Medication therapy for depression
Depression is a common companion to many illnesses. It can also appear as a separate illness. Treatment for this pathology often requires the use of medication. Treatment of depression with medications is carried out in combination with psychotherapy, acupuncture and physiotherapy methods.
In the center “Alko Clinic” the most modern methods of therapy are used to remove patients from this condition.
What medications are used to treat depression?
After a patient is found to have a depressive problem that requires medication therapy, the doctor selects a medication that belongs to a large group of antidepressants. The main effect of these drugs is to level out and stabilize the mood and emotional background. The treatment of depression by medication implies a strict individual approach, taking into account the prevailing complaints, the severity of the condition, age and other characteristics of each patient.
How medications work
Impulse transmission in the nerve tissues of the brain, which regulate mood and emotions, is performed with the help of special compounds – mediators. A disturbance in the content of mediators leads to the formation of a depressive state. Antidepressants are practically nonaddictive and have the ability to regulate and normalize the balance of mediators, which causes reduction and complete disappearance of painful manifestations. The doctor’s task is to determine the appropriate group of antidepressants and choose the most suitable medication for the patient. In the course of treatment, the specialist carefully monitors the person’s condition and adjusts the doses, and sometimes changes the medication.
Classification of medicines, peculiarities of action of the main representatives
At the present time in medicine, a variety of drugs for the elimination of a depressed state are used. Each of them has its own peculiarities of use, specific side effects, to which the doctor is necessarily guided when prescribing.
Representatives of the tricyclic series have been used in the treatment of depression with pills for quite a long time, since the 50s of the XX century. They received their name because of their chemical structure, which includes “three rings”. When taken, they cause an increase in noradrenaline in the brain, leading to the stabilization of mood.
The effect of these medications on other mediators provokes the development of side effects, which limits the effect of tricyclic medications, and their intake requires special monitoring by medics.
It is important to remember that patients with suicidal thoughts are contraindicated with these medications.
Monoamine oxidase inhibitors (MAOIs) . By inhibiting the monoamine oxidase enzyme that can break down norepinephrine, serotonin, and other nervous system mediators, monoamine oxidase inhibitors even out the background of these mediators when they are in excess, thus improving patients’ mood.
If the doctor prescribes drugs in this group to treat depression, he carefully examines the patient for the presence of other diseases. Since the use of other drugs for various pathologies is often incompatible with therapy with MAO inhibitors.
Currently, selective serotonin reuptake inhibitors are more commonly used. They affect mainly the serotonin metabolism. This selective action is also responsible for the lesser side effects of this group of antidepressants.
Among other groups of antidepressants available in the doctor’s arsenal, it is necessary to distinguish drugs with a predominant sedative (sedative) effect. There are also drugs with the opposite – stimulating effect. A number of medications used for depression also include:
- NASA-antidepressants – have similar effects to norepinephrine and serotonin.
- Dopaminergic drugs – promote the accumulation of dopamine in synapses.
- Noradrenergic – increase the amount of noradrenaline.
- Melatoninergic drugs (drugs) – affect deep brain structures.
Pharmacological treatment of depression in women often occurs against a background of prolonged and uncontrolled use of tranquilizers that make patients addicted to drugs. Rejection of these drugs is accompanied by a pronounced oppression of the patient’s general state. In this case, specific drugs are used, for example, Trittico.
The peculiarity of the action of all drugs of this kind is the gradualness of the effect, sometimes the result of taking the drug can be seen only after a month. Therapy with medication must necessarily be accompanied by psychotherapy and the use of other techniques.
Text checked by doctors-experts: Head of social-psychological service of AlkoClinic MC, doctor psychiatrist-drug specialist Serova L.A.
Consult with a specialist
MEDICATIONS FOR DEPRESSION
Depression is one of the most widespread illnesses. Its prevalence is second only to cardiovascular disease. And of all those suffering from depression, no more than 20% seek qualified help.
In this article we will tell you about all the medications used to treat depression.
All antidepressant medications can be divided into several groups:
Initially, drugs in this group were developed to treat depression. Currently, the indications for taking antidepressants have expanded. They are also used for other mental disorders: neuroses, personality disorders, aggression, psychosis, schizophrenia. And also for many diseases: chronic pain, irritable bowel syndrome, bedwetting, insomnia. Used in practice since 1957. The basis of action of antidepressants – restoration of the disturbed metabolism of serotonin. Altered metabolism of neurotransmitters – one of the main mechanisms of depression, so its normalization provides an antidepressant effect. Antidepressants remove the symptoms of depression, they will have no effect on a person with a normal mood.
A list of the most common and effective antidepressants
Amitriptyline is one of the strongest and most effective antidepressants. It is the drug of first choice for severe depression. When administered intravenously and intramuscularly it works quickly, therefore it is used in emergency psychiatric care. Of the disadvantages – side effects: drowsiness, dry mouth, blurred vision, mild coordination disorders.
Clomipramine (anafranil) – also has a strong antidepressant effect and frequent side effects. In addition to its antidepressant effect, it reduces obsessions and anxiety.
Imipramine (melipramine) has a pronounced stimulant effect. It is effective for depression with apathy and lethargy. Like all tricyclic antidepressants, it has a large number of side effects (dry mouth, tendency to constipation, etc.).
Azafen. Of all the tricyclic antidepressants, it is well tolerated, so it is often recommended for the elderly and those with concomitant internal diseases.
Monoamine oxidase inhibitors (MAOIs)
Nialamide. A first-generation drug of this group, it went out of practice many years ago.
Pirazidol. A highly effective broad-spectrum antidepressant with minimal side effects. It is still used today.
Moclobemide (Aurorix). It has an anti-anxiety effect, which makes it effective for depression accompanied by sociophobia and anxiety.
Selective norepinephrine reuptake inhibitors
Maprotiline (ludomil). Good for depression with fatigue, loss of feeling, and lethargy. A big plus of this drug is the availability of ampoule forms that allow it to be administered intravenously, which gives the possibility of a rapid onset of therapeutic effect.
Doxepin (Sinequan). This drug is rarely used.
Selective serotonin reuptake inhibitors SSRIs
These antidepressants are now the most commonly prescribed. They have achieved this “popularity” because of a number of advantages: they are effective, easy to dose, well tolerated, and are widely advertised by the pharmaceutical companies. There are only seven of them, and their effectiveness is approximately the same:
Selective norepinephrine and serotonin reuptake inhibitors.
This group is effective for resistant (not amenable to traditional treatment) depression.
Antidepressant receptor blockers
Drugs in this group are distinguished by their sedative effect and restorative sleep action.
A new class of antidepressants
Characterized by a mild antidepressant effect, but excellent tolerability: side effects are extremely rare. It is used for non-serious depression.
Agomelatine (Valdoxan). Normalizes sleep.
Vortioxetine (brintellix). Improves cognitive function.
Medications in this group have an antidepressant effect only when the depressed state is caused by chronic affective illnesses such as bipolar affective disorder (BAD, manic depressive psychosis), cyclothymia, dysthymia, schizoaffective disorder. The most commonly used medications are:
Although most neuroleptics depress the nervous system, there are drugs with antidepressant effects among them:
Flupentixol (fluanxol). It has an antidepressant effect only when prescribed in low doses (less than 2 mg per day).
Aripiprazole. Effective for depression in bipolar affective disorder and schizytic disorders.
Levomepromazine (tizercine). Prescribed for endogenous depression accompanied by insomnia.
Bromodihydrochlorophenylbenzodiazepine (phenazepam). The drug of choice for neurotic states with depression, for post-stress states. That is, in those cases where short-term treatment is needed.
Clonazepam. A strong anti-anxiety and sedative effect. With prolonged use it is addictive.
Alprazolam. Prescribed for anxiety-depressive states. Recommended in short courses (not more than 10 days) because of the risk of addiction and dependence.
Nootropics and metabolic agents
Agents in this group help to get rid of depression that has developed as a result of stress, fatigue, encephalopathy, and the effects of trauma and poisoning. By improving the blood supply of neurons and energy metabolism inside the cells, they help to activate cognitive functions and memory. The most effective drugs in this group are:
Among the large number of herbal remedies, preparations based on St. John’s wort turned out to be the most effective and trustworthy for doctors:
Glycine. The most effective drug of this group. In addition to its own antidepressant effect, it has the ability to enhance the antidepressant effect of drugs of other groups (antidepressants, normotimics).
Glutamic acid. Used in conjunction with depression with neurological diseases and mental retardation.
Caffeine. Caffeine (a drug containing caffeine)
Phenamine. Banned for use in our country. In some Western countries, used by doctors to achieve rapid antidepressant effect.
Sydnocarb (Mesocarb). Domestic effective stimulant, unfortunately, is not currently available due to low demand and production shutdown.
What medications for depression can be obtained at the pharmacy without a prescription
Only medications from the group of Herbal remedies and Amino Acids. All other medications are purchased only with a prescription from a clinic doctor. Alprazolam, phenazepam, clonazepam, and tizercine are prescribed on special Form 148 prescription forms.
What depression medications can be addictive?
Most antidepressant medications are not addictive or dependent. Exceptions: drugs from the tranquilizer group: phenazepam, alprazolam, clonazepam.
Are there any non-drug ways to treat depression?
In addition to medication, there are many non-drug methods of treating depression. These include psychotherapy, biofeedback therapy, diet therapy, physical therapy, exercise therapy, reflexology, light and color therapy, sleep deprivation, etc. Most often, a combination of several methods is used to treat depression. For example: psychotherapy + medication, biofeedback therapy + psychotherapy, taking medication + diet therapy, etc.
Do not prescribe and use medication by yourself. If you or your loved one has a depression problem, you need to see a psychiatrist or psychotherapist! Only on his recommendations can you use medication. Self-treatment is life-threatening!