Many people treat these medicines with caution. “These are anti depressants – psychotropic drugs!” Indeed, there is something “awesome” about this, especially, given our attitude towards psychiatry. But let's take away subjective judgments and judgments, and turn only to facts that will enable us to understand what anti depressants really are? Are they addictive? How safe is it to take them? Are these tablets can cope with depression and devastation – favorite companions of depression.
Anti depressants: how it all started
Anti depressants are psychotropic drugs that are used to treat depression, anxiety disorders, obsessive-compulsive, post-traumatic syndromes and other mental disorders.
Until anti depressants were discovered, depressants were treated with substances that have an exciting effect, capable of entering into a state of euphoria. So, for this purpose, opiates, caffeine, ginseng and others were used.
Since the beginning of the last century, scientists have tried to synthesize a substance that can alleviate the suffering of people with depression, but all attempts of researchers have not been successful. However, in 1957, quite a random group of scientists drew attention to the drug iproniazid, which was used in the comprehensive treatment of tuberculosis. The researchers were surprised by the fact that the side effect of the drug is an increase in mood in patients. Already after a while iproniazid began to be used to eliminate the symptoms of depression. Over the past decades, the pharmaceutical industry has produced many different types of anti depressants that differ in both the mechanism of action and the realization of the therapeutic effect
How do anti depressants work?
How is it that a small pill allows you to say goodbye to sadness and regain lost mood? We will not go into the biochemical subtleties of this process, but describe only the general features of the pharmacological action of anti depressants.
As is known, our brain consists of tens of billions of neurons (nerve cells) that are linked together by synapses – through which one neuron can transmit information (impulses) to another neuron. The transfer of such information is carried out by the intermediary – a chemical substance or a mediator. According to modern theory, depression from the point of view of biochemistry is a decrease in the concentration of some mediators in synapses.
Currently, scientists have identified more than 30 different mediators of the nervous system, but only three such substances – dopamine, norepinephrine and serotonin – are related to depression fat loss. These mediators are called biogenic amines. anti depressants are able to regulate the concentration of one or more of these biogenic amines, thereby correcting the work of the brain.
These drugs have a selective effect on depression, they can be used in combination with neuroleptics to relieve affective-delusional syndromes.
Moclobemide (aurorix) is a selective MAO inhibitor of type A. It is characterized by a distinct stimulating effect with inhibited depressions. It is indicated with somatization of depression. Doses from 300-600 mg / day are recommended, for the development of a timoanaleptic effect, two to three weeks are necessary. Contraindicated in anxious depression.
Bethol – the original domestic anti depressant with an activating effect of action (asthenic, anergic depression). It is used in the depressive phase of cyclothymia. The average therapeutic doses are 100-500 mg / day.
Toloxaton (humoral) is close in action to moclobemide, devoid of cholinolytic and cardiotoxic properties. Effective with depression with severe inhibition in doses of 600-1000 mg / day.
Pyrazidol (pyrlinol) is an effective domestic anti depressant, reversible inhibitor of MAO type A. It is used to treat both inhibited depressing depressions and depressions with anxiety manifestations. It has no contraindications in the presence of glaucoma and prostatitis. Dosages of the drug are 200-400 mg / day. Holinolytic effects are not manifested, which allows prescribing the drug for cardiovascular pathology.
Imipramine (melipramine) is the first studied anti depressant of the tricyclic structure. It is used to treat “major depressions with a predominance of sadness, inhibition, the presence of suicidal thoughts. When administered orally, doses of 25-50 to 300-350 mg / day, parenteral administration (in the muscle, in the vein), in one ampoule contains 25 mg of melipramine, a daily dose for intramuscular injection of 100-150 mg.
Amitriptyline is also a “classical” anti depressant of the tricyclic structure, differs from imipramine by a powerful sedative effect, and is therefore indicated in the treatment of anxious, agitated depressions with the presence of “vitality” manifestations. In tablets prescribe up to 350 mg / day, parenterally up to 150 mg with intramuscular and up to 100 mg with intravenous administration.
Anaphranil is a potent anti depressant, obtained as a result of directed synthesis and introduction of a chlorine atom into an imipramine molecule. It is used for the treatment of resistant depressions (psychotic variants) in doses up to 150-200 mg / day for oral administration, 100-125 mg / day for intravenous administration in cases of severe depressions for relief of affective phases in MDP.
Pertofran is a desmethylated imipramine, it has a more powerful activating effect in comparison with it, it is used in the treatment of depressions with depersonalization. Dosage – up to 300 mg / day (in tablets).
Trimipramine (Herphonol) is the most powerful anti depressant for anxiety. The profile of psychotropic activity is close to amitriptyline. The average daily doses range from 150 to 300 mg. The drug, like amitriptyline, causes cholinolytic effects (dry mouth, urination disorders, orthostatic hypotension), which must be taken into account when conducting course treatment.
Azafen (pipofezin) – a domestic anti depressant, which is indicated for the treatment of “small” depressions of the cyclothymic register. It combines mild timoanaleptic and sedative effects. The maximum dosage is 300-400 mg / day when administered orally.
Maprotiline (ludomil) – an anti depressant of the tetracyclic structure, has a powerful thymoanaleptic effect with an anxiolytic and sedative component. It is shown with a typical circular depression with ideas of self-blame, is used successfully in involutional melancholy. Dosage – up to 200-250 mg / day for oral use. Intravenously drip the drug with resistant depressions to 100-150 mg / day (60 drops per minute for 300 ml of isotonic solution). Usually make 10-15 infusions.
Mianserin (lerivon) has a mild sedative effect in small doses, which makes it possible to use it in the treatment of cyclothymia with insomnia phenomena. When the drug is prescribed in doses of 120-150 mg / day, the phenomena of a major depressive episode are orally stopped.
Fluoxetine (Prozac) has a distinct timoanaleptic effect with a predominantly stimulating component, is particularly effective in the presence of obsessive-phobic symptoms in the structure of depression. It belongs to the group of selective serotonin reuptake inhibitors (SSRIs), completely devoid of antihistaminic, cholinolytic and adrenolytic effects of classical tricyclic anti depressants. Has a very long half-life (60 h). It is convenient for treatment in that it is prescribed once a day for 20 mg together with the intake of the drink. The permissible dose is 80 mg / day. The course of treatment is not less than 1-2 months.
Fevarin has a moderately pronounced thymoanaleptic effect, but a vegetostabilizing effect is manifested. The applied doses are from 100 to 200 mg / day, it is prescribed once a day in the evening.
Citalopram (cipramil) has moderate thymoanaleptic properties with a stimulating component, belongs to the SSRI group is prescribed once a day at a dose of 20-60 mg with oral administration.
Sertraline (zoloft) does not have anticholinergic and cardiotoxic properties, it gives a distinct timoanaleptic effect with: a weak stimulating effect. Especially effective at somatized, atypical depressions with bulimia phenomena. Assign a dose of 50-100 mg once a day, the effect is observed 10-14 days after the initiation of therapy.
Paroxetine (rexetin, paxil) – a derivative of piperidine has a complex bicyclic structure. The main properties of psychoactive activity of paroxetine are thymoanaleptic and anxiolytic action in the presence of stimulation manifestations. Effective in both classical endogenous and neurotic depressions. Has a positive effect in both dull and inhibited versions, while not inferior to the activity of imipramine. Detected: preventive action of paxil in unipolar depressive phases. It is prescribed once a day at a dose of 20-40 mg / day.
Simbalta (duloxetine) is used to treat depression with the presence of panic attacks, is prescribed in capsules of 60-120 mg once a day.
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