What are antidepressants for? Antidepressants - what are they? Tranquilizers and antidepressants

Chemicals found in the human brain that affect mood are called neurotransmitters or neurotransmitters. People suffering from depression and other mood disorders have altered levels of these chemicals. Antidepressants work by helping to normalize the levels of these compounds, which in turn normalizes the functioning of neurotransmitters in the brain. Depression and mental health disorders are serious problems that need to be treated. In our country, antidepressants are prescribed by doctors of all specialties, but in fact only a psychiatrist should prescribe them, since only a psychiatrist can make a conclusion about the severity of mood imbalance and prescribe adequate therapy to help balance the chemical composition of neurotransmitters.

Types of Antidepressants

Antidepressants These are psychotropic drugs used to treat depression, affecting the level of neurotransmitters such as serotonin, norepinephrine and dopamine. In patients with depression, they improve mood, reduce or completely relieve melancholy, lethargy, a feeling of indifference, neutralize anxiety, restlessness, irritability and emotional stress, increase mental activity, normalize the structure of sleep phases, affect the duration of sleep, appetite.

There are the following classes of antidepressants working in different directions.

They act similarly to SSRIs, but allow more norepinephrine to be produced in the synaptic cleft. TCAs include Protriptyline (Vivactil), trimipramine (Surmontil) and (Tofranil)

Monoamine oxidase inhibitors (MAOIs).

MAO inhibitors slow the breakdown of serotonin, dopamine and norepinephrine in the brain. Isocarboxazid (Marplan), Phenelzine (Nardil), and Razageline (Azilect) are examples of monoamine oxidase inhibitors.

Every patient is different, but many depressed patients are prescribed one of the SSRIs for the first time. If drugs in this group do not work, then the next drug of choice is a tricyclic antidepressant. Last but not least, monoamine oxidase inhibitors (MAOIs) are prescribed. This is due to the fact that all antidepressants have many side effects and restrictions on use.

May take time

Antidepressants work best for treating depression when given in conjunction with psychotherapy, but they do not work right away. Many antidepressants have a cumulative effect and it will take 1 to 3 weeks for it to start working, and about 2 more weeks for the effect to reach its maximum. Most symptoms associated with depression—a lack of interest in things that were once enjoyable, as well as feelings of hopelessness and sadness—eventually improve with antidepressants. In rare cases, some people may be resistant to certain antidepressants, and finding what works may require trial and error with other medications. The effect of the drug may not be noticeable for weeks or months. Each different type and class may be associated with different potential risks.

Make adjustments if necessary

In general, it takes about 4-6 weeks for antidepressants to take effect. If you are still experiencing symptoms after this amount of time, talk to your doctor. You may need to increase the dose of your current antidepressant medication or switch to another one. Some people experience treatment failure with the first antidepressant they try. In these cases, switching to a drug in a different class may be a better option. It may take up to three months to achieve the maximum effect of antidepressant treatment. Very rarely, some people who take antidepressants notice that the drug stops working. Such cases, as well as any other difficulties associated with treatment, must be reported to your doctor. Remember that depression left unattended is a risk to your mental health.

Regular visits to your doctor are necessary in order to adjust treatment in the changing picture of the disease. Depression and anxiety are serious illnesses and can be associated with suicidal ideation and other symptoms. It is extremely important to address complaints that concern you in a timely manner. Treatment with selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), and other antidepressants requires monitoring and precise dosing. The goal is to relieve depression and anxiety without side effects or symptoms. You may also need treatment adjustments if you have undergone a major life change, such as being diagnosed with a serious illness or losing your job. Women who are pregnant may also need to adjust the type or dose of medications they take. Some medications may have negative effects on the developing fetus.

How long does treatment last?

Treatment with antidepressants for depression can last from several months to a year. It is very important not to stop treatment or reduce the dose of your prescribed medication just because you start to feel better. If you do this, the depression will return. It is important to stay on your prescribed dose for as long as your doctor tells you to do so. Take the medication at the same time each day for maximum benefit. You can take your tablets with breakfast each morning as an easy way to remember to take your medications.

Tell your doctor about side effects

Some people may experience side effects from antidepressants. Be sure to discuss them with your doctor. Some common side effects may include increased or decreased appetite; difficulty falling asleep or excessive sleepiness; weight gain or loss, problems with libido. Some people may experience nausea. Your doctor can help you come up with solutions to potential side effects. Often, side effects from antidepressants are temporary and may go away after a few weeks of taking them. If the side effects are severe, your doctor may prescribe a different medicine for you. Never stop taking your antidepressants. This can lead to severe withdrawal symptoms and depression.

Interaction with other drugs

Antidepressants prescribed today are often of much higher quality and have fewer side effects and drug interactions than older drugs across different classes. However, reactions with other medications, herbs, and supplements you take are always possible. Interactions may interfere with how the drug works or may reduce the effectiveness of the drug. Always make sure your healthcare provider knows about all the prescriptions and medications, supplements, and herbs you are taking.

Myths about antidepressants as drugs

Many people are afraid to take antidepressants to treat depression and anxiety because they believe that antidepressants are drugs and are addictive. Some fear that antidepressants will make them robotic and emotionless. Yes, they can help relieve feelings of sadness and hopelessness, but they will not make you detach from your emotions. Some people also mistakenly believe that they will need to be treated with antidepressants for life. Most people are treated for 6 to 12 months. Follow your doctor's instructions about starting, increasing, decreasing, or stopping medications and you will receive good treatment. Abruptly stopping antidepressants is dangerous and can lead to withdrawal symptoms.

It is best to combine treatment

Several studies show that combining antidepressants with psychotherapy is the most effective treatment for depression. Mental illness is serious. It is important to take your depression medications as directed and see your GP regularly. Mental illness is first and foremost a disease and is nothing to be ashamed of. Millions of people suffer from depression, anxiety and other mental health disorders. People should feel as comfortable seeking help for mental health disorders as they would for other organic conditions, such as heart disease or diabetes. Cognitive behavioral therapy (CBT) helps control and change unwanted thoughts and behaviors. Interpersonal therapy helps patients interact better and more effectively with others.

Stopping antidepressants

Withdrawal from an antidepressant should be carried out very carefully by a specialist to avoid withdrawal symptoms. Follow your doctor's instructions to reduce your dose and eventually stop the medication. If you stop taking antidepressants too early, depression will return. In general, tapering the dose very gradually is the best plan. Tell your doctor if you experience side effects or symptoms when you reduce the dose of your medication or stop it altogether.

Getting help for depression is the right thing to do. The risks of untreated depression outweigh the potential side effects of medications. Ongoing clinical trials continue to explore potential new treatments for depression and other mood disorders. The FDA has issued a warning that some SSRIs, MAOIs, and TCAs may increase the risk of suicidal thoughts and behavior in adolescents and young adults aged 18 to 24 years during the first two months of treatment.

Sooner or later, a modern person is faced with the need to purchase antidepressant drugs used in complex treatment for a depressed emotional state. Antidepressants are “called upon” to serve a person to elevate mood, create a positive emotional background, and ultimately.

When is a doctor's prescription required for antidepressants?

The dosage and daily regimen of medication is prescribed, of course, by the doctor. Only a qualified specialist will be able to assess the true state of your psyche, accurately calculate and schedule the dosage of medications. Compliance with the prescription when treating depression is one of the components of success in the fight against depression.

A prescription for purchasing antidepressant drugs is required only in the following cases:

• exacerbation of the disease;
• treatment of the most severe forms of depression;
• with an atypical form of the disease.

In this situation, the doctor prescribes monoamine oxidase inhibitors (MAOIs). These are potent antidepressant drugs that are used when other types are ineffective or have severe side effects.

The most effective in treating severe forms of depression are moclobemide, phenelzine, isocarboxazid and tranylcypromine.

Phenelzine, isocarboxazid and tranylcypromine are time-tested drugs, but have been used since the 50s of the 20th century and have many side effects. Moclobemide is a new generation medicine, with a faster effect and fewer associated negative reactions.

Mild antidepressants of a new generation. What's special?

A mild form of depression can be “corrected” with the help of drugs for which pharmacies do not require a prescription. New generation antidepressants, as a rule, do not cause as much harm to the body as drugs produced in the last century. Modern “over-the-counter” antidepressants are fundamentally different from heavy medications and drugs of the older generation.

Advantages of modern antidepressants:

1. faster effect on the body and elimination of depression;
2. fewer side effects;
3. possibility of simultaneous use with many other medications;
4. absence of significant addiction to the action of the drug.

Based on the effect the drugs have on a person’s mental state, antidepressants are distinguished between stimulating and sedative properties.

It is very important to accurately determine the nature of the disease and the subsequent correct choice of antidepressant medication (to stimulate or inhibit the central nervous system). The time and effectiveness of treatment largely depends on this.

List of mild antidepressants available without prescription (15 drugs)

Over-the-counter antidepressants are divided into different groups according to the degree and type of their effect. Let us list the main groups and the drugs included in them. Let's start the list by listing stimulant antidepressants.

1. Maprotiline

Drug name: Maprotiline.

Analogues: Ludiomil, Ladiomil, Flexyx.

Indications: endogenous, involutional, psychogenic and neurotic depression, exhaustion, somatogenic, latent, menopausal depression.

Action: reducing apathy, improving mood, relieving psychomotor retardation.

Side effects: headache, lethargy, drowsiness, hearing loss, hallucinations, tachycardia, arrhythmia, vomiting, nausea, dry mouth, urticaria, swelling, weight gain, sexual disorders, stomatitis.

Contraindications: epileptic disease, kidney disease, liver disease, pregnancy.

2. Prozac

Drug name: Prozac.

Analogues: Fluoxetine, Prodel, Profluzac, Fluval.

Indications: depression, bulimia nervosa, obsessive-compulsive disorder (obsessive thoughts and actions).

Action:

• relieves emotional overload and obsessive thoughts;
• will alleviate anorexia nervosa;
• eliminates premenstrual disorders;
• reduce anxiety and panic.

Side effects: at the beginning of treatment and when the dose is increased - anxiety, drowsiness, headache, nausea. Rarely – convulsions. Possible skin rashes, pain in muscles, joints, fever

Contraindications: hypersensitivity, pregnancy, lactation.

3. Paxil

Drug name: Paxil.

Analogues: Rexetine, Adepress, Actaparoxetine, Plizil, Paroxetine hydrochloride hemihydride, Sirestill.

Indications: depression of all types in adults and children 7-17 years old.

Action: in the first weeks of use, symptoms of depression decrease and suicidal thoughts are eliminated. Prevents relapses of depression.

Side effects: drowsiness, insomnia, loss of appetite, tachycardia, nausea, constipation, seizures, sweating.

Contraindications: hypersensitivity to paroxetine and the components of the drug. Pregnancy, lactation.

Drug name: Deprim.

Analogues: Gelarium hypericum, Doppel-Hertz Nervotonic.

Indications: chronic fatigue syndrome, depression, emotional exhaustion, decreased ability to work.

Action: increased performance, mental and physical activity, normalization of sleep.

Side effects: dry mouth, changes in the gastrointestinal tract, fatigue.

Contraindications: children under 6 years old. Individual intolerance. It should be taken with special caution during pregnancy and lactation.

Along with medications of chemical origin, herbal preparations can be taken to combat depression. Antidepressants of herbal etiology are herbal infusions that can be purchased at a pharmacy or prepared at home.

5. Leuzea extract

Drug name: Leuzea extract (Raponticum safflower).

Indications: as a complex therapy.

Action: general tonic effect, increased performance, improved mood, increased appetite .

Side effects: headache, irritability, increased blood pressure, allergic reaction, insomnia.

Contraindications: hypersensitivity, epilepsy, chronic sleep disorders, acute period of infectious diseases.

6. Ginseng tincture

Drug name: Ginseng tincture.

Indications: hypotension, increased fatigue, overwork.

Action: increased performance, decreased fatigue, increased blood pressure.

Side effects: insomnia, headache, diarrhea, nausea, nosebleeds.

Contraindications: hypertension, children under 16 years of age, hyperfunction of the thyroid gland.

7. Schisandra tincture

Drug name: Schisandra tincture.

Indications: hypotension, neurasthenia, depression.

Action: stimulating the central nervous system, increasing blood pressure, improving visual acuity.

Side effects: overexcitation of the central nervous and cardiovascular systems.

Contraindications: insomnia, high blood pressure, acute infectious diseases.

Let's take a closer look at the class of sedative antidepressants.

8. Azafen

Drug name: Azafen.

Indications: asthenodepressive syndrome, anxiety-depressive state, alcoholic depression, endogenous depression, exogenous depression, depressive states in chronic somatic diseases.

Action: elimination of anxiety and depression, manifestations of senile depression, smoothing out the negative state caused by long-term use of antipsychotics.

Side effects: nausea, vomiting, headache, dizziness.

Contraindications: hypersensitivity, myocardial infarction, coronary heart disease, diabetes mellitus, pregnancy, acute infectious diseases.

9. Persen

Drug name: Persen.

Indications: poor sleep, irritability, increased nervous excitability.

Action: sedative and antispasmodic effect.

Side effects: allergic reaction. With prolonged use - constipation.

Contraindications: hypersensitivity to the components of the drug, arterial hypotension. Children under 3 years old (tablets), children under 12 years old (capsules)

10. Mianserin

Drug name: Mianserin.

Indications: Depression of various origins.

Action: improved sleep, decreased nervous excitability.

Side effects: drowsiness, hypokinesia, convulsions.

Contraindications: manic syndrome, pregnancy, lactation, childhood (up to 18 years). Liver and kidney failure.

11. Amitriptyline

Drug name: Amitriptyline.

Indications: manic-depressive psychosis, bulimia nervosa, childhood enuresis.

Action: sedative effect, antidiuretic effect for bedwetting, analgesic effect.

Side effects: drowsiness, disorientation, excitability, hallucinations, fatigue, tachycardia, nausea, vomiting, weight gain.

Contraindications: epilepsy, intestinal obstruction, angle-closure glaucoma, pregnancy, breastfeeding.

12. Mirtazapine

Drug name: Mirtazapine.

Indications: depressive states, early awakening from sleep, loss of interest, anxious depression.

Action: restoring the ability to enjoy, adjusting sleep, eliminating suicidal thoughts.

Side effects: drowsiness, dizziness, unusual dreams, tachycardia, nausea, diarrhea, decreased libido, dry mouth, increased appetite.

Contraindications: hypersensitivity to the components of the drug, epilepsy, organic brain damage.

13. Novo-passit

Drug name: Novo-passit.

Indications: neurasthenia, “manager” syndrome, migraine, eczema of psychological etiology.

Action: sedative, relieving nervous excitability of the premenstrual and menopausal periods, eliminating anxiety.

Side effects: allergic reactions, dizziness, drowsiness, slight decrease in muscle tone.

Contraindications: hypersensitivity to the components of the drug, children (up to 12 years), alcoholism, epilepsy, diseases, brain injuries.

14. Hawthorn tincture

Drug name: Hawthorn tincture.

Indications: nervousness, cardiovascular diseases, menopause, high cholesterol.

Action: calming effect on the nervous system, normalization of heart activity, reduction of excitability during menopause.

Side effects: allergic reactions, itching, urticaria.

Contraindications: pregnancy, lactation period, individual intolerance, children under 12 years of age.

15. Valerian tincture

Drug name: Valerian tincture.

Indications: insomnia, migraine, hysteria, increased excitability, smooth muscle spasms.

Action: calming, antispasmodic, choleretic, normalizing effect for the gastrointestinal tract.

Side effects: decreased performance, drowsiness, depression.

Contraindications: individual intolerance.

Contraindications for over-the-counter antidepressants

Antidepressants sold without a prescription have a beneficial effect on the elimination of neurotic conditions of various etiologies. But this does not mean at all that you can take these drugs for a very long time and without negative consequences.

Many antidepressant medications that are freely available in pharmacies may have a number of contraindications.

These “prohibitions” apply to almost all antidepressants:

• individual intolerance to the components of the drug;
• pregnancy;
• breastfeeding period;
• children under 18 years of age.

It must be said that each drug with antidepressant action, along with the contraindications listed above, may also have its own, unique to this medicine.

If you are in doubt about whether or not to take antidepressants, watch a video that will enlighten you and destroy a number of myths about drugs of this kind:

Constant stressful situations and the very fast pace of modern life lead to many people becoming overly irritable, nervous, and susceptible to various types of phobias. Depressive conditions, unfortunately, have ceased to be something unique and isolated.

Nowadays, even young children are familiar with the term “depression.”

The chemical composition and clinical use of these drugs may vary. The search for new pharmacological compounds to combat depression in medical science does not stop.

The first medications to combat depression began to be prescribed to patients in the 50s of the 20th century. The drug iproniazid is at the origins of antidepressants. Currently, there are about 125 drugs with antidepressant effects in pharmacology. Be careful when choosing antidepressants!

Since ancient times, humanity has experienced the heavy influence of stress, fallen into depression and needed help. The 21st century is considered depressive according to the statistics of these diseases. However, people have been suffering from this disease since ancient times.

But in past times, stimulants were used to combat depression, among which the most common are opium, ginseng, and caffeine. In order to cope with anxiety and restlessness, valerian, bromine salts, and aralia tincture were widely used.

However, some and other substances could only give a temporary effect. They did not relieve the symptoms of depression, did not remove the causes or treat the depressive state.

Modern ones appeared only in the mid-50s of the last century and began to actively develop and improve.

A little history

The first drug for depression was discovered in 1957. It happened almost by accident. The drug Iproniazid, well known for use against tuberculosis, significantly improved the mood of patients. A whole group of doctors immediately drew attention to this. This drug was unsuccessful as a treatment for tuberculosis, but it was continued to be given because it improved the psychological state of the patients.

Following these findings, iproniazid became widely used in the treatment of depressive conditions. However, this drug revealed one serious problem: it increased the risk of hepatitis C. For this reason, the use of iproniazid was prohibited, and the drug itself was withdrawn from the public market.

The next antidepressant that appeared after iproniazid was Imipromine. It was discovered by Ronald Kuhn in Germany. This drug is still actively used to combat depression.

The next famous drug was Prozac. Over time, this drug completely replaced past medications. It appeared at the end of the last century. Prozac was developed in the USA.

Action

Antidepressants can correct the activity of certain parts of the brain.

As you know, the brain consists of neurons. There is communication between them. The mechanism of this connection is as follows: there is space between neurons (synapse - synaptic cleft). Information between neurons is transmitted by a special chemical messenger called a transmitter. Normally, this is how it all works. But sometimes the level of transmitters in the synapse decreases, and information is transferred incompletely or at a slow pace. In this case, depression occurs.

Mediators related to the onset of depression include three known substances: dopamine, norepinephrine, and serotonin.

Antidepressants are able to regulate the concentration of any specific neurotransmitter or all of them at once, thereby correcting the mechanisms of brain function.

Antidepressants: myths and reality

Myth 1

There is a very popular opinion that antidepressants do not always have a positive effect on the human body. They believe that you can get used to antidepressants. There is even a theory that antidepressants can lead to insanity.

Reality: Antidepressants, like any substance, can have side effects. In Soviet times, they were very often prescribed “just in case,” and in large doses. For this reason, unpredictable results were obtained.

Myth 2

For a long time it was believed that antidepressants are used when a person’s character is weak, weak-willed and lacking in concentration. People are rarely able to understand that depression is an illness. Like any disease, it needs to be treated. This requires medications, the best of which are antidepressants.

Reality: It is virtually impossible to completely get rid of mental problems with the help of medications. Treatment of depression requires, in addition to medications, high activity of the person himself in solving his own problems. However, to begin to show any activity, you need the ability to act, which only antidepressants can provide.

In European countries, antidepressants have become part of the lifestyle culture. They are used by about 65% of the population. Modern drugs are not addictive. They are able to restore brain activity, which is disrupted during depressive states.

Antidepressants are prescribed for a number of neuropsychiatric diseases and pathologies:

• pain syndromes of various etiologies;
• psychosomatic diseases;
• anxiety states;
• narcolepsy;
• anorexia and;
• alcoholism;
• chronic fatigue syndrome;
• phobic syndromes;
• crises of various etiologies.

The psychiatrist's task

The psychiatrist faces a difficult task: the correct choice of the type and dosage of medications. As a rule, only half of patients begin to feel an improvement in their condition after starting a course of therapy. Very often, several drugs are prescribed at once. It may take at least 2-3 weeks before the first lasting effect appears.

It often seems that improvement is simply impossible. But that's not true. In fact, the process of correcting the action of mediators has begun and, soon, the patient will begin to feel an improvement in mood and general condition.

Antidepressants bring positive changes to some people immediately, while others have to wait a long time for them.

There is another problem with their use. Antidepressants can be aimed at only one type of mediators: norepinephrine, serotonin, dopamine. In humans, only one connection between neurons may also be disrupted. It is almost impossible to guess which mediator is not effective enough. Therefore, you have to do this by trial and error, changing the type of prescribed medications.

Antidepressants in our country, and many European countries, are sold only with a doctor's prescription. For this reason, many people who self-medicate their condition use herbal antidepressants, the so-called “mild drugs”: Fenebit, Novopassit, Tenotoen, Valfen, Hypericum, etc.

Herbal decoctions (for example, St. John's wort, lemon balm) or special preparations are often used. Of course, herbal antidepressants are not as safe as we think, but still this is not an artificial effect on brain activity. And when self-medicating, it is better to use them than to look for “your” medicine on your own.

Even an experienced doctor often needs a long time to select the ideal drug. Each person is individual. And in addition to the effect, you also need to take into account possible side effects and individual intolerance. In addition, factors such as gender, age, depth of the disease, and the mood of the patient are taken into account.

During treatment you need to follow several recommendations:

• Start and stop taking antidepressants gradually;
• Taking medications must be combined with psychotherapy;
• You should not drink alcohol while taking antidepressants.

How to choose antidepressants

It is a very common opinion that all modern drugs are either ineffective or are modifications of amyltriptylene. This is far from true. And you need to be able to understand the modern abundance of drugs in this direction.

It should be said that free antidepressants are prescribed only to patients registered as psychiatric patients. All other patients have to buy these drugs themselves. Their prices range from 1.5 to 6 thousand rubles. Naturally, this is not a cheap “pleasure”. Considering that the medicine may simply not be suitable for a given patient, and it cannot be returned to the pharmacy, treatment for depression can lead to another depression.

Antidepressants are used in the treatment of depression, a list of which can be seen below. Antidepressants are drugs that selectively affect a person’s depressive state. These drugs and antipsychotics for depression can be used to relieve affective-delusional syndromes in children and adults.

The most common mild antidepressants are:

• Moclobemide;
• Bethol;
• Toloxatone;
• Pyrazidol;
• Imipramine;
• Amitriptyline;
• Anafranil;
• Pertofran;
• Trimipramine;
• Azafen;
• Maprotiline;
• Mianserin;
• Fluoxetine;
• Fevarin;
• Citalopram;
• Sertraline;
• Paroxetine;
• Cymbalta.

This is only some of the antidepressants used to combat nervous disorders and depression. All of them are divided into several classifications.

Calming

Anti-depressants are a classification of the most common drugs used to combat depression.

Amitriptyline belongs to the classic type of mild antidepressants with a tricyclic structure. It is distinguished from Imipramine by its rather strong sedative effect. It is used to get rid of depression of anxious and agitated types, which can manifest themselves with “vitality”. This drug is available in the form of tablets and injections.

Another domestic antidepressant is Azafen, or Hypophysin. It is used to combat the symptoms of “minor” depressive disorders of the cyclothymic register. The drug has moderate sedative and thymoanaleptic effects.

Mianserin, or Lerivon, is a drug that has a strong sedative effect when used in small doses. Due to this effect, it can be used to treat cyclothymia in combination with insomnia. It is able to cure depression with major episodes.

Stimulating

Moclobemide, or Aurorix, is a selective MAO inhibitor. The drug has a powerful stimulating effect on people suffering from inhibited types of depression. It is prescribed for somatized types of depression. But the drug is strictly prohibited for use in anxiety depression.

Imipramine, or Melipramine, is the first fully studied tricyclic antidepressant. It is used in the treatment of severe depression with a high prevalence of sadness and lethargy, and with suicidal thoughts. The drug is available both in the form of tablets and as intramuscular injections.

Fluoxetine is a drug that has a thymoanaleptic effect. Its second name is Prozac. The drug is effective during the treatment of depression with obsessive-phobic symptoms.

This type of medication is called a selective serotonin reuptake inhibitor (SSRI). The drug is devoid of some effects of clinical tricyclic antidepressants:

• antihistamine;
• adrenolytic;
• cholinolytic.

Pertofran is a more powerful version of Imipramine (desmethylated). It has a brighter activating effect. The drug is used to combat depression combined with depersonalization.

Balanced drugs

The second name of Pyrazidol is Pirlindol. The drug is produced in Russia. It is a reversible inhibitor of MAO type A, like Moclobemide. This drug is used to prevent and treat depression of the inhibited type, as well as depressive disorders with pronounced anxiety manifestations. The advantages of the drug are that it can be taken for glaucoma, prostatitis and heart pathologies.

Another powerful drug created as a result of the synthesis and introduction of a chlorine atom into the imipramine molecule is Anafranil. It is used to treat resistant depression and to relieve the affective phases of severe depression.

Maprotiline, or Ludiomil, is an antidepressant with a tetracyclic structure. It has a fairly powerful thymoanaleptic effect when interacting with anxiolytic and sedative components. It can be used for circular depression in combination with ideas of self-blame. The drug is used for involutional melancholia. Maprotiline is produced in the form of oral medications and injections.

Reversible monoamine oxidase inhibitors and selective reuptake inhibitors

Befol is one of the domestic drugs that are prescribed for depressive disorders of asthenic and anergic types. It is used to treat the depressive phase of cyclothymia.

Fevarin and Fluoxetine belong to the classification of drugs with thymoanaleptic action. The drugs have a vegetative stabilizing effect.

Citalopram and Tsipramil are other names for thymoanaleptic antidepressants that can be used to treat depression. They belong to the group of sedating serotonin reuptake inhibitors (SSRIs).

Afobazole is an over-the-counter antidepressant. It is used to combat somatic diseases with adaptation disorders, anxiety, neurasthenia and oncological and dermatological diseases.

The drug has a good effect in treating sleep disorders and relieving PMS symptoms. But it is worth considering that it is contraindicated for children and women during pregnancy and lactation.

Tricyclic

Trimipramine, or Gerfonal, is used in the treatment of depression with increased anxiety. This is one of the most powerful drugs of this kind. Its psychotropic activity is similar to Amitriptyline. When carrying out treatment, it is worth considering the list of contraindications of this antidepressant:

• dry mouth;
• orthostatic hypotension;
• problems with urination.

New generation antidepressants

Sertraline and Zoloft are names of antidepressants with a strong thymoanaleptic effect and a weak stimulating effect. Moreover, the drugs do not have anticholinergic or cardiotoxic properties.

They achieve maximum effect when fighting somatized atypical depression with some manifestations of bulimia.

Paroxetine is a derivative of piperidine. It has a rather complex bicyclic structure. The main properties of Paroxetine are thymoanaleptic and anxiolytic. They appear when there is stimulation.

The drug shows itself well in the fight against endogenous and neurotic depression, their melancholy or inhibited variants.

Venlafaxine is an antidepressant used for depression associated with severe mental disorders such as schizophrenia, etc.

Opipramol is used to treat somatized and alcoholic depression. It is able to prevent vomiting, convulsions and generally stabilize the autonomic nervous system.

Toloxatone, or Humoril, is similar in its effect on the human body to Moclobemide. The drug does not have anticholinergic or cardiotoxic properties. But it copes well with treating depression with pronounced inhibition.

Cymbalta or Duloxetine are used to combat depression with panic attacks.

Side effects

Most antidepressants have a fair number of side effects. Their list is quite long:

• hypotension;
• arrhythmia;
• sinus tachycardia;
• violation of intracardiac conduction;
• suppression of bone marrow functions;
• agranulocytosis;
• thrombocytopenia;
• hemolytic anemia;
• dry mucous membranes;
• violation of accommodation;
• intestinal hypotension;
• problems with urination;
• increased appetite;
• increase in body weight.

Such side effects occur quite often due to the use of tricyclic antidepressants. In contrast, antidepressants that are serotonin reuptake inhibitors have less pronounced side effects. But it could be:

• frequent headaches;
• insomnia;
• anxiety states;
• depotentiating effects.

If combination therapy is used for treatment, that is, drugs of both types are used simultaneously, then serotonin syndrome may occur, characterized by an increase in temperature, signs of intoxication of the body, and disturbances in the functioning of the heart and blood vessels.

Any antidepressants for depression should be taken only after a complete medical examination and an accurate and complete diagnosis.

And for children they are prescribed with extreme caution. Be sure to do this under the supervision of a doctor so as not to harm the body.

Antidepressants are needed to stabilize mood and eliminate symptoms of depression. They quickly affect the patient’s nervous system and are often combined with various medications. Before using any of these drugs, you should consult your doctor. Only he will accurately find out the cause of the psychological problem, help you choose the appropriate medications, determine the duration of the necessary treatment and the correct dose. Drugs that do not have a strong effect are dispensed at pharmacies without a doctor’s certificate, but when prescribing potent antidepressants (monoamine oxidase inhibitors), the doctor writes a prescription.

The drug relieves depression of various types and degrees of severity, eliminates feelings of anxiety.

1. Indications. Paxil helps during panic attacks, agoraphobia, and nightmares. It is used during stress disorders in the post-traumatic period.
2. Application and dosage. One tablet is taken after eating food, 20 mg daily for a couple of weeks, the dose can be increased every week by 10 mg (maximum up to 50 mg per day). The minimum course of medication use is 4 months.
3. Side effects. Nervousness, insomnia, pain in the head, convulsions, complications of depression, and dry mouth may occur. Bleeding, nausea, and fainting may occur.
4. Contraindications. Not recommended for use under 18 years of age, during lactation or hypersensitivity to this type of medication.
5. Analogues. Adepress, Plizil, Sirestill, Rexetine.

The price of a package of Paxil for 30 tablets in Russia is about 700 rubles, and in Ukraine you will have to pay almost 500 UAH for the same one.

Mianserin belongs to the group of psychoactive drugs. The drug has an antiemetic effect and stimulates appetite.

1. Indications. Various mental disorders, feelings of constant anxiety, deep depression.
2. Application and dosage. Swallow the tablets with water (do not chew them), preferably take them before bed in a couple of doses, dividing the 60 mg daily dose into two doses (30 mg each). For elderly people, 30 mg is enough, followed by increasing the dosage. The course of treatment is usually about 4 weeks.
3. Side effects. Constipation, a feeling of dryness in the mouth, drowsiness, headache, some weakness, and slight dizziness occur. The patient may begin to gain weight, there may be pain in the joints, a rash, and arthritis.
4. Contraindications. Severe sensitivity to this medicine, liver dysfunction, previous heart attack, pregnancy, lactation. It should be taken very carefully if you have kidney disease, glaucoma, or diabetes.
5. Analogues. Miansan, Lerivon.

One pack of Mianserin contains 20 tablets. Their cost in Russia fluctuates around 1000 rubles, and in Ukraine the price is 250–400 UAH.

The drug Mirtazapine is sold in the form of convex, oval-shaped tablets with a special film coating applied on top. They have a yellow-brown color.

1. Indications. Prescribed by a doctor during periods of depression with noticeable lethargy, weight loss, insomnia, and suicidal thoughts.
2. Application and dosage. The tablet should be taken once a day, swallowed with a small amount of water. Reception does not depend on food consumption. For patients under 60 years of age, 15 mg per day is enough, increasing the dose to 45 mg. Treatment for depression lasts about 6 months.
3. Side effects. Slow reaction, anxiety, weakness, convulsions, hallucinations, epileptic seizures. Appetite may increase, body weight may increase, stomach pain may be felt, potency may decrease, vomiting, skin rashes, and swelling are also possible.
4. Contraindications. High sensitivity to this drug. Use with caution during pregnancy, breastfeeding and in patients with high sugar levels.
5. Analogues. Mirtel, Esprital, Mirazep, Mirtastadin, Remeron.

The cost of a package of Mirtazapine (30 mg / 20 pcs.) in Russian pharmacies is about 2100–2300 rubles. In Ukraine the price will be 400–500 UAH.

Azafen is a fairly common drug that is also prescribed as a sedative.

1. Indications. Prescribed by a doctor for depression of various types: alcoholic, senile, exogenous. Treats feelings of increased anxiety and deep stress.
2. Application and dosage. The tablet should be swallowed with a small amount of water. 25–50 mg per day (in two doses) is sufficient. If there is no effect, then the dose is increased to 200 mg per day. Treatment lasts more than one month, up to a year.
3. Side effects. Headaches, allergies, dizziness, vomiting and bouts of nausea may occur.
4. Contraindications. High sensitivity to the active substance, liver or kidney disease, previous stroke or heart attack, heart disease, infections, diabetes.
5. Analogues. Velaxin, Normazidol, Esprital, Coaxil, Befol, Tetrindol, Deprim, Alventa, etc.

Azafen in a package of 50 tablets (25 mg) is available in any pharmacy in Russia for 180–200 rubles; in Ukraine, a similar drug costs about 250 UAH.

One of the most potent antidepressants is undoubtedly Amitriptyline, which has a characteristic sedative effect.

1. Indications. The drug should be used strictly as prescribed by the doctor during periods of depression. Amitriptyline helps with acute feelings of anxiety.
2. Application and dosage. Per day you need to take from 50 to 75 mg (divided into separate small parts), increasing the dose as necessary. It is optimal to take 200 mg per day, but in acute depression it can reach 300 mg. The drug is used for 2–4 weeks.
3. Side effects. Deterioration of vision, poor urination, headaches, weakness, nightmares, constipation, insomnia. Possible tachycardia, fainting, vomiting, loss of taste, diarrhea, rash, brittle hair, sweating.
4. Contraindications. Intolerance to the components included in the drug, heart disease, liver or kidney problems, pregnancy, ulcer, previous heart attack.
5. Analogues. Tryptisol, Amirol, Saroten, Amizol, Elivel.

The price of Amitriptyline (25 mg, 50 tablets) in Russian pharmacies fluctuates around 25–30 rubles. Ukrainian pharmacies sell similar packaging for 15–17 UAH.

Modern antidepressants are highly effective with a minimum of side effects. They are produced in quite a large number and it is impossible to list them all. It is only worth noting that any of the drugs used to treat various types of depression and all kinds of mental disorders requires consultation with a doctor, and self-medication of depression is fraught with consequences.

Myths and facts about antidepressants are told by Rina Dragunova in this video: