List of the best pills for depression in adults and children. What are antidepressants? Tranquilizers and antidepressants Does the church ban antidepressants?

Antidepressants Are medications that improve mood and relieve anxiety and irritability. Most often, doctors prescribe them for chronic stress or.

With violations of the emotional background in the body, not only the activity of the nervous system changes, but also the production of substances responsible for good mood and a calm perception of reality.

For a long time, plant materials (motherwort, valerian, eleutherococcus, lemongrass, etc.) have been used as agents that have a beneficial effect on the human psyche. And in the 20th century, synthesized pills appeared that regulate the level of neurotransmitters (serotonin, norepinephrine, dopamine), substances on which a person's emotional mood depends.

Antidepressants are so firmly established that they are even praised in modern show business. For example, the last hit of the Chelyabinsk rap group “Triagrutrika” is called “Antidepressant”. And some foreign music channels annually make the top of the antidepressant songs.

Thus, the name of a group of pharmacological drugs precisely reflects their action, which finds its application in the cultural areas of human life. This appears to be related to the way the drugs work and their ability to lift your mood.

Mechanism of action

The secret of our emotional life is revealed by the biochemical theory, at the heart of its deterioration are processes that reduce the amount of nutrients in the human body.Antidepressants are able to normalize chemical metabolism in brain cells, regulate the level of serotonin, dopamine and norepinephrine, hormones responsible for a person's good mood.

These drugs, depending on their action, can block the seizure of mediators by neurons or increase their concentration (production by the glands of the brain or adrenal glands).

Indications for use

• neuroses;
• phobias (fears);
• increased anxiety;
• chronic depression;
• prolonged stress;
• panic conditions;
• anerexia or bulimia;
• sexual dysfunctions;
• affective disorders;
• refusal from drugs, alcohol, nicotine.

Patient responses to antidepressant medications are varied. Sometimes, when they are canceled, symptoms reappear in patients, or, also, some remedies are not used in women using a diet for weight loss, as they can contribute to gaining excess weight.

Therefore, it is very important to choose the right drug and carefully study its side effects. Only after weighing all the pros and cons at a doctor's appointment (neurologist, psychotherapist, psychiatrist) can you go to the pharmacy to buy an antidepressant.

Classification

1. Timiretics , stimulate the activity of the nervous system.
2. Thymoleptics , drugs with a pronounced sedative (sedative) effect.
3. Non-selective actions (Melipramine, Amisole).
4. Electoral actions (Flunisan, Sertraline, Fluvoxamine, Maprotelin, Reboxetine).
5. Monoamine oxidase inhibitors (Transamin, Autorix).
6. Selective (Coaxil,).
7. Lungs antidepressants (Doxepin, Mianserin, Tianeptin), gently improve sleep and mood, have a beneficial effect on a person's perception of reality.
8. Strong antidepressants (Imipramine, Maprotiline,) actively and quickly eliminate the manifestations of depression, but have a number of pronounced side effects.

The most popular over-the-counter antidepressants

Names and prices:

Alcohol tinctures have a mild antidepressant effect:

• maral root, immortelle, Rhodiola rosea (relieve fatigue, apathy);
• liuzei, raise the general tone of the body;
• ginseng, promotes vigor and activity;
• lures, stimulates performance;
• mint, valerian, motherwort, normalize sleep, relieve nervous tension.
  Prices for these funds in pharmacies on average: from 50 to 100 rubles.

Tricyclic antidepressants are used to treat persistent and prolonged depression.

List of drugs:

Despite the powerful effect in treatment mental disorders tricyclic drugs have a number of pronounced side effects, medical studies show that because of them, more than 30% of patients stopped taking these drugs without completing the course of treatment. This prompted pharmacists to create new drugs without side effects that negatively affect the digestive, renal and metabolic processes in the body, as well as drugs that do not give the "withdrawal syndrome".

New generation antidepressants (list of the best drugs) :

Before you start taking any antidepressant, it is important to know:

Video:

Today, depression affects not only adults but also children and adolescents. This disease and methods of dealing with it are devoted to many studies of specialists and a huge number of articles and books. If translated from "scientific" into ordinary language, depression is a loss of strength and desire to live. The symptoms of this disease are apathy and constant anxiety and fatigue, lethargy and gloom.

Modern pharmacology offers antidepressants of the latest generation to combat this disease. How many generations of thymoleptics (as they also call drugs working against depression) exist today, what do they have in common and how do they differ from each other, what is the mechanism of their action? These and other questions will be considered in the article offered to your attention.

What are antidepressants?

Thanks to which you can relieve symptoms and even prevent depressive conditions. Their main mechanism of action is aimed at correcting the biochemical activity of the human brain. its components constantly interact with each other by means of special substances - neurotransmitters. According to one theory, depressive disorders occur when the brain, due to various reasons, the level of any mediator or biogenic amine: dopamine, norepinephrine or serotonin is significantly reduced. Antidepressants of the latest generation, like all previous ones, have a regulating and corrective effect on the biochemical processes of the brain by changing the concentration of one or another biogenic amine.

What are they needed for?

In addition to the fact that modern antidepressants help to cope with the symptoms of depression, they are often used to get rid of such problems:

• various pains of unexplained origin;
• disturbances in appetite or sleep;
• severe fatigue or loss of strength;
• nervousness or feelings of constant tension;
• attacks of nervousness or anxiety;
• problems concentrating or remembering.

Generations of antidepressants

Before considering how many generations of anti-depression drugs have been created by today, it should be remembered that antidepressants were discovered only in the middle of the 20th century. To date, depending on the time of invention and the beginning of use in clinical practice, as well as on the action of antidepressants, it is customary to distinguish four generations of these medicines.

First generation drugs

The first generation, discovered in the 50s of the last century, is represented by cyclic tricyclic thymoleptics (TCA). These include the following drugs: "Amitriptyline" (an antidepressant, the very first of the discovered) and its derivatives, as well as drugs "Nefazodone", "Anafranil" and "Melipramine". These compounds block the reuptake of norepinephrine, thereby increasing its concentration. However, TCAs blocked not only norepinephrine (norepinephrine), but also all other neurotransmitters that got in their way, which led to a large number of unpleasant side effects, primarily such as a sharp increase in blood pressure and an increase in heart rate. The drugs in this group are quite toxic, and the probability of an overdose when using them is very high, which is why they are so little used in the treatment of depressive disorders today.

In addition, the first generation includes drugs that are no longer used today, containing irreversible inhibitors of monoamine oxidase (MAO) - "Iproniazid", "Tranylcypromin", "Isocarboxazid". Their action is based on suppressing the activity of the nerve endings of neurons in the brain, as a result of which the concentration of serotonin and norepinephrine increases.

Second generation drugs

The second generation, in contrast to the first, has a more selective, but also weaker effect on neurotransmitters and neurons themselves. It includes tetracyclic irreversible (MAO-B) and reversible (MAO-A) monoamine reuptake inhibitors, represented by such drugs as "Lerivon", "Lyudiomil", "Pyrazidol" and a number of others. Due to the fact that when they were taken, there were many rather serious side effects, as well as because of the interaction with various drugs and the unpredictability of the effect, drugs in this group are used extremely rarely. It is rather difficult to find antidepressants from the group of monoamine reuptake inhibitors in pharmacies. But in some cases they are found under other trade names. So, experts say that the drug "Lyudiomil" is the same tablets "Maprotiline", the price, the manufacturer and the country are only different.

Third generation

Modern researchers have found that about 30 mediators are involved in the work of the brain and nervous system, but only three of them are "involved" in depression: serotonin, dopamine and norepinephrine (norepinephrine). The third generation includes selective serotonin reuptake inhibitors (SSRIs), represented by such most commonly used modern antidepressants as Zoloft, Citalopram, Prozac, Tsipralex, Paroxetine, Plizil and many others. These drugs do not block all mediators, but only one - serotonin. In terms of the strength of the effect, they are inferior to the drugs of the first generation, but they have significantly fewer side effects than any other predecessors. All SSRI drugs are very effective and should be tolerated by patients in about the same way. However, each of us's body has its own individual characteristics, and it is because of them that the number and intensity of side effects will be different in each case. Doctors say the most common side effects of third-generation drugs are insomnia, dizziness, nausea, and anxiety.

The drugs of the SSRI group are quite expensive. So, for a fairly well-known and widely used drug "Citalopram", the price in pharmacies, depending on the brand under which it is produced, can vary from 870 to 2000 rubles.

Fourth generation antidepressants

These include drugs of the SSRIs group (selective serotonin and norepinephrine reuptake inhibitors). These are such antidepressants of the latest generation as drugs "Simbalta", "Milnacipran", "Remeron", "Effexor", which block the seizure of both norepinephrine and serotonin. The drugs "Zyban" and "Wellbutrin" do not interact with serotonin, but retain dopamine and norepinephrine. The development of medicines belonging to this group began only in the mid-90s of the last century, and every year more and more new medicines appear.

Doctors cannot say unequivocally that it is in this group that the most best antidepressant, this is in principle impossible, since for the treatment of various types of depressive disorders, drugs are selected individually, taking into account the characteristics of the health of each patient.

Popular modern thymoleptics

Knowing about the serious effect of drugs in this group on nervous system, it is necessary to remember that all possible - both positive and negative - consequences can only be predicted and neutralized qualified specialist - a doctor. Taking into account all the individual characteristics and making a diagnosis, it is the physician who will be able to prescribe exactly those antidepressants that can best help in your particular case, with minimal side effects... In the event that any problems arise while taking the prescribed medication, it is the attending physician who will be able to adjust or change the treatment regimen. Today, most practitioners recommend drugs from the group of selective serotonin and norepinephrine reuptake inhibitors for patients with depressive disorders, the effectiveness of which has been tested in practice. Medicines such as Milnacipran, Fluxen (Fluoxetine), Duloxetine, Velaxin (Venlafaxine) are the most typical and widely used antidepressants of the latest generation. Consider the most popular thymoleptics in the treatment of depressive disorders.

The medicine "Flucosetin"

This drug is one of the first representatives of the SSRI group, it combines both antidepressant and stimulating effects. The medicine "Fluxen", also known as the antidepressant "Fluoxetine", helps to reduce anxiety and tension, eliminates the feeling of fear and improves mood. Its most effective use, according to practicing psychotherapists, in cases of asthenic depressive disorders with apathy, as well as depression of varying severity and obsessions... This drug is also used in the treatment of bulimia. The antidepressant "Fluoxetine" was first registered in 1974 in the United States, and in the last decade it came out on top in sales in the UK, only under a different trade name - means "Prozac". In Russia, this medicine is widely used, and many practicing doctors confirm that they prescribe him or his generics to patients for various depressive conditions.

The drug "Paroxetine"

It is the strongest member of the selective serotonin uptake inhibitors group and is widely used in the treatment of anxiety and depression. Today, there are a lot of medicines, the active ingredient of which is paroxetine. This and russian drug "Adepress" from "Veropharm", medicine "Plizil" from the Croatian company Pliva, Hungarian tablets "Reksetin" from and many others. Regardless of what the name of the medicine "Paroxetine" is, reviews about it both from patients and from doctors are mostly positive.

Medicinal product "Wellbutrin"

It is better known as "Zyban" or "NouSmok". The active ingredient of all three drugs is bupropion hydrochloride, which increases the amount of dopamine and norepinephrine in the brain. Medications with this active ingredient not only relieve symptoms of depression, but also help overcome the emotional consequences of quitting nicotine. This medication improves mood and performance. Reviews of those who got rid of nicotine addiction with the help of such drugs as "Wellbutrin", "NouSmok" and "Zyban" indicate the high effectiveness of these drugs during the period of quitting smoking.

Medicine "Simbalta"

The drug of the fourth generation of antidepressants, which is an inhibitor of the reuptake of norepinephrine and serotonin, simultaneously carrying out a slight seizure of dopamine. This drug, the active ingredient of which is duloxetine, has a rather high speed of action in comparison with other antidepressants. According to the reviews of both doctors and patients, a clear antidepressant effect appears by the end of the first - beginning of the second week of admission. In addition, this drug is characterized by uniformity of action and throughout the entire period of its use. However, there is a group of patients, according to whose reviews the effect of this medication, if it comes, is very weak. As already mentioned, the individual characteristics of the course of biochemical reactions quite often lead to the fact that a particular medication prescribed by a doctor may not have the expected result.

How much is?

Today it is quite difficult to talk about the prices of medicines. This is due to the fact that the foreign exchange market is extremely unstable, and new antidepressants for the most part come to us from foreign manufacturers whose prices are presented in euros. That is why the table below shows the minimum and maximum prices in rubles, since it is simply impossible to average them. Some of the drugs that were received earlier are sold at the old prices, while new supplies are much more expensive.

If you look closely at the table, you will notice that there are no second-generation drugs in it, namely MAOIs (monoamine reuptake inhibitors). It's not a mistake. The thing is that these antidepressants, which have a large number of unpleasant side effects and incompatibility with many drugs, are practically not used in European countries. In the USA, the medicines "Isocarboxazid", "Ugenelzin" and "Tranylcypromine" are used quite rarely, and in our country - the medicine "Nialamid". All of the above medications are available only under the supervision of a specialist psychiatrist.

This table shows well that the price for "classic" tricyclic antidepressants is significantly lower than for newer drugs from the SSRI and SSRIs groups. Thus, there is no need to talk about the high availability of effective antidepressant drugs for the majority of the population. However, your doctor can help you find a less expensive drug with similar properties, the so-called generic.

Interaction with other drugs

Antidepressants can interact with others, even those that seem completely safe and familiar to us. The most active in this regard are tricyclic thymoanaleptics and monoamine oxidase inhibitors, but the drugs of the SSRIs and SSRIs groups practically do not interact with other medicines. In any case, if your doctor prescribes any medications for depression, be sure to find out if you can combine them with the use of other medications, dietary supplements, and even teas and herbal decoctions.

Oddly enough it sounds, but many people who need thymoleptics for various reasons ask the question of how often it is possible to combine the intake of "intoxicating" drinks and pills for depression. The answer to this question is quite simple: if you want to risk your mental and physical health, and maybe your life, try it! The fact is that both alcohol and antidepressants have a serious effect on the central nervous system and the brain, and such double pressure can negatively affect both the "flight control center", that is, the brain, and the organs and systems that obey it. Whether or not you should combine - the decision is made by you and only you.

Instead of a conclusion

Do not think and "rack your brains" over which antidepressants are better and more effective. If you feel that every new day is becoming harder to live than the previous one, you do not have enough strength even for the simplest and most ordinary things, contact a specialist! The doctor will be able to diagnose your condition and prescribe the necessary treatment, choosing the most suitable medicines for you. It can be not only antidepressants. The arsenal of today's medicine is quite extensive: different kinds psychotherapy, physical exercise and acupuncture, breathing practices and physiotherapy treatments.

IN last years depressive states in people, and especially among residents of large cities, began to occur quite often. 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 this way, but it is quite possible to gradually become an alcoholic. Depression is a disease and must be treated with medications - antidepressants.

The mechanism of action of antidepressants

Currently, the pharmacy network sells a variety of antidepressants belonging to various groups of 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 positive effect from reception 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. In this case, 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 stop taking 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 own expensive analogues... 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 they are taken, the patient often has problems falling asleep. But 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, sexual dysfunction. As practice shows, all these side effects are observed in the first days of taking antidepressants and subsequently go away on their own, without requiring any additional treatment.

Most modern drugs for the treatment of depression hardly react with other medications taken. But if you buy antidepressants without a prescription and take any other means, including dietary supplements (biologically active additives), then be sure to consult with a specialist about the safety of their joint reception.

Common myths about antidepressants

Many people are wary of antidepressant treatment, believing that these drugs will 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, longing. 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 do not cause physical addiction or mental dependence. They are just 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 antidepressants without a prescription, it is better to 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 yourself 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.

YouTube video related to the article:

I am writing this text from three positions. From the position of a therapist who sometimes offers clients to add medication to therapeutic assistance. From the position of a person who had both the experience of getting out of a depressive episode using only psychotherapy and the experience of taking antidepressants along with therapy. It was my decision every time. The only experience that I do not have is an ultimatum or compulsory drug treatment. Therefore, the text is exclusively for those who are ready to make their decisions independently and independently bear responsibility for their consequences.

Now in essence

First. Depression is not only when a person is already lying with his nose against the wall, unable to get up, wash, go to work or meet friends. And not even when the whole meaning of life is lost and there is no joy from the word at all.

Depression, which is more common, is more likely to be mild and medium gravity. This can be, among other things, everything that we habitually call laziness, procrastination, bad mood, spoiled character, etc. To avoid self-diagnosis, there will be no clear criteria. The diagnosis is made by a doctor ... Yes, psychiatrist ... And yes, it doesn't bite.

Second. Drinking antidepressants is not a shame. Just like corvalol or, for example, no-shpu or nurofen, if something hurts. Or as embarrassing as any other medication. Antidepressants, like intimate hygiene, are everyone's personal business and you are not obliged to let your boss, colleagues, friends, relatives know about it. Doctor and psychotherapist. The rest are optional. At your request.

Experiences

Subjectively, a person can be filled with hopelessness and sadness. He cannot see the good in his life. He does not want to and loves to suffer, namely he cannot. Your attempts to show him how beautiful the world is, creates a feeling that he was not understood and intensifies suffering.

And this does not mean that there is no need to try - sometimes it works.

A person in depression is irritable and / or capricious for no reason (for an external observer) or for scanty reasons. In fact, it is often very vulnerable and injured. Not by you. And not now. And it arrives to you. Because now / recently the brakes have failed. Often, irritation and tears are the only ways to relieve a little of the colossal inner tension that such a person experiences. Tension that builds up again rather quickly, because these methods are precisely stress relief, acting out, but not satisfaction of an urgent need. The tighter the loop of depression, the more difficult it is to recognize this very need. Most of all, relatives and children suffer from mood swings of a person with depression. And, of course, he himself. Because emotional outburst is often followed by guilt or shame for the inadequacy of the outburst. Guilt or shame keeps the inner circle going.

If there is not a lot of guilt and shame, then some time after the outbreak is a time of relief. The love and tenderness that a depressed person feels for someone who just annoyed him is completely sincere. It just became easier and these feelings can flow quietly for a while.

Children of depressed parents grow up early, learning to care for their parents during episodes of deterioration. This is neither good nor bad - it is.

From within, the world seems to a depressed person to be hostile, not warm and not giving. Self-hatred and self-accusations are off the charts. People around are seen as cold and rejecting. And, naturally, from there, from the inside, it is rather difficult to imagine that such people should be asked for help or support.

At the same time, most of all in need of a warming supportive relationship, a person is extremely sensitive and vulnerable precisely in relationships. Everything hurts him: words, intonations, gestures. It is impossible to please him, and it is not necessary, otherwise it is fraught with your tension and desire to break contact, which he, of course, will catch, even if you do not realize this impulse. Out of hunger, he reaches out to people. From vulnerability and pain repels them. Such a push-push.

He is no longer pleased with things that pleased him only recently. If the work was loved and it ceases to bring joy, the person is frightened even more. Still, not everything is all right here.

Hobbies, sports, loved ones, pets, colors cease to please, the sense of taste of favorite products disappears. Often a person starts to overeat or malnourish. Smoking or drinking more than usual. Partly, trying to feel at least something, partly, not coping with the recognition of the simplest bodily needs - hunger, cold, etc.

Difficulty in recognizing basic bodily needs and, consequently, their untimely - to eat, drink, sleep, go to the toilet on time - reduces the already small amount of energy in depressed person, who spent them on an internal struggle with himself. Depressive states can often be accompanied by sleep disturbances - insomnia, disturbed sleep and wakefulness cycles. Naturally, the ability to work and energy for life are reduced.

The longer a person stays in a depressed state, the greater his real dissatisfaction with life. The fewer people in reality are willing and able to stay close and give the much needed warmth in this state.

The longer the depression lasts, the less there are memories of what was once different, memories to rely on to get out. It seems that "that I" was a completely different person, or then there was a different time / youth / marriage / health. A critical attitude towards one's state is lost precisely as a state, period, problem in which help is needed. And this is replaced by the experience of it as a given, from which there is no way out. Followed by meaninglessness and despair.

How antidepressants can help.

First, they relieve the acuteness of the condition. There is a little more strength for life, contact, and therefore more chances to receive warmth, support, more opportunities for psychotherapeutic assistance.

Secondly, medications gradually level out the emotional background, go away completely or become much less frequent outbreaks of irritation, sudden tears, acute vulnerability, states when it throws it into a fever, then into a cold. Removing acute peak emotional reactions allows you to better hear and recognize less vivid feelings, and therefore more accurately identify your needs. Most antidepressants have a calming effect and improve sleep.

A more complex action of drugs consists in the gradual alignment of the hormonal balance in the body, which makes the body more resilient, and depressive episodes are more rare.

In parallel with taking medications, therapeutic work is necessary, within which a person finds support, warmth, contact, as well as an analysis of the ways in which he himself involuntarily tightens his own loop of depression. Better awareness of situations and experiences that a person cannot cope with and which lead to depressive episodes allows each next time to go through this situation a little differently, more successfully, to organize for oneself the necessary amount of support inside and outside. Therapeutic, friendly, medicinal, and whatever the person needs. All this is the work of psychotherapy. Without this job, the daunting addiction of many to antidepressants could become a reality. Because if you are given a plaster cast, and after removing it, you stubbornly go and break the same hand in the same way and again come to the same emergency room, then yes, you will be addicted to plaster. The more often you repeat this maneuver, the stronger. So it is with antidepressants.

The first antidepressants were synthesized in the fifties of the twentieth century. Nowadays, pharmacological companies continue to work on creating new groups of antidepressants, taking into account the current scientific understanding of mental illness. These medications affect the painfully depressed mood that occurs with.

How do antidepressants work?

Mental illness, including depression, is still a largely unexplored territory. There are many hypotheses to explain the nature of these diseases. According to the generally accepted monoamine theory of depression, the disease arises from a deficiency of monoamine neurotransmitters (serotonin, dopamine, norepinephrine). Accordingly, in order to overcome depression, it is necessary to restore the normal metabolism and balance of these neurotransmitters. This is how antidepressants work.

Neurotransmitters are substances that transmit information from a neuron to another cell (nerve, muscle, etc.). The area of \u200b\u200bcontact between these cells is called a synapse. Neurotransmitters are formed in the presynaptic membrane of a neuron. Then from there they are released into the synaptic cleft - the space between adjacent neurons. Most of neurotransmitter penetrates into the adjacent neuron through the postsynaptic membrane. A smaller proportion of the remaining neurotransmitters are captured back into the presynaptic membrane. According to the monoamine theory of depression, an increased reuptake of monoamine neurotransmitters, in particular serotonin, occurs during illness. That is, neurotransmitters are produced, but do not reach their destination. Because of this, mental activity is disturbed, apathy and bad mood appear.

A group of antidepressants such as selective serotonin reuptake inhibitors (SSRIs) just prevents the re-uptake of this neurotransmitter by the presynaptic membrane. That is, the amount of serotonin in the synaptic cleft increases, respectively, the postsynaptic membrane receives it in the proper amount. This is how the antidepressant effect is realized.

There is also a group of antidepressants such as monoamine oxidase (MAO) inhibitors... Monoamine oxidase is an enzyme that breaks down monoamine neurotransmitters. So, the use of MAO inhibitors helps to suppress the activity of this enzyme, because of which neurotransmitters are not destroyed and, accordingly, their concentration increases.

Types of antidepressants

Exist different classifications antidepressants. This is how the classification looks according to the mechanism of action of the drugs:

1. Drugs that block neuronal uptake of monoamine neurotransmitters
   • Non-selective (non-selective) actions that block the reuptake of serotonin and norepinephrine (Amitriptyline, Imipramine);
   • Selective (selective) actions that block the seizure of only a certain neurotransmitter:
     • Blocking the reuptake of serotonin, this group is also called SSRIs (Fluoxetine, Paroxetine, Citalopram);
     • Blocking the reuptake of norepinephrine (Maprotiline).
2. Monoamine oxidase (MAO) inhibitors:
   • Indiscriminate Action (Nialamid);
   • Selective action (Pirlindol, Moclobemide).
3. Various (blocker of serotonin and alpha2-adrenergic receptors - the drug Mianserin, an agonist of melatoninergic receptors - Valdoxan).

In addition, there is also a classification of antidepressants according to their effect. Antidepressants, in addition to their own antidepressant effect, have an additional effect: sedative or psychostimulating. Based on this, they allocate antidepressants with predominantly sedating effect (Amitriptyline, Mianserin), predominantly with a psychostimulating effect (Fluoxetine, Moclobemide). Also, antidepressants of balanced action are isolated (Paroxetine, Sertraline, Duloxetine). The doctor takes these aspects into account when choosing a drug for a particular patient, because in some people depression occurs with apathy, slowing down of motor and mental activity, and in someone with high anxiety and psychomotor agitation.

Indications for use

Already by the name of the group of drugs, one can understand that they are used in the fight against depression. However, the range of prescriptions for modern antidepressants, namely SSRIs, is quite wide. They are also prescribed for such conditions:

• Anxiety disorder;
• Panic disorder;
• Obsessive compulsive disorder;
• Complex.

Thus, SSRI antidepressants are widely used in general medical practice. Antidepressants are prescribed by a doctor and only if there are objective indications.

Many people are afraid to take antidepressants, even if they are prescribed by a doctor. They are driven by fears caused by popular myths about these drugs. So, many believe that antidepressants are drugs that you can't get off of later.

In fact, antidepressants are not narcotics. Their use is capable of influencing only the pathologically low mood. They do not cause euphoria, they are not able to improve mood in people who do not suffer from depression. That is, if healthy man takes an antidepressant, he will not feel any effect. Plus, antidepressants are not addictive. .

Application features

The use of antidepressants has its own characteristics. We are so arranged that we want to immediately get rid of unpleasant symptoms with one pill. However, this will not work with antidepressants. The fact is that the antidepressant effect when using this group of drugs occurs after about two to three weeks.

Much earlier, an additional effect of the drug is realized: soothing or stimulating. It is because of this that SSRI antidepressants are used in the treatment of anxiety disorders, because anxiety and anxiety decrease quickly enough.

Note! Due to the fact that the antidepressant effect does not develop immediately, many people stop taking the medicine on their own, considering it useless. You can't do that. The effectiveness of the drug can be said for sure after a month. If the medication is really not effective, the doctor will replace it with another medication.

The dose of the drug is increased gradually, reaching the required clinical effect. That is, the dose is selected individually for each patient. The course of taking antidepressants is quite long. Initially, their use is aimed at eliminating the painful condition, it takes on average two to three months. After the elimination of depressive symptoms, antidepressants are not stopped and they are taken for another four to six months as maintenance therapy. In case of normalization of the condition, the doctor cancels the drug. This should be done in a measured manner, gradually reducing the dose of the medicine. In general, the course of taking an antidepressant is at least six months. Sometimes the treatment can take a year or even two.

Important! The path to recovery from depression can be quite long, but don't give up. By following the doctor's instructions and working on yourself, you can get rid of painful symptoms and enjoy life again!

Side effects

First generation antidepressants (tricyclic antidepressants, irreversible MAO inhibitors) have had many side effects. These are urinary retention, orthostatic hypotension, edema, cardio- and hepatotoxic effects, headaches, tremors,.

Antidepressants last generations have fewer side effects, but they still need to be considered. First of all, at the beginning of treatment with the drug, there may be an increase in anxiety, anxiety,. This is due to the stimulating effect of the drug. To prevent this side effects antidepressants are often prescribed with tranquilizers initially. Treatment should be supervised by a physician.

Side effects of SSRI inhibitors are also related to the fact that serotonin receptors are found in many organs. Stimulation of the receptors can cause the following side effects:

• , constipation;
• Daytime sleepiness,;
• Apathy;
• Fast fatiguability;
• Tremor;
• Sweating;
• Decreased sex drive, anorgasmia.

Side effects occur in the first weeks of treatment and usually disappear as therapy continues.

Note! The use of any antidepressant is associated with the risk of developing manic conditions. Therefore, antidepressants should be used with caution in bipolar disorder.

Popular drugs

The most modern and widely used antidepressants are SSRIs. They are much better tolerated by patients than antidepressants in other groups. Their use has fewer contraindications and side effects. In addition, they can be used not only for depression, but also for anxiety disorders.

Amitriptyline

A drug from the group of tricyclic antidepressants (TCAs). Available in tablet form and solution for injection. The medicine quickly enough has a pronounced antidepressant effect. It also has a sedative, anti-anxiety, hypnotic effect.

Amitriptyline is less well tolerated by patients than SSRIs. Its main side effects are:

• Dry mouth;
• Dilation of the pupils;
• Disturbance of eye accommodation;
• Constipation;
• Delay in urination;
• Hand tremor;
• Heart rhythm disorders.

Amitriptyline is contraindicated in case of high intraocular pressure, cardiac conduction disorders, prostate adenoma, epilepsy.

The drug is not prescribed as widely as SSRIs. Amitriptyline is used in the treatment of severe endogenous depression. Treatment with the drug should be carried out in a hospital under the supervision of a physician.

Fluoxetine

It is a popular SSRI antidepressant, also known under the brand name Prozac. The drug normalizes mood, reduces anxiety and fear. However, Fluoxetine is classified as a psychostimulant antidepressant. Accordingly, it is prescribed for depression, proceeding with a slowdown in motor activity and thought processes... In patients with psychomotor agitation, severe anxiety, the drug can aggravate pathological symptoms. It is prescribed for moderate depression, anxiety disorders. Suitable for outpatient treatment.

The drug does not cause orthostatic hypotension, does not have a toxic effect on the heart, unlike Amitriptyline. At the same time, taking Fluoxetine is not devoid of adverse reactions generally. These can be headaches, daytime sleepiness, nausea, vomiting, dry mouth.

Tsipralex

Belongs to the SSRI group, active substance - escitalopram. Indicated for depression and panic disorder. The antidepressant effect develops after about 2-4 weeks. When treating panic disorder, maximum therapeutic effect can be achieved after three months of treatment.

The medicine is used with caution in the treatment of people with,.

Paroxetine

A drug from the SSRI group has a pronounced anti-anxiety effect. The spectrum of application of Paroxetine is very wide: from depression to post-traumatic stress disorder. This medication is preferred for anxiety disorders. With depressive disorder with motor retardation, apathy, the drug can aggravate these symptoms.

Grigorova Valeria, medical columnist