For a long time, mankind has experienced a heavy impact of stress, fell into depression and needed ah. The 21st century is considered depressive according to the statistics of these diseases. However, people have been suffering from this ailment for a long time.

But in the past, stimulants were used to combat depression, among which the most common are opium, ginseng, and caffeine. In order to cope with anxiety and anxiety, valerian, bromine salts, and aralia tincture were widely used.

However, some and other substances could only have a temporary effect. They did not treat the symptoms of depression, did not remove the causes, and did not treat the depressive state.

Modern ones appeared only in the mid-50s of the last century and began to actively develop and improve.

A bit of history

The first drug for depression was discovered in 1957. It happened almost by accident. The drug Iproniazid known in the use of tuberculosis significantly improved the mood of patients. A whole group of doctors immediately noticed this. This drug was unsuccessful as a remedy for tuberculosis, but it was continued to be given, since it improved the psychological state of the patients.

Following these findings, iproniazide began to be widely used in the treatment of depressive conditions. However, this drug revealed one serious problem: it increased the risk of hepatitis C. For this reason, the use of iproniazide was banned, and the drug itself was withdrawn from the free market.

The next antidepressant that appeared after iproniazid was Imipromin. It was opened by Ronald Kuhn in Germany. This medicinal product is still actively used to combat depression.

The next well-known drug was Prozac. This drug has over time completely replaced the past drugs. It appeared at the end of the last century. Prozac was developed in the USA.

Act

Antidepressants are able to correct the activity of some parts of the brain.

As you know, the brain is made up of neurons. Communication is carried out between them. The mechanism of this connection is as follows: there is a space between neurons (synapse - synaptic cleft). Information between neurons is transmitted by a special chemical messenger called a neurotransmitter. This is how it works normally. But sometimes the level of neurotransmitters in the synapse decreases, and information is transferred incompletely or at a slow pace. In this case, depression occurs.

Mediators related to the onset of a depressive state include three known substances: dopamine, norepinephrine, serotonin.

Antidepressants are able to regulate the concentration of any particular neurotransmitter or all of them at once, thereby adjusting the way the brain works.

Antidepressants: myths and reality

Myth 1

There is a very popular opinion that antidepressants do not always have a positive effect on the human body. It is believed that antidepressants can take some getting used to. There is even a version that antidepressants can lead to insanity.

Reality: Antidepressants, like any substance, can have side effects. In Soviet times, they were very often prescribed "just in case", and in large doses. For this reason, unpredictable results were obtained.

Myth 2

For a long time, it was believed that antidepressants are used when a person's character is weak, weak-willed and uncoordinated. People are rarely able to understand that depression is a disease. Like any disease, it must be treated. This requires medications, the best of which are antidepressants.

Reality: It is virtually impossible to completely get rid of mental problems with drugs. Treatment of depression requires, in addition to drugs, high activity of the person himself in solving his own problems. However, to begin to show any activity, you need the ability to act, which only antidepressants can provide.

In European countries, antidepressants have entered the culture of lifestyle. They are used by about 65% of the population. Modern drugs are not addictive. They are able to restore the activity of the brain, which is disturbed in depressive conditions.

Antidepressants are prescribed for a number of neuropsychic and diseases and pathologies:

• pain syndromes of various etiologies;
• psychosomatic diseases;
• anxious states;
• narcolepsy;
• anorexia and;
• alcoholism;
• chronic fatigue syndrome;
• phobic syndromes;
• crises of various etiologies.

The psychiatrist's task

The psychiatrist faces a difficult task: right choice type and dosage of medicines. As a rule, only half of patients begin to feel an improvement in their condition after starting a course of therapy. Very often, several drugs are prescribed at once. It may take at least 2-3 weeks before the first lasting effect appears.

It often seems that improvement is simply impossible. But this is not the case. In fact, the process of correcting the action of mediators has been launched and, soon, the patient will begin to feel an improvement in mood and general condition.

Antidepressants in some people bring positive changes quite quickly, others have to wait for them for a long time.

There is one more problem with their application. Antidepressants can target only one type of mediator: norepinephrine, serotonin, dopamine. In humans, only one connection between neurons can also be broken. It is almost impossible to guess which pick is not effective enough. Therefore, you have to do this by trial and error, changing the type of prescribed drugs.

Antidepressants in our country, and many European countries, are sold only by prescription. For this reason, many people self-medicating their condition use herbal antidepressants, the so-called "mild drugs": Fenebit, Novopassit, Tenoen, Walfen, Hypericum, etc.

Herbal teas (for example, St. John's wort, lemon balm,) or special preparations are often used. Of course, herbal antidepressants are not as safe as we think, but still they are not an artificial influence on brain activity. And with self-medication, it is better to use them than to look for "your" medicine on your own.

Even an experienced doctor often takes a long time to find the perfect remedy. Every person is different. And besides the effect, you need to take into account other possible side effects and individual intolerance. In addition, factors such as gender, age, the depth of the disease, the mood of the patient himself are taken into account.

During treatment, you need to follow several recommendations:

• Start and stop taking antidepressants gradually;
• Taking medications must be combined with psychotherapy;
• Alcohol should not be consumed while taking antidepressants.

How to choose antidepressants

It is a very common belief that all modern drugs are either ineffective or are a modification of amyltriptylene. This is far from the case. And you need to be able to understand the current abundance of drugs in this direction.

It should be said that free antidepressants are prescribed only to patients who are on a psychiatric account. All other patients have to buy these drugs on their own. Their prices range from 1.5 to 6 thousand rubles. Naturally, this is not a cheap "pleasure". Considering that the medicine may simply not be suitable for this patient, and it cannot be returned to the pharmacy, treatment for depression can drive into another depression.

The word "antidepressants" is alarming. We do not know much about mental disorders, especially if we are not specifically interested in it. Around mental disorders - if not a halo of romanticism and mystery, then frightening stories. There are also those who consider antidepressants to be dangerous drugs that change personality and addictive and dire consequences. Because of this, sometimes those who need treatment refuse it. After all, suddenly all these stories are true?

the site understands how everything really is: what antidepressants are and why they are needed, how they are used, whether they cause side effects and addiction, can they be canceled at any time and why to take them if necessary,- fine.

What are antidepressants

Antidepressants are substances that affect the functioning of the central nervous system, and, as the name suggests, is primarily used in the treatment of depression.

These drugs relieve feelings of melancholy, apathy, anxiety, anxiety, irritability, tension, increase mental activity, normalize appetite and sleep. To understand how antidepressants work, you need to understand how the nervous system works.

How the central nervous system works

The central nervous system (CNS) "leads the parade". It includes the spinal cord and the brain, and is responsible for simple and complex reflexes.- standard reactions to any impact. It all works with nerve signals.-pulses.

The nervous system consists of many nerve cells-neurons ... For neurons to conduct nerve impulses, they must be connected into a network that will transmit impulses from one cell to another. Imagine the children passing the ball to each other in PE class. Children- nerve cells connected to the system, and the ball- nervous impulse. And here are the hands with which children pass the ballis a synapse , such a place of contact.

At synapses, a nerve impulse is transmitted from one cell to another. This happens with the helpneurotransmitters- these are intermediary substances. Accordingly, if there are not enough neurotransmitters, then the impulses will pass poorly. This means that the work of the whole organism will be disrupted: after all, the nervous system controls everything.

In addition, there is one more nuance. Neurotransmitters are substances of a different nature, in particular, norepinephrine, serotonin and dopamine are among them. These substances are hormones. Therefore, in addition to transmitting nerve impulses, they perform many more functions as hormones. They affect the work of individual organs and systems, on the processes of contractility of muscles and blood vessels, and partly on mood and internal sensations. And with depression, the level of these neurotransmitter hormones often decreases in a person. Therefore, it is so difficult for patients: feelings of anxiety, apathy and their own worthlessness are caused by a lack of serotonin, dopamine and norepinephrine. And since hormones also affect many functions of the body, this explains the physical manifestations of depression - weakness, fatigue, unstable appetite.

Antidepressants influence the level of these neurotransmitter hormones: they block their breakdown or seizure by neurons. From this, their level rises.

When are antidepressants prescribed and why they may not work

Antidepressants, despite their name, are used for more than just treating depression. They are also used for many other diseases: this is precisely because they affect a variety of processes in the body.

For depression and other mental disorders, antidepressants are also not always used. Scientists still do not know exactly all the features and causes of depression. If it were just a lack of neurotransmitters, then antidepressants would help everyone, which is not the case. In addition, then drugs such as amphetamine or cocaine would help with depression: they affect neurotransmitters and therefore cause a feeling of euphoria. But depression- a much more complex disorder in which different mechanisms are involved.

Therefore, the reaction to antidepressants is individual, but you should not give up on them either. They help to stop serious conditions so that patients can cope with the disease. Antidepressants are usually not used on their own, but are combined with psychotherapy and other treatments. Sometimes you can do without them altogether.- it depends on the condition of the patient. The doctor makes the appointment individually.

Is there a dependence on antidepressants

No. But it cannot be denied that after the withdrawal of antidepressants, the risk of suicide increases, and the patient feels unwell. This is a withdrawal syndrome that many people mistake for addiction. The fact is that if the artificial support of the level of neurotransmitters is abruptly cut off, then their level will fall - then it seems to the patient that depression has returned, and now he cannot live without pills. This problem is solved by intensified psychotherapy and a slow decrease in the dosage of the drug. Yes, and withdrawal syndrome does not occur in everyone, but most often in patients who took high doses.

How antidepressants help depression

the site asked a girl who went through depression and an eating disorder to tell her story. She shared how she faced a problem, underwent treatment, and then- refused antidepressants and returned to normal life. We publish her story on condition of anonymity.

"When I was a year old my mother left me. I rarely saw her, my grandmother raised me. Since childhood, I felt unnecessary and was afraid that I would be abandoned. And so it happened when I met a guy: once he just did not come on a date, stopped answering for calls - I could not contact him anymore. I did not know the reason, did not understand what was happening. Then I came up with a reason myself: I am fat. By the way, then I weighed 48 kg with a height of 164 cm. I became a vegetarian, I ate twice day, periodically starved and worked out in the gym until the seventh sweat. I was irritated by the feeling of satiety, and I forbade myself everything. After that, compulsive overeating began: I ate so much that it was painful to breathe, and hated myself even more. Monthly periods became irregular, and then I was scared and ran to the gynecologist. She asked me about the diet, and I said that I was eating normally. I was really convinced that I was eating normally, but I overeat because I was weak.

The gynecologist prescribed hormonal. My period went, but when I gave up the pills, they stopped again. It was then that I graduated from the university and stopped receiving the scholarship. Stress, uncertainty and lack of work plunged into panic: after all, now I did not have money for the gym, and I could put on weight. Even then, the depression began. Once I pasted over all the mirrors in the house so that only the face was visible. I could not see myself and my body. I hated them.

She worked. Then my grandmother died. It was hard and I continued to fast and exercise. Menstruation was out of the question, but I didn't care.

So 4 years passed - and all this time I did not suspect that I had an eating disorder. One day a friend developed the same symptoms and her mother bought her antidepressants. I googled these pills and came across the term "bulimia nervosa" - it exactly matched my condition. At first I wanted to drink antidepressants myself, but could not find one that could be sold without a prescription. Then I decided to turn to a psychotherapist to write them out for me. By that time, I no longer wanted to live, it became difficult to get up in the morning. I was so disgusted with myself that I wanted to scratch my face and cut my body.

The therapist was not in favor of prescribing me drugs, but I insisted. I was prescribed a small dose: I drank one fourth of the pill. In parallel, I underwent psychotherapy with him and with a psychologist. The effect of the pills was almost immediately: anxiety and self-hatred disappeared, and a desire to live appeared. My period has gone. After 7 sessions, I gave up both therapy and pills - I suddenly realized that there was my inner work that no one would do for me. There were no side effects and no withdrawal syndrome: at some point, I just began to forget to take the pills.

I quit my job and started working remotely. I remembered what I have always loved - to draw. I entered the second degree in design. When I found myself and began to do what I liked, the problems with food stopped, skipping workouts stopped scaring me. I didn't train all winter because I studied and worked. Now I go to the gym, but only because I like it. I do not limit myself in food, and the breakdowns have stopped. Yes, I have an imperfect body, and now I weigh 57 kg. But none of this matters: I finally began to live. I still have to work on myself: jokes about weight and posts about losing weight work as a trigger and cause bouts of anxiety. I cannot say that I am completely healthy. But I learned to love myself and listen to my body. "

Antidepressants are psychiatric drugs given to people with depressive disorders to relieve symptoms. They correct chemical imbalances in neurotransmitters in the brain that are likely to cause changes in mood and behavior.

Antidepressants can be used for a wide range of psychiatric conditions, including comorbidity, anxiety, and dysthymia ( mild chronic ).

Antidepressants were originally developed in the 1950s. Over the past twenty years, their use has become more common.

Antidepressant use is increasing

In 1996, there were 13.3 million people in the United States who were using antidepressants. By 2010, this figure was 23.3 million. Researchers from Medical Center Columbia University, the New York State Psychiatric Institute and the University of Pennsylvania added that levels remain low among racial and ethnic minorities.

They believe that the use of antidepressants has become more common because:

• The understanding of the needs for
• Promotion campaigns psychiatric care become more common
• Treatment methods mental problems become more widespread among the public

It was reported that adolescents with major depression who received a combination of drugs and psychotherapy for 36 weeks improved significantly compared to patients of the same age who received only one type of therapy. They noted that a higher percentage (15%) of patients receiving fluoxetine had suicidal ideation than those who were on cognitive behavioral therapy (6%) or combined treatment (8%).

Can I become addicted to antidepressants?

Unlike nicotine, some illegal street drugs, tranquilizers, and many pain relievers, you don't need to increase your dose to get the same effect from antidepressants - so they're not addictive in that sense.

When a person stops taking the antidepressant, they will not experience the withdrawal symptoms that are present with nicotine addiction and sudden smoking cessation.

However, studies have shown that almost a third of all patients receiving SSRIs and SNRIs experienced withdrawal symptoms when treatment was stopped. Withdrawal symptoms lasted from two weeks to several months.

Withdrawal symptoms reported included anxiety, dizziness, nightmares and / or vivid dreams, flu symptoms, and abdominal pain. In the vast majority of cases, the symptoms were mild. Severe cases are rare and most often occur when patients refuse Seroxat and Efessor. Doctors should wean patients off antidepressants gradually to minimize the risk of unpleasant withdrawal symptoms.

Is this a withdrawal syndrome or a relapse of the disease? - If a patient has difficulty coping several months after stopping antidepressant therapy, it is probably because their original illness or condition has returned, and not a withdrawal problem.

Disappointing findings regarding exercise and depression, published in the BMJ (British Medical Journal), showed that there were no differences in outcomes between depressed peoplethose who received “conventional treatment” and those who received “conventional treatment plus exercise”.

People with mild depression can benefit from counseling.

St. John's wort, a medicinal herb, has been shown to help a number of people with depression.

National Center for Complementary and alternative medicine, a member of the US National Institutes of Health, says St. John's wort may help some types of depression. However, he also warns that combining St. John's wort with certain antidepressants increases the risk of a potentially life-threatening increase in serotonin. There is also a risk that the herb may reduce the effectiveness of certain prescription drugs. It's important to tell your doctor or pharmacist if you plan to take St. John's wort.

For those with SAD (seasonal affective disorder), a light box can help. The light box is turned on for a specified period every day and the patient sits in front of it. SAD is said to affect some adults and adolescents during the winter months due to lack of sunlight. A lot of sun exposure helps maintain healthy vitamin D levels. Research has shown that women with depression who were treated for vitamin D deficiency responded well and reported fewer depressive symptoms.

The US National Library of Medicine warns that a light box is not effective for about half of all SAD sufferers.

On the Internet, in traditional books and any media, you can find a variety of information about the rules for taking antidepressants, their effects. The forums are full of opinions and advice. The topic is not at all new. Why then correct reception antidepressants remain a stumbling block in the treatment of depression?

What are antidepressants?

Let's first understand the concept of antidepressants.

Antidepressants are substances that are used to treat depression. The doctor can prescribe them for other mental disorders, in combination with drugs from different groups. Antidepressants can have more than just an antidepressant effect on the body.

Properties and effects of antidepressants.

All antidepressants, depending on the effect, can be divided into three groups:

1. Sedative antidepressants. In addition to directly affecting the depressive syndrome, they can help with anxiety, anxiety, bad dream... The most famous representative: Amitriptyline. The drug is a hundred years old at lunchtime, but it is not going to give up its positions in terms of the strength of the antidepressant effect. Of the more modern ones, I can name Mianserin and Buspirone. Doxepin has proven itself very well in my practice.
2. Stimulating antidepressants. It is used in cases where lethargy, passivity, depression and indifference prevail. Everything is clear here, I think. I would like to point out one fact. The stimulating effect occurs significantly earlier than the antidepressant. This is not always good. I prescribe drugs of this group usually together with sedatives (sedatives) in small doses. The most prominent representative is Escitalopram.
3. Antidepressants with a balanced effect. They have incorporated the properties of the first and second groups. Representatives are Pirazidol and Sertraline.

Rules for taking antidepressants.

Now you can talk about the rules for taking antidepressants.

When prescribing any drug, the doctor will certainly tell the patient how to take it, and specifically answer the following questions: “What?”, “When?”, “How much?”, “How often?”.

Anyone who takes antidepressants himself, or looks after the recipient must remember and follow the following rules in the strictest order:

• Take antidepressants regularly. Usually, modern drugs are drunk 1-2 times a day. It is better to keep the schedule and drink the medicine every day at the same time. If one dose was missed, the next pill is taken at the due time. The admission schedule is not shifted, the doses are not independently increased.
• Having a week's supply of medicine at home can avoid many troubles. There is no need to buy 5-10-100 packs of the drug for future use.
• Drink antidepressants with plain water. The use of alcoholic beverages during treatment with antidepressants is strictly contraindicated.
• Only a doctor knows when to end antidepressant treatment. He will tell you how to properly reduce doses without harm to health.
• Antidepressants can have side effects like other medicines, even vegetable origin... There is no need to rush to refuse treatment when side effects... Most of them will go away in the first week of treatment. If the patient is experiencing significant discomfort, malaise is a reason to see a doctor ahead of schedule.
• The choice of antidepressant, the selection of the dosage and duration of treatment is very difficult process... Foresee the same positive effect from treating two different patients is impossible. It is possible that in the course of treatment it will be necessary to repeatedly change doses or antidepressants. It is necessary to assist the doctor in every possible way. Celebrate positive and negative changes in your condition.
• The average course of treatment for depression is about 3-6 months. You need to be prepared for long-term drug use.

Taking antidepressants and the main mistakes of patients.

As you can see, everything is quite simple. But. Errors in taking antidepressants occur hourly.

And here, in fact, are the main reasons for the misuse of antidepressants that I have noted:

1. Fear of becoming different, of changing. Patients are often afraid to take psychotropic drugs. They believe that these drugs can "somehow change my Self." I am convincing. Psychotropic drugs used for medicinal purposes do not change personality. The person will remain as he was. Is that before the illness.
2. Difficulty following doctor's recommendations due to symptoms of depression. Patients with moderate to severe depression do find it difficult to follow antidepressant medication guidelines. Dear relatives! Be vigilant and show concern and attention! Don't leave it all to chance.
3. The influence of others. A sick person seeks help from relatives and friends. Unfortunately, due to the prevailing stereotypes, those around them can harm their misunderstanding of the problem. And they don't want to do anything ... If I face such a problem with my patients, I ask you to come to the appointment with my family.
4. "And the woman Masha from the 34th apartment said ...". She had a lot to say. She could say that "antidepressants turn people into vegetables" (this is my favorite phrase, especially if taken literally), she could say: "you will get used to it and you will sit on this poison for the rest of your days." Do you remember the average time for taking antidepressants? 3-6 months ... Forced, for the veracity of the picture, to make one remark. Severe depressive disorders may indeed require very long-term drug use, but this is an exceptional necessity. In this case, a parallel can be drawn with diabetes mellitus. Insulin is a vital substance. For those suffering from severe depression, antidepressants are vital and allow them to live a full life. Not everything is so gloomy. Depression is not a sentence.
5. Early cancellation due to complications. Something somewhere stabbed, got sick and, of course, antidepressants are to blame. And Baba Masha could have left her mark here too ... Most often, complications are observed in the first week of treatment. Is there reason to blame an antidepressant? Earlier, before depression, did not it prick? Or maybe it stabbed before, but because of depression you did not pay attention? A visit to your doctor will help you figure it out.
6. Refusal to receive with positive dynamics. Almost half of all patients, even those with repeated depressive disorders, stop taking antidepressants when they begin to feel better. This is the worst mistake. Well done, well done doctor. correctly selected treatment, correct reception, positive dynamics ... You cannot quit the drug even if you feel great. It is imperative to complete the course of admission. Most antidepressants require a gradual dose reduction. Too early withdrawal from antidepressants and the inappropriate withdrawal of the drug greatly increase the risk of depression recurrence.

Dear Readers. Antidepressants are meant to help, not cripple. Patients who trust the doctor and follow the recommendations come out of depression earlier. With any difficulties in taking medications, only a doctor is able to assess the patient's condition and give good advice.

All the best.

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Update: October 2018

Depression can be characterized as a common emotional exhaustion... As a rule, this is due to the inability to solve an important, from the point of view of this person, task. When a person is suppressed by external circumstances and she fails to adequately realize her desires and ambitions, the body may well respond with situational depression.

Another common type of depressive disorder is somatized depression. In this case, mental discomfort translates into diseases. internal organs (peptic ulcer, hormonal disorders, cardiovascular problems).

Depression is also known against the background of fluctuations in the level of sex hormones (in menopause or after childbirth) as a result of prolonged stress, chronic or terminal illness, injury, or disability.

In general, depression is irritability multiplied by weakness against the background of a low level of its own pleasure hormones (enkephalins and enedorphins) in the brain, which leads to dissatisfaction with oneself and the surrounding reality in the absence of the strength to radically change something.

Possible workarounds are support from the environment, a specialist (psychiatrist or psychologist) and / or medication... With a favorable combination of circumstances, this will help to choose new priorities in life and get rid of the very reason that entailed a painful state of mind.

Medicines used to treat depression are called antidepressants. Their use created a real sensation in psychiatry and made it possible to significantly improve the prognosis of patients with depression, as well as significantly reduce the number of suicides associated with depressive disorders.

Antidepressants without a prescription

Today, only the lazy is not involved in treating depression. Psychologists with teacher education, coach-trainers of all stripes, folk healers and even hereditary sorceresses. All this heterogeneous company still reads something on the problem and understands that it is unlikely that it will be possible to cure real clinically expressed depression simply by talking and laying on of hands.

And many who feel that they have begun to fall into the pit of a depressive state, but are afraid to go to a psychiatrist, do not mind taking drugs that could simply be bought without a prescription in a pharmacy. This is because the system of psychiatric care in our country still more resembles a light mixture of the army with the bazaar, because either immediately "registered" or for money!

Let's immediately disappoint the audience with the message that antidepressants are prescription drugs today. If a commercial pharmacy, in violation of the rules, sells something without a prescription, then antidepressants from this do not become over-the-counter. They have a lot of serious side effects, so the advisability of taking them, the individual selection of dosages should be carried out only by the attending physician.

Unfortunately, just taking an antidepressant and hoping for a quick relief from depression is a futile business. After all, depression and depression are different. On the same dosages of the same medication for depression, one patient comes to complete clinical recovery, while the other is just beginning to have suicidal thoughts.

What are the best antidepressants to take

Any sane person understands that it is better to be treated with those drugs that have been prescribed by a specialist who understands this, is guided by treatment standards, information about the drug and his clinical experience of using the drug.

Turning your own precious body into a testing ground for antidepressants is at least imprudent. If you have already visited such a fix idea, then it is better to find some Institute of Psychiatry, where programs for clinical testing of medicines are regularly conducted (although you will receive competent advice and free treatment).

In general, antidepressants are medications that lift your mood, improve overall mental well-being, and also induce an emotional uplift without falling into euphoria or ecstasy.

Antidepressant names

Antidepressants can be subdivided according to their action on inhibition processes. There are drugs with a calming, stimulating and balanced effect.

• Soothing: Amitriptyline, Pipofezin (Azafen), Mianserin (Lerivon), Doxepin.
• Stimulants: Metralindol (Inkazan), Imipramine (Melipramine), Nortriptyline, Bupropion (Wellbutrin), Moclobemide (Aurorix), Fluoxetine (Prozac, Prodel, Profluzac, Fluval).
• Balanced formulations: clomipramine (Anafranil), Maprotiline (Lyudiomil), Tianeptine (Coaxil), Pyrazidol.

They are all divisible by seven large groups, each of which has its own indications and preferences for certain manifestations of depression.

Tricyclic antidepressants

These are the first generation drugs. They interfere with the reuptake of norepinephrine and serotonin in the nerve synapse. Due to this, these neurotransmitters accumulate in the nerve junction and accelerate the transmission of nerve impulses. These funds include:

• Amitriptyline, Doxepin, Imipramine
• Desipramine, Trimipramine, Nortriptyline

Due to the fact that this group of drugs has quite a few side effects (dry mouth and mucous membranes, constipation, difficulty urinating, heart rhythm disturbances, hand tremors, visual impairment), it is used less and less.

Selective serotonin reuptake inhibitors

• Sertraline - Aleval, Asentra, Zoloft, Seralin, Stimuloton
• Paroxetine - Paxil, Reksetin, Adepress, Plizil, Actaparoxetine
• Fluoxetine - Prozac, Fluval, Prodel
• Fluvoxamine - Fevarin
• Citalopram - Oprah, Cipralex, Selektra

Such antidepressants are preferable for neurotic depression accompanied by fears, aggression,. The side effects of these drugs are not extensive. The main one is nervous excitement. But large doses or overdose can lead to the accumulation of serotonin and serotonin syndrome.

This syndrome is manifested by dizziness, trembling of the limbs, which can develop into seizures, increased blood pressure, nausea, diarrhea, increased physical activity, and even mental disorders.

That is why popular and good antidepressants like fluoxetine (Prozac), which enterprising pharmacists sometimes sell without a prescription, when taken uncontrolled or exceeded, can bring a person from banal mood disorders to convulsive seizures with loss of consciousness. hypertensive crisis or cerebral hemorrhage, or even to the "slumped roof".

Selective inhibitors of serotonin and norepinephrine uptake

They work similarly to the drugs in the previous group. Milnacipran and venlafaxine are indicated for depression with obsessions or phobias. Of the side effects, they are characterized by headache, drowsiness, anxiety.

Heterocyclic antidepressants

Heterocyclic antidepressants (with a receptor effect) are preferred in the elderly and in cases of depression and sleep disorders. Causes drowsiness, may increase appetite and may contribute to weight gain.

• Mianserin (Lerivon), Nefazodon
• Mirtazapine (Remeron), Trazodone (Trittico)

Monoamine oxidase inhibitors

Drugs of choice for depressive disorders with panic attacks, fear of open spaces, with psychosomatic manifestations (when depression provokes internal illnesses). They are divided into:

• irreversible - Tranylcypromine, Fenelzine
• reversible - Betol, Pyrazidol (Normazidol), Moclobemide (Aurorix)

Serotonin reuptake activators - new generation antidepressants

Able to deal with the symptoms of depression in one week. They are effective for somatized depressions with palpitations, headaches. They are also used for depression of an alcoholic nature or depression with psychosis against the background of cerebrovascular accidents. But these drugs can be addictive like opiates, they include: Tianeptine (Coaxil).

These powerful over-the-counter antidepressants were no longer marketed after many inexpensive high drinkers had misused them throughout the post-Soviet space for several years. The result of such experiments was not only multiple inflammation and venous thrombosis, but also a shortening of life up to 4 months from the beginning of systematic use.

Antidepressants of different groups

• Buspirone (Spitomin), Nefazadone
• Heptral (see)
• Bupropion (Wellbutrin)

List of new generation antidepressants

The most popular today are drugs from the group of selective blockers reverse capture serotonin and norepinephrine.

• Sertraline (Surlift, Zoloft, Stimuloton) - the "gold standard" in the treatment of depression today. Other drugs are compared with it in terms of effectiveness. Preferred in the treatment of depression associated with overeating, obsessive compulsions and anxiety.
• Venlafaxine (Venlaxor, Velaksin, Efevelon) - prescribed for depression against the background of more severe mental disorders (for example, schizophrenia).
• Paroxetine (Paxil, Reksetin, Adepress, Sirestill, Plizil) - effective for mood disorders, melancholy and inhibited depression. Also removes anxiety, suicidal tendencies. Treats personality disorders.
• Opipramol - the best option for somatized and alcoholic depression, as it inhibits vomiting, prevents seizures, stabilizes the autonomic nervous system.
• Mild antidepressants Is fluoxetine (Prozac), which is slightly weaker, but milder than other serotonin uptake inhibitors.

Antidepressants and tranquilizers: difference between groups

In addition to antidepressants, tranquilizers are also used in the treatment of depression:

• This group of medicines eliminates feelings of fear, emotional stress and anxiety.
• At the same time, drugs do not disturb memory and thinking.
• Additionally, tranquilizers are able to prevent and remove seizures, relax muscles, and normalize the autonomic nervous system.
• In medium doses, tranquilizers lower arterial pressure, normalize heart rate and blood circulation in the brain.

Thus, tranquilizers generally differ from antidepressants by the opposite effect on the autonomic nervous system. Also, tranquilizers most of all affect fear and anxiety, which can remove even with a single dose, and antidepressants require a course of treatment. Tranquilizers are more likely to cause addiction and their withdrawal syndrome is more pronounced and severe.

The group's main side effect is addiction. Drowsiness, muscle weakness, prolonged reaction time, unsteadiness of gait, speech disorders, urinary incontinence, weakening of libido may also develop. In case of overdose, paralysis of the respiratory center and respiratory arrest may develop.

With a sharp withdrawal of tranquilizers after a long intake of them, withdrawal syndrome may develop, manifested by sweating, trembling limbs, dizziness, sleep disturbances, intestinal dysfunctions, headache, drowsiness, hypersensitivity to sounds and smells, tinnitus, disorders of perception of reality, depression.

An overview of herbal antidepressants (over the counter)

Often, herbal sedatives are referred to antidepressants, which are not any antidepressants:

• Preparations of Valerian, Melissa, Peppermint, Motherwort
• Combined tablets - Novopassit, Persen, Tenoten - these are sedatives that will not help with depression.

The only medicinal plant with antidepressant properties is perforatum and drugs based on it, which are prescribed for mild depressive conditions.

There is one thing: in order to eliminate the manifestations of depression, synthetic drugs, which are dozens of times superior in effectiveness, have to be drunk in courses of several months. Therefore, St. John's wort will have to be brewed, insisted in kilograms, and consumed in liters, which, of course, is inconvenient, and inappropriate, although it can somewhat distract from sad thoughts about the frailty of everything during depression.

The pharmaceutical industry offers St. John's wort in tablet form without a prescription as a mild antidepressant (nootropic) for psychovegetative disorders, neurotic reactions, mild depressive conditions - this is Deprim, Neuroplant, Doppelgerts nervotonik, Negrustin, Gelarium. Since the active substance in the preparations is the same, then contraindications, side effects, interaction with others medicines these drugs are similar.

Deprim Composition: dry standardized extract of St. John's wort. It has a pronounced sedative effect, since active substances St. John's wort - pseudohypericin, hypericin, hyperforin and flavonoids have a positive effect on functional state CNS and autonomic nervous system. Increases physical activity, improves mood, normalizes sleep. Indications: sensitivity to weather changes, mild depression, anxiety, Contraindications: severe depression, pills for children under 6 years old are contraindicated, capsules under 12 years old, hypersensitivity - allergic reactions to St. John's wort and the components of the drug, the effect of the drug on the fetus - there are no reliable studies, therefore, it is not prescribed during pregnancy and lactation. Dosages: from 6 to 12 years old only under the supervision of a doctor, 1-2 tablets in the morning and in the evening, for adults 1 capsule or table 1 r / day or 3 r / day, possibly 2 tablets 2 times a day. The effect occurs after 2 weeks of admission, you can not take a double dose in case of missed admission. Side effects: constipation, nausea, vomiting, anxiety, feeling tired, itchy skin, skin redness, photosensitivity - the simultaneous administration of the drug and sunbathing can lead to (see). Tetracyclines, thiazide diuretics, sulfonamides, quinolones, piroxicam especially enhance photosensitization. Overdose: weakness, drowsiness, side effects intensify. Special instructions: you should carefully prescribe the drug simultaneously with other antidepressants, oral contraceptives (see), it is not prescribed simultaneously with cardiac glycosides, cyclosporine, theophylline, indinavir, reserpine. Strengthens the action of analgesics, general anesthesia. During the intake, you should avoid drinking alcohol, exposure to the sun and other UV radiation. If after a month of use there is no improvement, the use is discontinued and a doctor should be consulted.

Neuroplant 20 tab. RUB 200 Ingredients: dry extract of the herb St. John's wort, ascorbic acid. Indications and contraindications are similar to the drug Deprim. In addition, Neuroplan is strictly contraindicated for children under 12 years old, for women during pregnancy and breastfeeding, with increased photosensitivity, it is prescribed with caution when diabetes mellitus. Dosage: It is better to take before meals, do not chew, but take 1 table whole with water. 2-3 r / day, also if there is no effect within several weeks of admission, the drug is canceled and the treatment is adjusted. Side effects: indigestion, skin allergic reactions, psycho-emotional stress, apathy,. Simultaneous reception with other drugs: reduces the concentration of hormonal contraceptives and increases the risk of occurrence. When taken simultaneously with antidepressants, the likelihood of side effects increases - unreasonable fear, anxiety, vomiting, nausea, as well as a decrease in the action of amitriptyline, midazolam, nortriptyline. When taken with drugs that increase photosensitivity, the risk of photosensitivity increases. Neuroplant reduces therapeutic action indinavir and other HIV protease inhibitors, drugs used to treat cancer that inhibit cell growth.

Doppelhertz nervotonic 250 ml. 320- 350 rubles. Ingredients: Elixir Doppelgerts Nervotonic - liquid extract St. John's wort, as well as cherry liqueur concentrate and liqueur wine. Indications and contraindications are similar to Deprim and Neuroplant. Additionally: with caution, Doppelgerts Nervotonik is taken for diseases of the brain, for liver diseases, head injuries, for alcoholism. Side effects: rarely allergic reactions, in persons with fair skin with a tendency to photosensitivity - photosensitivity reactions. Application: 3 r / day, 20 ml. after eating for 1.5-2 months, if there is no effect, you should consult a doctor. Special instructions: like other drugs with St. John's wort extract, interaction with other drugs should be taken into account when taken simultaneously. The drug contains 18 vol.% Ethanol, that is, when taking the recommended dose, 2.8 g of ethanol enter the body, therefore, from driving vehicle and you should refrain from working with other mechanisms that require the speed of psychomotor reactions (driving a car, working as a dispatcher, working with moving mechanisms, etc.)

Negrustin Capsules Negrustin - dry extract of St. John's wort Solution Negrustin - liquid extract of St. John's wort Indications, contraindications and side effects are similar to other preparations of St. John's wort. Dosage: children over 12 years old and adults 1 capsule 1-2 r / day or 3 r / day 1 ml. solution, course of therapy 6-8 weeks, possibly repeated courses. Capsules should be taken with meals, washed down with liquid, the solution can also be taken diluted with meals, or not diluted. Special instructions: Like other drugs with active ingredient St. John's wort extract should be used with caution when used together with the drugs listed above. Sorbitol is contained in the Negrustin solution and 121 mg is supplied with each intake. Also, the drug is prescribed with caution to persons with fructose intolerance. Negrustin, while consuming alcohol or tranquilizers, affects the psychophysical abilities of a person (driving vehicles and working with other mechanisms).

Gelarium Dragee Gelarium Hypericum - dry extract of the herb St. John's wort. Indications, contraindications, side effects, interaction with other drugs similar to all drugs with St. John's wort. Application: 1 tablet 3 r / day over 12 years old and for adults, a course of at least 4 weeks, during meals, washed down with water. Special instructions: the interval between taking the above drugs (with simultaneous administration) should be at least 2 weeks, in diabetes mellitus, it should be borne in mind that a single dose contains less than 0.03 XE.

In pharmacy chains, phytopreparations with St. John's wort are widely presented, the price is 20 filter bags or 50 gr. dry matter 40-50 rubles.