What antidepressants to take. Taking antidepressants and the main mistakes of patients

What are antidepressants? Evil, from which a person becomes dependent, weak, unable to cope with depression on his own or salvation from depression and others mental problems. In this article, you will learn the whole truth about them, myths and reality, learn about the harm of antidepressants on the human body, about possible benefits and much more.

What are antidepressants really and what are they for

In short, antidepressants are drugs that restore a chemical imbalance in the brain, resulting in a decrease in the oppressive, depressive state of the psyche.

Indeed, it has been scientifically proven that depression occurs due to a lack of certain hormones in the body that are responsible for good mood such as serotonin and dopamine. So you just need to restore the balance of these substances, and the person will get rid of his depression.

Everything seems logical, but this is only a superficial view of the problem. And also, let's not forget what any drugs are needed for at all.

Most of the drugs invented by people and which everyone now drinks in large quantities, in the hope of becoming healthy, will never really cure a person. In most cases, they only relieve symptoms, alleviate conditions, but do not solve the problem at the root. Of course, I'm not talking about all drugs, but, I repeat, most drugs have such a sin and antidepressants belong to them.

When we get sick, we want to take some miracle pill and get rid of our suffering forever.

But this is an illusion.

Remember once and for all:

There are no miracle cures and there never will be.

Moreover, no antidepressant will make you a happy person who does not know what depression is.

To gain mental health, you need some work on yourself and a number of methods that restore the normal functioning of the psyche.

Antidepressants, like other drugs, can be used as a necessary measure in severe cases to quickly help a person, relieve symptoms, and alleviate the condition. But if a person wants to get rid of depression in the future, he should give them up, since antidepressants will only reduce the chance of recovery later. Why is that?

What are the dangers and harms of antidepressants?

To understand why drugs will never get rid of depression, you need to understand why it occurs.

Yes, it is true that during depression, the concentration of certain hormones decreases. But this is only a consequence of more complex pathological processes in the body, leading to such an imbalance. And if we artificially, with the help of antidepressants, change the amount of hormones, then we can change the pathology only for a while. Then it will return again and often with even greater force. We have not solved the problem at the root.

Depression is a disease of the soul and body, an imbalance in the internal energy, a distorted view of the surrounding reality.

Depression can come from either too low energy or too high. With a low level of energy, a person ceases to experience such positive feelings as joy, love, pleasure, he loses his taste for life. And with high energy, but distorted work of the psyche, this distortion, mental pathology increases with high energy. For example, some obsessive wrong thought is highly charged energetically, distorts the view of the surrounding reality, does not allow you to live normally, and leads to depression.

To cope with depression, you need to correct mental distortion, as well as restore balance in energy. If the energy is very low, you need to increase it.

And how do antidepressants and many other drugs used to treat mental pathologies in fact. Yes, they change the hormonal composition, but they also reduce the level of vital energy. Now the energy that fed the pathological distorted state of the psyche, which does not allow a normal life, is reduced and the person no longer feels it so strongly. He can forget about it, push it out of the actual consciousness. But it didn't disappear. Distortion driven deep inside. It can be said that antidepressants do not cure depression, but drive it inside, into the subconscious, reducing the strength of its influence. But the problem has not disappeared, it continues to poison a person, but it does so imperceptibly.

Often the cause of depression is some kind of internal feeling, which, as a result, for example, of stress, was driven inside. A person cannot understand what it is, but this feeling unconsciously, imperceptibly for the person himself, spoils his life. To get rid of a driven emotion, you must first get it from the depths of the subconscious, and then dissolve it, realizing it. And antidepressants, on the contrary, drive negative emotions, the causes of depression, deeper into the depths. It seems to be easier for a person, but in fact, a driven feeling will sooner or later shoot in the form of a disease of the body or an even greater distortion of the psyche.

How will antidepressants affect the human body if you start taking them?

By artificially changing the hormonal background, they take reserve energy sources of the body for these purposes. All this is unnatural and greatly reduces vitality. Imagine that there is a violation at a deeper level, and we are artificially trying to change this violation at a superficial level. As a result, prolonged use of drugs turns a person into a "vegetable" with low energy, no longer able to really cope with depression.

And as mentioned above, a low level of vital energy is also one of the causes of depression, as a person ceases to experience positive feelings and emotions. Over time it turns out vicious circle from which there seems to be no way out.

Antidepressants cause addiction

Antidepressants are like drugs and are addictive, mentally and physically addictive.

Indeed, after drinking a course of pills, a person seems to get better, especially at first. A program is formed in the brain, a chain: a pill - a decrease in the symptoms of depression - positive, albeit artificially created feelings and emotions. Now this program is difficult to get out of my head. During the next difficult states of the soul, it turns on and the person reaches for the pills. If they are not there, the program is not executed, it crashes, positive feelings do not come. This psychological dependence. Also, the body gets used to the artificial equalization of hormones and if depression occurs again, it does not feel very good. This is a physical addiction.

The depressed sufferer is caught in a vicious cycle that leads to more depression in the future. big problems.

He cannot break out of it in order to truly get rid of the disease.

To defeat depression, you need energy, willpower, a desire to get rid of it.

And antidepressants kill all this in a person, reduce the level of vital energy. It turns out a vicious circle also due to the fact that it seems impossible to increase energy, because it will feed mental distortion, aggravating depression.

The person is completely trapped.

There are also breakdowns during the abolition of antidepressants, although these are not such severe conditions as with drug addiction, but still the body suffers very much.

It is not uncommon when, after the abolition of antidepressants, especially sharp, one feels feeling unwell, headaches, decreased vitality, the return of depression with even greater force.

Therefore, you need to know how to give up antidepressants correctly, you won’t be able to stop drinking them abruptly, especially if you have been taking them for a long time. Some people drink them all their lives.

But how to still get rid of dependence on antidepressants, you will learn at the end of the article.

Do antidepressants really help?

Irwin Kirsch of the British University and his team conducted a study and came to the stunning conclusion that many antidepressants help only because of the placebo effect. In his opinion, drugs for depression are simply useless.

Many criticized his work, citing unprofessional research, however, he raised a fuss. Many have wondered whether antidepressants actually cure, whether it is possible to drink them, or is it better not to drink them at all.

Of course, most drugs do change brain chemistry. But the recovery of the subjects mainly occurred due to the fact that the reserve forces of the body, capable of miracles, woke up inside. Faith in medicines helped trigger these forces. To understand how this happens, please read the article about.

For those who did not have the placebo effect, changes, I repeat, also occurred, but the result was already much worse.

There have also been studies confirming bad influence antidepressants on the human body. Many antidepressants simply don't have the effect they're advertised for and do much more harm. There is action, but it is not what it should be.

It is not profitable for pharmaceutical companies to tell the whole truth. After all, they make billions of dollars on it. The disadvantage of any advertisement is that it shows a part of reality, embellishes it, does not show the other side of the coin. And this also applies to antidepressants. If everyone is cured of depression, who will take the pills? It just doesn't work for the system.

The American biologist Paul Andrews, in the course of his research, came to the conclusion that antidepressants help only at the very beginning, with a short-term intake, taking the patient out of a severe mental crisis. Prolonged exposure to antidepressants is not only ineffective, but has a destructive effect on the body and psyche.

Until now, there are disputes around antidepressants, there are pros and cons, both among physicians and among patients.

The danger of antidepressants, the consequences of their use, side effects

There have been numerous studies confirming the harmful effects of antidepressants. Mostly they write about the negative effect on the liver, about getting used to them. However, there are a number of other possible complications and side effects as a result of long-term use of antidepressants:

• disruption of work of cardio-vascular system, tachycardia, low blood pressure;
• problems with the gastrointestinal tract, nausea, vomiting;
• headaches, noise in the head;
• drowsiness, weakness, and insomnia;
• improper metabolism;
• hormonal disbalance;
• loss of concentration;
• change in character traits;
• a person becomes either aggressive or weak-willed, lethargic, weak-willed.

As well as other side effects, problems with the psyche and body.

It is also possible poisoning with antidepressants, the effect on potency in men, the failure of menstruation in women.

The negative effect of antidepressants on the brain, psyche, and thinking is confirmation that a person is turning into a "vegetable" with a lack of willpower, with an inability to really cope with depression in the future. And the negative impact on the body, health problems with prolonged use of antidepressants is the result of not only chemical exposure drugs, but also pathological changes with a general decrease in vital energy.

Basically, all sorts of problems arise from the prolonged use of drugs.

Benefits of antidepressants

Despite the fact that antidepressants have a negative effect on the body, turn a person into a weak-willed creature with a lack of fortitude, in some cases they are simply necessary. As with everything, it has its pros and cons.

Depression is a complex disease with many causes and in many cases difficult to treat. Violation of neurochemical processes in the brain can arise from many factors.

Often this leads to great distortions in the psyche, to a disruption in the normal functioning of the body, and a person cannot cope with this. He loses his last vitality, the will disappears, the desire to do something, but the desire to live simply disappears. Suicidal thoughts arise.

If urgent action is not taken, a person will find himself in such a severe depression, from which it will then be very difficult to escape. In such cases, antidepressants come to the rescue. They help not to fall into the abyss of deep depression, help to recover.

Therefore, if you have a very severe depression, you have no strength at all, do not self-medicate, run to the doctor. Consult a psychologist, a psychotherapist or even a psychiatrist. In severe cases, only a specialist can help you, only he will prescribe the necessary medicines for you.

In severe cases, antidepressants are needed in complex therapy.

But we must remember that this is only a temporary measure that alleviates the symptoms of a depressive state, but does not actually cure depression. And when long-term use often backfiring. Don't forget that antidepressants make you weaker, and to truly cope with depression, you need inner strength, which is so lacking in those who fight depression by artificially increasing brain biochemistry.

When a person is already flying into the abyss, at least something, at least a small twig, is needed to hold on and not fall to the very bottom. But in order to then get out of this abyss, you need to apply diligence and strength. Make a dash and climb up. And if a person continues to hold on to the same branch, he will not only remain in a hanging position, but may also fall and break to death. The branch will not be able to hold a person for a long time. Same with antidepressants.

Depression needs to be fought. But often a person cannot or simply does not want to understand the cause of the depressive state and eliminate the root problem of the disease. It’s easier to take a sedative or get hooked on antidepressants, as a result of which depression simply drives inward, leading to even more problems in the future. It's hard for a person to stop.

Therefore, if you have not very severe depression, it is better not to take antidepressants at all. Do not drive yourself into a trap from which it will be difficult to escape. Think about whether it is worth taking antidepressants if they will bring even more problems in the future.

How to live without antidepressants

Is it possible to live without antidepressants and how to cope with depression without them? This is possible and the only way to deal with severe blues. After reading this article, I think you will finally think about the fact that antidepressants only destroy your brain, do not cure depression in the long run, but only have the opposite effect, they make you and your body bad.

You can read how to cure depression without antidepressants at home in a separate one.

Follow the tips from that article and you will gradually get rid of depression. Of course, this will not happen immediately, be patient, but it will be a real path to a happy and healthy life. The real way, not artificial with the help of pills. A real one that strengthens your psyche, making you stronger in spirit.

And where there is strength of mind, there is no depression and other mental problems. Trust me, I've been through this myself. But if you have been taking antidepressants for a long time, you should stop them gradually. But you need to refuse, you don’t need to stretch it out for a long time, otherwise you will never quit. Applying the tips from the article on how to get rid of depression over time, you just don’t want to take them yourself. You will start new life no depression and no antidepressants.

Good luck to you.

Two videos for you.

Sincerely, Sergey Tigrov

Depression, antidepressants and their use is a complex and sensitive topic in relation to antidepressants. Depression is not an independent disease, but is caused by various reasons and diseases. It is very common and, according to WHO, more than 300 million people worldwide suffer from it. Depression differs from normal mood changes in the duration and severity of the course. In severe forms, it leads to severe suffering, disruption of functioning at work and at home. In the most dangerous cases, it can lead to suicide. When a person is depressed, suicidal thoughts are visited, which are his symptom. In such cases, many need treatment, patients are not always ready to agree with this. People with depression often cannot cope with depression on their own. He needs the help of a doctor, a psychologist, the help of friends and colleagues, and often medication.

Antidepressants are divided into several groups:

Drugs that block neuronal uptake of monoamines
Non-selective action, blocking the neuronal uptake of serotonin and norepinephrine (imipramine, amitriptyline)
electoral action
Blocking neuronal uptake of serotonin (fluoxetine)
Blocking the neuronal reuptake of norepinephrine (maprotiline)
Monoamine oxidase (MAO) inhibitors
Non-selective action, inhibit MAO-A and MAO-B (nialamide, transamine)
Selective action, inhibit MAO-A (moclobemide).
Monoamine receptor agonists
Noradrenergic and specific serotonergic antidepressants
Specific serotonergic antidepressants

In each of the groups there are several dozen drugs and their analogues, but only a practicing psychiatrist can choose the right treatment, since an antidepressant can work in one case, but not in another. To prescribe drugs of this group, most of of which are sold by prescription, qualifications and experience are required. The doctor selects the type of antidepressant, dose and treatment regimen.

Some people have the misconception that antidepressants are addictive and addictive. Is it so?

Of course, some drugs, not only psychotropic ones, can be addictive, but this, firstly, does not always happen, and secondly, for this, the doctor's help in treatment is needed so that, by manipulating different types medicinal substances, dose, regimens, etc., minimized side effects. Many drugs do not cause addiction and withdrawal syndrome; others, upon reaching the effect, must be abandoned gradually, leaving the body to cope on its own. But the most common practice is to gradually reduce the dose over the course of a month. In some cases it is necessary hospital treatment under daily supervision. Therefore, fears about addiction, withdrawal syndrome, etc., are exaggerated and all risks are offset by the fact that antidepressants should always be taken under medical supervision.

There is also a common misconception that psychotropic drugs change the personality of a person who supposedly can stop being himself. In reality, antidepressants do not affect the personality component, mental abilities, and the mind always remains with a person. Antidepressants remove anxiety, painful tension, etc. Will suppression occurs at high doses, which lead to severe drowsiness. For a person, depression is primarily dangerous, especially in severe forms, and full life recovers after it has been overcome.

Sometimes people with depression fear that they think antidepressants have serious side effects. Indeed, all drugs, with rare, even the rarest exception, have side effects. And therefore, many products are sold only by prescription, and almost all are recommended for use only under the supervision of a doctor. The art of the doctor is to minimize side effects, for which sometimes it is enough to replace one remedy with another, reduce the dose, etc.

The most common side effects include nausea, weight gain or loss, lethargy, drowsiness, and insomnia. but in most cases, they are not dangerous to life and health, it is enough to reduce the dose or replace it with an analogue or a drug from another group.

When treating with antidepressants, it is also necessary to understand that they cannot get out of depression at once, but require a course of treatment and it is unacceptable to abruptly interrupt the intake process as soon as it gets better. For most antidepressants, the period when symptoms disappear is at least two weeks, when anxiety, fears, etc. begin to go away. But this does not mean that the treatment is over. Taking the risk of stopping the drug at the first positive effect, you can get a "withdrawal syndrome", or "rebound syndrome", so the antidepressant must be taken in a course, and the terms must be strictly determined by the doctor.

In the same time Do not think that antidepressants will solve all problems. In case of achievement therapeutic effect they relieve symptoms, help to get out of a difficult situation, but a lot depends on the person himself - he must rethink his life situation, work on himself. Treatment gives strength, but if he does not change something in life, then the depressive state will return.

Self-treatment. Antidepressants are prescribed by a doctor; they cannot be sold in pharmacies without a prescription. It is dangerous to self-medicate, since the application requires special knowledge that cannot be gleaned from popular articles read on the Internet. Even with treatment under medical supervision, constant monitoring and course adjustment is required, it is impossible to cure yourself on your own just as it is impossible to pull yourself out of the swamp by the hair. moreover, even among doctors there is an opinion that a doctor cannot treat himself in difficult cases. If you do not have mutual understanding with the doctor, then you do not need to brush aside medical assistance in general and look for another.

Accounting in PND - a stigma for life? This question can be painful, especially since many people remember the times when this information came to work, at the place of study, but now information about registration in the IPA can only be obtained at the request of the court or the internal affairs authorities. When applying for a job, sometimes you need a certificate from a psychiatrist, but the psychiatrist does not write in the certificate whether the person is registered, but gives an opinion on the person’s ability to work in this position. In the case successful treatment and the absence of exacerbations, a person is deregistered after a few years.

It is also worth remembering that antidepressants are the most important and necessary allies of treatment, but do not give health on their own, automatically. They must be used correctly, and the patient is simply obliged to want to be cured and must himself help the doctor to make him healthy.

We wish you health and a long, happy life!

Antidepressants are medicines that are aimed at treating and eliminating various kinds depression. It should be distinguished simply Bad mood and drug-induced depression. You do not need to swallow pills if you are able to survive stress on your own. Antidepressants have a number of side effects that can make the situation worse.

Depression can lead to a variety of illnesses.

There are visible and invisible causes of depression. The visible ones can be recognized immediately.

It could be:

1. Loss of loved ones;
2. Job loss;
3. Some bright unpleasant event in life.

And there are invisible reasons when neither you nor the doctor can immediately determine a sharp deterioration emotional state. Perhaps something was accumulating inside, or you realized some unpleasant things.

Most often emotional disorders at people are observed in the spring and autumn periods. This is due to the fact that there is a sharp change in the weather. In one case - for the better, in the other - for the worse. Such changes are reflected in our condition, and in some people too much.

How to get rid of depression?

So that the body does not experience a deficiency of serotonin, try to always make your life brighter than it is now. Say yes to your life!

1. Participate in all the activities that someone offers you. If there are none, then most likely you have a bunch of themed evenings and parties in the city.
2. Get involved in sports, if not professionally, then at least as an amateur. At any time of the year, you can lead an interesting sports life: rollerblading or skating, cycling or skiing, swimming in the river or in the pool, exercising in the gym.
3. Find new friends. You can get acquainted both on the Internet and in everyday life. You will see how diverse life can be.
4. Eat right, sometimes allow yourself chocolate, eat fruits more often, especially bananas and citrus fruits. They will help lift your mood, and antidepressants may not even come in handy;
5. Travel when possible. If it is not there, then explore the nearby territories, there will also be a lot of interesting things there.
6. Find a circle of interests - participation in some kind of party, in various business communities, musical events can very well change your life. Try to find them, if it didn’t work out, organize it yourself!

Names of antidepressants

Now we will analyze what antidepressants are. It should be remembered, as a rule, they are prohibited for sale without a prescription. Therefore, either you go to the doctor and he writes you a prescription, or you use antidepressant drugs that you can buy at the pharmacy, more on that below. Of course, private pharmacies, for their own benefit, can sell antidepressants without a prescription, taking risks and transgressing the law. But you need to understand that such laws were invented for a reason. Taking strong antidepressants puts your health at risk.

Medications for depression:

• tryptophan;
• rexetine;
• noofen;
• fluoxetine;
• sonopax;
• amitriptyline;
• paxil;
• grandaxin.

a) Paxil b) "Noofen"

Side effects of antidepressants

Self-administration of such drugs can cause unpleasant side effects.

It could be:

• headache;
• vomit;
• diarrhea;
• insomnia;
• anxiety;
• lack of appetite;
• temperature.

And other disorders. They depend on the type of medicine.

Taking antidepressants - reviews

In their reviews, women often complain about side effects, but there are those for whom the drugs really helped.

A lot of people have already tried antidepressants, some of them were prescribed by a doctor, others managed to buy them on their own. How to proceed - see for yourself, but we recommend that you first consult with knowledgeable person. Because you can immerse yourself in the state of an even larger vegetable than you were before.

Antidepressants without a prescription

There are antidepressants that you can buy at the pharmacy without a prescription:

1. afobazole;
2. new pass;
3. hawthorn tincture;
4. Valerian tincture;
5. negrustin.

Most of them are made on the basis of herbs and do not cause addiction, do not harm the body. If the situation has not gone far, then it is better to do with simple drugs.

Treatment with antidepressants - consequences

Antidepressants can cause addiction, hallucinations, sleep disturbance. Possible decreased libido. Therefore, strong drugs should be taken only as directed by a doctor. In mild cases, you can get by with a tincture of hawthorn or valerian.

On the Internet, in traditional books and by any means mass media you can find a variety of information about the rules for taking antidepressants, their effects. Forums are full of opinions and advice. The topic is by no means new. Why 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 in the treatment of depression. The doctor may prescribe them for other mental disorders in combination with drugs 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 a direct impact on 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 position 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. Stimulant antidepressants. Used in cases of dominance of lethargy, passivity, depression and indifference. Everything is clear, I think. I would like to point out one fact. The stimulating effect occurs much earlier than the antidepressant. This is not always good. I prescribe drugs of this group usually together with sedatives (sedatives) in small doses. The brightest representative is Escitalopram.
3. Antidepressants with a balanced effect. They absorbed the properties of the first and second groups. Representatives Pyrazidol and Sertraline.

Rules for taking antidepressants.

Now we can talk about the rules for taking antidepressants.

By appointing any medicinal product the doctor will definitely tell the patient how to take it, and specifically answer such questions: “What?”, “When?”, “How much?”, “How often?”.

Any person who takes antidepressants himself, or looks after the recipient, must remember and observe the following rules in the strictest order:

• Take antidepressants regularly. Usually, modern drugs, drink 1-2 times a day. It is better to keep a schedule of taking and drink the medicine every day at the same time. If one dose was missed, the next tablet is taken at the scheduled time. The schedule of admission is not shifted, the doses are not independently increased.
• Having a weekly supply of medicine at home can avoid many troubles. There is no need to buy 5-10-100 packs of the drug for the future.
• Take antidepressants with plain water. The use of alcoholic beverages during treatment with antidepressants is strictly contraindicated.
• Only a doctor knows when to finish a course of antidepressant treatment. He will tell you how to properly reduce doses without harm to health.
• Antidepressants can have side effects like other medicines, even plant 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 experiences significant discomfort, malaise is a reason to consult a doctor ahead of schedule.
• The choice of antidepressant, the choice of dosage and duration of treatment is a very difficult process. Anticipate the same positive effect from treatment in 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 cooperate with the doctor in every possible way. Notice 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 medication.

Taking antidepressants and the main mistakes of patients.

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

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

1. Fear of being different, of changing. Patients are often afraid to take psychotropic drugs. They believe that these drugs can "somehow change my self." I convince you. Psychotropic drugs used for therapeutic purposes do not change personality. The man will remain as he was. Except for illness.
2. Difficulty following doctor's recommendations due to symptoms of depression. It is really difficult for patients with moderate and severe depression to adhere to the rules for taking antidepressants. Dear relatives! Be vigilant and show care and attention! Don't leave everything to chance.
3. The influence of others. A sick person seeks help from relatives and friends. Unfortunately, due to the prevailing stereotypes, others can harm with their misunderstanding of the problem. And my hands fall down to do something ... If I encounter such a problem with my patients, I ask you to come to the appointment with your relatives.
4. "And Baba 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 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 can indeed require very long medications, but this is an exceptional need. In this case, a parallel can be drawn with diabetes. Insulin is a vital substance. For those suffering from severe forms of depression, antidepressants are vital and allow them to live fully. Not everything is so gloomy. Depression is far from a death sentence.
5. Early cancellation due to complications. Something, somewhere, stabbed, got sick, and of course, antidepressants are to blame. And Baba Masha could leave her mark even here ... Most often, complications are observed in the first week of treatment. Is there any reason to blame the antidepressant? Previously, before the depression, did not prick? Or maybe you used to prick, but because of depression you did not pay attention? A visit to the doctor will help sort things out.
6. Refusal to accept with positive dynamics. Almost half of all patients, even those who have repeatedly suffered depressive disorders stop taking antidepressants when they start to feel better. This is the worst mistake. You are great, good doctor. correctly selected treatment, correct intake, positive dynamics… You can’t stop taking the drug even if you feel great. You must complete the course. Most antidepressants require gradual dose reduction. Stopping antidepressants too early and inappropriately stopping the drug greatly increases the risk of depression recurring.

Dear readers. Antidepressants are meant to help, not hurt. 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 practical advice.

All the best.

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« Recently, there has been more and more talk about anxiety-depressive disorders and their treatment - antidepressants. On Internet forums about these drugs, the most polar opinions are heard - from enthusiastic praise to terrible curses. Is there any objective information on this?»

What are antidepressants?

ANTIDEPRESSANTS new generation is special group psychotropic drugs, which never and under no circumstances cause any drug dependence (this risk exists only if used incorrectly tranquilizers), nor prolonged inhibition, emotional flattening or a decrease in the clarity of consciousness, memory, attention, mental activity (data negative effects are possible mainly by using neuroleptics and tricyclic antidepressants of the past generation). The vast majority of neurotic psycho-emotional disorders with which they turn to a psychotherapist are successfully treated with one well-prescribed antidepressant. The cause of failure, as practice shows, is not the drug itself, but.

What are new generation antidepressants?

New generation antidepressants, or serotonin-selective antidepressants, refer to SSRI group– selective inhibitors recapture serotonin. They are ideally tolerated, do not have cardio-, nephro- and hepatotoxic effects, i.e. do not have a negative effect on the liver, kidneys, heart and other organs, many of them are widely used in childhood and old age, with concomitant physical diseases, in the post-infarction and post-stroke periods, in combination with others therapeutic agents. V Western countries modern antidepressants are increasingly positioned as drugs that improve the quality of life, because they allow you to maintain a sense of inner comfort, resistance to stress and a positive attitude towards life for a long time and stably.

How does an antidepressant work?

Simply put, antidepressant effect manifested by the fact that the brain comes out of the stressful mode of functioning - anxiety decreases, internal stress is removed, mood improves, irritability and nervousness disappear, normalization night sleep, stabilizes the vegetative nervous system- for example, palpitations, dizziness, headache, fluctuations in blood pressure, emotionally caused disorders of the stomach, intestines, etc. stop. This is achieved by restoring the proper functioning of brain neurotransmitters - serotonin, norepinephrine, dopamine and other protein molecules that ensure the transmission of electrical impulses between neurons. This takes time, so the effect of modern antidepressants develops very gradually, manifesting itself no earlier than 3-5 weeks from the start of the drug. Full final effect high degree depends on: 1) right choice drug, 2) the correct selection of the dosage, 3) the correct duration of treatment; 4) correct cancellation. Violation of even one of the points can lead to the failure of the entire treatment, and such cases are widely discussed by patients who unjustifiably consider the drug itself to be the cause of failure.

How to take an antidepressant correctly?

Treatment with antidepressants consists of two main stages:

1) main, during which all symptoms of depression, anxiety neurosis or autonomic dysfunction (the use of an antidepressant does not at all mean that the patient's problem is precisely or only depression);

2) supportive, preventive(or control), during which it is absolutely necessary to continue treatment in the absence of symptoms and the patient's ideal state of health. Moreover, only under this condition, maintenance treatment makes sense, otherwise the choice of the drug and / or its dosage should be reviewed.

Thus, if the full effect is absent at the first stage of treatment, then it is pointless and wrong to continue it in a maintenance regimen, since this can cause a decrease in the body's susceptibility to the drug (resistance, tolerance) and its further inefficiency.

How long should an antidepressant be taken?

With a competent approach, drawing up the final treatment regimen usually requires only 2-3 consultations of a psychotherapist in the first 2-3 months of treatment. The main period of treatment until the elimination of all symptoms of a psycho-emotional disorder usually takes 2-5 months. After that, the therapy in no case stops, but goes to a maintenance stage, which, in the absence of external aggravating factors (continuous or new unforeseen emotional stresses, endocrine disorders, somatic diseases, etc.), usually lasts 6-12 months, much more rare, but requiring that cases - can last for years.

This situation can be compared, for example, with treatment hypertension when long-term or even constant use of a drug that normalizes blood pressure is necessary. It would never occur to anyone that a hypertensive patient is "addicted" or "used" to a drug that allows him to live with a normal blood pressure, everyone understands that long-term treatment is necessary based on the characteristics of the disease. However, even this is an exaggeration: the course of taking an antidepressant in the vast majority of cases is only long-term, and not lifelong.

I emphasize again that a long course of treatment with an antidepressant makes sense not in anticipation of the result, but after it has been achieved, i.e. performed when the patient is in perfect health.

When can an antidepressant be stopped?

Stopping antidepressant treatment, as well as its beginning, must necessarily be agreed with the attending physician and is carried out not so much for medical reasons (all the more so, the date of cancellation is not determined by any calendar period), but for socio-psychological indications, i.e. when positive changes stably manifest themselves not only in the patient's well-being, but also positively affect the events of his life, for example, lead to a real way out of that negative psycho-traumatic situation in which the neurosis arose.

How to stop an antidepressant?

Cancellation of an antidepressant should be carried out gradually according to the scheme proposed by the attending physician and should not be sharp or sudden, but also excessively prolonged. The higher the dosage of the drug, the longer the cancellation is made, but in any case, this period takes no more than a month, otherwise the situation described in.

Unforeseen interruptions are undesirable during treatment (there should always be a supply of 1-2 packs at home), because. 3-4 days after the sudden cessation of taking an antidepressant, a harmless, but subjectively unpleasant withdrawal syndrome, caused not by dependence or addiction to the drug, but by an "unexpected" for the brain receptors, the cessation of its entry into the blood, which often happens also with a sharp abolition of other medicines that are not psychotropic.

In the event of an unforeseen interruption in taking an antidepressant, all manifestations of the withdrawal syndrome disappear within the next few hours after the resumption of its reception, and if the reception is not resumed, then they completely disappear within 5-10 days.

With well-planned withdrawal of an antidepressant, whatever the duration of its use, the withdrawal syndrome, if felt, does not cause any serious inconvenience. Some antidepressants (eg, fluoxetine, vortioxetine) are generally not capable of causing a withdrawal syndrome under any circumstances.

What happens after you stop taking an antidepressant?

At proper treatment after discontinuation of the antidepressant in the foreseeable future, the effect that was achieved at the main and fixed at the maintenance stages of treatment is maintained.

Antidepressant withdrawal syndrome

The “consequences” of taking antidepressants, widely discussed among the people (most often they talk about supposedly “addicting” to the drug or the inability to stop taking it due to a severe “withdrawal syndrome”) can really scare the patient in the following cases:

1) the drug and / or its dosage were chosen incorrectly, as a result, the full therapeutic effect was not achieved at all, there was only a masking of the symptoms of a psycho-emotional disorder, the improvement was partial, the patient's state of health became "somewhat better", and did not change dramatically and qualitatively;

2) supportive treatment was carried out with an incomplete therapeutic effect, the patient was not aware of what result should be achieved, and balanced between poor and "acceptable" health, from which, after discontinuation of the drug, health, of course, became steadily poor again;

3) maintenance treatment was not carried out at all, the antidepressant was canceled immediately after the effect was achieved, i.e. clearly premature;

4) the patient was not warned by the doctor about a possible temporary discomfort lasting 5-10 days (slight nausea, dizziness, lethargy, headache, sleep disturbance) when the antidepressant was canceled, mistaking these sensations for the resumption of neurosis ( detailed description sensations arising from the withdrawal syndrome -);

5) the drug was withdrawn rudely, abruptly, suddenly, without the consent of the doctor, as a result of which the patient experienced a pronounced withdrawal syndrome, mistaking his symptoms for the resumption of neurosis, or even deciding that he was "used to", "addicted to the drug" and was experiencing "breaking";

6) the withdrawal of the drug was delayed, it was unreasonably long: faced with the first manifestations of the withdrawal syndrome when the dosage was reduced, the patient was frightened and stopped its further reduction (for example, taking "quarters", "halves" of the tablet a day or every other day, or depending on well-being for a long time), thereby artificially keeping oneself in a state of withdrawal syndrome, not allowing it to end, while, as a rule, complaining of an extremely difficult "weaning" from the drug; in some cases, this situation can last for months.

What kind of drugs belong to the new generation of antidepressants?

SSRIs - selective serotonin reuptake inhibitors: fluoxetine (prozac, fluoxetine lannacher, apofluoxetine, prodep, profluzak, fluval), fluvoxamine (fevarin ), citalopram (cipramil, pram, oprah, siozam) escitalopram (cipralex, lexapro, selectra, elicea, lenuxin), sertraline (zoloft, asentra, stimuloton, serlift, aleval, serenata, torin), paroxetine (paxil, rexetine, adepress, plizil, actaparoxetine).

SSRI - a selective serotonin reuptake inhibitor of multimodal action - an antagonist of 5-HT 3 -, 5-HT 7 -, 5-HT 1D receptors, a partial agonist of 5-HT 1B - and an agonist of 5-HT 1A receptors: vortioxetine (brintellix ).

SSRI - selective serotonin reuptake inhibitor, partial agonist of 5-HT 1A receptors: vilazodon (viibrid). Vilazodone is currently absent in the Russian Federation.

SSRIs - selective serotonin and norepinephrine reuptake inhibitors: duloxetine (simbalta, duloxent), milnacipran (ixel ).

SSRIs - selective serotonin, norepinephrine and dopamine reuptake inhibitor: venlafaxine (effexor,Velaxin , venlaxor, velafax, newlong, efevelon).

SNRIs - selective norepinephrine and dopamine reuptake inhibitor: bupropion (wellbutrin, zyban). Bupropion is currently not available in Russia.

SNRI - selective norepinephrine reuptake inhibitor: reboxetine (endronax). Reboxetine is currently not available in Russia.

SSRIs - serotonin reuptake inhibitors, antagonists of 5-HT 2 receptors: trazodone (desirel, oleptro, trittiko, azona), nefazodon (Serzon). Nefazodon is currently absent in the Russian Federation.

Tetracyclic antagonist of central presynaptic α 2 -adrenergic receptors: mirtazapine (remeron, calixta, mirzaten, mirtazonal).

Melatonin receptor stimulant - agomelatine (valdoxan ) .

Note: bold bold international titles (active substances) new generation antidepressants; in italics - trade names original drugs; others given in brackets are the trade names of some generics / analogues produced by various pharmaceutical companies. The trade names of the new generation of antidepressants currently sold in pharmacies of the Russian Federation (strictly by prescription) are highlighted in blue. The last antidepressant on the list, agomelatine (Valdoxan), according to some reports, does not have a proven effectiveness declared by the manufacturer and does not exclude hepatotoxicity.

WHY DOES ANTIDEPRESSANTS NOT WORK? WHAT MAKES A DRUG NOT EFFECTIVE?

COMMON ERRORS WHEN USING ANTIDEPRESSANTS

1. The antidepressant was selected independently (for example, on the advice of friends) or the doctor made the appointment "mechanically", without telling the patient about the features of the action of antidepressants, their differences from other groups of psychotropic drugs (tranquilizers, neuroleptics, psychostimulants), the degree of safety, the prevalence of use, possible sensations in the process of taking, the expected dynamics of changes in well-being, the duration of treatment, the conditions for cancellation. As a result, the patient remained anxious about taking "some kind of possibly dangerous psychotropic drug", which did not allow him to overcome the main component of almost any psycho-emotional disorder - anxiety. For details on this, see - "HORROR TELLS (MYTHS) ABOUT ANTIDEPRESSANT. YES OR NO TO MEDICATIONAL TREATMENT?".

2.The antidepressant was chosen incorrectly. For example, with anxiety neurosis without pronounced depressive symptoms a tricyclic (amitriptizine, clomipramine, etc.) rather than a serotonin-selective (fluvoxamine, escitalopram, etc.) antidepressant was prescribed; or - for panic disorder, a serotonin-selective antidepressant with an activating component of action (fluoxetine, milnacipran) is recommended instead of a drug with sedative effect(paroxetine, escitalopram).

3. Selected antidepressantwas discontinued prematurely or replaced with another drug due to its alleged inefficiency(for example, already after 2 weeks from the start of administration), contrary to the absolute rule that the effect of an antidepressant cannot manifest itself to the full extent earlier than after 3-5 weeks, and in some disorders (for example, OCD) - 3-5 months.

4. The antidepressant was prescribed in the sub-therapeutic room, i.e. not enough to show therapeutic effect dosage, or with insufficient frequency of doses with a short half-life of the drug. For example, fluvoxamine at a dosage of 50 mg/day with proven efficacy of this drug in the range of recommended doses from 100 to 300 mg/day; or paroxetine 10 mg/day in a dosage range of 20 to 60 mg/day that has been shown to be effective; or venlafaxine of a non-prolonged (not retarded) form 1 time per day, if necessary, its 3-4 times administration. As a result, he was able to have at best a placebo effect.

5. There was no titration of the antidepressant dosage, i.e. the dosage was not selected individually for this patient, the need for its correction during the treatment process was not determined, respectively, and the results could not be optimal.

6. The principle of a mild, smooth, gradual increase in the dosage of an antidepressant, mandatory for the start of treatment, was not observed. simultaneous reception benzodiazepine tranquilizer (phenazepam, clonazepam, alprazolam, diazepam, etc.), i.e. from the first day of treatment, the antidepressant was taken at the full therapeutic dosage (for example, escitalopram - 10 mg / day or paroxetine - 20 mg / day) without a "cover" with a tranquilizer, as a result of which the patient faced a sharp increase in anxiety and / or already existing his autonomic symptoms, which aggravated the discomfort caused by the antidepressant itself (dry mouth, nausea, dizziness, weakness, drowsiness, lethargy, headache, intestinal upset), and stopped treatment.

7. The patient was not warned by the doctor that the new generation antidepressant does not show the main therapeutic effect in the first 2-3 weeks of taking it, on the contrary, an increase in vegetative discomfort, anxiety or apathy, which is absolutely natural for this period, is possible. Also at the stage of adaptation to an antidepressantsensations of dry mouth, nausea, weakness, drowsiness, lethargy, laziness, phlegm () are quite likely, in men - delayed ejaculation without impaired potency and erection, in women - decreased sexual excitability, anorgasmia () and, fearing the development of "severe side effects ' stopped treatment.

8. The antidepressant was discontinued immediately after improvement in well-being and elimination of symptoms of a psycho-emotional disorderwithout absolutely necessary supportive (prophylactic) treatment, as a result, the symptoms gradually (for example, over the next 3-5 months) resumed, and the entire treatment course was considered ineffective, or the patient was considered intractable.

9. Supportive treatment was carried out with incomplete elimination of symptoms of a psychoemotional disorder or/and it was not long enough in time, or/and it was carried out with a subtherapeutic dosage of an antidepressant (see paragraph 4) or/and ended earlier than the psychotraumatic (stressful) situation lost its relevance for the patient. As a result, the symptoms gradually (for example, over the next 3-5 months) resumed, and the entire treatment course was considered ineffective, or the patient was found to be intractable.

10. Cancellation of the antidepressant was not carried out according to the rules– rudely, abruptly, suddenly, without the consent of the doctor, or the doctor did not warn the patient about the peculiarities of the short-term (5-10 days) withdrawal syndrome and the resulting discomfort, the appearance of which was perceived by the patient as a resumption of a psycho-emotional disorder or even as a manifestation of "addiction", "addiction" to the drug, which led to another unforeseen increase in neurotic anxiety, or, in fact, to the emergence of a new neurotic symptom - pharmacophobia.

11. At the time of therapy, there was polypharmacy- unreasonable prescription of 3-4 (sometimes even more) drugs at the same time instead of following the necessary principlemonotherapy - competent choice and use throughout the entire period of treatment of the ONE most effective drug for this disorder and optimally tolerated by this patient.A polypragmatic approach makes it impossible to take into account a number of chemical interactions between drugs in the body, which significantly worsens treatment tolerance and increases the likelihood of side effects, does not allow determining the effectiveness and, accordingly, the need to use each specific drug from the “scheme”, deprives the patient of the opportunity to understand the course of treatment. process and actively participate in the process of their recovery.

12. For a long time (several years) treatment was carried out on the basis of empirical selection of the drug., i.e. "at random", "by trial and error", "until a suitable one is found", the result was "tried" a large number of(up to several dozen) pharmacological agents and their combinations. Brain receptors in such cases can become tolerant (resistant, stable, immune) to the action of really necessary drugs. In such circumstances, it is especially difficult to obtain the desired effect even with the most adequate therapeutic approach.

For a detailed overview of the alleged and real side effects of antidepressants, see the article:

"HORRIBLE (MYTHS) ABOUT ANTIDEPRESSANTS or ALL ABOUT SIDE EFFECTS OF PSYCHOTROPIC DRUGS. YES OR NO TO MEDICATIONAL TREATMENT?"

For a popular description of the features of the action and use of basic psychotropic drugs, see the article:

"PSYCHOTROPIC DRUGS: ANTIDEPRESSANTS, TRANQUILIZERS, NEUROLEPTICS - WHAT IS THE DIFFERENCE?"

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