Taking antidepressants. Latest generation antidepressants

In recent years, depressive states in people, and especially among residents of large cities, have become quite common. This is largely due to the rapid pace of life, disturbed ecology, and constant stress. Some people try to cure depression with alcoholic beverages... But this approach is fundamentally wrong. The problem will not be solved in this way, but it is quite possible to gradually become an alcoholic. Depression is a disease and must be treated with drugs - antidepressants.

The mechanism of action of antidepressants

Currently, the pharmacy network sells a wide variety of antidepressants belonging to different groups medicinal substances... But the action of most of them is the same and is aimed at changing the content in the brain tissues of some chemical substancescalled neurotransmitters. Their lack leads to various disorders of the psyche and central nervous activity, in particular, causes the development of depression.

The effect of antidepressants is that they either increase the amount of neurotransmitters in the brain or make brain cells more susceptible to them. All antidepressants are prescribed for long enough courses. This is due to the fact that they do not begin to show their effect immediately. Often the positive effect of taking medicinal product begins to develop only a few weeks after the start of its intake. In cases where it is required that the effect of antidepressants appears faster, the doctor may prescribe them in injections.

According to reviews, antidepressants are quite effective drugs. Their reception reliably eliminates such manifestations of depression as a feeling of hopelessness, loss of interest in life, apathy, sadness, anxiety and melancholy.

What if antidepressants don't work?

You can often hear from people that there is no point in taking these medications, in view of their ineffectiveness. But most often the problem is that a person purchases antidepressants at the pharmacy without a prescription, and, therefore, without consulting a doctor. If this happens, the medication may simply not be right for you, or you are taking the wrong dosage. See your doctor and he will prescribe the treatment you need. In addition, do not forget that in order to correctly assess the effectiveness of antidepressant treatment, they should be taken for a long time, at least three months.

Cheap doesn't mean bad

It is not uncommon for patients to refuse to take antidepressants because of their high cost. However, in pharmacies, you can almost always buy cheaper analogues (generics) that are not inferior to the main drug in terms of their effectiveness, quality or safety. Cheap antidepressants, according to patients' reviews, are no worse than their expensive counterparts. But if you still have doubts, then you can always consult your doctor about the choice of a drug.

How long does antidepressant treatment take?

Usually, doctors prescribe antidepressants for long courses from three months to one year. You should not refuse treatment on your own until you complete the course recommended by your doctor.

Some antidepressants not only relieve the symptoms of depression, but also have a psychostimulant effect. When taken, the patient often has trouble falling asleep. But even in this case, one should not refuse further treatment with antidepressants. It is necessary to consult a doctor and ask him to change the treatment regimen. For example, your doctor may recommend that you take your medication in the morning and at lunchtime.

Side effects of antidepressants

Taking any medications, including antidepressants, can lead to the development of side effects. Antidepressants, according to reviews, most often cause a mild feeling of nausea, trouble falling asleep, and very rarely, violations in the sexual sphere. As practice shows, all these side effects are observed in the first days of taking antidepressants and then go away on their own without requiring any additional treatment.

Most modern drugs to treat depression have little to no response with other medications being taken. But if you buy antidepressants without a prescription and take any other means, including dietary supplements (dietary supplements), be sure to consult with a specialist about the safety of taking them together.

Common myths about antidepressants

Many people are wary of antidepressant treatment, believing that these medicines rob them of all human emotions and thus turn them into soulless robots. But actually it is not. According to reviews, antidepressants eliminate only feelings of fear, anxiety, melancholy. But they have no effect on all other emotions.

Another common myth about antidepressants is that once you start treatment with these drugs, you will have to continue it your entire life. In fact, antidepressants are not physically addictive or psychologically addictive. They are simply prescribed by a doctor for a long course.

Antidepressant treatment and exercise

During sports training, the human body begins to intensively produce "hormones of joy" - endorphins. They are good at reducing the severity of depression and improving mood. Therefore, regular sports activities are perfectly combined with antidepressant treatment, shorten its duration, and reduce the dosage of the drugs used.

For mild depression, instead of going to the pharmacy and buying over-the-counter antidepressants, head to the pool or gym. Thus, you will not only improve your mood without the use of medications, but also bring a lot of benefits to your body as a whole.

End of antidepressant treatment

If you have started a course of antidepressant therapy, then never end it on your own without the advice of a doctor. This is due to the fact that the withdrawal of antidepressants should be slow and gradual. With a sharp refusal from further treatment of depression, its symptoms return almost immediately, and often become even stronger than they were before the start of therapy. Therefore, the abolition of antidepressants should be carried out strictly according to the scheme recommended by the attending physician.

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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 task, from the point of view of this person. 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 the climacteric period or after childbirth), as a result of prolonged stress, chronic or incurable illness, injury or disability.

In general, depression is irritability multiplied by weakness against the background of a low level of 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 set 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.

Medications 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, depression is not treated only by the lazy. 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 contact a psychiatrist, do not mind taking drugs that could simply be bought without a prescription in a pharmacy. All because the system psychiatric care in our country it is still more reminiscent of a light mixture of the army with the bazaar, because either immediately "registered" or for money!

Let us 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, individual selection of dosages should be carried out only by the attending physician.

One of the mild antidepressants sold without a prescription can be considered Afobazol (270-320 rubles. 60 tablets). Indications: for somatic diseases with adjustment disorders - irritable bowel syndrome, bronchial asthma, coronary artery disease, hypertension, arrhythmias. In case of anxiety, neurasthenia, oncological and dermatological. diseases. With sleep disorders (), with PMS symptoms, neurocirculatory dystonia, alcohol withdrawal syndrome, smoking cessation to relieve withdrawal symptoms. Contraindications: Increased individual sensitivity, children under 18 years of age, during pregnancy and lactation. Application: after meals, 10mg 3r / day, no more than 60mg per day, the course of treatment is 2-4 weeks, the course can be extended up to 3 months. Side effects: allergic reactions.

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 antidepressant drugs 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 carried out (although you will receive competent advice and free treatment).

In general, antidepressants are medications that raise mood, improve overall mental well-being, and also induce 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 drugs: clomipramine (Anafranil), Maprotiline (Lyudiomil), Tianeptine (Coaxil), Pyrazidol.

All of them are divided into seven large groups, each of which has its own indications and preferences for certain manifestations of depression.

Tricyclic antidepressants

These are 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, Selectra

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 convulsions, 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 seizure with loss of consciousness, hypertensive crisis or cerebral hemorrhage, or even all the way up to the “slammed roof”.

Selective inhibitors of serotonin and norepinephrine uptake

They work in a similar way to the drugs in the previous group. Milnacipran and venlafaxine are indicated for depression with obsessive compulsions or phobias. Of the side effects, they are characterized by headache, drowsiness, and 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 illness). They are divided into:

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

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 accident. 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 used them for several years throughout the post-Soviet space. The result of such experiments was not only multiple inflammation and thrombosis of the veins, 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 next generation antidepressants

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

• 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, Velaxin, Efevelon) - prescribed for depression against a 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 - This is fluoxetine (Prozac), which is somewhat 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 impair 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 blood 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 of the limbs, dizziness, sleep disturbances, intestinal dysfunctions, headache, drowsiness, increased sensitivity to sounds and smells, tinnitus, disorders of perception of reality, depression.

Benzodiazepine derivatives	Heterocyclic drugs
They remove all types of anxiety, are effective for sleep disorders, panic attacks, fears, obsessive states. Bromazepam Peksotan Diazepam (apaurin, religion) Chlordiazepaxide (Elenium) Nitrazepam Mezepam Clonazepam Alprozolam (Xanax) Zopiclone (Imovan)	These are new tranquilizers. The most popular is buspirone, which combines the properties of a tranquilizer and an antidepressant. Its mechanism of action is based on the normalization of serotonin transmission. Buspirone perfectly soothes, neutralizes anxiety, has an anticonvulsant effect. Does not cause lethargy and weakness, does not impair memory, memorization and thinking. Can be combined with alcohol, not addictive. Ivadal Zoligdem Buspirone (Spitomin)
Triazole benzodiazepine drugs	Glycerol analogs - Equanil (Meprobomat) Diphenylmethane analogs - Hydroxyzine (Atarax), Benaktizin (Amisil)
Used for depression combined with anxiety: Midazolam (Dormikum)

An overview of herbal antidepressants (over the counter)

Herbal sedatives are often referred to as 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 taken 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. Insofar as active substance the drugs are the same, then the contraindications, side effects, interactions with other drugs of these drugs are similar.

Deprim Composition: dry standardized extract of St. John's wort. It has a pronounced sedative effect, since the active substances of 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 physician, 1-2 tablets in the morning and in the evening, 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 - 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 you should consult a doctor.

Neuroplant 20 tab. 200 RUB 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, with caution it is prescribed for 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 for several weeks of admission, the drug is canceled and the treatment is adjusted. Side effects: indigestion, allergic skin 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 - causeless 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. The neuroplant reduces the therapeutic effect of indinavir and other HIV protease inhibitors, drugs used to treat cancer that inhibit cell growth.

Doppelherz nervotonic 250 ml. 320-350 rubles. Ingredients: Elixir Doppelgerz Nervotonic - liquid extract of 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, liver diseases, traumatic brain injuries, and 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, you should refrain from driving vehicles and working with other mechanisms that require the speed of psychomotor reactions (driving a car, work of 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, a 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 the active substance of St. John's wort extract, care should be taken when used together with the drugs listed above. The solution of Negrustin contains sorbitol and with each intake, 121 mg of it comes. 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 is a 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, for at least 4 weeks, during meals, with water. Special instructions: the break 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.

Antidepressants are becoming more and more common in the life of many people in Russia. And despite the fact that there is a consensus in the professional community regarding their effectiveness in treating depression, the use of antidepressants is not considered to be something healthy in Russian society. Many of those who take these drugs in the hope of improving their mental conditionare confronted with misunderstandings from family and friends, who often see their use as a whim or even a conspiracy of pharmaceutical companies. The Village asked science journalist Svetlana Yastrebova to explain how antidepressants actually work, whether it is worth fearing their spread, and why myths about ineffectiveness are being born around them.

Global trends

Since the early 2000s, the use of antidepressants has increased in almost all countries. In 2000, these drugs were most often used by residents of Iceland: 71 out of a thousand people admitted that they regularly use them, and in 2011 this number increased to 106 people per thousand. In Canada and Australia, the indicators are not much better: in 2011, 86 and 89 people out of a thousand resorted to anti-depression drugs there, respectively. The Scandinavians and other Europeans lagged behind, but not much. Residents of Eastern Europe avoid the constant use of antidepressants, but they often use them once (to be honest, this does not make much sense for health). Women treat depression more often than men, and bisexuals more often than homosexuals and heterosexuals. Unfortunately, there are no exact data on Russia.

Process chemistry

There is no unambiguously correct answer to the question "what causes depression", and it is unlikely that it will appear soon. There are several theories of the onset of depression, and most of them are somehow tied to neurotransmitters - substances that transmit a signal from one nerve cell to other nerve or muscle cells. The most popular hypothesis is serotonin. It says that in patients with depression, either the production of serotonin itself is impaired, or its perception. Most medications for depression are designed to correct this problem. Some of the newest and most commonly used are selective serotonin reuptake inhibitors (SSRIs). They trap serotonin molecules in the gap between two nerve cells, resulting in a longer and stronger neurotransmitter effect. SSRIs should not act on other neurotransmitters.

Previous generations have more side effects. These are, for example, inhibitors of monoamine oxidase (MAO), an enzyme that breaks down serotonin and dopamine. Since these two neurotransmitters act not only on mood, but also on many other processes in the body (for example, serotonin increases intestinal motility, as well as constricts blood vessels, due to which to some extent controls erection), MAO inhibitors can have a wide variety of side effects. Therefore, they are used much less often SSRIs, and even then, if possible, in the clinic, under the constant supervision of a doctor.

There is another opinion about the causes of depression. It is known that during depression, practically no new connections are formed between nerve cells. This is probably the cause of the disease. Maybe serotonin does not affect mood at all, but only helps to trigger the increased formation of contacts between neurons. If this is so, then it becomes clear why most antidepressants do not raise mood immediately after the first intake (like food and alcohol), but only after two weeks, and also why SSRIs sometimes help with anxiety disorders, which are not particularly associated with serotonin.

Why shouldn't you choose antidepressants yourself?

First, you don't know what caused depression in your particular case. The chemistry of the process as a whole is not fully known, and even more so, it will not work to determine by eye which system of neurotransmitters has broken down specifically in your case. In addition, there are many clinical research and their meta-analyzes, which show that antidepressants help only if the severity of the disease is above average. Most likely, a person whom antidepressants can really help, feels so bad that he is not able to think about any selection of pills himself.

Psychiatrists define the severity of depression in several ways. One of them is the so-called Hamilton scale. Most often it is used just in the study of the effectiveness of individual drugs. It includes 21 questions about the patient's condition. Each answer option gives a certain number of points, and the more there are in total, the more severe the depression. The maximum possible number of points is 23, mild depression starts from 8, severe - from 19. A drug is considered effective if, thanks to it, the patient's score on the Hamilton scale falls at least three points lower than from "treatment" with a placebo. This drop does not occur in patients with mild to moderate depression.

And finally, like any substance that interferes with brain chemistry, any antidepressant has a wide variety of side effects - from constipation and erection problems to a realized desire to die. Of course, the safest possible drugs are entering the pharmaceutical market, and their direct and side effects have been studied in animals and in the clinic. At the same time, no one canceled the so-called publication bias: both in medicine and in basic science, positive research results are more often published, and undesirable ones are silent. That is, no one is lying, but some are holding back. This is, in part, due to the way drug regulatory organizations' demands on antidepressant manufacturers sound. For example, the US Food and Drug Administration (FDA) takes into account only those side effects that were observed during the study itself and within 24 hours after its completion in its documents. If something happens to a research participant later than this date, it will not be recorded anywhere.

Are there ways to find the right medicine quickly?

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The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. A specialist consultation is required!

What are antidepressant medications?

Antidepressants is a group of pharmacological drugs that act on the central nervous system and eliminate the cause and symptoms of depression. In some cases, these drugs are also used to treat other diseases, but their effectiveness is significantly reduced.

The main effect of antidepressants is to alter the level of serotonin, dopamine and norepinephrine in the cells of the central nervous system. In patients with depression, they eliminate apathy, stimulate interest in physical and intellectual activity, and raise mood in general. It should be noted that people who are not depressed may not feel this effect.

What is the difference between tranquilizers and antidepressants?

Tranquilizers and antidepressants are different pharmacological groups, as these drugs act differently on the central nervous system ( CNS). Almost all tranquilizers have a pronounced sedative ( sedative) action. They can cause drowsiness, apathy, and inhibit physical activity. Their main task is to relieve psychomotor agitation if the patient is overly active or aggressive.

Antidepressants, on the other hand, combine a fairly wide range of therapeutic effects. Only a few drugs in this group give effects more or less similar to the action of tranquilizers. Basically, they relieve symptoms and eliminate the causes of depression - they activate the emotional sphere, raise internal motivation, and give strength ( in a psychological aspect).

In addition, antidepressants and tranquilizers have different chemical structures, interact with different mediators and other substances in the body. For some pathologies, doctors may prescribe the parallel administration of drugs from these two groups.

Can you buy antidepressants at the pharmacy without a prescription and a doctor's prescription?

There are a number of antidepressants that have fewer side effects. Most of these drugs also have a weaker therapeutic effect. In combination, their action is considered "milder", therefore, in many states, they are allowed to be dispensed in a pharmacy without presenting a prescription from a doctor.

It should be noted that even these drugs, which are, in principle, freely available, should not be used for active self-medication. The problem is not the direct harm from these antidepressants, but rather the unforeseen situations that can occur on rare occasions.

There is a certain risk of self-administration of any antidepressants for the following reasons:

• Possibility of an allergic reaction. Almost any drug can cause an allergic reaction. It depends on the individual characteristics of the patient's body, and no specialist can predict such a complication in advance. If the patient has a predisposition to allergies ( for other substances), it is better to warn the attending physician about this and not take any new drugs on your own.
• Possibility of error in diagnostics. The patient is not always able to correctly diagnose the problem. This is especially difficult in the case of mental and emotional disorders. If the diagnosis was initially incorrect, antidepressants may not only fail to provide therapeutic effectbut also make the problem worse. That is why it is better to take any drug after consulting a specialist.
• Possibility of drug interactions. As a rule, in the instructions for a specific drug, the manufacturer indicates various unwanted interactions with other drugs. However, each medicine has many trade names, and patients often do not go into details. Because of this, a “harmless” over-the-counter antidepressant can be harmful when combined with another drug the patient is taking. In the case of a consultation with a qualified specialist, this risk is minimized.

Which doctor writes a prescription for antidepressants?

In principle, the main specialist doctors who often prescribe antidepressants in their practice are psychiatrists ( sign up) and neurologists ( sign up) ... It is these specialists who are most closely associated with disorders in the functioning of the central nervous system ( both structural and functional). In addition, other doctors usually refer patients with depression or related disorders.

If necessary, antidepressants can be prescribed by other professionals. Usually they are emergency doctors, therapists ( sign up) , family doctors, etc. It should be noted that they usually prescribe weaker drugs, which do not require a prescription. However, legally, any doctor with a valid license has the right to write a prescription for a patient for a more potent drug. At the same time, he takes responsibility for familiarizing the patient with the admission rules and for the possible consequences.

What are the "prohibited" and "allowed" ( non-prescription) antidepressants?

Antidepressants, like everyone else medications, in principle, can be divided into two large groups... These are "allowed" drugs that anyone can freely purchase at the pharmacy, and conditionally "prohibited" drugs that are sold by prescription.
In each country, the list of approved and prohibited drugs is slightly different. It depends on the health policy, current legislation, the prevalence of narcotic and semi-narcotic drugs.

Over-the-counter antidepressants are generally less effective. They do not have such a wide range of side effects and practically cannot cause serious harm to the patient's health. However, the effectiveness of these drugs in severe depression is very low.

OTC antidepressants in most countries include the following drugs:

• prozac;
• zyban;
• maprotiline;
• deprim, etc.

There are also a number of herbal products on the free market ( valerian, St. John's wort, etc.), which have an antidepressant effect.

Conventionally "prohibited" antidepressants are called so because their distribution is restricted by law. This is partly done for the safety of the patients themselves. These drugs have many side effects, and they independent application can cause serious injury. Also, some drugs in this group can be equated to drugs and addictive. In this regard, a prescription for them is written by a specialist who, before that, will make sure that the patient really needs this medicine.

"Banned" antidepressants with a stronger effect include the following drugs:

• imipramine;
• maprotiline;
• anafranil, etc.

It should be noted that as a result of changes in the WHO recommendations ( world health organization) and with reforms at the national level, the list of “permitted” and “prohibited” antidepressants changes periodically.

Classification of antidepressants

Classification of antidepressants is a very difficult task, since various criteria can be taken as a basis ( chemical structure, mechanism of action, etc.). It is now accepted to distinguish between two main groups of these drugs. The first affects the capture of neurotransmitters between the membranes of nerve cells. The second neutralizes the action of the enzyme that releases the receptors. In practice, drugs of these two groups are used almost equally. It should also be noted that such a division is very arbitrary, since each representative of any of these groups has its own characteristics. That is why the vast majority of antidepressants are prescribed by a specialist who is familiar with the intricacies of the action of each drug.

Chemical and pharmacological groups of antidepressants

From a practical point of view, the most convenient classification of antidepressants is based on the chemical structure of the drug in combination with the mechanism of action. In most countries, specialists are guided by these very criteria. They allow, if necessary, to replace an intolerable or ineffective drug with another, the closest in action.

The following groups of antidepressants are distinguished according to their chemical structure:

• Tricyclic. In the chemical structure of tricyclic antidepressants, so-called "rings" or "cycles" are present. These are groups of atoms united in a closed chain, which largely determine the properties of the drug.
• Tetracyclic. There are four cycles in the structure of tetracyclic antidepressants. There are significantly fewer drugs in this group than in the tricyclic one.
• Another structure. For convenience, this group includes substances that do not have cycles in their chemical structure ( rings), but with a similar effect on the central nervous system.

According to the mechanism of action, antidepressants are usually subdivided according to the enzymes and mediators with which they interact in the central nervous system.

Tricyclic antidepressants

Tricyclic antidepressants belong to the first generation of antidepressants and are used in medical practice for several decades. In the chemical structure of these substances, three interconnected "rings" or cycles are common. The drugs of this group are non-selective inhibitors of the reuptake of a number of substances in the central nervous system. Their reception eliminates anxiety, fear or depression, and also causes a general "uplift" of mood. Currently, tricyclic antidepressants are still widely used for many mental disorders. The main disadvantage of this group is the large number of side effects. This is due precisely to the indiscriminate effect on various processes in the brain.

The most common representatives of the group of tricyclic antidepressants are:

• amitriptyline;
• imipramine;
• clomipramine;
• trimipramine;
• nortriptyline, etc.

Tetracyclic antidepressants ( first generation antidepressants)

This group is represented by substances that have four "rings" of atoms in the molecule. In medical practice, they are used much less frequently than tricyclic antidepressants.

The most common tetracyclic antidepressants are:

• mianserin;
• mirtazapine;
• pirlindol, etc.

Selective serotonin reuptake inhibitors ( SSRI)

SSRIs are one of the most widespread and demanded groups of antidepressants in modern medical practice. The mechanism of action of these drugs is reduced to the selective blocking of certain enzymes in the central nervous system ( CNS). This allows you to achieve the desired therapeutic effect with greater precision. The risk of various side effects from the use of drugs is also reduced. This group includes serotonin reuptake inhibitors, but, in principle, for each neurotransmitter ( substance - transmitter) in the nervous system found their own drugs. The medicine is selected by a specialist who can accurately diagnose and determine violations in the central nervous system.

The following reuptake inhibitors are available for various neurotransmitters:

• Serotonin - cipralex, fluvoxamine, etc.
• Norepinephrine - nortriptyline, maprotiline, etc.
• Dopamine - diclofenzin.

There are also a number of drugs that block the reuptake of both norepinephrine and serotonin. These include amitriptyline, imipramine, and other tricyclic antidepressants. They are called non-selective.

What is the difference between different groups of antidepressants?

Antidepressants, like most other drugs, are divided into pharmacological groups, which have some characteristic differences. This is necessary for the convenience of the practical use of drugs in treatment. The chemical structure of molecules in this case is most often of secondary importance. The main criterion is the mechanism of action of the drug.

Antidepressants of different groups have the following differences:

• Mechanism of action. Each group of antidepressants has a different mechanism of action. Drugs from different groups interact with different substances in the central nervous system, which ultimately leads to a similar effect from taking the drug. That is, the action of drugs is similar, but the chain of biochemical reactions that occur in the body is very different.
• The strength of the drug. The strength of the drug is determined by how effective it is to block enzymes in the central nervous system. There are stronger antidepressants that have a pronounced and stable effect. They are generally available with a prescription due to the risk of severe side effects. Medications with a weaker effect can be purchased at the pharmacy yourself.
• Transformation of the drug in the body. The set of chemical transformations that a drug molecule undergoes in the body is called pharmacodynamics or drug metabolism. In this regard, almost every drug has its own characteristics. For example, the duration of blocking of an enzyme may vary. Accordingly, the effect of one drug will last for a long time ( up to a day), while the other took only a few hours. This determines the reception mode. There is also a time of elimination of the drug from the body after administration. Some substances are excreted naturally quickly, while others can accumulate during the course of treatment. This should be considered when choosing a medicine. The mechanism of drug elimination is also important. If the substance is eventually excreted in the urine through the kidneys, and the patient has renal impairment ( difficult filtration of blood and urine formation), then the drug will accumulate in the body, and the risk of serious complications is greatly increased.
• Side effects. Depending on the characteristics of the action of a particular antidepressant on the body, it can cause various side effects. It is important for specialists to know them in order to notice their symptoms in time and take the necessary measures.
• Interaction with other drugs. Drugs in the human body interact with various substances. Taking several medicines at the same time can increase or decrease their effect, and sometimes give other, unpredictable effects. In the instructions for each of the antidepressants, manufacturers usually indicate with which drugs a given substance can interact.
• The possibility of developing an allergic reaction. Each antidepressant has its own chemical structure. An allergic reaction in a patient can be almost any drug ( with varying probability). If you are allergic to one drug, you need to consult a doctor and change it to another drug that differs in chemical structure, but is similar in therapeutic effect.
• The chemical structure of the molecule. The chemical structure of the molecule determines the properties of any drug. It is because of this that each antidepressant has its own advantages and disadvantages. In addition, the characteristics of the chemical structure underlie the classification of antidepressants.

Are there natural antidepressants ( natural herbs)?

There are not many recipes in traditional medicine that could provide real help in the fight against depression. This is largely due to the complexity of the processes that take place in the central nervous system. If antidepressants act selectively, affecting certain substances ( neurotransmitters, enzymes, etc.), then their natural counterparts do not possess such selectivity. Their effect will be much weaker, and the likelihood of side effects increases ( neither decoctions nor infusions allow isolating only the active substance from a particular plant). That is why, with severe depression and other serious psychiatric diseases, it is recommended, first of all, to contact a specialist, and, with his consent, to start taking folk remedies. Most often, they will have to be combined with certain pharmacological drugs.

The following herbs have a weak effect similar to that of antidepressants:

• The rhizome of the enticement. The crushed rhizome is poured with medical alcohol ( 70% ethyl alcohol solution) in a ratio of 1 to 10 and insist for several hours. The infusion is taken 1 teaspoon 2 times a day.
• Chamomile aster flowers. For 1 tablespoon of dried flowers, 200 ml of boiling water is needed. Infusion lasts at least 4 hours. The resulting product is taken 1 tablespoon 3 times a day.
• Bird Highlander. 3 - 5 grams of dried mountaineer is poured with 2 cups of boiled water and insisted until the water cools independently to room temperature. The infusion is drunk half a glass before meals ( 3 times a day).
• Aralia Manchu. The crushed roots of aralia are poured with medical alcohol in a ratio of 1 to 5 and insisted for 24 hours. The resulting tincture is taken 10 drops 2 - 3 times a day, diluted in boiled water.
• Ginseng root. Dried ginseng root is ground and poured alcohol solution (50 – 60% ) in a ratio of 1 to 10. The mixture is infused for 2 - 3 days in a closed vessel. The resulting tincture is drunk 10-15 drops 2 times a day.

Properties and action of antidepressants

Antidepressants, as a separate pharmacological group, have certain general properties... First of all, this concerns the predominant effect on the central nervous system. Any antidepressant affects the transmission of nerve impulses in the brain, and its effect on other organs and systems will be secondary. Otherwise, most drugs in this group have their own characteristics. So, for example, from antidepressants, drugs can be distinguished that give a hypnotic or, conversely, an invigorating effect. Side effects can affect almost any organ or system. This is due to the fact that the brain, one way or another, regulates the vital activity of the whole organism, and any changes in its work will inevitably affect the organism as a whole.

The mechanism of action of antidepressants

To better understand the mechanism of action of antidepressants, you need to understand in general terms how the central nervous system works. The brain consists of many nerve cells, neurons, that perform the most important functions. Neurons have a large number of different processes that connect to other nerve cells. As a result, a kind of network of cell contacts is formed. The impulses entering the brain are distributed in this network in a certain way, and the brain reacts to the information received. Each part of the brain is responsible for regulating certain processes in the body. Depression, as well as various nervous and mental disorders, are primarily a consequence of the excitation of certain parts of the brain. Antidepressants affect the junction of nerve cells, speeding up or slowing down the transmission of nerve impulses in various ways ( depends on the specific drug).

The transmission of a nerve impulse in the brain occurs as follows:

• An impulse is formed in a nerve cell as a result of chemical interactions and travels along one of the processes to the junction with another nerve cell.
• The junction of two nerve cells is called a synapse. Here, at a very close distance, there are two cell membranes. The gap between them is called the synaptic cleft.
• The nerve impulse reaches the presynaptic membrane ( the cell that transmits the impulse). There are bubbles with a special substance - a neurotransmitter.
• As a result of excitement, enzymes are activated that lead to the release of the mediator from the vesicles and its entry into the synaptic cleft.
• In the synaptic cleft, neurotransmitter molecules interact with receptors on the postsynaptic membrane ( membrane of the cell "receiving" the impulse). As a result, a chemical reaction occurs, and a nerve impulse arises that is transmitted through the cell.
• The mediator molecules, which carried out the transmission of impulses between cells, are captured back by special receptors and are concentrated in vesicles or destroyed in the synaptic cleft.

Thus, a number of different substances are involved in the propagation of nerve impulses in the central nervous system. There are also enzymes that interfere with the propagation of the pulse. That is, both excitation and inhibition can occur between cells.

Antidepressant molecules interact with specific receptors, mediators or enzymes, and affect the overall transmission of impulses. Thus, the excitation or inhibition of processes in various parts of the brain occurs.

What side effects do antidepressants have?

The vast majority of antidepressants have a fairly wide range of side effects that severely limit the use of these drugs. Most often, such phenomena occur due to the parallel action of the drug on receptors in the peripheral nervous system. This affects the work of many internal organs. However, there are other mechanisms for the development of side effects.

Side effects from taking antidepressants can be divided into the following groups:

• Dose dependent. This group of side effects includes problems that arise when the therapeutic ( curative) dose. All drugs, without exception, have them. Many of these side effects can be interpreted as signs of overdose. In the case of tricyclic antidepressants, for example, this may be a hypotensive effect ( lowering blood pressure). As a rule, all such effects disappear when the dose is reduced.
• Dose independent. This group of side effects usually appears during long-term treatment. A drug with a similar structure and action affects the work of certain cells or tissues, which, sooner or later, may cause various problems. For example, when using tricyclic antidepressants, leukopenia is possible ( low leukocyte count and weakened immunity), and in the treatment of serotonergic antidepressants - inflammation and pain in the joints ( arthropathy). In such cases, lowering the dose will not solve the problem. It is recommended to stop treatment and prescribe the patient drugs from another pharmacological group... This gives the body time to recover a little.
• Pseudo-allergic. This group of side effects resembles common allergic reactions ( urticaria, etc.). Such problems are quite rare, mainly while taking serotonergic antidepressants.

In general, the spectrum of side effects that can occur while taking antidepressants is very wide. Disruptions in the work of various organs and systems are possible. Patients often not only develop any symptoms and complaints, but also abnormalities are observed in various studies ( for example, in a blood test).

Possible side effects of antidepressant medication

Affected organs or systems	Complaints and violations	Possible solutions to the problem
The cardiovascular system		Reducing the dose of antidepressant. If impossible - drugs to eliminate symptoms ( at the discretion of the cardiologist).
	Heart rhythm disorders ( on the electrocardiogram)
	Increased blood pressure ( sometimes sharp)
	A strong change in blood pressure with a change in body position ( orthostatic hypotension)
Digestive system		Reducing the dose of the drug. Changing the receive mode ( more often, but in smaller doses), a gradual increase in the dose at the beginning of treatment. If jaundice develops, it is recommended to stop treatment or change the drug.
	Bitter taste in the mouth
Blood and hematopoietic system	An increase or decrease in the level of leukocytes ( respectively leukocytosis or leukopenia), low platelet count ( thrombocytopenia), elevated level eosinophils ( eosinophilia). These violations are detected when general analysis blood	Termination of treatment, change of the drug.
central nervous system	Lethargy and drowsiness ( in severe cases and confusion)	At the discretion of the attending physician ( psychiatrist or neurologist) you can reduce the dose, stop taking the drug or prescribe symptomatic treatment in parallel ( lithium salts, antipsychotics, phenobarbital, beta-blockers - depending on the symptoms).
	Nervous excitement, increased activity
	Irritability
	Hives
Swelling and joint pain
A sharp increase in blood pressure (hypertensive crisis)
	Nausea and vomiting
General disorders and symptoms	Decreased sex drive
	Hormonal disorders
	Hearing impairment

In principle, if, against the background of a single or long-term use of antidepressants, the patient begins to develop any unusual symptoms, you should seek the advice of your doctor. Many of the above side effects indicate poor drug tolerance. If you do not stop treatment, the patient may develop very serious damage to organs or systems, which will require additional treatment.

Also, the side effects of many antidepressants include addiction, and, as a result, withdrawal syndrome that occurs after stopping treatment. In these cases, the tactics of treatment may be different. Treatment is prescribed by a specialist who takes care of the patient.

Are there antidepressants without side effects?

In principle, any pharmacological drug can potentially cause certain side effects. Among antidepressants with a very broad spectrum of action, there are no drugs that would be ideal for all patients. This is due to the characteristics of the underlying disease ( antidepressants are prescribed not only for depression) and the individual characteristics of the organism.

To reduce the likelihood of side effects when choosing a drug, you should pay attention to the following points. First, newer drugs ( "new generation") have a narrowly targeted effect on the body and usually have fewer side effects. Second, over-the-counter antidepressants have a weaker effect on the body as a whole. That is why they are commercially available. As a rule, serious side effects occur much less often when taken.

Ideally, the selection of the drug is carried out by the attending physician. To avoid serious side effects, he conducts a number of tests and better learns the characteristics of the body of a particular patient ( concomitant diseases, accurate diagnosis, etc.). Of course, in this case, there is no one hundred percent guarantee. However, under the supervision of a physician, it is always possible to replace the drug or find an effective symptomatic treatment that will eliminate the complaints and allow you to continue the course of treatment.

Compatibility of antidepressants with other drugs ( antipsychotics, hypnotics, sedatives, psychotropic, etc.)

The simultaneous administration of several drugs in medicine is a very urgent problem. In the case of antidepressants, it should be noted that they are often used as part of complex therapy... This is necessary to achieve a more complete and rapid effect in a number of mental disorders.

The following combinations of antidepressants are very relevant in psychiatry:

• Tranquilizers - with neuroses, psychopathies, reactive psychosis.
• Lithium salts or carbamazepine - with affective psychoses.
• Antipsychotics - with schizophrenia.

According to statistics, almost 80% of patients in psychiatric wards receive such combinations. However, in this case, therapy is prescribed by a specialist, and the patient is always under the supervision of doctors - in a hospital.

In general, the combination of antidepressants with many other pharmacological drugs often gives negative consequences. There may be unexpected side effects or a decrease in the effectiveness of a drug ( there is no expected therapeutic effect). There are several mechanisms behind this.

Negative combinations of antidepressants with a number of drugs can be dangerous for the following reasons:

• Pharmacodynamic interactions. In this case, we are talking about the difficulty in the assimilation of medicinal substances. After taking an antidepressant ( in pill form) the active substance should be normally absorbed in the intestine, enter the liver, and combine with blood proteins. Taking other pharmacological drugs can break this chain at any stage. For example, many drugs are converted in one way or another in the liver. Taking several drugs that interact with the same enzymes can weaken the effect of each one individually or cause some complications from the liver itself. To avoid such complications, the doctor prescribes drugs taking into account the time of their assimilation, specifying the regimen.
• Pharmacokinetic interactions. In this case, we are talking about the effect of several drugs on the same body system ( the same target cells or enzymes). Antidepressants work at the level of nerve connections in the central nervous system. Taking other drugs that affect the nervous system can enhance their effect or, conversely, neutralize it. In both cases, the expected therapeutic effect will not be obtained, and the risk of side effects will greatly increase.

That is why, during the course of treatment with antidepressants, one should be very careful and not take even familiar and familiar drugs that are sold in pharmacies without a prescription without a doctor's prescription. In some cases, improper drug combinations can seriously damage the patient's health or even endanger his life. If you need to take any drug, it is advisable to consult with your doctor or pharmacist. Most drugs ( in instructions) often indicate the most dangerous drug combinations for a particular drug.

Do antidepressants have a stimulating effect?

In principle, most antidepressants, to one degree or another, have a stimulating effect on the central nervous system. Depression itself is accompanied by a state of depression. The patient is passive because he has no desire to do anything. With the right antidepressant, you will regain the desire to do something and thus give you strength.

However, one should not confuse the stimulating effect of antidepressants with the effect of energy drinks or certain drugs. The stimulating effect is manifested more in the emotional and mental sphere. Physical fatigue decreases due to the removal of a certain "psychological block". The drugs promote motivation and interest in various activities.

The greatest stimulating effect in this regard is possessed by MAO inhibitors ( monoamine oxidase). However, this effect develops in them gradually, as the corresponding enzymes and mediators accumulate in the body. You can feel the changes 1 to 2 weeks after you start taking the drug ( provided that it is correctly selected and taken in the required dose).

There are also antidepressants that have hypnotic and sedative effects. They stimulate mental and emotional activity, but the physical condition of a person changes little. These include, for example, amitriptyline, azafen, pyrazidol. Thus, the patient may not get the expected result. In order not to be mistaken, it is better to consult in advance with a specialist who can explain in detail what effect he expects from treatment with this or that drug.

Do antidepressants have pain relief?

The main effect of antidepressants is to get rid of the patient's symptoms and signs of depression, including drowsiness, passivity, lack of motivation, mental and emotional depression. None of the drugs in this group has a pronounced analgesic effect in the conventional sense. In other words, with an obvious source of acute pain ( inflammation, trauma, etc.) taking antidepressants will not alleviate the patient's condition.

However, some antidepressant drugs have been used successfully for chronic pain. The fact is that chronic pain often accompanies long-term depression. Mental disorders are not the only source of pain, but they may well increase it and, thus, greatly worsen the patient's condition. Experts have noticed that a number of antidepressants can relieve chronic pain like this. In this case, it is more about a reduction in pain perception than an analgesic effect.

The following antidepressants can be used to treat chronic pain syndromes:

• venlafaxine;
• amitriptyline;
• clomipramine;
• desipramine.

Of course, you shouldn't start taking antidepressants on your own if you have chronic pain. Firstly, this group of drugs has a wide range of side effects, and the patient may have other problems. Secondly, by eliminating the pain syndrome, the patient runs the risk of "masking" the problem. After all, back pain, muscle pain or headaches do not always accompany depression. Most often they have a well-defined reason that should be eliminated. That is why patients need to consult a specialist to make the correct diagnosis. Only when depression is confirmed in combination with chronic pain, the use of the above antidepressants will be justified and rational. Before use, you must consult with a specialist.

Good afternoon, dear readers.

Today I want to discuss the topic: the impact of antidepressant use on human health ... More and more people around the world are using antidepressants to treat depression, nervous system disorders, stress, anxiety, apathy, anxiety, sadness or melancholy. But is everything so good with these drugs?

I propose to study in more detail antidepressants on the human body and evaluate all the pros and cons of using them in your life.

According to scientists, about 10% of people from developed countries use drugs in order to feel "better". Most of the patients are women. They are more vulnerable to life difficulties than men. To restore their state of mind, many of them turn to psychologists for help, who offer their patients intensive course antidepressants, as, in their opinion, the most optimal remedy.

I do not argue, sometimes there is a need to "support" your body when you experience severe stress. And this is one of the options for solving the problem. But this is an easy path, following which it is important to stop in time.

After the start of the intake, a person really begins to feel better, experiences and anxieties are removed, life begins to seem simple and carefree. At first glance, it may seem that this is the optimal remedy for depression, that everyone is happy (the patient gets a tool to suppress his emotions and experiences, and the doctor finds effective method help your patients cope with problems).

Unfortunately, not everything is as cool as it might seem at first glance ...

First, let's look at exactly how antidepressants affect the human body. What reactions occur when taking these drugs. There are many different types antidepressants, which include various medicinal substances.

Interestingly, their effect on the cells of the body is almost the same.

EFFECTS OF ANTI-DEPRESSANTS ON THE BODY.

Their main area of \u200b\u200binfluence is the human brain. Many studies have been carried out and it has been proven that the onset of depression depends on the state of the brain tissues, or rather, the presence of chemicals in them - neurotransmitters. The main neurotransmitters include such substances: serotonin, endorphins, norepinephrine, dopamine, and others. Serotonin, which controls mood, plays an important role.

Lack of neurotransmitters leads to many disorders of the nervous system. The main effect of any anti-depression drug is to increase the concentration of neurotransmitters in the brain cells and improve the sensitivity to them.

Experts advise taking antidepressants very carefully, because the drugs have many contraindications and if the dosage is not followed, they are harmful. Here is a list of the main potential complications that can occur if taken incorrectly:

POSSIBLE COMPLICATIONS FROM THE USE OF ANTI-DEPRESSANTS.

1. Heavy sweating.
2. Disruption of the cardiovascular system.
3. The inability remains motionless for a long time (akathisia).
4. The emergence of aggressiveness.
5. The person becomes hostile to others.
6. Inability to concentrate your attention.
7. Inability to express your thoughts clearly.
8. The possibility of hallucinations.
9. Insomnia.
10. Highly addictive to drugs.
11. Disruption of the gastrointestinal tract.
12. Photosensitivity.
13. Metabolic disease.
14. Nausea or vomiting
15. Dry mouth.
16. Dizziness.
17. Complications during pregnancy.
18. Sexual dysfunction.
19. Changes in character (indifference and callousness appear).
20. Bleeding.
21. Increase or decrease in body weight

In no case should you self-medicate - the drug may be intolerant to the body. It is necessary to carefully select the course of treatment, taking into account the individual intolerance of the body to the components of the drug.

The more time you have to use antidepressants, the more the likelihood of complications increases, and health deteriorates. They also have a bad effect on the cognitive work of the brain (the production of many hormones is disrupted, the transmission of nerve impulses worsens).

Very interesting research was carried out by the American biologist at McMaster University - Paul Andrews. He analyzed many studies on the effects of antidepressants on patients. The scientist put forward convincing arguments about the harm of drugs to health. In his opinion, a course of treatment with antidepressants can only help with a short-term period of use, with long-term use, the treatment is not effective.

The scientist recommended refraining from using them, or using them for a short period of time, composing a gentle course of treatment with the doctor. If the course of treatment is not followed, the number of complications increases and dependence appears (in its strength it is similar to nicotine or alcohol).

Addiction is dangerous because the brain gets used to antidepressants and cannot do without them. When trying to stop taking drugs, many patients begin to experience the same condition as before starting treatment (relapse occurs). It is very important at this stage to help such people overcome this problem. With a strong dependence, it is recommended to choose an individual plan for refusing the medication and draw up a set of measures to support physical and mental balance.

In such cases, the help of close people (relatives, friends, acquaintances) is very important. You need to train yourself to deal with depression. physical exercise, healthy eating, air procedures (more time to spend in the fresh air) and friendly communication. It is very important during this period to communicate with others. A person should not be left alone with his problems, he should not "close" in himself ... Communication with loved ones is one of the most important methods of dealing with addiction to antidepressants.

Psychologists recommend good remedy when dealing with depression, it is switching your attention to the problems of another person and helping him in solving them. Taking care of his morale, you forget about your problems. By listening to the interlocutor and giving him valuable advice, you will increase your self-esteem, saving yourself from bad mood, anxiety and experiences. The method is time-tested and very effective. I hope that the information in this article will be valuable for you and can help.

I bring to your attention an interesting video, where the topic "Do I need antidepressants?" Psychologist S. Shatova answers this question. Take care of your health !!!