Latest generation antidepressants. Antidepressants: Which Are Better? Reviews of doctors, prices

Not everyone knows that depression is not just a bad condition of a person, it is a disease.

Depression does not go away without treatment. If you do not take care of your health, various accompanying psychological disordersand a bad mood turns into a way of life.

With depression, the patient's mood changes, but the disease affects overall health, behavior and thoughts. Since any medical drugs, which are designed to fight this disease, affect the entire nervous system, only the attending physician can choose an effective and safe drug that will not harm and at the same time will have the maximum positive effect.

In the case of severe depression, psychologists and neurologists all over the world almost always prescribe in combination general therapy antidepressants of the new generation. In comparison with other types of antidepressants, they can be used in almost all patients (with special reservations, even for children and pregnant women), side effects these medicines are practically absent.

In addition, new generation antidepressants have a double effect, not only serotonin is inhibited, but also norepinephrine. Thus, this type of drug is suitable for all cases of depression. Including for a chronic type of disease.

Features of the group drugs

Since antidepressants act on the nervous system, there are a number of important features. For example, any drug from this group should never be discontinued immediately.

The dose should be gradually reduced. This will avoid relapses of the disease. We must not forget about the seriousness of depression. When prescribing antidepressants to patients, you should constantly monitor them during the first weeks of using the drug - this is done in order to avoid suicide attempts.

Practical research

These medications performed well in a clinical trial in Holland. In order to assess as objectively as possible, it is worth excluding the placebo effect, especially this type of new generation antidepressants, such as in vitro. A placebo is a change in the state of the body with the help of self-hypnosis, in which case it is in no way explained by the effect of any biochemical drugs.

A drug such as Fluoxetine has shown itself very well, it acts without any side effects, but its effectiveness is somewhat weaker than that of other modern antidepressants of the new generation.

In the case of using several antidepressants at the same time, the most effective means will be Escitalopram and Mirtazapine, as well as the same Fluoxetine. When only Sertraline was used, the effect was lower compared to the combined course of treatment.

A new generation antidepressant such as Effexor, or, in other words, Venlafaxine, has also been investigated. It blocks all serotonin receptors, but we must not forget that, if the dose is increased, the reuptake of a substance such as norepinephrine will be blocked.

There is another remedy with a non-standard principle of action - Remeron, which stimulates the production of histamine. Also, this drug helps to overcome insomnia. However, do not forget that this drug has its own side effects, like all other antidepressants.

The best new generation antidepressants

In the Netherlands, a study was conducted that compared the new generation of antidepressants. For comparison, factors such as treatment efficacy, side effects and patient tolerance to drugs were used. More than 25 thousand people who suffered from depression took part in this study.

Based on the data obtained, reviews and analysis of open information, we have compiled the following list, which includes only the best modern antidepressants of the new generation, almost all of which are without side effects:

1. Sertraline. The drug has a very good degree of effectiveness and a low price. But don't forget about the side effects. And this is drowsiness, pain in the head area, ataxia, aggressiveness, anxiety, dry mouth, decreased appetite and others.
2. Paxil. A fairly well-known antidepressant that is prescribed by a large number of doctors. It should not be used in combination with Thioridazine and MAO inhibitors.
3. Escitalopram. The drug has high level effectiveness and excellent tolerance in people over 18 years of age. Children should choose another drug.
4. Citalopram, an antidepressant, has shown good tolerance, and also has quite a few contraindications, including too much sensitivity to the substance or taking it in conjunction with MAO inhibitors.
5. Bupropion is well tolerated, but for some, price is a factor. The monetary value of the drug is quite high and the effectiveness is rather average. For this reason, it is better to turn your attention to other medicines.
6. Fluvoxamine. The drug has a fairly good level of effectiveness and is well tolerated. Side effects worth noting pain around the head, infection respiratory tract, decreased libido and others.
7. Milnacipram. The drug is in the middle of the list and is somewhere in between in all indicators. During pregnancy, you should refrain from undergoing treatment with this drug.
8. Fluoxetine has a low level of effectiveness, but there are practically no side effects. Even pregnant women can use this drug, but when undergoing a course of treatment, it is worth refusing to breastfeed.
9. Mirtazapine. The drug also showed a very high level of efficacy, but more than 15% of the subjects interrupted treatment due to increased appetite, confusion, strange dreams, asthenia and other side effects.
10. Insidon. Most often it is prescribed for outpatient treatment... It has anti-vomiting and anti-seizure effects, and is also an anesthetic.
11. Venlafaxine, an antidepressant, has shown excellent efficacy, but many side effects have been reported. Almost every 5 people who took it had side effects. Among them is insomnia, increased sleepiness, asthenia, nausea and others.
12. Paroxetine, like Fluoxetine, is not highly effective. There may also be side effects such as urticaria, myalgia, nausea and vomiting, and sweating. The drug is poorly tolerated.
13. Duloxetine. It has middle degree effectiveness and side effects quite often appear, so it is better to turn your attention to other antidepressants.
14. Agomelatine. Not so long ago, an antidepressant appeared that proved to be excellent. However, it is not recommended for use by children or lactose intolerant patients. If mania develops, the drug should be discontinued.
15. Closing the list is Reboxetine. Poor tolerance and low effectiveness suggest that this is far from the best medicine for depression.

Voice of the people

Reviews of people who have undergone treatment with new generation antidepressants.

I was using Reboxetine a few weeks ago. I had panic attacks. I have no side effects. This was my first time taking antidepressants.

The five most effective antidepressants

Antidepressants are needed to stabilize mood and relieve symptoms of depression. They quickly affect the patient's nervous system and are often combined with various medications. Before using any of these drugs, you should consult your doctor. Only he will accurately find out the cause of the psychological problem, help you choose the right medications, determine the duration of the required treatment and the correct dose. Drugs that do not have a strong effect are dispensed in a pharmacy without a doctor's certificate, but when prescribing potent antidepressants (monoamine oxidase inhibitors), the doctor writes a prescription.

Paxil

The drug relieves depression of various types and degrees of severity, eliminates anxiety.

1. Indications. Paxil helps during panic attacks, agoraphobia, nightmares. It is used during stress disorders in the post-traumatic period.

The price of a Paxil package for 30 tablets in Russia is about 700 rubles, and in Ukraine you will have to pay almost 500 UAH for the same.

Mianserin

Mianserin belongs to the group of psychoactive drugs. The drug has an antiemetic effect and awakens the appetite.

1. Indications. Various mental disorders, feeling of constant anxiety, deep depression.

There are 20 tablets in one pack of Mianserin. Their cost in Russia is around 1000 rubles, and in Ukraine the price is 250–400 UAH.

Mirtazapine

The drug Mirtazapine is sold in the form of oval-shaped convex tablets, with a special film coated on top. They are yellow-brown in color.

1. Indications. Prescribed by a doctor during a period of depression with noticeable lethargy, weight loss, insomnia, and suicidal thoughts.

The cost of a pack of Mirtazapine (30 mg / 20 pcs.) In Russian pharmacies is about 2100-2300 rubles. In Ukraine, the price will be 400-500 UAH.

Azafen

Azafen is a fairly common remedy that is also prescribed as a sedative.

1. Indications. Discharged by a doctor for depression of various types: alcoholic, senile, exogenous. Heals feelings of heightened anxiety and deep stress.

Azafen in a package of 50 tablets (25 mg) is available in any pharmacy in Russia for 180-200 rubles, in Ukraine similar drug costs about 250 UAH.

Amitriptyline

One of the most potent antidepressants is undoubtedly Amitriptyline, which has a characteristic sedative effect.

1. Indications. The drug should be used strictly according to the doctor's prescription during depression. Amitriptyline helps with acute feelings of anxiety.

The price of Amitriptyline (25 mg, 50 tablets) in Russian pharmacies fluctuates around 25-30 rubles. Ukrainian pharmacies sell similar packaging for UAH 15-17.

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Complete List of Non-Prescription Antidepressants

An antidepressant is a drug that affects the production of serotonin and norepinephrine and affects / regulates a person's mood. In most cases, they are drugs, but we will analyze those that:

• widely available;
• do not require a doctor's prescription;
• natural, unnatural, safe and not so good.

Immediately, we note that we will not touch on powerful pharmaceutical preparations, because they have a huge number of side effects, and taking them will turn out "we treat one thing, we cripple the other."

What is responsible for the presence or absence of depression

Serotonin is a substance that is responsible for a person's mood. It is located in the brain, gastrointestinal tract, hemocytes. However, modern stresses lead to a decrease in its level, respectively, it is necessary to increase it in every possible way.

A lack of serotonin leads to the following disorders: bad dream, bad mood, appetite disturbances (constant need for sweet and simple carbohydrates), depression, headaches, muscle and other pains.

Signs of a lack of serotonin: depression, obesity, bulimia, insomnia, narcolepsy, sleep apnea, headaches, migraines, fibromyalgia, premenstrual syndrome.

What antidepressants can be bought without a prescription

It is a tetracyclic antidepressant that helps relieve apathy, anxiety and improve mood. Possible weak effect when taken.

Side effects - convulsions, especially in case of overdose.

Prozac (done, fluoxetine, fluval, profluzac)

Selective serotonin inhibitor. It is widely used by doctors. Helps relieve panic, anxiety, obsessive thoughts, premenstrual disorders.

Side effects range from headaches and pressure problems to sexual dysfunction. Withdrawal syndrome is possible.

Bioavailability - up to 70%. The composition is unnatural.

Zyban (Bupropion, Nousmok, Wellbutrin)

Action - selective inhibition reverse capture norepinephrine and dopamine. Helps with the abolition of various addictions: nicotine, narcotic. Removes lethargy, fatigue, hypersomnia.

Side effects ¬– hypertension, seizures, nausea, insomnia, tinnitus.

Bioavailability - up to 20%. The composition is unnatural.

Paxil (paroxetine, adepress, plizil, rexetin, sirestill, plizil)

Action - a selective serotonin reuptake inhibitor. Helps get rid of depression, anxiety, phobias, panic attacks, nightmares.

Side effects - a wide list that affects following systems organism: central nervous system, vegetative, cardiovascular, lymphatic, endocrine, genitourinary, respiratory, gastrointestinal tract. Overdose can lead to coma.

Bioavailability is 100%. The composition is unnatural.

Has a sedative effect. Helps get rid of depression, improve sleep, improve mood, increase physical and mental activity.

Side effects - allergies, nausea, vomiting, constipation, lethargy, fatigue, drowsiness.

Has a sedative effect. Helps to reduce nervous tension, depression, improve mood.

Side effects - allergies, constipation.

Bioavailability has not been studied. Composition - semi-natural.

Has a sedative effect. Helps to improve mood, reduce anxiety, reduce nervous tension, depression.

Side effects - allergies, nausea, heaviness in the stomach, heartburn, diarrhea, constipation, weakness, joint pain, drowsiness, depression, dizziness.

Bioavailability has not been studied. Composition - semi-natural.

The most effective and safest antidepressant

5 Hydroxytryptophan (5 HTP) is a natural amino acid that is converted into serotonin in the body. This occurs when the amino acid Decarboxylase is exposed to aromatic L-amino acids.

To get 5 hydroxytryptophan, the body must get tryptophan, which is quite energy-intensive and some people have problems synthesizing it. And taking 5 HTP, you eliminate one link in the metabolism and actually give the body a blank, from which it easily makes serotonin.

Helps relieve depression, headaches, improve sleep, improve mood, reduce anxiety, normalize appetite.

Side effects - allergies, nausea, diarrhea.

Bioavailability has not been studied. Composition - natural.

Herbal antidepressants

It is possible to buy other natural antidepressants, which are sold at the pharmacy. Usually these are various herbal infusions or their collections, which must be brewed and drunk. From side effects you can get - no positive effect, allergies, nausea, diarrhea.

Tinctures - the root of maral, Rhodiola rosea, immortal, lemongrass, leuzea, ginseng, meadow clover, blue honeysuckle, oregano, motherwort. Improve mood, resistance to stress, increase efficiency, stimulate psychomotor functions, reduce or eliminate depression.

Please note that tinctures in most cases are based on alcohol, which negatively affects the body.

Herbs and their combinations - zamaniha, oregano, chamomile, dill, caraway seeds, valerian, peppermint, hops, hawthorn, angelica, calendula. They help with seasonal depression, insomnia, improve sleep, efficiency, reduce fatigue, stress, depression.

Precautions

Unfortunately, in our country it is customary for any health problem to immediately run to the pharmacy without visiting a doctor. Of course, it can be attributed to the fact that the doctor may be incompetent or indifferent to his patients.

In addition, statistics show that most people who buy antidepressants on their own do not suffer from depression or mental problems... They just need a good rest.

However, there are qualified professionals who can help without the use of pharmaceuticals or medicinal plants. Therefore, we recommend that you first see a doctor, psychiatrist, and only then go to the pharmacy.

Thus, the possible side effects of the pharmaceutical product will be taken into account. Since some of them form addiction and dependence.

Best New Generation Strong Antidepressants, Non-Prescription Drug List

Stress and depression have so "captured" modern humanity that many people use antidepressants as food or dessert. However, few people know what are the best and most powerful antidepressants available without a prescription from a psychotherapist, what effect they have on the psyche and brain biochemistry, as well as what side effects different antidepressants have.

Safe strong antidepressants - names

Any strong antidepressants, including the so-called "safe" ones, are drugs (essentially psychotropics) that mainly affect the levels of serotonin, dopamine, and norepinephrine (neurotransmitters) in the biochemistry of the brain in depressive and stressful disorders.

It is with a decrease in the listed "hormones of joy", often with stress, emotional and mental overstrain, psychotrauma, etc. the person may experience depression. Strong, safe antidepressants help to improve mood, remove sadness, anxiety, anxiety and irritability, they improve sleep phases and make a person more efficient.

Antidepressants have different names, more often they are trademarks behind which a common denominator may be hidden international name one or another antidepressant drug.

The best antidepressants - a list of new generation drugs

Many of the best new generation antidepressants are available without a prescription and are mainly composed of various herbs and other natural substances. However, this does not mean at all that they are completely safe and can really save a person from depression once and for all.

Antidepressants - a list of new generation drugs:

Natural, herbal antidepressants

Basic natural herbal antidepressants:

Tricyclic antidepressants

Tricyclic antidepressants - list of drugs:

What is better than taking antidepressants? Psychotherapy and psycho-training

Even the best and safest antidepressants in one way or another have side effects, moreover, they do not cure the disease itself, do not remove the source of depression or stress, but only relieve the symptoms, improving the emotional mental condition person.

After stopping antidepressant medication, "withdrawal syndrome" may occur and depression may return in an even more severe form soon.

Antidepressants should be taken only in crisis situations, and when the condition improves, resort to non-drug psychotherapy and psychological training. Only in this case is it possible to get rid of the very source of depression and carry out antidepressant prophylaxis for the future.

Be sure to check out the psychotherapist's journal for helpful articles and advice. Discuss your psychological problems in a psychological club

Review of popular modern antidepressants

Effective modern dual-acting antidepressants are free from some of the side effects of previous analogues. Their use gives a positive result in 2-3 weeks. Due to different side effects it is difficult to choose one effective remedy from the group of antidepressants. Consider the most popular new antidepressants that are prescribed in our country. Let's compare them with analogs used in Europe.

New antidepressants popular in Europe and Russia

New antidepressants of the new generation SSRIs group are prescribed for depressive conditions. The effectiveness of their use depends on the strength and proportionality in the selective inhibition of the norepinephrine and serotonin receptors. The ability to block the release of both substances eliminates the need to use several drugs for pathology with impaired metabolism of both mediators. The most popular antidepressants in Russia are fluoxetine, venlafaxine, milnacipral, deloxetine.

Attention! The drugs are sold in the pharmacy only with a doctor's prescription.

Venlafaxine

A fairly strong drug with a narcotic side effect arising from a pronounced blockade of norepinephrine secretion in nerve synapses. It is prescribed for schizophrenia and others mental disordersah, accompanied by depressive states.

Fluoxetine ("Portal")

For milder depressive disorders, it is better to replace venlafaxine with fluoxetine. Its effect is associated with a decrease in the uptake of serotonin, which forms a softer action. The drug is used all over the world for depressive disorders, bulimia nervosa, but other new generation antidepressants are preferable to it.

The drug was widely used due to the lack of effect on the exchange of other mediators, except for norepinephrine and serotonin. The stimulating and weak sedative activity of fluoxetine made it possible to use it in the outpatient clinical practice of a physician.

Regardless of the time of administration, the medicine is well absorbed. Its half-life is 1-3 days. The duration of action up to 15 days, which is described in the annotation to the agent, is due to its active metabolite, norfluxetin. Fluoxetine is produced under the name "portal" by the firm "LEK". 20 mg of fluoxetine contains a portal capsule. The standard dose of an antidepressant for fears and phobias is 1 capsule per day.

Clinical studies have shown that the "portal" is particularly effective in the treatment of depression of various origins. Modern antidepressants such as portal are used to treat patients with compulsive-obsessional disorders in old age.

"Portal" is well tolerated by patients. Side effects are either mild or absent. In any case, when identifying negative effects when using the drug, it should not be canceled, but only corrective therapy for the disorders should be carried out. Contraindication to the appointment is hypersensitivity to MAOIs and fluoxetine.

Sertraline

A new generation antidepressant with the most pronounced effect. It is the "gold standard" in the treatment of anxiety and depression. Maximum effectiveness is observed with bulimia nervosa (lack of appetite). The dose is mg per day.

Paxil

It has anxiolytic and thymoanaleptic effect. It is used for inhibited and melancholy depressions, relieves suicidal thoughts and treats personality disorders. Anxiety conditions quickly disappear with a daily dose of drugs. In some cases, doctors increase the dosage to 80 mg.

Insidon (opipramol)

An antidepressant with antiemetic, hypothermic and anticonvulsant effects. Antiserotonin, analgesic and antihistamine activity is manifested. Insidon is used to stabilize the active background. In the first days of using the drug, a pronounced tranquilizing effect is observed.

Additionally, opipramol is used to stabilize the autonomic system with dyskinesias of the genitourinary organs, intestines, heart pain, vegetative-vascular dystonia (VVD). Due to the above effects, antidepressants of the opipramol group are considered “psychosomatic hormone agents”.

They are used on an outpatient basis and in hospitals for myocardial infarction, treatment of diseases internal organs, bronchial asthma, angina pectoris, increased blood pressure. The therapeutic dose is mg per day.

Clinical trials of new generation antidepressants

New generation antidepressants have proven themselves well in clinical trials conducted in Holland. When determining the effectiveness of drugs in vitro to assess their positive and negative sides the placebo effect must be excluded. It means a psychological state of improvement, which is not justified by biochemical action. drug.

Sertraline is the "gold standard" against which the effects of other antidepressants are compared.

Clinical studies in Holland reveal some interesting features modern drugs for the treatment of depressive conditions. So in 42 independent studies, the superiority in terms of the therapeutic effect was confirmed:

• Citalopram over reboxetine,
• Fluoxetine over fluvoxamine,
• Reboxetine over Paroxetine,
• Escitalopram on citalopram,
• Mirtazopine on fluoxetine,
• Sertraline over fluoxetine.

By tolerance, fluoxetine is noticeably released, which acts "gently", but also healing effect it is weaker than other analogues.

Group combination therapy is more effective with mirtazapine, escitalopram, venflaxine and sertraline over fluvoskamine, fluoxetine and duloxetine. When using sertraline alone, the therapeutic effect is slightly lower than with combined therapy with vanlafaxine, mirtazapine and escitalopram.

Some modern antidepressants of the new generation have a pronounced effect on the metabolic systems of serotonin and norepinephrine in nerve cells. This mechanism of action allows them to be used in the treatment of chronic forms of the disease.

For example, venlafaxine (Effexor) is a selective serotonin receptor blocker, but blocks the reuptake of norepinephrine when the dosage is increased.

Remeron (mirtazapine) is a tetracyclic antidepressant with a special mechanism of action. It increases histamine levels by affecting postsynaptic serotonin metabolism. The drug is prescribed at bedtime for insomnia. This approach is explained by an increase in the concentration of histamine, which leads to drowsiness. However, mirtazapine also increases the level of norepinephrine, therefore, in addition to the sedative effect, it has side effects, like other antidepressants.

Ukrainian antidepressant is actively discussed in the press last generation Miaser. The manufacturer claims that it does not form addiction, but in clinical practice there is a state of drowsiness, unsteadiness of gait in patients to whom it is prescribed for 2 weeks.

Results from Dutch studies have confirmed that reboxetine has the weakest effect of all the antidepressants discussed above.

The experiments were carried out in a sample of 66 people in the treatment of depressive conditions. The drug is not registered in the Netherlands, as it shows minimal effectiveness in the treatment of mental disorders.

The latest generation antidepressants prescribed in Russia (paroxetine and fluosetine) are not on the list of first-choice drugs in European countries.

Nodepress is considered to be one of the best remedies when highly effective antidepressants are required. It meets all international requirements that apply to this group of drugs. Nodepress has a wide variety of uses. It has no sedative effect, does not cause drowsiness and lethargy. No addiction is formed to the drug. Compatible with other medicines.

Valdoxan is used primarily to normalize sleep. His active substance - agomelatine accelerates the release of dopamine in the prefrontal cortex, but does not affect serotonin levels. Agomelatine restores the normal structure of sleep, and also reduces the temperature caused by the instability of neurological processes.

The indications for the use of Valdoxan are anxiety disorders (\u003e 25 on the Hamilton scale). The dosage of the drug is 25 mg once a day. The lack of clinical dynamics allows the doctor to increase the dose to 50 mg without fear of side effects. Throughout the entire period of treatment with agomelatine, liver function should be monitored, since the course is long (up to 6 months).

In conclusion, we note that modern antidepressants are prescribed for several months. Even after the symptoms of depressive conditions have ceased, they must be taken in reduced doses to avoid a recurrence of the depressed mood.

New generation antidepressants: the right use and drugs without a prescription

Depression, unfortunately, is not just tiredness or blues, as many are used to perceive it, but a serious illness. But the ways to treat it continue to progress.

There have been several generations of antidepressants, the last of which is more effective. We will tell you about the features of their reception in this article.

Popular new generation antidepressants

Modern drugs of this profile are also called fourth-generation antidepressants. The period of the beginning of their development starts from the 90s of the last century. These drugs are combined into a group called SSRIs (Selective Serotonin and Norepinephrine Reuptake Inhibitors).

The most popular remedies in this group are:

The latest generation of drugs have some advantages over the previous drugs for depression.

1. The number of side effects has decreased.
2. The result of the action appears faster.
3. The risk of addiction has been significantly reduced.
4. Compatible with a wide variety of drugs.

Modern antidepressants are divided into two groups according to the principle of their effect on the human psyche:

Clinical studies of antidepressants

Of all the generations of antidepressants, the first generation drugs have long remained the most powerful. Their main disadvantage is the side effects that these drugs can give on the body. Means of the next generations were distinguished by a more gentle effect, but at the same time the treatment process slowed down.

European experts conducted clinical researches antidepressants of the last generation, according to the conclusions of which:

1. The antidepressant sertraline is considered the "gold standard".
2. Moreover, its effect is enhanced when combined with vanlafaxine, mirtazapine and escitalopram.
3. Fluoxetine is very easily absorbed by the body, but its effect weakens.
4. Reboxetine is one of the weakest antidepressants available.
5. One of the most effective drugs is called "Nodepress" (there is no addiction, does not cause "lethargy").
6. To normalize sleep, you need to take drugs containing the substance agomelatine.

But there is no one universal remedy that is ideal for every person. Like other medicines, antidepressants are selected for each organism individually.

When do you need a doctor's prescription for antidepressants?

The drugs that treat depression can be roughly divided into two groups:

• lungs (those that can be purchased without a prescription);
• strong (not available without a prescription).

A person most often needs potent drugs in such cases:

1. Mental illness in the acute stage.
2. Atypical form of the disease.
3. Severe depression.

In such situations, it is necessary to consult a doctor, only he can choose the right drugs for depression and concomitant diseases and their dosage.

In cases where medicine is faced with advanced forms of the disease, potent first-generation antidepressants such as phenelzine or isocarboxazid are prescribed for treatment. Among modern drugs, moclobemide is a worthy competitor to them.

In our similar article, you can find more useful information about antidepressants.

What is special about antidepressants?

Medicines, which we used to call antidepressants, actually successfully fight in the human body not only against the disease that is called "depression".

These funds also accept:

• with pain of an indeterminate nature;
• with sleep disorders, appetite;
• with constant fatigue;
• with anxiety attacks;
• with attention disorders;
• to ease panic attacks;
• with alcohol and drug addiction;
• in case of bulimia nervosa or anorexia.

Correct reception

The most appropriate decision in the event of symptoms of depression should be to see a doctor. In some cases, spontaneous antidepressant treatment can worsen the problem. Prescribing such drugs is based on whether your brain needs sedatives or stimulants.

Some medications may work right away, but in most cases, antidepressant medications will take 2-4 weeks to take effect.

When taking weaker drugs, the symptoms of depression begin to disappear only after 6-8 weeks of using them. In the first few weeks, antidepressants stop the disease, and in the following months they prevent it from recurring.

Only in certain cases prophylactic treatment with such drugs is prescribed for up to several years.

When taking medication for depression, you need to carefully learn about the compatibility of each individual drug with other medications.

For example, the following side effects are known:

1. Antidepressants + antipsychotics, tranquilizers, antidepressants of other groups, oral contraceptives - slowing down the metabolism, increasing side effects.
2. Antidepressants + anticonvulsants, barbiturates - a decrease in the concentration of medicinal substances in the blood.
3. Antidepressants + sympathomimetics, thyroidin - the development of tachycardia.

List of over-the-counter drugs

In addition to serious antidepressants, as mentioned above, there are a number of lightweight drugs. Their action really implies rather not the treatment of a serious mental illness, but the removal of stress and fatigue.

The most popular stimulating antidepressants (and their analogues), which can be easily purchased at a pharmacy, are:

Over-the-counter sedative antidepressants:

Remember that even the seemingly harmless antidepressants can cause side effects.

Conclusion

If you are thinking about going to the pharmacy and purchasing a drug with the loud name of an antidepressant, answer yourself a few questions:

1. Am I really depressed? Perhaps you are simply overworked and do not need serious medication at all. Try drinking valerian and similar sedatives first.
2. What medicines do I need? If you are really overtaken by a psychological illness, you need to find out to what extent strong drugs specifically your nervous system needs. It may happen that by taking too light antidepressants you will only aggravate your illness, and heavy ones will bring unnecessary side effects.
3. What did the doctor say? Self-medication is not the best solution. Experienced specialists will examine you and help you choose the appropriate treatment.

Most importantly, remember - depression is also a disease. And antidepressants are medications, when taking which you need to be careful and follow all instructions.

What antidepressants are most effective?

For people suffering from depression, strong antidepressants can be a real lifesaver. But many questions immediately arise. How to choose best remedy from depression? What dosage will be effective and safe? Do you need a prescription from a doctor? Is not the advertised " best antidepressant"Just a mild cure for common despondency?

But all these questions are very easy to answer. The key is to remember that prescription-only powerful antidepressants are not toys. They are real addictive and can be a serious hazard to your body. If antidepressants are required, which is better in a particular case, only a doctor can tell. When drug treatment for prolonged depression, it is important to know how to choose the right strong, but good and safe drug.

Classification

Antidepressants are medicinal psychotropic substances that help psychotherapists treat different types depression. The emergence of these drugs created a real sensation among psychiatrists, because taking these drugs significantly improved the indicators of patients, significantly reducing the percentage of suicides caused by prolonged depression.

With the development of drugs, a classification appeared. Antidepressants are divided into three groups based on their effect on inhibitory mechanisms: sedative, stimulating, and balanced. They are all divided into 7 more types. Below is a list of groups of antidepressants depending on their effect on the body:

1. Tricyclic drugs. The first drugs to hit the market. They have many side effects (dry mucous membranes, tremors, constipation), which is why they are used less and less in psychiatry.
2. Selective serotonin reuptake inhibitors. This type of antidepressant is considered stronger than lungs and is often sold only by prescription, because if taken uncontrolled, it can cause seizures, crises and other serious health problems. Applies when neurotic disordersah, panic attacks.
3. Selective inhibitors of serotonin and norepinephrine uptake. They are similar to the previous type. Work with depression associated with phobias or obsessive compulsions. They do an excellent job with uncontrolled aggression and neuroticism.
4. Heterocyclic antidepressants. Designed for seniors with mental sleep disorders. Considered mild and relatively safe drugs.
5. Monoamine oxidase inhibitors. Strong antidepressants, divided into reversible and irreversible. They are prescribed for panic attacks, fear of open spaces and psychosomatic manifestations of depression (when a severe psychological condition causes illness).
6. Serotonin reuptake activators. Strong antidepressants of the new generation. Extremely effective and fairly versatile drugs that are addictive, just like opiates. Sold exclusively by prescription.

There are many drugs that help with depression. The main rule when choosing a medicine: do not rely on yourself or friends, it is better to consult a specialist. Only a qualified psychiatrist can choose the most best drug and prescribe the correct dosage. Do not self-medicate, it is dangerous to health!

Features of appointment

Which strong prescription drugs are available and which can be bought at any pharmacy?

The dosage of even the lightest antidepressant can only be prescribed by a doctor.

Even good and expensive pills have side effects from overdose or uncontrolled use, not to mention strong and highly targeted medications.

By far the best anti-depression drug at the moment is a new generation of selective serotonin and norepinephrine reuptake blockers. They are of the highest quality and universal method cures for depression, but only available with a prescription. This type of antidepressant is used for serious disorders, even with suicidal tendencies. Below is a list of similar drugs:

1. Zoloft, Surlift, Stimuloton. The basis of these drugs is the substance sertraline. These drugs are called the "gold standard" for depression treatment and are the most effective and flexible drugs available today. They get rid of obsessive thoughts, anxiety and overeating.
2. Efevelon, Venlaxor, Velaxin. The active substance is venlafaxine. They are prescribed for severe mental disorders, for example, for schizophrenia, combined with depression.
3. Paxil, Reksetin, Sirestill, etc. Paroxetine, contained in these medicines, helps with personality disorders, suicidal tendencies, anxiety. It is also effective against mood changes, longing and suppressed depression.
4. Opipramol. The best choice with alcoholic depression. Among other things, the prevention of seizures and the normalization of the autonomic nervous system makes it an excellent drug against somatisation disorders.

In addition to the above drugs, this group also includes mild drugs like Prozac. They are often sold over the counter, but can be just as dangerous to humans. This group is characterized by dangerous side effects that cannot be neglected. Only an experienced psychiatrist can choose good remedies. Violation of the dosage or duration of admission can be fatal!

Herbal preparations and tranquilizers

Some experts prescribe herbal analogs of antidepressants to patients, assuring that the effect of them is no less strong, but much safer. Such infusions and decoctions can be recommended even in the pharmacy as a useful addition to classic medicines. But no valerian, lemon balm, motherwort or mint are not even mild antidepressants. Taking these drugs instead of the prescribed treatment will only worsen your condition. They produce some calming effect, but there can be no talk of a full-fledged treatment of depression with their help. Only St. John's wort and medicines based on it can have a real effect.

Medications like Novopassit and Persen are also often prescribed in addition to antidepressants. These drugs may indeed be prescribed for mild distress and depressed mood, but they have nothing to do with the treatment of depression.

Tranquilizers are a group of drugs that have a lot in common with those described above. strong medicines, but they are fundamentally different from them in the mode of action and purpose. These are very powerful and extremely dangerous substances that are used in the treatment of severe depression. They easily eliminate fear, emotional stress, anxiety, can lower blood pressure and normalize the heart rate, but very quickly become addictive. This type of antidepressant should never be taken without the supervision of your doctor.

Side effects

Antidepressants are notable for the fact that they have significant side effects if the dosage is incorrect or the course is taken too long. Even mild drugs like Prozac have their limitations. But if in the case of them a person runs the risk of getting only a headache, then strong substances can cause seizures and even thrombosis. But this does not mean that all medications are devoid of simple side effects that can occur even when taken correctly.

Substances of the tricyclic group have the greatest number of effects of admission. Side effects include dry mucous membranes, poor urination, constipation, changes in heart rate, tremors, and even blurred vision. Because of this, such medicines are almost never used by modern doctors.

Selective inhibitors of serotonin and norepinephrine uptake, in combination with heterocyclic antidepressants, have relatively harmless side effects. The former can cause headaches, drowsiness and anxiety, while the latter only increase appetite and promote weight gain. Such harmless effects cannot be compared with the effect of the following type of substances.

The new generation of powerful antidepressants has only one side effect. These drugs are easily addictive and have often been used in the past as a means of getting an inexpensive high. Such handling of substances caused inflammation and thrombosis of the veins, and sometimes even seriously shortened life.

Antidepressants are an important and integral part of any depression treatment. These beneficial drugs have prevented millions of suicidal deaths. But when taking strong antidepressants, you need to be careful. Without consulting your doctor about taking them, you can easily ruin your life by becoming addicted to drugs like a drug. Any medication that is not taken as intended can be very harmful to the body. Self-medication is medicine's worst enemy.

Antidepressants: Which Are Better? Funds overview

The term "antidepressants" speaks for itself. It refers to a group of drugs for the fight against depression. However, the scope of use of antidepressants is much wider than the name suggests. In addition to depression, they know how to deal with feelings of melancholy, anxiety and fears, relieve emotional stress, and normalize sleep and appetite. With the help of some of them, they even fight smoking and nocturnal enuresis. And antidepressants are often used as pain relievers for chronic pain. Currently, there are a significant number of drugs that are classified as antidepressants, and their list is constantly increasing. This article will provide you with information on the most common and commonly used antidepressants.

How do antidepressants work?

Antidepressants affect the brain's neurotransmitter systems through a variety of mechanisms. Neurotransmitters are special substances through which various "information" is transmitted between nerve cells. The content and ratio of neurotransmitters affects not only a person's mood and emotional background, but almost all nervous activity.

The main neurotransmitters, imbalance or deficiency of which is associated with depression, are serotonin, norepinephrine, dopamine. Antidepressants normalize the amount and ratio of neurotransmitters, thereby eliminating clinical manifestations depression. Thus, they have only a regulatory effect, and not a substitute, therefore, they do not cause addiction (contrary to existing opinion).

So far, there is not a single antidepressant, the effect of which would be visible from the first pill taken. Most drugs take a long time to show their potential. This often causes patients to stop taking the drug themselves. After all, you want unpleasant symptoms to be eliminated, as if by magic. Unfortunately, such a "golden" antidepressant has not yet been synthesized. The search for new drugs is due not only to the desire to accelerate the development of the effect of taking antidepressants, but also to the need to get rid of unwanted side effects, to reduce the number of contraindications for their use.

Choosing an antidepressant

Choosing an antidepressant among all the abundance of drugs on the pharmaceutical market is a rather difficult task. An important point that every person should remember is that an antidepressant cannot be chosen independently by a patient with an already established diagnosis or a person who has "considered" the symptoms of depression in himself. Also, the drug cannot be prescribed by a pharmacist (which is often practiced in our pharmacies). The same applies to changing the drug.

Antidepressants are far from harmless medications... They have a lot of side effects and also have a number of contraindications. In addition, sometimes symptoms of depression are the first signs of another, more serious illness (for example, a brain tumor), and uncontrolled use of antidepressants can play a fatal role in this case. Therefore, such drugs should be prescribed only by the attending physician after an accurate diagnosis.

Classification of antidepressants

All over the world, it is accepted to divide antidepressants into groups according to their chemical structure. For physicians, at the same time, such a delimitation means the mechanism of action of drugs.

From this position, several groups of drugs are distinguished.

• non-selective (non-selective) - Nialamid, Isocarboxazid (Marplan), Iproniazid. Today they are not used as antidepressants due to the large number of side effects;
• selective (selective) - Moclobemide (Aurorix), Pirindol (Pyrazidol), Betol. Recently, the use of this subgroup of funds is very limited. Their use is fraught with a number of difficulties and inconveniences. The complexity of use is associated with the incompatibility of drugs with drugs of other groups (for example, with pain relievers and drugs for colds), as well as the need to follow a diet when taking them. Patients need to stop eating cheese, legumes, liver, bananas, herring, smoked meats, chocolate, sauerkraut and a number of other foods due to the possibility of developing the so-called "cheese" syndrome (high blood pressure with a high risk of myocardial infarction or stroke). Therefore, these drugs are already a thing of the past, giving way to more "convenient" drugs in use.

Non-selective neurotransmitter reuptake inhibitors (that is, drugs that block the seizure of all neurotransmitters by neurons, without exception):

• tricyclic antidepressants - Amitriptyline, Imipramine (Imizin, Melipramine), Clomipramine (Anafranil);
• four-cycle antidepressants (atypical antidepressants) - Maprotiline (Lyudiomil), Mianserin (Lerivon).

Selective neurotransmitter reuptake inhibitors:

• serotonin - Fluoxetine (Prozac, Prodel), Fluvoxamine (Fevarin), Sertraline (Zoloft). Paroxetine (Paxil), Tsipralex, Tsipramil (Cytagexal);
• serotonin and norepinephrine - Milnacipran (Ixel), Venlafaxine (Velaxin), Duloxetine (Simbalta),
• norepinephrine and dopamine - Bupropion (Zyban).

Antidepressants with a different mechanism of action: Tianeptine (Coaxil), Sydnofen.

The subgroup of selective neurotransmitter reuptake inhibitors is currently the most commonly used worldwide. This is due to the relatively good tolerance of drugs, a small number of contraindications and wide opportunities for use not only in depression.

From a clinical point of view, antidepressants are quite often subdivided into drugs with predominantly sedative (sedative), activating (stimulating) and harmonizing (balanced) effects. The latter classification is convenient for the attending physician and patient, since it reflects the main effects of drugs, in addition to the antidepressant. Although, in fairness, it should be said that it is not always possible to clearly distinguish between drugs according to this principle.

Sedative drugs include Amitriptyline, Mianserin, Fluvoxamine; with balanced action - Maprotiline, Tianeptine, Sertraline, Paroxetine, Milnacipran, Duloxetine; with an activating effect - Fluoxetine, Moclobemide, Imipramine, Befol. It turns out that even within the same subgroup of drugs, with the same structure and mechanism of action, there are significant differences in additional, so to speak, therapeutic effect.

Features of the use of antidepressants

First, antidepressants in most cases require a gradual increase in the dose to an individually effective one, that is, in each case, the dose of the drug will be different. After the effect is achieved, the drug continues to be taken for some time, and then it is canceled as gradually as it was started. This mode allows you to avoid the occurrence of side effects and relapse of the disease with a sharp withdrawal.

Second, there are no instant antidepressants. It is impossible to get rid of depression within 1-2 days. Therefore, antidepressants are prescribed for a long time, and the effect appears at 1-2 weeks of use (or even later). Only if after a month from the beginning of the reception there are no positive changes in health, the drug is replaced with another.

Thirdly, almost all antidepressants are undesirable to use during pregnancy and the period breastfeeding... Their intake is not compatible with alcohol consumption.

Another feature of the use of antidepressants is more early onset sedative or activating action than directly antidepressant. Sometimes this quality becomes the basis for choosing a drug.

Almost all antidepressants have an unpleasant side effect of sexual dysfunction. This can be a decrease in sex drive, anorgasmia, erectile dysfunction. Of course, this complication of antidepressant therapy does not occur in all patients, and although the problem is very delicate, it should not be silent about. In any case, sexual dysfunction is completely transient.

Each group of drugs has its own advantages and disadvantages. So, for example, tricyclic antidepressants have a good and fairly rapid antidepressant effect, are quite cheap (compared to other groups), but cause tachycardia, urinary retention and increased intraocular pressure, and a decrease in cognitive (mental) functions. Because of these side effects, they should not be used for people with prostate adenoma, glaucoma and heart rhythm problems, which are quite common in old age. But the group of selective neurotransmitter reuptake inhibitors is devoid of such side effects, but these antidepressants begin to perform their main purpose 2 or even 3 weeks after the start of admission, and their price category is not cheap. In addition, there is evidence of their lower clinical effectiveness in severe depression.

To summarize the above, it turns out that the choice of antidepressant should be maximally personalized. As many different factors as possible should be taken into account when prescribing a particular drug. And certainly the rule of the "neighbor" should not work in this case: what helped one person can harm another.

Let's take a closer look at some of the most commonly used antidepressants.

Amitriptyline

The drug is from the group of tricyclic antidepressants. Possesses high bioavailability and, among the drugs of its group, good tolerance. Available in the form of tablets and solution for injection (which is necessary in severe cases). It is taken orally after meals, starting with smg per day. The dose is gradually increased until the desired effect occurs. When the signs of depression recede, the dose should be reduced by domg / day and taken for a long time (several months).

The most common side effects include dry mouth, urinary retention, dilated pupils and blurred vision, drowsiness and dizziness, hand tremors, heart rhythm disturbances, and impaired memory and thinking.

The drug is contraindicated in case of increased intraocular pressure, prostate adenoma, severe cardiac conduction disorders.

In addition to depression, it can be used for neuropathic pain (including migraine), nocturnal enuresis in children, psychogenic appetite disorders.

Mianserin (Lerivon)

It is a well-tolerated drug with moderate sedation. In addition to depression, it can be used to treat fibromyalgia. The effective dose is 30 to 120 mg / day. It is recommended to divide the daily dose into 2-3 doses.

Of course, this drug, like others, has its own side effects. But they develop in very few patients. To the most common side effects from taking Lerivon include weight gain, increased activity of liver enzymes and slight edema.

The drug is not used until the age of 18, for liver diseases, for allergic intolerance to it. If possible, it should not be taken by people with diabetes mellitus, prostate adenoma, renal, hepatic, heart failure, angle-closure glaucoma.

Tianeptine (Coaxil)

The drug is actively used not only for the treatment of depression, but also for neuroses, climacteric syndrome, in the treatment of alcohol withdrawal symptoms. One of the side effects of its use is sleep normalization.

Coaxil is taken at 12.5 mg 3 times a day before meals. Practically has no contraindications (it cannot be used until the age of 15, simultaneously with monoamine oxidase inhibitors and with individual intolerance), therefore it is often prescribed in old age.

Side effects include dry mouth, dizziness, nausea, and increased heart rate.

Fluoxetine (Prozac)

This is perhaps one of the most popular drugs of the latest generation. It is preferred by both doctors and patients. Doctors - for high efficiency, patients - for ease of use and good tolerance. Fluoxetine is also produced by a domestic manufacturer, so a drug with this name is also quite economical. Prozac is produced in the UK and is therefore quite expensive, especially when you consider the need for long-term use.

The only drawback, perhaps, is the relatively delayed antidepressant effect. Usually, a persistent improvement in the condition develops in the 2-3rd week of use. The drug is taken at a dose of mg / day, and various schemes of use are possible (only in the morning or twice a day). For the elderly, the maximum daily dose is no more than 60 mg. Eating food does not affect the absorption of the drug.

The drug can be safely used in people with cardiovascular and urological pathology.

Although side effects are rare when using Fluoxetine, they are nonetheless present. These are drowsiness, headache, loss of appetite, nausea, vomiting, constipation, dry mouth. The drug is contraindicated only in case of individual intolerance.

Venlafaxine (Velaxin)

Refers to new drugs that are only gaining momentum in the treatment of depressive disorders. It is taken immediately at 37.5 mg 2 times a day (that is, it does not require a gradual dose selection). In rare cases (with severe depression), it may be necessary to increase the daily dosage to 150 mg. But it is necessary to reduce the dosage at the end of treatment as gradually as when using most antidepressants. Venlafaxine must be taken with meals.

Venlafaxine has an interesting feature: it's dose-dependent side effects. This means that if one of the side effects occurs, it is necessary to reduce the dosage of the drug for a while. With prolonged use, the frequency and severity of side effects (if any) are reduced, and there is no need to change the drug. The most common side effects include decreased appetite, weight loss, constipation, nausea, vomiting, high blood cholesterol, high blood pressure, redness skin, dizziness.

Contraindications to the use of Venlafaxine are as follows: age up to 18 years, severe liver and kidney dysfunction, individual intolerance, concomitant use of monoamine oxidase inhibitors.

Duloxetine (Simbalta)

Also new drug... It is recommended to take it at 60 mg 1 time per day, regardless of food intake. The maximum daily dose is 120 mg. Duloxetine can be used as a means of relieving pain in diabetic polyneuropathy, chronic pain syndrome in fibromyalgia.

Side effects: often causes decreased appetite, insomnia, headache, dizziness, nausea, dry mouth, constipation, increased fatigue, increased urination, increased sweating.

Duloxetine is contraindicated in renal and liver failure, glaucoma, uncontrolled arterial hypertension, up to 18 years of age, with hypersensitivity to the components of the drug and simultaneous administration with monoamine oxidase inhibitors.

Bupropion (Zyban)

This antidepressant is known as effective remedy to combat nicotine addiction. But even as a simple antidepressant, it is quite good. Its advantage over a number of other drugs is the absence of a side effect in the form of sexual dysfunction. If such a side effect occurs when using, for example, selective serotonin reuptake inhibitors, then the patient should be transferred to taking Bupropion. There are studies that have even shown an improvement in the quality of sex life in people without depression while taking this drug. Only this fact should be correctly interpreted: Bupropion does not affect the sexual life of a healthy person, but only works if there are any problems in this area (which means that Viagra is not).

Bupropion is also used to treat obesity and neuropathic pain.

The usual regimen of Bupropion is as follows: for the first week, 150 mg is taken 1 time per day, regardless of food intake, and then 150 mg 2 times a day for several weeks.

Bupropion is not without side effects. It can be dizziness and unsteadiness when walking, trembling limbs, dry mouth and abdominal pain, upset stools, itchy skin or rash, epileptic seizures.

The drug is contraindicated in epilepsy, Parkinson's disease, Alzheimer's disease, diabetes mellitus, chronic diseases liver and kidney, before the age of 18 and after 60 years.

By and large, there is no perfect antidepressant. Each drug has its own disadvantages and advantages. And individual sensitivity is also one of the main factors in the effectiveness of this or that antidepressant. And although it is not always possible to strike depression in the heart at the first attempt, there will certainly be a drug that will save the patient. The patient will definitely get out of depression, you just have to be patient.

Antidepressants are used in the treatment of depression, a list of which can be seen below. Antidepressants include drugs that selectively affect a person's depressive state. These drugs and antipsychotics for depression can be used in the case of relief of affective-delusional syndromes in children and adults.

The most common mild antidepressants are:

• Moclobemide;
• Befol;
• Toloxaton;
• Pyrazidol;
• Imipramine;
• Amitriptyline;
• Anafranil;
• Pertofran;
• Trimipramine;
• Azafen;
• Maprotiline;
• Mianserin;
• Fluoxetine;
• Fevarin;
• Citalopram;
• Sertraline;
• Paroxetine;
• Simbalta.

These are just a few of the antidepressants used to combat nervous disorders and depression. They are all subdivided into several classifications.

Soothing

Anxiolytic antidepressants are a classification of the most common drugs used to combat depression.

Amitriptyline is a classic type of mild antidepressant with a tricyclic structure. It is distinguished from Imipramine by a rather strong sedative effect. It is used to get rid of depression of anxious and agitated types, which can manifest with "vitality." This drug is available in pill and injection form.

Another domestic antidepressant is Azafen, or Gipofizin. It is used to combat the symptoms of "minor" depressive disorders of the cyclothymic register. The drug has moderate sedative and thymoanaleptic effects.

Mianserin, or Lerivon, is a drug that, when used in small doses, has a strong sedative effect. Due to this effect, it can be used to treat cyclothymia in combination with insomnia. It is able to cure depression with major episodes.

Stimulating

Moclobemide, or Aurorix, is a selective MAO inhibitor. The drug has a powerful stimulating effect on people suffering from inhibited types of depression. It is prescribed for somatized types of depression. But the drug is strictly prohibited for use in anxiety depression.

Imipramine, or Melipramine, is the first fully studied antidepressant with a tricyclic structure. It is used in the treatment of severe depression with a high predominance of sadness and lethargy, with suicidal thoughts. The drug is produced both in the form of tablets and in the form of intramuscular injections.

Fluoxetine is a drug with thymoanaleptic effect. Its second name is Prozac. The drug is effective during the treatment of depression with obsessive-phobic symptoms.

This type of drug belongs to the so-called selective serotonin reuptake inhibitors (SSRIs). The drug is devoid of some of the effects of clinical tricyclic antidepressants:

• antihistamine;
• adrenolytic;
• anticholinergic.

Pertofran is a more potent variant of Imipramine (demethylated). It has a brighter activating effect. A drug is used to combat depression, combined with depersonalization.

Balanced drugs

The second name of Pirazidol is Pirlindol. The drug is manufactured in Russia. It is a reversible inhibitor of MAO type A, like Moclobemide. This drug is used to prevent and treat depression of the inhibited type, as well as depressive disorders with pronounced anxiety manifestations. The advantages of the drug in the possibility of taking it for glaucoma, prostatitis and cardiac pathologies.

Another powerful drug created as a result of the synthesis and introduction of a chlorine atom into the imipramine molecule is Anafranil. It is used to treat refractory depressions and to relieve the affective phases of severe depressions.

Maprotiline, or Lyudiomil, is a tetracyclic antidepressant. It has a rather powerful thymoanaleptic effect when interacting with anxiolytic and sedative components. It can be used for circular depression in combination with self-blame ideas. The drug is used for involutional melancholy. Maprotiline is produced in the form of oral preparations and injections.

Reversible Monoamine Oxidase Inhibitors and Selective Reuptake Inhibitors

Befol belongs to domestic drugs that are prescribed for depressive disorders of asthenic and anergic types. It is used to treat the depressive phase of cyclothymia.

Fevarin and Fluoxetine belong to the classification of drugs of thymoanaleptic action. The drugs have a vegetative stabilizing effect.

Citalopram and Cipramil are other names for thymoanaleptic antidepressants that can be used to treat depression. They belong to the group of sedative serotonin reuptake inhibitors (SSRIs).

Afobazole is an over-the-counter antidepressant. It is used to combat somatic diseases with adjustment disorders, anxiety, neurasthenia, and oncological and dermatological diseases.

The drug has a good effect in treating sleep disorders and relieving PMS symptoms. But it should be borne in mind that taking it for children and women during pregnancy and lactation is contraindicated.

Tricyclic

Trimipramine, or Gerfonal, is used to treat depression with increased anxiety. This is one of the most powerful drugs of this kind. Its psychotropic activity is similar to Amitriptyline. When carrying out treatment, it is worth considering the list of contraindications for this antidepressant:

• dry mouth;
• orthostatic hypotension;
• problems with urination.

New generation antidepressants

Sertraline and Zoloft are the names of antidepressants with a bright thymoanaleptic effect with a weak stimulating effect. At the same time, the drugs do not have anticholinergic and cardiotoxic properties.

They achieve the maximum effect in the fight against somatized atypical depression with some manifestations of bulimia.

Paroxetine is a derivative of Piperidine. It has a rather complex bicyclic structure. The main properties of Paroxetine are thymoanaleptic and anxiolytic. They appear when there is stimulation.

The drug shows itself well in the fight against endogenous and neurotic depressions, their dreary or inhibited variants.

Venlafaxine is an antidepressant used for depression associated with severe mental disorders such as schizophrenia, etc.

Opipramol is used to treat somatized and alcoholic depression. It is able to prevent vomiting, seizures and generally stabilize the autonomic nervous system.

Toloxatone, or Humoril, is similar in its method of exposure to the human body with Moclobemide. The drug has no anticholinergic and cardiotoxic properties. But it does a good job of treating depressions with pronounced lethargy.

Simbalta or Duloxetine is used to combat depression with panic attacks.

Side effects

Most antidepressants have a fair amount of side effects. The list is quite large:

• hypotension;
• arrhythmia;
• sinus tachycardia;
• violation of intracardiac conduction;
• oppression of bone marrow functions;
• agranulocytosis;
• thrombocytopenia;
• hemolytic anemia;
• dry mucous membranes;
• violation of accommodation;
• intestinal hypotension;
• trouble urinating;
• increased appetite;
• increase in body weight.

Such side effects due to the intake of the tricyclic type of antidepressants occur quite often. In contrast, antidepressant serotonin reuptake inhibitors have less pronounced side effects. But it can be:

• frequent headaches;
• insomnia;
• anxious states;
• depotentiating effects.

If a combination therapy is used for treatment, that is, drugs of both types are used simultaneously, then serotonin syndrome may manifest itself, characterized by an increase in temperature, signs of intoxication of the body and disturbances in the functioning of the heart and blood vessels.

Any antidepressant medication for depression should be taken only after a complete medical examination and an accurate and complete diagnosis.

And for children, they are prescribed with extreme caution. Be sure to do this under the supervision of a doctor so as not to harm the body.

According to statistics, 40% of people on our planet live non-stop. This intense rhythm of life, which is associated with colossal mental stress, lack of rest and food from time to time. No wonder that the body is simply not able to endure such stress for a long time. The nervous system is depleted, which leads to neuroses, chronic stress, and then depression.

Depression is a serious and many underestimated illness, which is accompanied by a depressed psychological state, constant feelings of dissatisfaction, anxiety, irritability, lack of interest in life, a sense of hopelessness and even suicidal thoughts. Without correct treatment depressive disorder can result in a serious deterioration in physical and mental health, up to complex mental illness and attempts to commit suicide.

It is clear that depression needs to be treated. But when faced with such a condition, a person, as a rule, is not in a hurry to understand the causes of the disease, but goes straight to the pharmacy for sedatives, that is, for antidepressants. Indeed, a short-term intake of such pills quickly solves the problem of depression, giving a person the desired calming, perfectly improving mood and coloring the world multi-colored paints. But is everything so simple and straightforward? Recent research by scientists suggests that antidepressants are not only not beneficial, but also harmful to the body. Is this so and how, then, is it correct to deal with depression?

How antidepressants work

Doctors assure us that psychotropic drugs, they are also antidepressants, regulate chemical imbalances in the body, replenishing the lack of hormones of joy and happiness - serotonin, dopamine and norepinephrine. Having received such a "charge of good mood", a person forgets about his worries and concerns, he loses lethargy and apathy, and instead appears good mood, deep sleep and appetite.

Already from the description, it becomes clear that such drugs do not solve the problem of depression, since they do not affect its cause and do not eliminate stress factors. That is, some time after stopping the medication, depression again makes itself felt. Is it worth taking pills that do not cure, but only temporarily hide the problem?

Dr. Hirsch's research

However, this is just the beginning. The Director of the Placebo Study Program, Dr. Irving Hirsch, has been studying the effects of antidepressants on the nervous system in detail for 16 years. Numerous studies have led the specialist to believe that improvements in antidepressant use are most often associated with the placebo effect!

Back in 2002, Dr. Hirsch conducted a study that showed that 80% of the effectiveness of psychotropic drugs is provided by the placebo effect. After assessing the condition of 700 patients, half of whom were taking real-life drugs and the other half were taking placebo, the specialist concluded that the difference between the drug and the "dummy" on the clinical scale was less than 2%! The incipient doubts about the effectiveness of antidepressants led Irving Hirsch to conduct another experiment. After selecting more than 300 participants with depressive disorders, the doctor asked each of them to undergo treatment with a specific antidepressant. Instead of a drug, the participants took gelatinous candies, that is, a placebo. The results of the experiment exceeded expectations - 75% of patients noted significant improvements in their condition!

The scientific world was extremely surprised to learn how ineffective antidepressants turned out to be. However, here you need to understand that the sale of sedatives is a multibillion-dollar business, not inferior in profitability to the turnover from the sale of antibiotics. That is why a wave of criticism fell on Dr. Hirsch, and they tried to stop his research activities.

However, belief in the effectiveness of antidepressants has waned. The Commission for the Control of Medicines has become interested in this issue. According to her findings, only 43% of all studies conducted confirmed the effectiveness of psychotropic drugs. All other studies were either not published due to not the most impressive results, or were not carried out at all!

Dr. Hirsch is echoed by the neuroscientist Joseph Coyle. According to the well-known expert, the version of chemical imbalance as the main culprit in the development of depression is outdated. It is likely that depression occurs for more complex reasons than a decrease in serotonin and dopamine levels, which means that it is pointless to fight the problem with antidepressants! According to Dr. Coyle, in the future, doctors will have to look for another, comprehensive approach to the treatment of this complex ailment.

Why antidepressants are dangerous

Modern research on antidepressants increasingly shows that these drugs are not only ineffective, but also harmful to the body. Assessing the harm from taking antidepressants, doctors identify two key problems - toxic liver damage and addiction to the drug, followed by a withdrawal syndrome.

In terms of possible liver damage, the most dangerous component is amitiptyline, a tricyclic antidepressant, which, with prolonged use, causes the development of toxic drug hepatitis. The so-called "withdrawal syndrome" is no less dangerous. People suffering from chronic stress and depression take antidepressants almost constantly, which means that abrupt refusal to take medications causes them to have pronounced depression, often with suicidal attempts. This condition is caused by an acute lack of serotonin, the level of which was previously artificially maintained by antidepressants. In this regard, withdrawal can be avoided only by smooth cessation of medication.

By the way, the manufacturers of antidepressants themselves note in the instructions for use that taking psychotropic drugs is associated with health risks. In particular, doctors warn that taking these drugs can provoke cardiovascular diseases, liver and kidney pathologies, stomach problems and metabolic disorders, aggressiveness and hostility towards others, insomnia and the appearance of hallucinations. Moreover, taking such drugs cannot exclude complications of pregnancy and problems of sexual activity.

How to deal with depression without medication

I would like to believe that after reading this article, you realize that taking antidepressants is not at all an option in the fight against depression. However, you should not despair! Almost every person can get rid of this disease, the main thing is to follow the advice of a psychologist. They sound like this:

1. Change your own thinking

First of all, take it for granted that some processes, such as death loved one, - cannot be controlled and prevented. It is necessary to learn to live with this.

2. Set yourself realistic goals

Having set unbelievable goals for himself, and not being able to achieve them, a person gradually falls into depression. Start your life anew with clear, easy-to-reach goals, and gradually raise the bar. So, step by step, you will achieve the desired self-realization.

3. Don't be alone with yourself

It's no secret that depression makes a person immerse himself in himself and engage in self-examination. To make it easier to drive away such thoughts, spend all your free time with friends, colleagues, and, of course, with your family. Communicate, discuss last news, make plans for the future, in general, distract yourself from the thoughts that depress you as much as possible.

4. Get a hobby

If before that you did not have a favorite pastime that you could enthusiastically do all day, be sure to find yourself such a hobby. It could be fishing or painting, writing poetry, or collecting car models. The main thing is that doing what you love, you get distracted from disturbing thoughts and get satisfaction.

5. Spend more time away from home

Sitting in "four camps" and trying to fight depression is a hopeless idea. You need to be more often in nature, walk in the park or in the forest, maybe even go hiking, hunting or fishing. In this case, the sun and fresh air, combined with your favorite pastime, will quickly relieve you of your existing mental disorder.

6. Get exercise

Sport not only distracts from anxious thoughts and relieves depression, but also promotes the production of "hormones of joy." In this regard, it is especially useful to go in for swimming, jogging, cycling, as well as any team sports where physical exercises can be combined with friendly communication.

7. Eat antidepressant foods

It turns out that you can fight depression by correcting your diet. To do this, it is enough just to diversify the diet with foods rich in Omega-3 fatty acids, namely, sea fish (sardines and salmon), other seafood, walnuts, almonds, eggs, olive and vegetable oil, avocado and leafy greens.

8. Give up bad habits

Determined to win the fight against depression, you need to end bad habits such as smoking and drinking alcohol forever. These substances, in fact, are depressants, which means that without giving up them forever, you will not be able to get rid of the problem you have.

As you can see, you can fight depression without antidepressants, especially if you take into account the information about their ineffectiveness and harmful effects on health. And if your doctor prescribes these drugs for you, try to take them strictly as prescribed, without exceeding the dosage. Good health to you!

20.10.2018

In the pharmacy, you can find over-the-counter antidepressants that help normalize sleep, relieve depression and relieve anxiety. These newer drugs affect the exchange of neurotransmitters in the brain (norepinephrine and serotonin).

The use of such drugs stimulates the human psyche. But what strong antidepressants to choose, below we will offer a list of drugs that you can drink without fear of side effects.

Antidepressants available to everyone

Only light pills can be bought without a doctor's prescription, which can also provide positive effect on the mood. Here are the names of the medicine, the tablets of which can be bought on the open market What are these products, and why you don't need a prescription to buy them.

Maprotiline (Lyudiomil)

When choosing the best antidepressant, consider this tetracyclic drug. With its help, you can raise your mood, eliminate apathy, anxiety, stabilize psychomotor retardation. Speaking of side effects, such a drug should not be taken during pregnancy, liver dysfunction, kidney disease.

Prozac (Fluval, Prodep, Profluzac, Fluoxetine)

These non-prescription antidepressants are classified as selective serotonin inhibitors (SSRIs). Such names are often used by the neurologist and therapist. The effect of the drugs is achieved in the treatment of menstrual disorder, elimination of anxiety and panic conditions, improves mood, can be used to get rid of obsessive thoughts. If you take such medications regularly, you can find a balanced psyche and improve your mood.

Zyban (Nousmok, Wellbutrin)

Paxil (Sirestill, Reksetin, Plizil, Adepress)

Taking antidepressants of the tricyclic group brings good effects, such drugs are often prescribed to drink in the doctor's office. Taking medications can be antidepressant and anti-anxiety drugs. If we talk about side effects and consequences, then it does not affect the work of the heart and psychomotor functions. Can be taken to correct heart function. It is recommended to drink when stressful situations, depression, different types phobias.

Deprim

Taking antidepressants of this type improves mood and performance. Such medicines contain St. John's wort, which has a good effect.

Persen

When choosing antidepressant treatment, you can opt for Persen. The drug provides a high effect, contains natural ingredients (peppermint, valerian, lemon balm). It improves mood and fights stress.

Novo-Passit

The effect of this type of antidepressant is pronounced sedation... Such medicines contain passion flower, hops, guaifenesin, lemon balm, elderberry, St. John's wort and hawthorn. You can take medications when you need to relieve feelings of anxiety, tension, headaches, and relieve premenstrual and climatic syndromes.

Herbal antidepressants

New generation antidepressants can contain drugs, they have a good effect and almost complete absence of side effects. It is recommended to drink such funds when you need to cope with a depressive and anxiety state that has appeared against the background of experiences and stress.

• Infusions of immortelle, Rhodiola rosea, maral root, lemongrass - these remedies eliminate the feeling of overwork. Preparations should be drunk before meals, 150 grams;
• Alcoholic extract of leuzea - \u200b\u200bsuch drugs stimulate the psychometric functions of a person, improve mood, increase efficiency;
• Ginseng tincture is capable of exerting a stimulating effect immune system... It treats the manifestations of depression, increases the body's resistance to stress. As side effects, it should be noted increased sensitivity to the sun. It is not recommended to go to the solarium if you decide to drink ginseng tincture;
• Zamaniha - can be used to improve performance, improve mood, normalize sleep;
• Motherwort, oregano, blue honeysuckle, meadow clover. Such funds allow you to get rid of a depressive state;
• Hawthorn has a calming effect;
• Hops, peppermint, valerian are excellent herbal antidepressants with no special side effects;
• Medicinal angelica is excellent for insomnia;
• You can drink calendula to relieve fatigue and stress.

These herbal medicines can be used only for moderate to mild disease. They have an effect on sleep disorders, anxiety, anxiety.

Another indication for herbal remedies is various psychovegetative disorders. This is a series of conditions in which, during examinations, the pathology of the internal organs is not detected, and the manifestations themselves are formed as consequences of disturbances in the functioning of the nervous autonomic system. They include:

• A feeling of shortness of breath;
• Headache and dizziness;
• Pain in the abdomen and heart;
• Heart palpitations;
• Disorders of bowel emptying and urination.

Antidepressants based on St. John's wort have practically no side effects, they can be used without a doctor's prescription. But in the case of more severe depressive conditions, such funds will not bring an effective result. In such conditions, the help of the attending physician and the appointment of antidepressants of a different category are necessary.

Security measures

Many people have various mental disorders. Unfortunately, people who are constantly in stressful situations, at work, at home and even on vacation, are familiar with the problems of sleep disturbance and irritability. Women usually try to take medications at the first manifestations of depression, without thinking about the consequences, men "kill the nerves in themselves."

Do not shy away from a psychiatrist. Such over-the-counter drugs may not help if there are factors causing the pathology. Only after determining it can you start taking medications... In other cases, the disease will develop into a chronic form with intervals of remission and exacerbations.

Consider the side effects before trying to get the next generation of antidepressants in the public domain. Can you tell the difference between neurosis and depression?

It may be better to visit a professional doctor who can rule out the negative effects of drugs on your body.

Even herbal preparations have a number of side effects if used incorrectly.

Medical statistics say that most modern people who buy a variety of sedatives do not suffer from mental problems. Such patients create a depression mindset within themselves and try to recover from a fictitious state.

In the West, as you know, antidepressants are widely used. After the release of the film of the same name, even such a definition appeared - "the Prozac generation" (this is the name of one of the popular antidepressants - Sputnik).

Belarusians are wary of these drugs. Sputnik correspondent Valeria Berekchiyan talked with specialists from the Republican Scientific and Practical Center for Mental Health and found out whether to be afraid of antidepressants, who should take them and when, and how not to blink and think of depression.

Last year, the World Health Organization (WHO) said that depression is the main cause of disability in the world: according to their estimates, more than 300 million people suffer from it.

Symptoms of depression and why Belarusians (not) find it at home

Depression is considered to be stable. bad mood (at least two weeks), which may be accompanied by apathy, low activity, inability to enjoy or be interested in something. Often, people who encounter it find it difficult to concentrate and start a new business, their sleep and appetite are impaired, their sex drive and self-esteem are reduced, and there is a sense of guilt.

Self-diagnosis of depression is not uncommon. According to Irina Khvostova, deputy director for the medical department of the Republican Scientific and Practical Center for Mental Health, there are several reasons.

First, it is really common: the risk of suffering depression in a lifetime reaches 12% in men and up to 30% in women. Secondly, modern people information on this topic is available, including professional information.

It also happens the other way around: often patients do not notice their illness; then a visit to a doctor should be initiated by people close to them. With mild depression and moderate more often they turn to a psychotherapist, but this practice is not very popular among Belarusians, experts say.

"Sometimes they do not go to the doctor because of the" masked "course of depression. Typical symptoms may appear insignificantly or absent altogether, sometimes the symptoms of a bodily ailment come to the fore - pain in the heart region, feeling of lack of air, uncomfortable / painful sensations from the outside digestive tract or functional disorders of the intestine. People turn to different specialists, undergo numerous examinations. And only when the treatment does not give the desired result, they are referred to a specialist in the field of mental health, "said Lyubov Karnitskaya, deputy director for medical department of the Republican Scientific and Practical Center for Mental Health.

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In some cases, inpatient treatment is required. In the above-mentioned RSPC, specialized departments have been created for such patients: here various specialists, experienced in the field of neurotic disorders, work with them, and research is carried out to solve the problem in a comprehensive manner.

"There is no need to be afraid of antidepressants, but there is no need to drink for no reason either."

Antidepressants are drunk so that the symptoms of depression subside or disappear altogether, and the affected patient regains a sense of well-being. In other words, their task is to return a person to normal life. According to Irina Khvostova, one should definitely not be afraid of antidepressants.

"Modern antidepressants are safe enough; they do not cause addiction. But it must be remembered that antidepressants are not candy, and they have contraindications and side effects. Only a doctor can correctly correlate the intended benefits of prescribing a drug and the possible negative consequences of taking it," - the specialist considers.

But you do not need to take them for an insignificant reason: according to Lyubov Karnitskaya, sometimes people get by with psychological help even in cases of strong oppression.

"One of our patients - a young woman - suffered the death of a loved one, and soon - an operation due to suspicion of malignant tumor; after being discharged due to long rehabilitation, she received a certificate of incapacity for work. Mood and physical activity decreased, thoughts of imminent death, pessimism in relation to life and people, depression, the desire to hide and not communicate with anyone appeared, "Karnitskaya recalled.

While waiting for the biopsy results, the woman twisted herself, tuned in for the worst outcome, felt more and more depressed, and then closed herself off. In the end, the sister insisted: we must go to a psychotherapist.

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"A psychocorrectional conversation was held, and when the woman received results on the benign quality of education and a favorable prognosis, her mental state improved rather quickly and the appointment of an antidepressant was not required," the doctor said.

Side effects of antidepressants, according to Irina Khvostova, are rare. However, it is worth knowing that among them - restlessness, increased anxiety, or, conversely, excessive calmness, sleep disturbances, nausea; and in some cases, weight gain and sexual dysfunction. The belief that antidepressants reduce performance is a myth, she said.

“Apathy and decreased activity are symptoms of depression; a person taking an antidepressant may at some point come to the erroneous conclusion that a decrease in his performance is a consequence of taking an antidepressant,” the doctor said.

Sometimes, in order to return to normal life, the patient only needs to find and eradicate the "source of trouble" - that which provokes negative thoughts and bad moods.

“A young woman complained of a low mood for several months, anxiety, uncertainty about the future, lack of pleasure from her favorite job. Lyubov Karnitskaya.

The patient had to part with the man. And after a course of psychotherapy, her condition improved even without prescribing antidepressants.

Who needs to take antidepressants and can I start it myself?

Khvostova categorically does not recommend starting the appointment on your own.

"This is not the case when a positive feedback from a neighbor or a friend from social networks can serve as a reason for taking a medicine. To choose the right antidepressant, you need professional knowledge and experience," she shared.

In addition, these pills do not work instantly: their effect is noticeable only in the third or fourth week of routine administration in the correct dosage, which can also be selected only by a doctor.

Antidepressants are advised in several cases. When psychotherapy does not help, and the symptoms of depression (for example, impaired appetite and sleep) are so pronounced that they simply do not allow a person to conduct normal life activities.

"They are also prescribed if a person has already struggled with such a problem with the help of antidepressants and in cases where the risk of suicide is high," Khvostova explained.

Another case from practice - a 55-year-old woman survived her husband's betrayal. The mood dropped, the patient stopped taking care of herself, lay in bed and was not at all interested in others, her appetite disappeared. She has lost a lot of weight.

"I began to express thoughts of unwillingness to live. I categorically refused to consult a doctor (formally agreed to meet with him after long persuasion of children). The severity of symptoms of depression and the presence of suicidal thoughts required the appointment of an antidepressant," Karnitskaya said.

Why is the use of antidepressants so widespread in the West? It was often heard that their reception became almost the norm, even when overworked.

"Most likely, this is a mistaken impression: after all, people can simply mention that they are taking these medications without going into the true reasons for the treatment (only the doctor knows the depth of the problem). Do not forget that in Western culture it is customary not to" cry into the vest. " and look successful and prosperous, even experiencing depression. Nevertheless, antidepressants all over the world are prescribed only if there is a medical indication for this, "said the specialist.

Antidepressants are sold in Belarus exclusively by prescription. With proper use, their effectiveness is undeniable, but their reception can have side effects, and sometimes quite pronounced. Therefore, their use is possible in our country only under the supervision of a doctor. But getting to him is not so difficult - it is enough to make an appointment with a psychotherapist at the place of residence or contact the psychological help service.