Injuries of the central (CNS) and peripheral nervous system (PNS) are a serious problem of the modern healthcare system. The situation is complicated by the lack of clinically effective neuroprotective drugs that can protect damaged neurons and glial cells from death. In addition, people who have undergone neurotrauma often develop mental disorders and neurodegenerative diseases that worsen the quality of life up to severe disability and death. Hydrogen sulfide (H₂S) is a gaseous signaling molecule that performs various cellular functions in normal and pathological conditions. However, the role of H₂S in neurotrauma and mental disorders remains unexplored and sometimes controversial. In this large-scale review study, we examined the various biological effects of H₂S associated with survival and cell death in trauma to the brain, spinal cord, and PNS, and the signaling mechanisms underlying the pathogenesis of mental illnesses, such as cognitive impairment, encephalopathy, depression and anxiety disorders, epilepsy and chronic pain. We also studied the role of H₂S in the pathogenesis of neurodegenerative diseases: Alzheimer’s disease (AD) and Parkinson’s disease (PD). In addition, we reviewed the current state of the art study of H₂S donors as neuroprotectors and the possibility of their therapeutic uses in medicine. Our study showed that H₂S has great neuroprotective potential. H₂S reduces oxidative stress, lipid peroxidation, and neuroinflammation; inhibits processes associated with apoptosis, autophagy, ferroptosis and pyroptosis; prevents the destruction of the blood-brain barrier; increases the expression of neurotrophic factors; and models the activity of Ca²⁺ channels in neurotrauma. In addition, H₂S activates neuroprotective signaling pathways in psychiatric and neurodegenerative diseases. However, high levels of H₂S can cause cytotoxic effects. Thus, the development of H₂S-associated neuroprotectors seems to be especially relevant. However, so far, all H₂S modulators are at the stage of preclinical trials. Nevertheless, many of them show a high neuroprotective effect in various animal models of neurotrauma and related disorders. Despite the fact that our review is very extensive and detailed, it is well structured right down to the conclusions, which will allow researchers to quickly find the proper information they are interested in.

Cardiovascular, rheumatic, kidney, and neurodegenerative diseases and mental disorders are a common cause of deterioration in the quality of life up to severe disability and death worldwide. Many pathological conditions, including this group of diseases, are based on increased cell death through apoptosis. It is known that this process is associated with signaling pathways controlled by a group of gaseous signaling molecules called gasotransmitters. They are unique messengers that can control the process of apoptosis at different stages of its implementation. However, their role in the regulation of apoptotic signaling in these pathological conditions is often controversial and not completely clear. This review analyzes the role of nitric oxide (NO), carbon monoxide (CO), hydrogen sulfide (H₂S), and sulfur dioxide (SO₂) in apoptotic cell death in cardiovascular, rheumatic, kidney, and neurodegenerative diseases. The signaling processes involved in apoptosis in schizophrenia, bipolar, depressive, and anxiety disorders are also considered. The role of gasotransmitters in apoptosis in these diseases is largely determined by cell specificity and concentration. NO has the greatest dualism; scales are more prone to apoptosis. At the same time, CO, H₂S, and SO₂ are more involved in cytoprotective processes.

The purpose of this work was to estimate the prevalence of depressive disorders in hemodialysis patients and conduct a gender comparison of depression. The study group consisted of 25 men and 25 women with chronic kidney disease receiving hemodialysis therapy. The Hamilton Depression Inventory was used for diagnosis. The prevalence of depression in the study population was 26%. The incidence of depression in women was 12% higher than in men. With increasing age, the level of depression in men went up. Suicidal behavior was observed 4% more often in the group of men than in women.

Affective disorders such as depression and anxiety occur in a significant proportion of patients with chronic kidney disease, especially those who receive programmed hemodialysis therapy. According to epidemiological studies, depression is detected from 20 to 40% in patients on hemodialysis, and the level of anxiety disorders reaches from 25 to 50%. Treatment of affective disorders in patients with chronic kidney disease is complicated by changes in the pharmacokinetics and pharmacodynamics of drugs. In patients receiving hemodialysis treatment, the glomerular filtration rate is reduced, which affects the excretion of drugs and requires dosage adjustments, especially when using antidepressants and anxiolytics. In this regard, the issue of choosing safe and effective psychopharmacotherapy regimens remains extremely relevant in the treatment of depressive and anxiety disorders in patients with chronic kidney disease. The purpose of the review: to analyze the effectiveness and safety of psychopharmacotherapy of affective disorders in patients with chronic kidney disease receiving programmed hemodialysis therapy, as well as to provide modern treatment regimens taking into account the specifics of metabolism and drug excretion in this category of patients.