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RELATIONSHIP OF DEPRESSION AND ANTIDOPAMINERGIC SIDE EFFECTS (EXTRAPYRAMIDAL SYNDROME AND HYPERPROLACTINEMIA) OF ANTIPSYCHOTIC MAINTENANCE TREATMENT IN SCHIZOPHRENIA

N.N. Petrova
Saint-Petersburg State University

Background. Currently, depression is seen as one of the most common symptoms in patients with schizophrenia, which can be observed at all stages of its course. The study of factors affecting the development of affective disorders in schizophrenia, including the relationship between post-schizophrenic depression and side effects of antipsychotics, remains topical.

Material and methods. At the stage of remission, 50 patients with paranoid schizophrenia who received antipsychotics at the time of inclusion in the study for at least 2 weeks were examined. Comparison groups were formed depending on the type of antipsychotic therapy and were comparable in age and duration of the disease. The study was conducted using a clinical scale score: Abnormal Involuntary Movement Scale (AIMS), Simpson Angus rating scale (SAS), Barnes akathisia rating scale, Calgary depression rating scale (CDSS) and Сlinical global impression scale (CGI). In all patients, the level of prolactin in the blood serum was determined on an empty stomach.

Results. The presence of depression was verified in 40 % of patients, including 52 % of women and 28 % of men. The depression was represented, mainly, by apato-adynamic syndrome. The total severity of the mental state of patients receiving second-generation antipsychotics was less. Patients treated with traditional antipsychotics had more pronounced extrapyramidal side effects in the form of pathological involuntary movements, akathisia, tremor, muscle rigidity, etc. Clinically defined depression was found in 68 % of patients receiving antipsychotics of the first generation and 12 % who received therapy with atypical antipsychotics. Side effects of antipsychotic therapy significantly correlated with the severity of depressive symptoms. A direct parallelism was found between the depression score on the Calgary scale and the level of prolactin in the blood.

Conclusion. Supportive therapy of schizophrenic patients with first-generation antipsychotics, accompanied by side effects, is a risk factor for the development of depression. For the prevention of post-schizophrenic depression, it is advisable to use second-generation antipsychotics that are safe with regard to the development of EPS and hyperprolactinaemia.

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