The pharmacodynamics of serotonergic antidepressants that differentially influence serotonin reuptake transporters is poorly investigated. The aim of this study was to compare the biochemical profiles in patients with anxious depression under the treatment with tianeptine, a serotonin reuptake enhancer, and sertraline, a selective serotonin reuptake inhibitor. Platelet monoamine oxidase (MAO) and serum amine oxidase (AO) activities, concentration of middle-mass endotoxic molecules (MMEM) and parameters that characterize the functional properties of serum albumin were investigated in 43 patients with anxious depression (ICD-10: F 32.1 and F 33.1). It was established that, in comparison with healthy controls, patients with anxious depression were characterized by the significant increase in MAO activity (by 95%), MMEM concentration (by 86%), and a significant decrease in AO activity (by 43%) and also in functional albumin activity. The results of the study show that both tianeptine and sertraline are equally effective in the treatment of anxious depression. The present biochemical investigation, however, suggests that the underlying biochemical changes are more complete following tianeptine treatment.

The state of binding centers in albumin molecule in patients with anxious depression was studied by the method of quenching of fluorescence of molecular probe (dimethyl-aminonaphthaleic acid carboxyphenylimide) with nitrate ions. Serum samples from 24 donors without somatic and mental diseases and 26 patients were analyzed. In the absence of the quenching agent, specific fluorescence of the probe (standardized by albumin concentration) was lower in patients with depression. The fluorescence quenching constant and the percentage of fluorescence available for quenching were also lower in serum samples from patients. These data indicate that the parameters of binding centers in albumin molecule in patients with anxious depression are significantly modified in comparison with normal subjects. The detected changes can play a role in the pathogenesis of depressive disorders.

Introduction. Biochemical bases of interaction between monoaminergic systems and cortisol as one of the main component of hypothalamic-pituitary-adrenal axis in pathogenesis of anxious depression are investigated poorly. Aim. Elucidate some biochemical aspects of interaction of monoaminergic systems and cortisol in pathogenetic mechanisms of anxious depression. Materials and Methods. Patient's state (61 patients) according to ICD-10 criteria was defined as a depressive episode as an independent disease (F32.1) and in the structure of recurrent depressive disorder (F33.1). The anxiety in the structure of the depression was the main indication to inclusion in the investigation. According to Hamilton rating scale for depression and Hamilton rating scale for anxiety the total points were 21.83 and 18.00, respectively, that corresponded to severe depressive disorder and severe anxiety. 43 of 61 patients were investigated biochemically. Results. There were revealed significant increase of platelet monoamine oxidase activity and cortisol level. It means that patients with anxious depression are characterized by profound disturbances of monoamine metabolism and hormonal status that are the reflection of disturbed homeostasis as a whole. Conclusion. There are revealed tight interaction between monoamines and cortisol. We hypothesize about biochemical mechanisms of disturbed balance between serotonergic and noradrenergic systems and cortisol in anxious depression.

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