Depressive disorders and cerebrovascular pathology: pathophysiological background of the relationship, clinical features and treatment strategy

O.O. Kopchak

Abstract


The main characteristic features of depressive disorders (DD) in comorbidity with cerebrovascular pathology are established. The hypothesis of vascular depression (VaD) and possible diagnostic criteria of vascular depression in the elderly (late-life depression); pathophysiological mechanisms linking depression with cerebrovascular disease, including the important role of chronic systemic inflammation, are discussed. The clinical features of late-life vascular depression and post-stroke depression are outlined. Peculiarities of relationship between cognitive impairment (CI) and DD in patients with cardiovascular disease and main signs of CI in VaD are observed. There is evidence that treatment of cardiovascular disease and risk factors can reduce the risk of VaD and can be effective in the therapy of late-life depression. The necessity of early antidepressant treatment of post-stroke depression is proved. The modern approaches to the treatment of vascular DD using antidepressant agents are described. Efficacy and safety of trazodone in the treatment of DD comorbid with cerebrovascular disease, based on its multifunctional mechanism of action, is discussed.

Keywords


depressive disorders; cerebrovascular pathology; pathophysiological mechanisms; clinical features; treatment

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DOI: https://doi.org/10.22141/2224-0713.2.88.2017.100200

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