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Abstract
The article presents the detailed analysis of literature concerning ademetionine physiological role in biochemical processes. There was conducted pathophysiological substantiation of Heptral appropriateness in treatment of liver cholestatic diseases, alcoholic liver disease, nonalcoholic fatty liver disease, liver drug injuries, viral hepatitis. There was described antidepressant properties of Heptral® and its significance in different psychic pathology as well. Pathophysiological and experimental data were illustrated with results of clinical trials, which justify effectiveness of the preparation in treatment of liver diseases, depression, abstinent syndrome etc. There were cited trial results regarding Heptral® safety and prospects of its use in the clinical practice. The data of experimental and clinical studies demonstrating anti-inflammatory, antifibrotic, cytoprotective, antiviral activity are presented. The results of a recently presented systematic review are considered, which proved the ability of ademetionine, regardless of the route of administration (parenteral or enteral), to effectively offset the manifestations of fatigue caused by various liver diseases, both in the short and long term. It has been proved that the antidepressant effect of ademetionine is comparable to the efficacy of monotherapy with imipramine or escitalopram; combined administration of ademetionine and probiotic strains for three months improves the quality of life of patients with subclinical, mild and moderate depression who are not sensitive to or cannot tolerate antidepressants. Special attention is paid to the antioxidant activity of ademetionine, which allows its use in neoplastic pathology as an adjuvant agent in glioblastoma, colorectal cancer, prostate cancer, multiple myeloma. It was proved that ademetionine reduces fatigue in patients with colorectal cancer against the background of chemotherapy regimens based on the use of oxaliplatin.
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