Depression belongs to the diseases with pronounced medical and social consequences, which include disability, reduced social functioning and suicides. There is the evidence that the depressive manifestations are closely related to disorders of circadian periodism and the function of the suprachiasmatic nuclei of the hypothalamus, the leading driver of biological rhythms. Authors reviewed the possibility to apply the concept of biological rhythms to the development and clinical features of depressive disorder. The potential effects of chronobiotic drugs like melatonin agonists is discussed.

Therapy with medicinal herbs in the complex of therapeutic actions for insomnia occupies a special place. The main advantage of phytotherapy of sleep disorders is their high therapeutic efficacy in the absence of side effects, except in cases of individual sensitivity to individual components of the drug. Unlike synthetic drugs, drugs, which are based on vegetable raw materials, have a rapid effect on the extracellular and intracellular metabolic processes. Therefore, the therapeutic effect of medicinal plants is persistent and prolonged. The method of phytotherapy is an alternative and highly effective method of treatment of insomnia, and it should not reject, but significantly complement other methods of modern medicine.

The article presents a review of the literature where, starting with the publication of Ekbom K. (1947), the history of the allocation of cluster headache into a separate form of primary head pain is described, modern diagnostic criteria are presented, the pathogenesis, clinical features of the disease are described. It is shown that due to the rarity of this type of headache and low awareness of doctors, the delay in diagnosis is on average 6–7 years. Patients are prescribed a lot of unnecessary examinations and expert consultations: oculists, ENT doctors, neurosurgeons, psychiatrists, etc. Favorite incorrect diagnoses are migraine and trigeminal neuralgia. The evidence of the leading role of the hypothalamus in the pathogenesis of cluster headache is presented. The principles of therapy are discussed: for the relief of acute attacks, triptans are used as in migraine, the leader of prophylactic therapy is a calcium channel blocker verapamil. In chronic forms and attacks resistant to pharmacological treatment, neurostimulation methods are used.

The subject of the article is defined by the relevance and recognition of the importance of early diagnosis of different cognitive and emotional disturbances in patients with multiple sclerosis. This allows appropriate treatment and improve the prognosis of the disease. The article presents a review of the pathogenesis and new theories about cognitive impairment in patients with different forms of multiple sclerosis. The author proposes a holistic treatment where treatment integral includes not only of multiple sclerosis, but also an approach that includes treatment of all pathologies present in the patient, the family, society and the health system.

The article is devoted to the study of postoperative cognitive dysfunction — a syndrome that is often found in the postoperative period and does not depend on the volume of surgeon. Based on the analysis of the results of modern studies, the authors cite the most likely etiological causes of the syndrome, grouped according to different categories of risk factors. The pathogenetic algorithm for cognitive dysfunction includes the appearance of systemic inflammation, improving blood-brain barrier permeability with the endothelial dysfunction, the migration of inflammatory agents into the central nervous system, and the formation of oxidative stress. The clinical manifestations of cognitive deficit in the outcome of surgeon performed under general anesthesia, the authors illustrate with their own observations of patients with a neurosurgical profile with spinal pathology operated on with the use of propofol anesthesia, comparing the results of neuropsychological testing with an assessment of the level of anxiety. In conclusion, the authors outline a strategy for the prevention of postoperative cognitive dysfunction and recommend conducting neuropsychological rehabilitation as an important component of postoperative recovery for all patients with a diagnosed cognitive deficit that occurred after surgery.

The dizziness is a multidiscipline problem in management of neurologists, ototrhinolaryngologists, general practicioners. The first clinical goal seems to be the differentiation between central and peripherial vestibular syndrome. After that doctor should search the nosological form. It may become the challenge if the disease is rare. In such cases it is impossible to limit the therapy with vestibular rehabilitation with usement of the vertigolitic drugs. Accordingly to nososlogical form surgical methods, anticonvulsants, glucocorticoids or cytostatics may be needful.

In the pharmacotherapy of chronic alcoholism a significant place is given to nootropic drugs. Currently, neurodegenerative processes are associated with the activity of various neurotrophic factors of the brain and neuropeptides. An important advantage of the use of neuropeptide drugs (cerebrolysin, semax, cortexin) in the treatment of chronic alcoholism is that they have an organ-specific multimodal effect on the brain: provide metabolic regulation, neuroprotection, functional neuromodulation and neurotrophic activity. They are recommended for relief of acute withdrawal syndrome, as well as in the post-abstinent period in asthenic syndrome and restoration of mnestic functions.

Objective. To assess anxiety-depressive disorders and indicators of quality of life in elderly women.

Materials and methods. The study included 540 women with hormonal disorders in the form of a premenopausal or menopausal syndrome: 270 women, aged 44–54 years (mean age 49.1 ± 2.2), of whom 150 women with ‘–’ and 120 with ‘+’ variant of the biological age and 270 women aged 55–64 years (mean age 57.2 ± 2.4), of which 150 with ‘–‘ and 120 people with ‘+’ version of biological age. All patients, depending on the proposed variant of nutritional support and physical activity, were divided into three groups: the 1st (standard recommendations), the 2nd (standard recommendations, scandinavian walking and daily walks for at least 30 minutes), the 3rd (standard recommendations, scandinavian walking, daily walks for at least 30 minutes and nutritional support). Assessment of the degree of depression was carried out on the basis of the Beck scale. The quality of life was determined by the SF-36 Health Status Survey, a visual analogue scale for assessing the anxiety-depressive syndrome.

Results. On the scale of assessing the level of depression, the level of anxiety-depressive syndrome in women, data were obtained on a reliable improvement of this indicator with the use of nutritional support and physical activity. The maximum difference was noted in older persons with ‘–‘ and ‘+’ variant of biological age. On the scale of assessing the level of psychological health in women, we obtained data on improving this indicator with nutritional support and physical activity, but a significant difference was found only in comparison with patients who received neither nutritional support nor physical activity.

Conclusion. The use of nutritional support and physical activity in elderly women improves the parameters of quality of life, especially in terms of general health, depression and social functioning.