Drugs for the treatment of depression, used in modern medicine, reflect a modern understanding of the role and place of the so-called neurotransmitters - chemicals that provide transmission of a nerve impulse between neurons of the brain. Since there are more than one neurotransmitter involved in the "work" of the nervous system, various medications are used to restore their functions.
The main group of drugs in the treatment of depressive disorders is antidepressants. Under the influence of the substances included in their composition, the mood is corrected to the inherent individual norm, the emotional background is stabilized, anxiety and anxiety are reduced, inhibition is eliminated, motor and mental activity is increased. The whole spectrum of effects is conditionally called "timolepticheskim action." Today, there are several groups of antidepressants, different in composition and mechanism of action (stimulating and soothing).
Antidepressants in depression are precisely those rescue drugs that can alleviate, eliminate and prevent the disease. Before the discovery of the drugs of this group, drugs with an exciting effect were actively used to treat disorders, which can cause a "melancholic" state of euphoria. Such stimulants were opium and other opiates, caffeine, ginseng. Along with them to reduce excitability and relieve anxiety used bromine salt, valerian, lemon balm, motherwort.
The discovery in the 50s of the last century of antidepressants has become a veritable revolution in psychopharmacology. And for more than half a century, these drugs are "authoritative" effective medications for depression. The first medicine for depression was "discovered" quite by accident, when an unusual side effect was found in isoproniazide, a drug used in the complex treatment of tuberculosis. Patients who took isoproniazide noted an unusually upbeat mood, a state of lightness and bliss. Soon this medicine was used to treat depressive disorders. At about the same time, in the course of experiments with various substances, the German physician discovered imipramine, which also increased mood and relieved spleen. Unlike isoproniazide, imipramine is still on the list of WHO official drugs and more recently it has been the most popular and sold antidepressant.
The purpose of antidepressants is to correct disorders in the work of individual brain mechanisms. To date, 30 chemical mediators - mediators - have been allocated, whose tasks include transferring information from one neuron to another. Directly related to depressive disorders have three mediators - biogenic amines: noradrenaline, dopamine and serotonin. Tablets against depression regulate the necessary level of concentration of one or more mediators, thereby correcting the mechanisms of brain functioning disturbed as a result of the disease.
There is an opinion that pills against depression are harmful and addictive. The answer is unequivocal: antidepressants, used today in psychopharmacology, do not cause addiction, regardless of the duration of their admission. Their task is to help the body restore the depressed mechanisms. Drugs from depression are able to "reconstruct" the broken inner world broken by an ailment and return a person to his characteristic activity and vivacity.
The action of antidepressants is not immediately apparent. As a rule, not less than two weeks pass between the time of their admission and the appearance of a positive effect, although some patients note positive changes in mood in one week.
An important point in choosing a drug is the name of an antidepressant. For example: one and the same medicine on the domestic market can be represented by a dozen pharmaceutical companies. That is, the drug with the same active substance is sold under 10 different names. The cheapest are domestic drugs from depression and stress and tablets produced by countries with cheap labor. Their minus - they often have a lot of side effects. Medicines produced by Western pharmaceutical companies are more expensive, but their therapeutic effect is better, and the side effects are much less pronounced.
Admission of antidepressants should be carried out daily, preferably at a certain time. The number of receptions and time depend on the action of the medicine. So, antidepressants with a hypnotic effect it is recommended to accept before a dream. Tablets aimed at increasing activity are taken in the morning.
Tricyclic antidepressants (TCAs) are the very first developments of pharmacists. Preparations of this group increase in the brain the content of noradrenaline and serotonin due to a decrease in the absorption of neurotransmitters. The action of drugs from this group can be both soothing and stimulating. True antidepressant effect occurs on average 3 weeks after the start of their admission, and stable results are achieved only after several months of treatment. Since these antidepressants are blocked by other mediators, they provoke a significant range of negative side effects. It should be borne in mind that an overdose of drugs in this group can lead to serious consequences, including death. Currently, psychiatrists are trying to reduce the appointment of these "representatives" of the past generation.
Monoamine Oxidase Inhibitors (MAOIs) Usually, MAOIs are prescribed to those patients who have not had an improvement after a course of treatment with tricyclic antidepressants. These drugs are used in atypical depression - a disease some of which are different from typical depression. Since MAOIs have not a calming effect but a pronounced stimulating effect, it is recommended that they be taken to treat a small depression - dysthymia. The drugs block the action of the enzyme monoamine oxidase, which is contained in the nerve endings. This substance destroys norepinephrine and serotonin, which affect the mood.
Selective serotonin reuptake inhibitors (SSRIs) are a later class of drugs that have become popular due to the minimal number of side effects, significantly less than the antidepressants of the previous two groups. The action of SSRIs is based on the stimulation of brain supply with serotonin, which regulates mood. Inhibitors block the re-uptake of serotonin in the synapse, thereby increasing the mediator concentration. The drugs are easy to apply and do not lead to overdose. SSRIs are used not only to combat depressive disorders. They are designed to deal with other unpleasant problems, for example: with overeating. SSRIs should not be prescribed to patients with bipolar depression, since they can cause manic conditions. Drugs are not recommended for patients with liver disease, as it is in this body that biochemical transformations of inhibitors occur. Also, you need to remember that the drugs of this group can negatively affect the erectile function.
There are also antidepressants that do not belong to any of the three previous groups, since they differ in both the mechanism of action and the chemical composition.
Melatoninergic antidepressants are the last achievement of psychopharmacological science. Today, the only drug of this class, represented on the Russian market, is Agomelatin (Melitor). The agent is able to influence simultaneously 3 types of receptors, which correspond in the body to the regulation of biological rhythms. The drug after 7 days of therapy normalizes sleep and daytime activity, reduces anxiety, restores working capacity.
The choice of the drug is the most responsible side of the treatment. She should only be dealt with by a doctor. When prescribing an antidepressant, it is necessary to take into account: patient's age, individual sensitivity to psychopharmacological drugs, severity of depression, effects from previous treatment, concomitant somatic condition, medications taken.
