Optimization of Antidepressant Therapy in Conditions of the Gerontology Psychiatric Out-Patient Clinic

Objective. To carry out a comparative assessment of the efficacy and safety of monotherapy with a new-generation antidepressant (venlafaxin, agomelatine, or fluvoxamine) and complex antidepressant therapy using one of these antidepressants in combination with acetyl-L-carnitine (ALC, Carnicetin) for the treatment of depression in elderly patients in a gerontology psychiatric out-patients clinic. Materials and methods. Two groups of patients (aged 60–79 years) with mild or moderate depression, comparable in terms of the main demographic and clinical characteristics, received antidepressant mono- or complex (antidepressant and ALC) therapy for eight weeks. Results. The use of complex therapy including the neuroprotector Carnicetin, which has neurotrophic and energotropic mechanisms of action, was found to provide a faster-onset therapeutic response and a stronger effect than antidepressant monotherapy, which was supported by a significant reduction in depressive disorders, including measures of the severity of anxiety, along with improvements in the patients’ cognitive functioning. Use of complex therapy was accompanied by a decrease in the frequency of adverse events. Conclusions. The results obtained here allow inclusion of Carnicetin into the complex antidepressant treatment to be recommended for use in gerontology psychiatric out-patient clinics.