Importance of current research is determined by the need to find the clinical and functional evaluation criteria for the systemic patterns of changes in physiological reactivity of the patient at various stages depression treatment.

Optimization of diagnostics and planning of treatment of patients with depression based on analysis psychopathological state and autonomic reactivity during active treatment using SSRI antidepressants.

System analyze of clinical-psychopathological characteristics and autonomic reactivity of major depression. Main group included 62 patients with the diagnosis of depressive episode. Control group: 64 healthy persons.

Clinico- psychopathological, clinico- anamnestic, Hamilton Depression Rating Scale (HDRS-17), the analysis of heart rate variability for investigation of autonomic regulation.

Results of the depressive patients autonomic regulation study show the reduction of total heart rate variability is observed at rest and in orthostatic test. The balance of sympathetic, parasympathetic and suprasegmental parts of autonomic nervous system was preserved at rest in depression. However after orthostatic test the activity of sympathetic baroreflex mechanisms is decreased and the hyperactivation of suprasegmental ergotropic systems is revealed. During the 4–6-weeks treatment the positive dynamics of psychopathological characteristics is observed but the changes of autonomic reactivity are not revealed. After 6-months therapy only 30, 6% of patients demonstrate signs of normalisation of autonomic regulation.

Obtained data, apparently, attest to the fact that the emotional and autonomic symptoms are restored with different speed. The results of study should be used in the planning of treatment in the psychiatric practice and in the primary medical care.