Brain neuro-plasticity, depression, and antidepressant therapy
Aim. To investigate tianeptine effects on depressive symptoms, physical performance, and quality of life (QoL) in patients with stable coronary heart disease (CHD). Material and methods. The study included 40 patients (20 men and 20 women), aged 36-72 years, with Functional Class (FC) II-III effort angina and co-morbid depression. All participants were randomized into two groups: the control group (standard therapy only) and the main group (standard therapy plus tianeptine, 37,5 mg/d for 6 weeks). Depression was diagnosed by Beck Depression Inventory, BDI (≥19 points) and clinical depressive symptoms, according to ICD-10. Physical performance was assessed in a stress test (veloergometry), and QoL - by a QoL questionnaire (at baseline and at Day 42). Results. Tianeptine demonstrated substantial anti-depressive effect: in the main group, the total BDI score decreased from 24,9±1,2 to 11,9±1,5 (-52%; р<0,001). Clinical status also improved: the number and severity of angina attacks decreased; in patients with co-morbid arterial hypertension, blood pressure (BP) control improved; the time of physical stress test increased by 3,3±0,9 minutes (р<0,05). Total QoL score significantly increased by 2,6±0,9 (р<0,01). In the control group, no significant dynamics of these parameters was observed. Conclusion. In CHD patients with depression, tianeptine therapy (37,5 mg/d) demonstrated substantial anti-depressive effect, improved BP control, increased physical stress tolerability and improved QoL.