Coaxil scientific update |
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Zh Nevrol Psikhiatr Im S S Korsakova. 2005;105(11):24-9.
Aleksandrovskii IuA, Avedisova AS, Boev IV, Bukhanovkskii AO, Voloshin VM, Tsygankov BD, Shamrei BK.
Efficacy and tolerability of coaxil (tianeptine) in the therapy of posttraumatic stress disorder [Article in Russian]
Treatment of posttraumatic stress disorder using of coaxil (tianeptine) and its efficacy and tolerability.
The results of a multicenter study of coaxil in the treatment of 90 patients with posttraumatic stress disorder (PTSD) are summarized. Two dosages of the drug, 75 mg daily (44 patients) and 37.5 mg daily (46 patients) have been compared. Coaxil efficacy was estimated with the Clinician Administered PTSD Scale (CAPS) and Hamilton depression scale (HAM-D). High efficacy of coaxil was shown, with 76.7 and 75.6% responders, respectively, for the dosages used. The optimum one proved to be 37.5 mg daily, which is congruent to the standard dose in the treatment of depression and provides not only the efficacy but tolerability of coaxil. The coaxil efficacy depended on a PTSD type: the drug was more effective in chronic PTSD that, in the authors' opinion, might be related to its antidepressant action.
Ter Arkh. 2006;78(4):38-44
Chazov EI, Oganov RG, Pogosova GV, Shal'nova SA, Romasenko LV,Shchurov DV.
Depression in cardiological practice: pilot results from a multicenter clinico-epidemiological trial in hypertensive patients with ischemic heart disease (koordinata) [Article in Russian]
Depression in cardiac patients with ischemic heart disease: a pilot results from a multicenter clinico-epidemiological trial in hypertensive patients.
AIM: To study effects of depression on the course and prognosis of arterial hypertension (AH) and coronary heart disease (CHD), potentialities of the combined treatment in a prospective multicenter trial. MATERIAL AND METHODS: A total of 376 patients with AH and/or CHD having depression (10 scores and higher by HADS scale) were assigned to two groups: 189 (50.3%) patients received somatotropic therapy+coaxil (the study group), 187 (49.7%) patients received somatotropic therapy alone (the comparison group). Coaxil was given for 6 weeks in a dose of 37.5 mg/day, to patients over 70 years--25 mg/day. The effects were assessed by changes in HADS, CGI scale, blood pressure, heart rate; by tolerance and side effects (objective effects); complaints, well- being, stress, tolerance (subjective effects). RESULTS: The addition of coaxil to somatotropic therapy of patients with AH and/or CHD associated with depression led to improvement of the psychological status (a 36% decrease by HADS depression scale from 13.1 +/- 2.75 to 8.43 +/- 3.64, -delta4.76, p < 0.0001; by HADS anxiety scale--by 35.6% from 12.08 +/- 3.90 to 7.78 +/- 3.63, -delta4.31, p < 0.0001; by response to psychoemotional stress--by 23% from 6.65 +/- 1.94 to 4.77 +/- 1.85, -delta1.88, p < 0.05). Control patients also showed a positive trend in the above indices (a decrease in the above indices from 13.15 +/- 2.65 to 11.79 +/- 3.31, from 11.50 +/- 3.66 to 10.12 +/- 3.95, from 6.63 +/- 1.99 to 6.03 +/- 2.07, p < 0.05, respectively) but positive changes were much weaker than in the coaxil group (p < 0.001). To the end of the treatment, patients of the study group had less number of complaints, more patients achieved the target level of arterial pressure under 140/90 mm Hz (43.9 versus 29.9% in the control group; p < 0.005). CONCLUSION: Standard somatotropic treatment of AH patients with CHD and depression is not sufficiently effective. Combination of such treatment with antidepressive therapy (coaxil) significantly improves psychological status, and efficacy of therapy of basic cardiological diseases.
Zh Nevrol Psikhiatr Im S S Korsakova. 2006;106(10):47-51.
Kochetkov IaA, Bel'tikova KV, Gorobets LN.
Anabolic-catabolic balance in depression: an effect of coaxil [Article in Russian]
Efficacy of coaxil in anabolic and catabolic balance in depression.
Correlation between anabolic and catabolic process in terms of neuroendocrine changes in depression has been studied before and after coaxil therapy. The index of catabolic processes was cortisol blood level and that of anabolic processes--dehydroepiandrosterone (dehydroepiandrosterone sulfate, DHEA-S) level. The total of 39 patients of middle age were studied: 25 of the study group treated with coaxil (37.5 mg/day during 4 weeks) and 14 of the comparison group treated with sertraline (50 mg/day during 4 weeks). A mean level of cortisol was higher than normal one in patients with depression. Coaxil and sertraline decreased the mean cortisol level, no significant differences being found between these drugs. There was negative correlation between the DHEA-S level and severity of depression before the treatment. Unlike sertraline, coaxil caused an increase of this parameter in patients with decreased DHEA-S level. The ratio cortisol/ DHEA-S decreased during the treatment with either coaxil or sertraline but in the former case it was more pronounced (p = 0.003). The authors considered the data obtained in the aspect of concept of allostasis--the ability of the organism to achieve changes (stress reaction).
Zh Nevrol Psikhiatr Im S S Korsakova. 2006;106(3):20-5.
Levin OS.
Coaxil (tianeptine) in the treatment of depression in Parkinson's disease [Article in Russian]
Treatment using Coaxil (tianeptine) for depression in patients with Parkinson's disease.
Clinical evaluation of tianeptine (coaxil) efficacy and safety has been conducted in an open non-comparison study of 18 patients with Parkinson's disease (PD) with moderate and marked depressive symptoms measured by Hamilton and Beck depression scales. To the end of the 3rd month of the treatment, scores on the Hamilton Depression Scale (HAM-D) decreased by 34% and by 31% on the Beck Depression Scale (p<0.05) as compared to the baseline level. Improvement was observed in 14 out of 18 patients (77%), with decreasing of HAM-D scores by 50% and over in 8 patients (44%). An analysis of depressive symptoms structure revealed that the improvement was due to the decrease of anxiety and somatoform symptoms and, to a lesser extent, to melancholy and sleep disorders. However, a level of apathy did not change. The decrease of depression was accompanied by significant improvement of quality of life. The efficacy of coaxil was higher in patients with less marked depressive and motor symptoms, shorter disease course and less cognitive impairment. Good tolerability of coaxil was observed during the whole study. Therefore, coaxil may be recommended for treatment of depressive symptoms in patients with PD.
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Drug category:Antidepressants
 Coaxil scientific update
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