Antidepressants of the different chemical groups: clinical and neurophysiological correlations in treating depression

Abstract

Developing options of the psychopharmacology require specialists to conduct goal-oriented and adequate therapy. The objective of the research was a comparative clinical and neurophysiological study of the action of amytriptyline, tyaneptine, fluoxetme and moclobemide, treating depressive disorders with the dominant affect of anguish. Totally, 107 depressed patients, aged 20-40, with depressive episode (38,3%), recurrent (53,3%) and bipolar (8,4%) affective disorders were clinically examined. Depression severity was assessed by clinical examination as well as by the administration of HAM-D Rating Scale and CGI Scale prior to and on the lOth, 20th and 40th days of treatment. Brainwave mapping was recorded before the therapy and on its 20th day. All patients were divided onto 4 groups: those, who were treated with amytriptyline (n=25), tyaneptine (n=28), fluoxetine (n=32) and moclobemide (n=22). Daily-dosages of amytriptyline (15&250 mg), tyaneptine (37.5-50 ma). fluoxetine (40-60 mz) and moclobemide (450-600 ma) depended on the depression &erity (moderate or severe levels). Control group consisted of 25 healthy people. Results of the study showed: when registering brain bio-electric activity of depressed patients prior to the treatment in comparison with the healthy group we have observed zones of "increased" activity in the right temporal fields and zones of "decreased" activity in the left temporal fields. Changes, occurring in these zones in response to the treatment, were more stable. Affecting the brain electric impulses all used agents demonstrated a similarity (core pattern) as well as the differences. All antidepressants reduced the activation of the right temporal zone and increased the activation of the left temporal zone. As a specific feature of the action, fluoxetine and moclobemide produced more significant increasing of the left temporal zone's activation. Amytriptyline caused an expanding of the activation zone from the left temporal fields to parietal and occipital fields. Tyaneptine produced migrating zones of activation.