which is an original combination of two drugs: ethylmethylhydroxypyridine succinate (EMHPS) (100 mg/ml) and meldonium dihydrate (100 mg/ml) in the form of a solution for intravenous and intramuscular injections in patients with ischemic stroke in the acute and early recovery period.Materials and methods. The study included 60 patients aged 18 to 80 years with the first ischemic stroke in the carotid or vertebrobasilar system, meeting the  inclusion/exclusion criteria. The total duration of  therapy was 24  days. The efficacy of therapy was assessed using the following tools: modified Rankin Scale (mRS), National Institutes of Health Stroke Scale (NIHSS), Rivermead Mobility Index (RMI), Montreal Cognitive Assessment scale (MoCA).Results. All patients showed improvement of their general condition by the end of therapy. The vast majority of patients noted that they had fewer difficulties with movement, self-care and daily activities as compared to the first visit. There was also a  significant improvement in  the total scores on the  NIHSS scale, the  Rivermead Mobility Index, and the  Montreal Cognitive Assessment Scale (p < 0.05) by the end of therapy. The proportion of patients with reported adverse events (AEs) accounted for 3.33%. All AEs were transient and did not require cessation of the therapy. No serious side effects were recorded in any of the groups.Conclusions. The study showed significant improvement of the key symptoms of ischemic stroke: regression of neurological deficit, functional and cognitive impairment. On top of that, it was noted that the incidence of adverse events associated with the use of Brainmax® was low, which did not lead to cessation of therapy. No serious side effects were recorded in any of the groups.