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Choosing antidepressant

23 Aug 2018

Antidepressants are different in the mechanism of action and the effects produced. The question is, the choice of the drug should be correct, and the treatment performed should be done according to the rules. No medicine, unfortunately, is a panacea, and even more so if it is intended for the treatment of some kind of mental illness. Either way, the medicines prescribed by the doctors are effective. Now a few words about why the doctor prescribes to you this or that antidepressant.

antidepressant fluoxetine

The first thing that determines the choice of an antidepressant is because of the severity of depression: the stronger the depression, the stronger it is to choose an antidepressant. Accordingly, if the depression is very severe, then the treatment will be carried out using large doses of MAO inhibitors or tricyclic antidepressants, or maybe even electroshock. If the manifestations of depression are small, then in this case, sometimes plant antidepressants containing hypericin (these are preparations of St. John's wort) are sufficient. The remaining antidepressants are located in the middle of this conditional line - from health to severe illness.

Concerning antidepressants of the "middle group", it should be said that most of them belong to a new generation of antidepressants, and most importantly their difference from each other in which neurotransmitters they affect. Some of these antidepressants affect only the state of affairs with serotonin, and some provide support for several neurotransmitters, for example, serotonin and norepinephrine. Accordingly, the selection of an antidepressant is performed by a physician taking into account all the symptoms of the disease (somewhere it is enough to affect only the state of affairs with serotonin, and somewhere it is necessary to influence another neurotransmitter), this is the second feature of the appointment of antidepressants.

The third thing that doctors mean when prescribing an antidepressant is its stimulating, or sedative, effect. The fact is that some antidepressants, in addition to the actually antidepressant effect, reduce the intensity of internal tension and anxiety; while others, on the contrary, struggle with apathy, lethargy and passivity. However, many new antidepressants have a so-called balanced effect, that is, they reduce anxiety and increase a person's activity.

Most antidepressants, except for plant, are sold in pharmacies only on prescriptions. And this is not someone's whim, this is a completely justified and absolutely correct decision. The right appointment of an antidepressant can be performed only by a doctor in the course of a direct conversation with a patient to whom he prescribes this antidepressant. There are a lot of nuances and subtleties that the doctor should take into account. And use an antidepressant according to the formula: "I know that it helped my grandmother" - is mistaken, although, unfortunately, occurs often enough.

The fourth, which sometimes misleads the non-specialists is the name of the antidepressant. The fact is that the same antidepressant can be produced by different pharmaceutical companies and therefore have different names. Take for example - fluoxetine, which is the most popular antidepressant in America and Europe (it accounts for almost 40% of sales of antidepressants in the world). In the Russian market, fluoxetine is represented by almost two dozen pharmaceutical companies, both Russian and foreign. Consequently, the same substance is sold in pharmacies with almost twenty different names.

How do you figure out exactly what to buy, because a doctor most often writes simply "fluoxetine" without specifying a company name? It remains to be guided by the ratio of "price / quality". Russian and Indian drugs, for example, are often cheaper than Western analogues, but, unfortunately, they differ in a large number of side effects and are not always as effective. On the contrary, Western companies tend to present to the Russian market, as a rule, more expensive, but also higher-quality medicines.

Treatment of depression, in a good way, is a specialist - a doctor-psychotherapist. However, there is a list of drugs that provide a good therapeutic effect for mild and moderate depression, and those that are sold in pharmacies without prescriptions. These are herbal antidepressants, produced on the basis of St. John's wort, the medicinal properties of which have been known to mankind for a long time. Modern research has proven the effectiveness of one of the components of St. John's Wort - Hypericine - in the treatment of depression. The best concentration of this substance was achieved in the preparation with the spoken name "Negrustin" (manufactured by the German firm "Hexal"). In one tablet of nerustine, the same amount of desired hypericin is concentrated, as in six to eight circles of strongly brewed St. John's wort; the amount of other active substances in it, on the contrary, is reduced. This allows "Negrustin" to be an effective antidepressant without side effects - it does not cause drowsiness or addiction (the only thing - do not sunbathe during treatment with this drug, in order to avoid skin reactions).

"Negrustin" not only defeats depression, but also reduces anxiety, improves the functioning of the autonomic nervous system, effectively copes with the syndrome of chronic fatigue and improves sleep. It allows women to reduce the severity of premenstrual syndrome and climacteric disorders. The standardized treatment regimen for "Neurustin" is as follows: the first two weeks it should be taken one capsule twice a day, and then one capsule for a month and a half or two months. If after a month of therapy you did not feel a tangible effect (and no drug is a panacea), then, of course, you can not do without the additional advice of a psychotherapist.

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