The modern "frantic" rhythm of life, the endless stream of information that a person needs to process daily, as well as many other, mostly negative factors, lead to the fact that the body and psyche can not stand it. Insomnia and stress, impaired performance and communication, often ignored, and most often drowned out by drugs or other potent substances, ultimately lead to such complex diseases as chronic fatigue syndrome (CFS) and various depression. According to the forecasts of medical analysts, depression by the 20s of this century will be ahead of the number of sick leaders of the twentieth century - infectious diseases and diseases of the cardiovascular system. In the fight against depressive disorders, various drugs are used that are based on both natural and synthetic components.
Antidepressants - what is it? What are they and can these drugs cure depression or only relieve its symptoms? What are the advantages and disadvantages of such drugs? In this article, we will try to answer these and other questions about antidepressants, the effect of their use and the consequences of taking.
What it is?
As the name implies, antidepressants (also called timoleptics) are psychotropic drugs that work against the symptoms of depression. Thanks to such drugs, increased anxiety and excessive emotional stress, lethargy and lethargy, insomnia are significantly reduced and even completely disappear. The drugs related to this group are different both in chemical structure and composition, and in the mechanism of action.
How it works?
Let's see, antidepressants - what is it: the destruction of the body or the help of the tormented human psyche. Let's look at how these drugs work. The human brain consists of many neurons - nerve cells that constantly carry out information exchange among themselves. To carry out such a transfer of information, special intermediary substances are necessary - neurotransmitters that penetrate through synaptic clefts in the space between neurons. Modern researchers distinguish more than 30 different mediators, but only three of them have a “direct” relationship to the development and course of depression: serotonin, norepinephrine (norepinephrine) and dopamine. According to research data, depression occurs when a significant quantitative decrease in neurotransmitters occurs at the sites of neuron interaction. The action of antidepressants is aimed at increasing the number of necessary mediators and normalizing the biochemical balance of the brain.
A bit of history
Before proceeding to the consideration of modern groups and types of antidepressants, we briefly talk about the history of their discovery.
Until the mid-twentieth century, depression and various neurotic conditions with similar symptoms were treated with a variety of herbal preparations. For “uplifting”, various stimulant formulations were used, which included caffeine, ginseng or opiates. They tried to “calm” nervous excitement with bromine salts or drugs based on Valerian officinalis. Various types of gymnastics and physiotherapeutic procedures were also used, the effectiveness of which was rather insignificant.
In the early 50s of the twentieth century, the drug "Promethazine" was created, which was originally used for anesthesia during surgical operations. Pharmacologists tried to strengthen the inhibitory and inhibitory effect of this medication, as a result of which, by 1951, "Chlorpromazine" was obtained, which became widely used in medical practice for treating depression. Today, this drug is known as Aminazine.
At the end of the 60s of the last century, Swiss doctors treating patients with tuberculosis noted a rather unusual side effect of such a drug as Iproniazide. Patients who received it were distinguished by increased mood. Gradually, they began to use it in psychiatric practice, since he helped very little against tuberculosis. Around the same time, German researcher Ronald Kun discovered Imipramine.
The discovery of the first timoleptics led to the rapid development of pharmacological research in this area and the creation of new medicines aimed at combating the symptoms and causes of depressive disorders.
Modern classification
Depending on the effect of the use of antidepressants on a depressed patient, they are divided as follows:
Group | Main action | Preparations |
Sedative | Removing psycho-emotional stress without sleeping pills | Herfonal, Amitriptyline |
Balanced action | Which can be taken only as directed and under the supervision of the attending physician, since when taking large doses, a stimulating effect occurs, but the average doses are calming | "Lyudiomil" "Pyrazidol" Asafen |
Stimulating | Used in the treatment of depression with symptoms of lethargy and apathy | Aurorix Melipramin Anafranil "Behol" |
In addition, there is a classification based on how the action of antidepressants affects the course of biochemical processes in the human body:
- TCAs - tricyclic thymoanaleptics.
- IMAO - monoamine oxidase inhibitors:
- irreversible ("Tranylcypromine", "Phenelzine");
- reversible ("Pyrazidol", "Moclobemide").
- IIPS - inhibitors of selective absorption of serotonin;
- IOZSIN - serotonin and norepinephrine reuptake inhibitors;
- HACCA - noradrenergic and specific serotonergic antidepressants.
There are also a number of antidepressant drugs that cannot be assigned to any of these groups.
TCA: tricyclic antidepressants, what is it?
Medications of the tricyclic group, such as Nortriptyline, Imipramine, and Amiltriptyline, got their name due to the triple carbon ring underlying them. These antidepressant drugs increase the amount of neurotransmitters in the brain such as norepinephrine (norepinephrine) and serotonin (the hormone of happiness). This is achieved by reducing the level of their consumption by nerve cells - neurons.
Due to the fact that not only the necessary neurotransmitters are blocked when taking these medicines, many different side effects occur. Taking tricyclic antidepressants may cause the following side effects:
- lethargy;
- drowsiness;
- nausea
- dry mouth
- weakness;
- dizziness;
- increased heart rate - heart rate;
- constipation
- decreased potency and libido;
- anxiety or anxiety.
Such drugs are usually prescribed by doctors in the first place, since they are the most studied and the consequences of their use are well known.
IMAO - monoamine oxidase inhibitors
The drug "Iproniazide", discovered by one of the first, as well as other medicines of this group, such as "Isocarboxazide", "Tranylcypromine", suppress the enzymatic reaction of monoamine oxidase contained in nerve endings. Due to this, the neurotransmitters responsible for our mood, such as serotonin, tyramine and norepinephrine, are not destroyed, but gradually accumulate in the brain.
Most often, MAOI antidepressants are prescribed for atypical depression or when the tricyclic group drugs did not fit and did not have the desired effect. The advantage of medicines in this group is that they do not have an overwhelming effect, but rather stimulate mental processes.
As well as tricyclic drugs, IMAO does not have an instant effect on the human condition - the effect of antidepressants occurs a few weeks after the start of their administration.
Due to the fact that MAO inhibitors have many side effects (and also easily interact with cough and cold medicines and can provoke a life-threatening increase in blood pressure), as well as due to a rather rigid diet when taking them such drugs are prescribed quite rarely, when other methods of treatment did not help.
Selective Serotonin Absorption Inhibitors
The TCA and IMAO groups considered by us are for the most part long-discovered and well-studied drugs. But the "old" generations of antidepressants are gradually being replaced by more modern drugs, the effect of which is not blocked by all mediators, but only by one - serotonin, preventing its reverse absorption by neurons. Due to this, its concentration increases and the therapeutic effect is found. IIPS includes such modern drugs as "Fluoxetine", "Sertraline", "Zoloft", "Paroxetine" and others. The drugs of this group have fewer side effects, and they do not affect the human body so much.
Serotonin and Norepinephrine Reuptake Inhibitors
These are fairly new drugs that are already in the third generation of antidepressants. They began to produce in the mid 90-ies of the twentieth century.
Drugs such as Cymbalta, Effexor block the reuptake of not only serotonin, but also noripinephrine, but drugs like Velbutrin and Zyban prevent the return of norepinephrine and dopamine.
Side effects in medicines of this group are much less than in others, and they are expressed rather weakly. After taking antidepressants created on the basis of inhibitors such as Duloxetine and Bupropion, weight gain and minor sexual dysfunctions can be observed.
Noradrenergic and specific serotonergic antidepressants - HACCA
Another of the modern groups of antidepressant drugs is HACCA, which slow down or completely stop the capture of norepinephrine by synapses of nerve cells, thereby increasing its concentration. Medicines such as Remeron, Lerivon, Serzon block serotonin receptors.
When taking this group of drugs, mild unpleasant side effects are observed, such as drowsiness, dry mouth, increased appetite and the associated weight gain. The withdrawal of antidepressants of this group proceeds without any serious problems.
In addition to the main groups of antidepressants presented above, there are a number of drugs that cannot be attributed to any of them. They differ both in chemical composition and in the mechanism of action. This, for example, drugs such as Bupropion, Hypericin, Tianeptin, Nefazodon and many others.
Alternative methods
Today, foreign experts are increasingly using drugs to treat depressive conditions that affect not the neurotransmitters and neurotransmitters, but the state of such organs of the endocrine system as the adrenal glands, hypothalamus and pituitary gland. Some of these drugs, such as Aminoglutethimide and Ketoconazole, block the synthesis of the hormone cortisol by the adrenal glands, but they have many side effects and have a negative effect on the endocrine system.
Antagonists of antalarmin receptors, combining the positive qualities possessed by tranquilizers and antidepressants, are usually referred to the second group.
In addition to the medical treatment of depressive conditions, methods such as periodic normobaric hypoxia and plasmapheresis, light therapy, and many others that help reduce symptoms and alleviate symptoms are increasingly being used.
Pros and cons
Most of those who took antidepressants agree that these are very effective drugs, especially if they are taken at the same time as a specialist course of therapy. It should be remembered that these drugs, as well as their dosage, can be prescribed only by a doctor, under whose control it is necessary to take them. Do not expect instant improvement. As a rule, a sense of hopelessness and loss of interest in life, as well as lethargy, apathy and sadness disappear 3-4 weeks after the start of a systematic administration.
One of the biggest disadvantages of these drugs is the antidepressant withdrawal syndrome, which manifests itself with a sharp and uncontrolled cessation of their intake.
How to apply?
1. If you have a diagnosed heart, kidney, or liver disease, be sure to inform your doctor.
2. Antidepressants act individually, so a specialist will select a drug that is suitable specifically for you.
3. In some cases, one medication is not enough, the doctor may prescribe the simultaneous administration of several (tranquilizers and antidepressants, antipsychotics and any anticonvulsants). Based on the diagnosis and controlling your physical condition, the specialist will select drugs that can complement each other and do not have a negative impact on the human body.
4. You can not stop taking antidepressant drugs suddenly and without consulting a specialist, as this can aggravate the course of depression and cause various unpleasant physiological reactions.
5. Many people ask if antidepressants and alcohol can be drunk together. All instructions for medicines indicate that this is categorically unacceptable, as it can lead to serious damage to the nervous system, even death.
Withdrawal syndrome or addiction?
If you took antidepressants for a long time, and then stopped abruptly for any reason, you may experience discomfort, such as emotionally unstable behavior, increased fatigue, muscle pain, dizziness. All of these symptoms are known as antidepressant withdrawal symptoms.
That is why doctors recommend gradually reducing the dose of medication and do it under the supervision of specialists. Only professionals will help relieve discomfort by selecting the necessary normotonics and plant-based drugs. If the drug was taken uncontrollably, and then its intake was abruptly stopped, such cancellation of antidepressants can lead to sleep disturbances, increased anxiety, and also problems from the cardiovascular system. In addition, the following symptoms may occur:
- causeless fears;
- flu-like symptoms;
- nausea, vomiting;
- cramping and pain in the gastrointestinal tract;
- loss of coordination and dizziness;
- nightmares;
- tremor of limbs.
Instead of a conclusion
From the foregoing, it can be concluded that such drugs, such as antidepressants, are powerful and quite dangerous, that they are modern drugs that can cope with depression. However, before you start taking them, be sure to consult a specialist - a psychiatrist or neuropsychiatrist, who will be able to find out what form of the disease you have and what medications will help to cope with it.