Comparative efficacy of antidepressant therapy for generalized anxiety disorder depending on the leading symptom complex

Background. Generalized anxiety disorder (F41.1; hereinafter referred to as GAD) increases the risk of cardiovascular disease, early mortality from a comorbid somatic disease or suicide, is the cause of psychosocial maladjustment and dissatisfaction with the quality of life. GAD accounts for more than a quarter of all anxiety disorders. The heterogeneous clinical picture and the high prevalence of GAD determine the need for a differentiated approach to the choice of therapy, the development of principles and approaches from the standpoint of personalized medicine. Objective: to study the differentiated use of antidepressants in the treatment of patients with GAD in accordance with the leading symptom complex. Material and Methods. With the help of a test of cardio-respiratory synchronism, the regulatory-adaptive capabilities of the body were assessed in 150 patients with GAD during dynamic monitoring of the results of antidepressant therapy. Results. The study of regulatory-adaptive capabilities, based on a comparative assessment of the general functional state and the level of body performance in patients with GAD, according to the dynamics of psychopharmacotherapy, showed that the predominance of the leading symptom complex is a factor that determines the individually differentiated prescription of an antidepressant. For patients with the ideator type of generalized anxiety disorder, the most effective drug of choice is venlafaxine, with the vegetative type - paroxetine, with the muscular type - mirtazapine.