The management of patients with chronic musculoskeletal pain is an important biomedical problem due to the prevalence of this pathology and its resistance to therapeutic interventions. Psychosocial factors play a significant role in the formation and maintenance of chronic pain. In this regard, psychotherapeutic assistance is very important in the management of patients with chronic pain within the framework of multidisciplinary treatment. This review discusses the main psychotherapeutic approaches that have been used for chronic musculoskeletal pain: cognitive behavioral therapy, mindfulness therapy, psychoanalysis, hypnosis. General information about the essence of the discussed methods and the evidence base for their use in chronic pain are presented. A significant effectiveness of cognitive-behavioral therapy and techniques based on mindfulness therapy has been demonstrated.

To evaluate the effectiveness of low doses (25-75 mg/day) of quetiapine (Seroquel) in patients with bipolar affective disorders in a euthymic state with signs of impaired impulse control. The main criteria for patients' selection were as follows: both sex, diagnoses of bipolar affective disorders, remission (euthymic state), adult age (from 18 to 60 years old), stable basic therapy. The duration of the study was 6 weeks, a dose of quetiapine (Seroquel) varied from 25 to 75 mg. The examinations were carried out with the Barratt scale, computerized Go-No-Go and Balloon tests. The study group included 32 patients (11 men and 21 women), mean age 31.2±9.7 years (minimum 18, maximum 60 years). The changes in Barratt total score (p=0.000014, Wilcoxon test, effect size 0.48) and Balloon total earnings (p=0.03, Wilcoxon test, effect size 0.22) were statistically significant and reflected clinically significant improvement. The changes of the indices of the Go-No-Go test were not significant. The data of fMRI showed an increase in the connectivity of the cortex of the central and parietal tegmentum of the left hemisphere with other areas of the brain, which correlated with the changes in psychometric and test parameters. The results of the study showed that add-on of the low doses of quetiapine (Seroquel) significantly decreases impaired impulse control in remitted patients with bipolar affective disorders both in self-evaluation and in risk-taking experimental test. The drop of high level of impulsivity can improve the quality and stability of remission and reduce behavioral risks due to impaired impulse control.

Background: It is estimated that at least 25-30% of cancer patients experience mental disorders. Due to the high prevalence of these disorders among this patient population, psychotropic drugs have been successfully utilized in oncology for an extended period of time. The use of psychotropic drugs enables targeted symptom management to improve the quality of life of cancer patients. However, it is essential to carefully evaluate the risks of drug interactions and potential side effects when prescribing any psychotropic medication. The aim of the study: The aim of this study was to analyze the utilization of psychopharmacotherapy in oncology practice for treating comorbid mental disorders and symptoms related to oncological diseases. An evaluation of the side effects and drug interactions of psychopharmacological and oncological drugs was conducted. Materials and methods: The eLibrary, PubMed, and Google Scholar databases were searched using the keywords “psychooncology” and “psychopharmacotherapy”. Reviews, meta-analyses, and therapy recommendations were selected from the obtained results, which provided the most comprehensive coverage of the current scientific data on this topic. Results: Anxiety disorders and depressive reactions are prevalent in cancer patients and can be successfully treated with psychopharmacological intervention. Additionally, symptoms associated with the oncological process or side effects of treatment such as anorexia, pain, and nausea can be alleviated through the use of antidepressants and antipsychotics. However, it is crucial to carefully evaluate the risks of drug interactions when prescribing any psychotropic drugs. For instance, strong cytochrome CYP2D6 inhibitors can lead to a decrease in the concentration of the active metabolite tamoxifen, while the combination of antidepressants and tramadol increases the risk of serotonin syndrome. Conclusion: The application of psychotropic drugs in the treatment of cancer can greatly enhance the patients' quality of life. However, potential side effects and drug interactions must be carefully evaluated.

INTRODUCTION. The success of incretin receptor agonists has changed the standard of obesity pharmacotherapy and has stimulated both the development of incremental innovations based on existing medicinal products and the search for substances with fundamentally new mechanisms of action. Given the rapid diversification of the development portfolio, its systematic monitoring is required to forecast therapeutic horizons and to prepare the healthcare system in advance for the introduction of new approaches. A IM. To perform a comprehensive analysis of the active portfolio of clinical developments in obesity pharmacotherapy in terms of the distribution across clinical trial phases, the types of molecular targets, the assessment of comorbidity outcomes, and the completeness of pharmacological profile disclosure. MATERIALS AND METHODS. Data from the ClinicalTrials.gov registry were analyzed. Of 726 records of the active development portfolio, 475 active interventional studies of anti-obesity medicinal products covering 210 active substances were selected. RESULTS. The study revealed a structural asymmetry of the portfolio: radical innovations accounted for 7.6% (16 substances) and incremental innovations for 21.0% (44), while the mechanism of action of 44.8% (94) was not disclosed. A translational barrier was identified: non-incretin medicinal products had not passed beyond phase II of clinical trials, whereas phases III–IV were dominated by agonists of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptors, as well as by amylin analogues. Radical targets address the loss of muscle mass (activin type II receptor inhibitors) and the recurrence of obesity, as well as modulation of independent axes of body weight regulation: the central axis (a monoamine oxidase B inhibitor), the endocannabinoid axis, and the hepatic axis (RNA interference targeting the INHBE gene). Incremental innovations are represented by monoand multiagonists of the GLP-1, GIP, and glucagon receptors, as well as by amylin and GLP-1 co-agonists. A paradigm shift was observed: in 18.7% (89) of the studies, comorbidity outcomes served as the primary endpoint (cardiovascular outcomes, 25.8%; carbohydrate metabolism outcomes, 24.7%). The leading sponsors of late-phase developments were Eli Lilly and Novo Nordisk (90 studies). More than half of the studies (245) were concentrated in the United States. The Chinese segment (117 studies) focused on scaling up validated approaches without creating fundamentally new targets; at the same time, 26 of the 94 substances with an undisclosed mechanism of action (27.7%) are being developed under the lead sponsorship of Chinese organizations. CONCLUSIONS. The identified translational barrier determines the medium-term prospects of obesity pharmacotherapy: in the coming years, the clinical armamentarium will be expanded primarily with multiagonists of the incretin axis and amylin analogues, whereas the need for medicinal products that preserve muscle mass and prevent obesity recurrence will remain unmet. The shift of focus toward comorbidity outcomes (the concept of obesity as a multisystem disease) requires the healthcare system to prepare for the integration of multi-target medicinal products into the standards of care for cardiovascular and metabolic complications. The high proportion of candidates with an undisclosed mechanism of action hampers comprehensive horizon scanning and strategic planning.