Antidepressants – medications, which are active in relation to depressive states. Depression is a mental disorder characterized by decreased mood, weakened motor activity, intellectual poverty, erroneous assessment of one’s “I” in the surrounding reality, somato-vegetative disorders.
Most probable cause the occurrence of depression is biochemical theory, according to which there is a decrease in the level of neurotransmitters - nutrients in the brain, as well as a decreased sensitivity of receptors to these substances.
All drugs in this group are divided into several classes, but now let’s talk about history.
History of the discovery of antidepressants
Since ancient times, humanity has approached the issue of treating depression with different theories and hypotheses. Ancient Rome was famous for its ancient Greek physician named Soranus of Ephesus, who proposed lithium salts for the treatment of mental disorders, including depression.
As scientific and medical progress progressed, some scientists resorted to a variety of substances that were used against the war against 
depression - from cannabis, opium and barbiturates to amphetamine. The last of them, however, was used in the treatment of apathetic and lethargic depression, which was accompanied by stupor and refusal to eat.
The first antidepressant was synthesized in the laboratories of the Geigy company in 1948. This drug became. After this we carried out clinical researches, but they did not begin to release it until 1954, when it was received. Since then, many antidepressants have been discovered, the classification of which we will talk about later.
Magic pills - their groups
All antidepressants are divided into 2 large groups:
- Thymiretics- drugs with a stimulating effect that are used to treat depressive states with signs of depression and oppression.
- Thymoleptics– drugs with sedative properties. Treatment of depression with predominantly excitatory processes.
Indiscriminate action:
Selective action:
- block serotonin uptake– Flunisan, Sertraline, ;
- block norepinephrine uptake— Maproteline, Reboxetine.
Monoamine oxidase inhibitors:
- indiscriminate(inhibit monoamine oxidase A and B) – Transamine;
- electoral(inhibit monoamine oxidase A) – Autorix.
Antidepressants of others pharmacological groups– Coaxil, Mirtazapine.
Mechanism of action of antidepressants
In short, antidepressants can correct some processes occurring in the brain. Human brain consists of a colossal number of nerve cells called neurons. A neuron consists of a body (soma) and processes - axons and dendrites. The neurons communicate with each other through these processes.
It should be clarified that they communicate with each other by a synapse (synaptic cleft), which is located between them. Information from one neuron to another is transmitted using a biochemical substance - a mediator. On this moment About 30 different mediators are known, but the following triad is associated with depression: serotonin, norepinephrine, dopamine. By regulating their concentration, antidepressants correct impaired brain function due to depression.
The mechanism of action differs depending on the group of antidepressants:
- Neuronal uptake inhibitors(non-selective action) block the reuptake of mediators - serotonin and norepinephrine.
- Neuronal serotonin uptake inhibitors: Inhibit the process of serotonin uptake, increasing its concentration in the synaptic cleft. Distinctive feature this group is the absence of m-anticholinergic activity. There is only a slight effect on α-adrenergic receptors. For this reason, such antidepressants have virtually no side effects.
- Neuronal norepinephrine uptake inhibitors: prevent the reuptake of norepinephrine.
- Monoamine oxidase inhibitors: monoamine oxidase is an enzyme that destroys the structure of neurotransmitters, resulting in their inactivation. Monoamine oxidase exists in two forms: MAO-A and MAO-B. MAO-A acts on serotonin and norepinephrine, MAO-B acts on dopamine. MAO inhibitors block the action of this enzyme, thereby increasing the concentration of mediators. The drugs of choice for treating depression are often MAO-A inhibitors.
Modern classification of antidepressants
Tricyclic antidepressants
Information is known about effective reception antidepressants as an auxiliary pharmacotherapy for early ejaculation and smoking.
Side effects
Since these antidepressants have a diverse chemical structure and mechanism of action, side effects may vary. 
But all antidepressants have the following characteristics: general signs when taking them: hallucinations, agitation, insomnia, development of manic syndrome.
Thymoleptics cause psychomotor retardation, drowsiness and lethargy, decreased concentration. Thymiretics can lead to psychoproductive symptoms (psychosis) and increased.
The most common side effects include:
- constipation;
- mydriasis;
- urinary retention;
- intestinal atony;
- violation of the act of swallowing;
- tachycardia;
- impairment of cognitive functions (impaired memory and learning processes).
Elderly patients may experience: disorientation, anxiety, visual hallucinations. In addition, the risk of weight gain increases, the development orthostatic hypotension, neurological disorders ( , ).
With long-term use - cardiotoxic effects (cardiac conduction disturbances, arrhythmias, ischemic disorders), decreased libido.
When taking selective inhibitors of neuronal serotonin uptake, the following reactions are possible: gastroenterological - dyspeptic syndrome: abdominal pain, dyspepsia, constipation, vomiting and nausea. Increased anxiety levels, insomnia, increased fatigue, tremors, impaired libido, loss of motivation and emotional dulling.
Selective norepinephrine reuptake inhibitors cause side effects such as: insomnia, dry mouth, dizziness, constipation, atony Bladder, irritability and aggressiveness.
Tranquilizers and antidepressants: what's the difference?
From this we can conclude that tranquilizers and antidepressants have different mechanisms of action and differ significantly from each other. Tranquilizers are unable to treat depressive disorders, therefore their appointment and reception is irrational.
The power of "magic pills"
Depending on the severity of the disease and the effect of use, several groups of drugs can be distinguished.
Strong antidepressants - effectively used in the treatment of severe depression: 
- – has pronounced antidepressant and sedative properties. The onset of the therapeutic effect is observed after 2-3 weeks. Side effect: tachycardia, constipation, difficulty urinating and dry mouth.
- Maprotiline,– similar to Imipramine.
- Paroxetine– high antidepressant activity and anxiolytic effect. Taken once a day. Therapeutic effect develops within 1-4 weeks after starting treatment.
Mild antidepressants - prescribed in cases of moderate and mild depression:
- Doxepin– improves mood, eliminates apathy and depression. A positive effect of therapy is observed after 2-3 weeks of taking the drug.
- - has antidepressant, sedative and hypnotic properties.
- Tianeptine– stops motor retardation, improves mood, increases the overall tone of the body. Leads to the disappearance of somatic complaints caused by anxiety. Due to availability balanced action, indicated for anxious and inhibited depression.
Herbal natural antidepressants:
- St. John's wort– contains hepericin, which has antidepressant properties.
- Novo-Passit– it contains valerian, hops, St. John's wort, hawthorn, lemon balm. Contributes to the disappearance, and.
- Persen– also contains a collection of herbs peppermint, lemon balm, valerian. Has a sedative effect.
Hawthorn, rose hips - have sedative properties.
Our TOP 30: the best antidepressants
We analyzed almost all antidepressants that were available for sale at the end of 2016, studied reviews and compiled a list of 30 the best drugs, which have virtually no side effects, but at the same time are very effective and perform their tasks well (each to their own):
- Agomelatine– used for episodes of major depression of various origins. The effect occurs after 2 weeks.
- – provokes inhibition of serotonin uptake, used for depressive episodes, the effect occurs after 7-14 days.
- Azafen– used for depressive episodes. The treatment course is at least 1.5 months.
- Azona– increases the content of serotonin, is part of the group of strong antidepressants.
- Aleval– prevention and treatment of depressive conditions of various etiologies.
- Amizol– prescribed for agitation, behavioral disorders, and depressive episodes.
- – stimulation of catecholaminergic transmission. It has adrenergic blocking and anticholinergic effects. Scope of application: depressive episodes.
- Asentra– a specific serotonin uptake inhibitor. Indicated for the treatment of depression.
- Aurorix– MAO-A inhibitor. Used for depression and phobias.
- Brintellix– antagonist of serotonin receptors 3, 7, 1d, agonist of serotonin receptors 1a, correction of depressive states.
- Valdoxan– a stimulator of melatonin receptors, to a small extent a blocker of a subgroup of serotonin receptors. Therapy.
- Velaxin– an antidepressant of another chemical group, enhances neurotransmitter activity.
- – used for mild depression.
- Venlaxor– a powerful serotonin reuptake inhibitor. Weak β-blocker. Treatment of depression and anxiety disorders.
- Heptor– in addition to antidepressant activity, it has antioxidant and hepatoprotective effects. Well tolerated.
- Herbion Hypericum– a herbal-based drug, part of the group of natural antidepressants. Prescribed for mild depression and.
- Deprex– an antidepressant has an antihistamine effect, used in the treatment.
- Deprefault– a serotonin uptake inhibitor, has a weak effect on dopamine and norepinephrine. There is no stimulating or sedative effect. The effect develops 2 weeks after administration.
- – antidepressant and sedative effects occur due to the presence of St. John's wort herb extract. Approved for use in the treatment of children.
- Doxepin– blocker of H1 serotonin receptors. The action develops 10-14 days after the start of administration. Indications -
- Miansan– stimulator of adrenergic transmission in the brain. Prescribed for depression of various origins.
- Miracitol– enhances the effect of serotonin, increases its content in the synapse. In combination with monoamine oxidase inhibitors, it causes severe side effects.
- Negrustin– antidepressant plant origin. Effective for mild depressive disorders.
- Newwelong– serotonin and norepinephrine reuptake inhibitor.
- Prodep– selectively blocks the uptake of serotonin, increasing its concentration. Does not cause a decrease in the activity of β-adrenergic receptors. Effective for depression.
- Citalon– a high-precision serotonin uptake blocker with minimal effect on the concentration of dopamine and norepinephrine.
There's something for everyone
Antidepressants are most often not cheap, we have compiled a list of the most inexpensive of them in ascending order of price, with the cheapest drugs at the beginning and the more expensive ones at the end:
The truth is always beyond theory
To understand the whole point about modern, even the most best antidepressants, to understand what their benefits and harms are, it is also necessary to study the reviews of people who had to take them. As you can see, there is nothing good in taking them.
I tried to fight depression with antidepressants. I quit because the result was depressing. I looked for a lot of information about them, read many sites. There is contradictory information everywhere, but everywhere I read it, they write that there is nothing good about them. I myself experienced shaking, pain, and dilated pupils. I got scared and decided that I didn’t need them.
Three years ago, depression began, while I was running to clinics to see doctors, it was getting worse. There was no appetite, she lost interest in life, there was no sleep, her memory deteriorated. I visited a psychiatrist, he prescribed Stimulaton for me. I felt the effect after 3 months of taking it, I stopped thinking about the disease. I drank for about 10 months. Helped me.
Karina, 27
It is important to remember that antidepressants are not harmless drugs and you should consult your doctor before using them. He will be able to pick up the right drug and its dosage.
You should monitor your mental health very carefully and contact specialized institutions in a timely manner so as not to aggravate the situation, but to get rid of the disease in time.
The ideological basis for the work of doctors and psychologists is the principle "Do no harm!". The ambiguous influence of antidepressants on the human body and possible side effects are known and are always taken into account by the attending physician when prescribing a particular drug to a patient.
Ideals and reality
The doctor’s goal is to eliminate the disease, so an antidepressant is prescribed in any case if there are indications for its use, and the doctor is based on the idea that the benefit of the drug will undoubtedly be greater than the possible damage to the body.
The problem is that it is impossible to know for sure how the human body will react to a particular antidepressant in advance. It sometimes takes several months to find a suitable remedy for a patient and not a single attempt to replace the medicine.
However, today drugs from the antidepressant group remain the main means of struggle with diseases such as:
- depression,
- bipolar disorder,
- dysthymia,
- anxiety disorder
- panic attacks,
- post-traumatic syndrome,
- phobias,
- bulimia and anorexia,
- severe pain of unknown nature and other illnesses.
The more severe the psychological problem and the more “advanced” it is, the more likely it is that the help of a psychologist alone will not be enough. The problem will turn into a disease, and the client into a patient who already psychiatrist will prescribe a course of antidepressants.
Maybe if our society were culturally developed to such an extent that people sought to solve their psychological problems as soon as they arise, and not until they got to the point, antidepressants would not be needed. After all, the majority serious problems with the psyche it is the result of expansion or accumulation huge amount smaller and seemingly frivolous psychological problems, as well as the elementary absence psychological culture personalities!
According to statistics 10% people in developed countries buy antidepressants simply to improve their mood. But a low mood is not such a thing a big problem so as not to cope with it yourself! To solve it, you don’t need to run for pills, it’s better to try to understand yourself, help yourself. But people easier take a “magic pill” rather than look for the cause of low mood, eliminate it and resort to more natural and in a useful way lifting the mood.
Someone will say: “I don’t have time to understand myself and have fun! A lot of work, children, debts, worries, and so on! Without denying the negative impact of an accelerated pace of life, bad ecology, negative factors labor and other negative phenomena of life in the modern world, I would still like to note that work on yourself(mainly consisting of timely resolution of internal problems) is the key to psychological well-being and health, and therefore happiness! What could be more important than this?!
Everyone wants to be happy, therefore, he strives to bring into his life as many “attributes” of happiness as possible (get married, take a high position, get rich, get an ideal body, and so on). But while focusing on form, many people forget about content: getting married does not mean becoming a happy wife, getting a desired position - being realized in a profession, losing weight - falling in love with yourself, and so on. The content of life consists of a person’s thoughts, desires, intentions, actions, his worldview, his attitude towards the world and himself. External world A person is, by and large, determined by his inner self.
Taking antidepressants is last resort. You need to do everything possible, that is, help yourself on one's own(change thoughts, habits, worldview) and seek help from specialists(psychologists, psychotherapists) to reduce the likelihood of an extreme condition ( mental disorder or pathology), when you can’t help yourself except with pills.
Moreover, carried out relatively recently, in 2012, research showed that even the most advanced, fourth-generation, antidepressants are not as effective as previously thought. Moreover, scientists have concluded that the side effects of taking these drugs may outweigh the possible benefits!
Unfortunately, many modern treatment standards bring more harm, rather than benefiting a person and contradict the principle “Do no harm!”
As Ilf and Petrov wrote in their novel “The Twelve Chairs”: “The rescue of drowning people is the work of the drowning people themselves!” This principle also applies to the treatment of depression and not only because modern medicine is far from perfect, but because no one can help a person if he doesn’t want help yourself!
The principle of action of antidepressants
To understand how antidepressants affect the body, you need to study the principles of brain function. For a person not familiar with the anatomy and physiology of higher nervous activity, this will not be easy to do. But basic postulates you can understand:
Most often, the “culprit” of depression is insufficient serotonin levels. It is interesting that scientists found this substance, as ancient as the world, not only in human body, but also in plants, mushrooms, fruits and in the body of animals.
In particular, studies conducted on laboratory animals have shown that only 5% of serotonin is found in the brain, a little more in the blood, and the bulk in the intestines! This explains why people get pleasure from food (especially foods containing a large “dose” of serotonin, such as bananas and chocolate), and some develop addiction to certain types of foods!
In general, the process of serotonin production is determined by the work of the central nervous system.
The important thing is that when " bringing happiness"For some reason, there are fewer neurotransmitters in the brain than they should be, that is not enough, the functioning of the nervous system is disrupted. Hence the bad mood, apathy, depression, unfounded fears and other problems.
Antidepressants are chemical drugs that prevent the breakdown of neurotransmitters in the human brain. Speaking in simple language, antidepressants do the work that the brain should normally do on its own. They do this in order to restore balance and harmony to the body.
Here lies the main problem. If you teach your brain that there is an artificial alternative to natural neurotransmitters, you can develop a dependence on antidepressants. Antidepressants can be a disservice if taken incorrectly.
Antidepressant addiction
Modern antidepressants successfully eliminate symptoms of depression and similar mental disorders. If the medicine is chosen correctly, the person returns to balance, energy, and the ability to enjoy life both while taking the medicine and after.
But it often happens that after discontinuation of the drug, relapse, that is, the return of all symptoms of the disease and even a deterioration in the patient’s well-being.
Symptoms when stopping antidepressants are similar to withdrawal symptoms for a drug addict. Their totality was called antidepressant withdrawal syndrome. This includes drowsiness, aches throughout the body, and headache, and the same feeling of hopelessness and terrifying anxiety.
It is very important that the doctor selects not only the right antidepressant, but also accurately determines the dose and duration of its use!
Today, doctors try to prescribe only a short and gentle course of treatment with antidepressants (including a one-time dose), and they are withdrawn gradually over six months after completing the main course of treatment, so that the body gradually weanes itself from outside help and gets used to working on its own.
If antidepressants are taken for too long, addiction can occur. Antidepressant addiction looks like a drug. The body becomes accustomed to antidepressants and becomes unable to maintain homeostasis without them. It is very difficult to get rid of such addiction.
Of course, not a single strong antidepressant is sold in pharmacies without a doctor’s prescription, but some mild antidepressants are sold, mainly on plant based. It is these drugs that people most often resort to who want to quickly get rid of a heavy mood, anxiety and just excitement, without seeking advice from a doctor.
Over-the-counter antidepressants seem harmless, but even such drugs should be used with caution, they can also be addictive! Always read the instructions carefully before use and do not exceed permissible norm taking medication!
Self-medication and taking antidepressants for too long (including those prescribed by a doctor) can cause irreparable harm to a person’s health.
Side effects
When a person starts taking an antidepressant that is suitable for him, he feels much better, anxiety, panic, apathy, insomnia, suicidal thoughts and other symptoms of depression or other mental disorder go away.
But at the same time, there may be such side effects of taking antidepressants How:
Even such an effective, natural, time-tested and experimental drug available in a pharmacy without a prescription as St. John's wort tincture, has a number of side effects, such as:
- feeling of fullness in the stomach,
- constipation,
- nausea,
- flatulence,
- dizziness,
- headache,
- increased fatigue,
- photosensitivity ( increased sensitivity to the light).
You can imagine what the consequences will be if you use an antidepressant longer and more than prescribed!
For example, it has been established that if normally, when taking an antidepressant, a person can only experience a decrease in libido, then in case of an overdose, damage and death of reproductive cells begins.
In addition to side effects, natural, over-the-counter and doctor-prescribed antidepressants have a number of contraindications and incompatibility with some other drugs. These points are also important to consider.
Pill or "pacifier"?
Side effects and the risk factor for dependence on antidepressants has worried scientists since these drugs began to be used in the middle of the last century.
American and British scientists have conducted many experiments and experiments in order to find a solution to the problem “how to treat people for depression without harm to their health?”
The most interesting is their following conclusion: the effectiveness of antidepressant and placebo almost the same!
This information also “surfaced” and was confirmed several years ago, when in the USA a group of scientists demanded that the organization that controls the release of licensed drugs provide access to all published and unpublished (!) studies on the effectiveness of antidepressants.
An analysis of published materials showed that antidepressants are 94% more effective than placebo. When unpublished materials were added to the published ones, this figure decreased, only in half of the cases ( 50% ) the antidepressant was more effective than placebo.
Today in the UK the difference between placebo and real medicine is considered so small that in most cases people are prescribed a "dummy"! Antidepressants are prescribed only in very severe cases.
Placebo translated from Latin as “if I please, I will please.” This substance is without medicinal properties(most often lactose) used as medicine. The therapeutic effect of such a “pacifier” is determined by by faith patient in the effectiveness of the drug.
The conclusion is simple: main component Any medicine must have a person’s faith in his recovery!
An alternative drug treatment depression and other similar diseases are psychodynamic and cognitive behavioral psychotherapy, as well as simple joys and life values: walks on fresh air, sports, good nutrition, healthy sleep, travel, study, hobbies, friendship, love, altruism.
Myosin protein molecules walk along the actin filament, dragging a ball of endorphin with them into the inner part of the parietal cortex (precuneus), responsible for happiness.
In the West, as you know, antidepressants are quite widespread. After the release of the film of the same name, even such a definition appeared - “the Prozac generation” (this is the name of one of the popular antidepressants - Sputnik).
Belarusians treat these drugs with caution. Sputnik correspondent Valeria Berekchiyan spoke with specialists from the Republican Scientific and Practical Center mental health and found out whether we should be afraid of antidepressants, who should take them and when, and how not to miss it and not create depression.
Last year, the World Health Organization (WHO) stated that depression is the leading cause of disability in the world: according to their estimates, more than 300 million people suffer from it.
Symptoms of depression and why Belarusians (don’t) find it in themselves
Depression is considered a stable condition bad mood(at least two weeks), which may be accompanied by apathy, low activity, inability to have fun or be interested in something. Often, people who are faced with it find it difficult to concentrate and start a new business, their sleep and appetite are worse, sexual desire and self-esteem are reduced, and there is a feeling of guilt.
“Self-diagnosis” of depression is not uncommon. According to Irina Khvostova, deputy medical director of the Republican Scientific and Practical Center for Mental Health, there are several reasons.
Firstly, it is really common: the risk of experiencing depression during your lifetime reaches 12% in men and up to 30% in women. Secondly, modern people Information on this topic is available, including professional information.
It also happens the other way around: patients often do not notice their illness; then contacting a doctor should be initiated by people close to them. WITH mild depression and moderate severity more often turn to a psychotherapist, but this practice is not very popular among Belarusians, experts say.
“Sometimes people don’t go to the doctor because of the “masked” course of depression. Typical symptoms may appear slightly or be absent altogether, sometimes the symptoms of a physical illness come to the fore - pain in the heart, a feeling of lack of air, discomfort/pain in the digestive tract or functional disorders intestines. People turn to different specialists and undergo numerous examinations. And only when treatment does not give the desired result, they are referred to a specialist in the field of mental health,” said Lyubov Karnitskaya, deputy director for the medical part of the Republican Scientific and Practical Center for Mental Health.
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In some cases, hospital treatment is required. In the mentioned Republican Scientific and Practical Center, specialized departments have been created for such patients: here various specialists, experienced in the field, work with them neurotic disorders, and research is being conducted to address the problem comprehensively.
“There is no need to be afraid of antidepressants, but there is no need to drink without reason”
Antidepressants are taken so that the symptoms of depression subside or disappear altogether, and the patient affected by it again feels a sense of well-being. In other words, their task is to return a person to normal life. According to Irina Khvostova, you definitely shouldn’t be afraid of antidepressants.
“Modern antidepressants are quite safe; they do not cause addiction. But it is necessary to remember that antidepressants are not candy, and they have contraindications and side effects. Only a doctor will be able to correctly correlate the expected benefits of prescribing the drug and possible Negative consequences its reception,” the specialist believes.
But there is no need to accept them for a minor reason: according to Lyubov Karnitskaya, sometimes people get by psychological help even in cases of severe oppression.
"One of our patients - a young woman - suffered death loved one, and soon - surgery due to suspected malignant tumor; After discharge, due to long rehabilitation, I received a certificate of incapacity for work. Mood and physical activity decreased, thoughts of imminent death appeared, pessimism towards life and people, a depressed state, a desire to hide and not communicate with anyone,” Karnitskaya recalled.
While waiting for the biopsy results, the woman stressed herself out, prepared herself for a worse outcome, felt more and more depressed, and then became withdrawn. In the end, my sister insisted: we need to go to a psychotherapist.
© Pixabay
“A psychocorrectional conversation was held, and when the woman received results about the benign quality of the formation and a favorable prognosis, she mental condition It improved quite quickly and no antidepressant was required,” said the doctor.
Side effects of antidepressants, according to Irina Khvostova, are rare. However, it is worth knowing that among them are restlessness, increased anxiety or, conversely, excessive calmness, sleep disturbance, nausea; and in some cases, weight gain and sexual dysfunction. The idea that antidepressants reduce performance is a myth, she said.
“Apathy and decreased activity are symptoms of depression; a person taking an antidepressant may at some point come to the erroneous conclusion that the decrease in his performance is a consequence of taking an antidepressant,” says the doctor.
Sometimes, in order to return to normal life, the patient only needs to find and eradicate the “source of trouble” - that which provokes negative thoughts and bad mood.
“A young woman complained of low mood for several months, anxiety, uncertainty about the future, lack of pleasure from her favorite job. From a conversation with a specialist, it became known about a chronic psychologically traumatic situation in the family - groundless jealousy of a partner, constant conflicts,” shared Lyubov Karnitskaya.
The patient had to break up with the man. And after a course of psychotherapy, her condition improved even without the prescription of antidepressants.
Who needs to take antidepressants and can you start taking them yourself?
Khvostova categorically does not recommend starting treatment on your own.
“This is not the case when the reason for taking medication can be a positive review from a neighbor or friend from social networks. To choose the right antidepressant, you need professional knowledge and experience,” she shared.
In addition, these pills do not work instantly: their effect is noticeable only in the third or fourth week of routine use. correct dosage, which can also only be selected by a doctor.
Antidepressants are recommended in several cases. When psychotherapy does not help, and the symptoms of depression (for example, disturbances in appetite and sleep) are so severe that they simply do not allow the person to lead normal life activities.
“They are also prescribed if a person has already struggled with such a problem with the help of antidepressants and in cases where there is a high risk of committing suicide,” Khvostova explained.
Another case from practice - a 55-year-old woman experienced her husband’s infidelity. Her mood dropped, the patient stopped taking care of herself, lay in bed and was not at all interested in those around her, and lost her appetite. She lost a lot of weight.
“I began to express thoughts about my unwillingness to live. I categorically refused to consult a doctor (formally agreed to meet with him after much persuasion from the children). The severity of the symptoms of depression and the presence of suicidal thoughts required the prescription of an antidepressant,” said Karnitskaya.
Why is the use of antidepressants so widespread in the West? I have often heard that taking them has almost become the norm even when overworked.
“Most likely, this is a mistaken impression: after all, people can simply mention that they are taking these medications without going into the true reasons for the treatment (most often only the doctor knows the depth of the problem). Do not forget that in Western culture it is customary not to “cry into your vest,” and look successful and prosperous, even when experiencing depression. However, antidepressants all over the world are prescribed only if there are medical indications for this,” the specialist said.
Antidepressants are sold in Belarus only with a doctor's prescription. When used correctly, their effectiveness is undeniable, but their use can cause side effects, and sometimes quite pronounced ones. Therefore, their use is possible in our country only under the supervision of a doctor. But getting to him is not so difficult - just make an appointment with a psychotherapist at your place of residence or contact a psychological help service.
Depression. Its vice squeezes the heart and tears the soul apart. Rest and sedative medications do not help. Only effective remedy fight - drugs from the antidepressant group.
The root of sad troubles
Lethargy, decreased vitality, gloomy mood and self-accusation of all mortal sins most often have nothing to do with bad character or unfavorable life circumstances. These symptoms are evidence of depression, which mercilessly breaks up families, deprives one of a career, and sometimes gives rise to terrible thoughts of putting an end to all this trouble once and for all.
According to the World Health Organization, about 350 million people in the world suffer from depression. Most patients, unfortunately, do not seek treatment medical care, blaming his sad state on anything but biochemical changes in the body. Meanwhile, they are the ones responsible for the development of depressive symptoms.
Scientists believe that the disease is associated with a deficiency of substances involved in the transmission of impulses from nerve cells - neurotransmitters, and especially serotonin. Sometimes the problem appears due to a deficiency of norepinephrine, dopamine and some other mediators. To solve the problem, the lack of all these important substances in the body must be compensated. This is possible with the help of a special class of drugs, combined into the group of antidepressants (ADs).
How to restore serotonin?
If you think that to treat depression it is enough to take “serotonin tablets”, you are deeply mistaken - such magic pills do not exist. The mechanism of action of antidepressants is much more complex.
Neurotransmitters synthesized by the body participate in the transmission of nerve impulses not “in full,” but only partially - the remaining substances are returned to nerve cell. Antidepressants block this mechanism, and substances do not return to the cells, while additional reserves of mediators are activated, compensating for their deficiency, which occurs with depression.
Despite the apparent simplicity of the mechanism of action, there are several rather heterogeneous subgroups of drugs that differ in both their capabilities and tolerability. Today, representatives of three generations of antidepressants are used.
First generation
Drugs of this class are confidently losing their positions. Most of them have already sunk into oblivion, and only tricyclic blood pressure, and in particular amitriptyline, are still widely used in medicine. Its feature is powerful and fast action, which becomes noticeable just a few hours after administration. At the same time, amitriptyline has a lot of side effects, including the development of addiction and severe withdrawal syndrome (when trying to reduce the dose, the disease worsens).
Second generation
This is a large class of drugs, which includes fluoxetine, paroxetine, escitalopram, etc. They are considered the first-line treatment for various types depression. Unlike amitriptyline, second-generation ADs begin to work only 3–4 weeks after the start of therapy. This property is associated with one, fortunately rare, but extremely dangerous side effect - suicidal tendencies.
The fact is that patients with depression who do not receive drug treatment are, as a rule, unable to attempt suicide due to loss of strength. The appointment of blood pressure allows short terms increase activity, but depression can be relieved only after 20–30 days of regular treatment. The “window period” formed in this way accounts for the largest number of suicide attempts. To prevent them, psychiatrists often prescribe fast-acting amitriptyline along with the “slow-acting” drugs of the second generation for several weeks until the main blood pressure begins to work.
All second-generation antidepressants are equally effective, but the response to treatment with them can vary significantly between patients. But the side effects that develop while taking drugs of this series are quite typical. Weight changes (both increases and decreases), decreased libido and erectile dysfunction, headaches, nausea and other unpleasant changes in condition are, unfortunately, typical when taking second-generation ADs.
Third generation
And the last, youngest and “non-standard” class is represented by drugs that help normalize the content of several mediators at once: serotonin, norepinephrine and dopamine. It should be noted that our mood depends on the concentration of the last two substances in the blood: the higher it is, the more optimistic we feel. Today there are only three third-generation drugs - venlafaxine, duloxetine and mirtazapine.
The most studied drug of this trio is venlafaxine, which is found to be as effective as amitriptyline, but much more easily tolerated. Very good results are obtained by combining venlafaxine and mirtazapine. According to studies, the combination of these two drugs can achieve remission in more than 50% of patients. This cocktail even received the loud name “California rocket fuel” - it can have such a powerful effect.
With regard to side effects, the situation with third-generation drugs is approximately the same as with their predecessors. The same sexual dysfunctions, changes in body weight, nausea, and headache can accompany therapy. However, doctors recommend not to lose heart: as treatment continues, the body can adapt to the drugs, and their tolerance often improves over time. In any case, it is necessary to fight depression, and not try to get along with it. Under constant control qualified doctor treatment can be quite comfortable, and recovery can be quite quick and confident.
Marina Pozdeeva
Photo istockphoto.com
