Insomnia

Definition

Insomnia (insomnia) is a disorder associated with difficulties in initiating and / or maintaining sleep. Insomnia is a quantitative and / or qualitative disorder of sleep with a concomitant deterioration in overall well-being and quality of life.

Causes
Stress, neurosis, mental, neurological, somatic diseases, the use of psychotropic drugs, alcohol abuse, toxic factors, endocrine-metabolic diseases, adverse external conditions (noise, humidity), shift work, jet lag, sleep hygiene. Causes of insomnia associated with the violation of the "sleep-wake" cycle, leading to a violation of melatonin secretion: psychophysiological factors (psycho-emotional and physical overstrain), endogenous factors of various diseases, exogenous factors (noise, time zone change).

Risk factors
Duration of sleep less than 5 hours, adverse heredity, difficulty breathing, overweight, circadian rhythm disorders, immaturity of the brain systems responsible for sleep and wakefulness regulation, stress, use of stimulants (caffeine, alcohol, tobacco) in children and adolescents, winter season.

Symptoms
Nocturnal symptoms:
- difficulty in falling asleep and / or sleeping;
- intermittent sleep (more than 3 awakenings per night);
- short duration of sleep (less than 6.5 hours), early awakening with the inability to fall asleep again;
- lack of a sense of freshness, recovery from sleep.

Daytime Symptoms:
- fatigue;
- drowsiness;
- increased excitability, irritability;
- anxiety.

Prevention and treatment
Prevention
Establish a daily schedule and observe the time of going to bed and waking up, waking up every day at the same time, regardless of when the sleep occurred, reduce the time spent in bed without sleep;

- avoid daytime sleep;
- increase the load in the afternoon, after lunch, and stop them 3-4 hours before going to bed;
- avoid taking foods containing caffeine and nicotine for 6 hours before going to bed;
- avoid excess fluid intake before going to bed;
- Ensure silence and comfortable temperature in the bedroom;
- remove the clock from the bedroom;
- use hypnotics only in rare cases.

Biologically active additives - Mystic, Yantavit, FET-X (chromium picolinate), Morpheus, etc.

Drug therapy
Anxiolytics - alprazolam (Alzolam, Zolomax, Neurol, Helex, Helex CP), aminophenylbutyric acid (Phenibut, Anvifen, Noofen), bromodihydrochlorophenylbenzodiazepine (Phenazepam, Tranquesipam, Phenorelaxan, Elzepam, Fezanef), diazepam (Sibazon, Relum, Seduxen), lorazepam Laurafen), medazepam (Mezapam), oxazepam (Nosepam, Tazepam), chlordiazepoxide (Elenium), and others.

Antidepressants - mirtazapine (Kaliksta, Mirzaten), etc.

Vitamins and vitamin-like products - Biovital elixir, etc.

Homeopathic remedies - Valerianahel, Vernison, Passidorm, Primula / Onopordone Composite, Ginkgo Biloba, etc.

Neurotropic agents are glycine (Glycine Fort, Noopept), and others.

Correctors of cerebral circulation disorders - ginkgo bilobate leaf extract (Bilobil intens 120, Ginos, Tanakan, Memoplant, Bilobil forte), etc.

Macro- and trace elements - Beresz Plus drops, etc.

Neuroleptics - alimamazine tartrate (Teraldzhen), clozapine (Leponex, Clozasten, Azaleprol), levomepromazine (Tizerzin), chlorpromazine (Aminazine, Chlorpromazine hydrochloride), chlorprotixen (Chlorprothixen Zentiva, Truksal) and others.

Sedatives - Dormiplant, Dormiplant-Valerian, Persen Fort, Persen, valerian medicinal rhizome with roots (Valerian tincture, Valdispert), Leonurus grass, Barbowal, Valemidin, Valoserdin, Valium drops, Novo-Passit, Phytodesan No. 3 (sedative collection ¹3), Fito Novo-Sed, Fitorelaks, Phytodesan ¹2 (sedative collection ¹2), Lundyshev-Leonurus drops, Corvalol, Valocordin, balm of medicinal herb, peppermint leaves, etc.

Sleeping pills - doxylamine succinate (Valocordin-Doxylamine), zolpidem, zopiclone, midazolam (Midazolam-hameln), nitrazepam, phenobarbital, etc.

Annoying Heartburn

An unpleasant burning sensation in the epigastrium or in the middle of the chest, or heartburn, can appear occasionally - for example after a heavy meal or consumption of fatty, fried and spicy food. Frequent heartburn may indicate a GI disease, in particular about gastroesophageal reflux disease. Excreted also heartburn pregnant.

One of the most frequently used groups of drugs used for heartburn is antacids. To date, the most in demand for the consumer non-absorbing antacids. They are characterized by a higher efficacy and a less pronounced side effect.

Slightly less than half of all sales (45.6%) are accounted for by antacids in the form of tablets, more than 35% of which are taken by TM Rennie, Gastal, Rutatsid and Gastrofarm. About a quarter of the total volume of sales of preparations for heartburn is made up of suspensions, for example, the share of the well-known Almagel drug was 12.3%, for another sample in the form of a suspension, the Sab simplex - 1.9%. Also popular are preparations of a similar consistency - gel, for example, Fosfalugel. There are preparations presented in both solid (tablets, capsules), and in liquid (suspension, emulsion) dosage form. These include Espumizan, Maalox, Gaviscon. Espumizan, the market leader, has 12.3% share of emulsion sales, 11.5% capsules.

Chronic venous insufficiency

Definition

Chronic venous insufficiency (CVI) of the lower limbs is a syndrome caused by a violation of the outflow of venous blood and manifested by pain, severity, rapid fatigue, pastose of the legs in an upright position, leading to the development of trophic disorders in later stages.

Causes (risk factors)
Age, high growth, standing work, weighed heredity, genetic characteristics of the body constitution, static loads associated with the "non-physiological" way of life, the use of hormonal contraception, pregnancy and childbirth, obesity.

Symptoms
- severity, tension and pain in the legs;
- pasty in the area of the ankles in the evening;
- itching;
- night cramps in the calf muscles.

Prevention
Maintaining optimal body weight, prevention of acute deep vein thrombosis.

Biologically active additives - VITABS Cardio, Venokomfort, Piknogenol-Extra, etc.

Drug therapy
Adenosinergic drugs are pentoxifylline (Vasonite, Trenpental).

Angio-protectors and correctors of microcirculation - Actovegin, Solcoseryl, Endotelone, Antistax, Antistax Gel, escin (Aescin, Venen, Dr. Thiess Venen gel, Escuzan 20), diosmin (Vasoket, Diovenor 600, Fleobody 600), pentoxifylline (Vazonite, Trenpental), chestnut (Venoplant), rutoside (Venoruton, Rutin), calcium dobezilate (Doxilek), troxerutin (Troxerutin Lechiva, Anavenol), hesperidin + diosmin (Venarus, Detralex), thiamine + escin (Escuzan), Yuglanex extract for oral administration , Cyclo 3 and others.

Antiaggregants - calcium dobezilate (Doxilek), pentoxifylline (Trenpental), etc.

Antihypoxants and antioxidants - Actovegin, Solcoseryl, ascorbic acid + rutozide (Prophylactin C), etc.

Anticoagulants - escin + essential phospholipids + sodium heparin (Essaven), etc.

Antiseptics and disinfectants - Cosmetic foot cream "Pirouette", etc.

Vitamins and vitamin-like agents - ascorbic acid + rutozide (Prophylactin C, Ascorutin), etc.

Immunomodulators - sodium deoxyribonucleate (Derinat), etc.

Compression knitwear - stockings, stockings, tights; compression knitwear is divided into 4 compression classes, each of which corresponds to a certain venous pathology: 1st class - light compression (18,4-21,1 mm Hg on the ankle) - recommended for the syndrome of "heavy legs", propensity to edema, for pregnant women; 2nd class - medium compression (25,2-32,3 mm Hg on the ankle) - recommended for acute thrombophlebitis, as a complex therapy after vein surgery and in the prevention of deep vein thrombosis; Grade 3 - strong compression (36.5-46.6 mm Hg on the ankle) - recommended for varicose veins with trophic disorders, deep vein thrombosis, lymphovenous insufficiency; 4th grade - (over 59 mm of mercury on the ankle) - recommended for serious anomalies of the venous system.

Nonsteroidal anti-inflammatory drugs- indomethacin + trokserutin (Indovazin), acetylsalicylic acid (Aspirin "York"), etc.

Regenerants and reparants - Aktovegin, Solkoseril, etc.

Fibrinolytics - Thrombovazim and others.

Food – antidepressants

Everyone, probably knows a state where everything is boring, nothing pleases, nothing you want. This means that we are in a state of constant stress, from which natural antidepressants help to exit, these are products that have beneficial effects on the body.

Why do these products help against depression? First, they stimulate the development of serotonin, which increases muscle tone and lifts the mood. He improves self-control and creates emotional stability, thanks to this, there are feelings of joy and satisfaction. And as noripinefrin which raises vigor, awakens the reaction of readiness, concentration

Chocolate
One of the most famous antidepressants is bitter chocolate. White, antidepressant quality does not possess. It does not have the theobromine, the tonic material, which is contained in cocoa products. And in bitter chocolate it is. Its aroma relieves irritation, and contained in it phenylethylamine, stimulates the production of endorphin, a hormone of happiness. Chocolate contains substances that improve digestion, increase efficiency.

Almond
It helps the body cope with stress. As in chocolate, almonds contain magnesium, which helps the nervous system cope with mental unrest. Neutralization of free radicals that lead the body into a stressful state is provided by vitamin E.

Almond helps to cope with irritability, aggression, fatigue. This is a fairly high-calorie product, which means you need to consume it in small portions, up to fifty grams a day.

Seafood
In our time, seafood has become almost indispensable food, and it turned out that not for nothing.

They also have antidepressant properties due to vitamins: A, D, B12, B2, PP, as well as zinc, phosphorus and protein. Salmon contains a huge amount of omega-3 fatty acids that relieve the body of stress.

In trout there are fatty acids, fat-soluble vitamins, vitamins B6 and B12 (cyanocobalamin), stimulating the reproduction of hormones of happiness. Pantothenic acid, responsible for the clear work of the adrenal glands, constantly producing adrenaline, is a part of sea kale.

Broccoli
This cabbage contains vitamins E, B1, B2, C, A, PP. In addition, it includes: potassium, iron, calcium, iodine and others. It is rich in folic acid. This acid helps to cope with anxiety.

Broccoli cabbage strongly contributes to the purification of the whole organism and neutralizes carcinogens and toxins, restores the hormonal balance.

Dairy
From early childhood we drink milk and do the right thing. It turns out that, it not only saturates the teeth and bones with calcium, but also suppresses the production of stress hormones. Microelements and B vitamins, as well as antioxidants successfully cope with nervous disorders, blood levels of tryptophan levels increase.

My heart hurts and aches ...

Currently, among all diseases, the greatest number of deaths in the world occurs in connection with cardiovascular diseases. According to WHO estimates, by the year 2030, about 23.6 million people will die of cardiovascular diseases, i.e. the main cause of death will, again, heart disease. Among the overall mortality in Russia, cardiovascular disease is 57%. Diseases of the heart and blood vessels are socially significant.

Sales of drugs for the treatment of cardiovascular diseases amounted to almost 43 billion rubles in the reporting period, which is 26% more than in the same period last year. Imported drugs account for 70% of the market (in value terms).

The leader of sales in value terms - Actovegin - 6.98% of total sales in value terms. A slightly smaller share is taken by Concor - 6.75%. Leader among domestic drugs for the treatment of cardiovascular disease became Mexidol with a share of sales of 1.64% in value terms.

The most commonly purchased drug is Validol, which has almost 11% of the total sales of this group of drugs in packs. It is followed by Enalapril - 9.73% of sales in physical terms.

The maximum sales of drugs for the treatment of heart disease and vascular system are fixed in the middle price segment - from 100 to 500 rubles.

The most expensive drug group - Trakliir (INN bosentan), the cost of which - more than $7000 per package. The cheapest drug is Envas (INN enalapril), its price is about $40.

Rating of Therapeutic Groups
1) C09 - drugs affecting the renin-angiotensin system
2) Ñ01 - cardiac therapy
3) Ñ07 - Beta - adrenoblockers
4) Ñ04 - peripheral vasolidators
5) Ñ03 - diuretics
6) C08 - calcium channel blockers
7) Ñ06 - other cardiovascular preparations
8) Ñ02 - antihypertensive drugs

Top 10 cardiovascular drugs
1) Actovegin
2) Concor
3) Mexidol
4) Lozap
5) Preductal
6) Enap
7) Panangin
8) Prestarium
9) Diroton
10) Noliprel

Best hepatoprotectors

Hepatoprotectors are complex drugs designed to increase liver resistance to toxic effects, promote the restoration of its functions, normalizing or enhancing the activity of liver enzymes.

Among hepatoprotectors, drugs containing essential phospholipids are most in demand. Their share was 56% of the total volume of the hepatoprotector group under study in value terms. Almost 40% of all sold drugs are on Essential, the share of Essling TM is 8.6% (an increase of 58% in money terms), Phosphogliv - 5.2%, and Resalut pro, previously not on the market, on the basis of the results of 8 months took a confident 7th place in the TOP10 with a share of 2.5%.

The second place on sales is occupied by the preparation Heptral (16,9% in value terms) on the basis of ademetionine. Also worth noting is Gepa-Merz with a share of 2.4%, sales of which have grown.

Among the herbal preparations, Carcil (8%) and Gepabene (1.8%) are the leaders on the basis of the extract of milk thistle, as well as the Indian combined drug LIV.52 (2.3%) and the pumpkin seed preparation Tykveol (2.5%) . The total share of hepatoprotectors of plant origin was 13.7% in USD.

The drug tioctic acid, Berlition, occupies the largest market share among hepatoprotectors of the group of vitamin-like compounds - 6.4%. Its increase compared to last year was 22% in monetary terms and 26% in quantitative terms.

The proportion of hepatoprotectors of animal origin (Hepatosan, Progepar, etc.) is very low and amounts to 0.1% of total sales.

The proportion of groups of hepatoprotectors
1) Essential phospholipids - 56.4%
2) Amino acids and their derivatives - 20.1%
3) Vegetable preparations - 13.7%
4) Vitamins and vitamin-like compounds - 9.7%
5) Preparations of animal origin - 0.1%

Top 10 hepatoprotectors
1) Essentiale
2) Heptral
3) Essler
4) Karsil
5) Berlition
6) Phosphogliv
7) Resalute about
8) Gepa-Mertz
9) Liv 52
10) Gepabene

Herniated disc: dangerous, but curable

According to different researchers, in adulthood, osteochondrosis disturbs from 50% to 85% of the world population, and there is a distinct tendency to "rejuvenate" this disease. The reason is simple and obvious: a sedentary lifestyle with an incorrect posture and an insufficiently developed muscular corset. For a long time, changes in the spine can develop imperceptibly, but at one not the perfect moment a person incorrectly undertakes to lift the heaviness, turns in an inclination to reach something, just drives along a bad road for a long time - with inevitable jerks and vibration - and then suddenly the back "Shoots" ... Very often, such a sudden painful attack becomes the first symptom of a severe and, alas, very common complication of the spine osteochondrosis - a herniated intervertebral disc.

What happens to the disks
The intervertebral disc, contrary to a fairly common belief, is by no means a single "piece" of cartilaginous tissue, rather freely inserted between the vertebrae. Sometimes you can hear about the dislocation of the disc, which results in the damage to the nerves, and usually it is the imaginary appearance of the whole cartilage from its place: just insert the disc in place - and everything will pass ... Alas, it's not so simple.

Each intervertebral disc consists of 2 parts - a fibrous ring, a dense cartilaginous membrane, and a pulpous core, a jelly-like disk content. The core serves as a shock absorber for vertical loads and shocks, the fibrous ring supports the shape of the disc and serves as a "hinge" in the intervertebral joint. When the load along the vertebra is compressed, the height of the disc may decrease by 1-2 mm, with spinal distension or at rest - it increases by 3-5 mm. When you move, there is a constant change in the shape and size of the discs - normal, physiological protrusions with flexion and extension of the spine, not overlapping the spinal canal and not squeezing nerves.

However, with age, the condition of the disc tissues changes: the core becomes denser, the shell is less elastic, prone to cracking and bundle formation under load, and it returns worse to the original form after changing the load. In this case, prolonged sitting without movement contributes to the flattening of the discs: the muscular corset in this case is relaxed, and the weight of our body gradually squeezes the spine. If you sit all the time with an ideal flat, straight back, it's easier to avoid dangerous consequences, but who among us is able to sit for hours on end, "like a count swallowing"? And after all, any imbalance of posture immediately creates an uneven load on the intervertebral discs, they begin to shrink in one place, in the other - to protrude more ... If this condition is fixed - a small bulge appears on the disk, directed towards the least load. Usually it comes out either backwards or slightly to the side - because in a relaxed state we sit, slightly bent forward, and the front side of the discs works on the compression. And behind, behind the vertebrae, we just have a spinal canal, along the edges of which spines of large nerves leave the spinal cord. So even a small protrusion - the protrusion - of the intervertebral disc already creates the risk of injuries, accompanied by pain and impaired nerve functions.

Dangerous protrusion
However, usually a protrusion of up to 3 mm does not cause any painful sensations, a person may simply not notice it, such a change in the shape of the disc is detected only when the spine is examined. But the next stage of the development of a hernia - entrusion, or prolapse of the disc - is the rupture of the fibrous ring with the release of the core contents into the spinal canal. Prolapse can be partial - when the nucleus extends no more than 10 mm - or full, when the protrusion is 10-16 mm, and the fibrous ring is destroyed. Already with partial prolapse, dull, moderate pain in the back begins, and with complete pain it becomes strong, it prevents to live and work normally. The last stage of hernia development is sequestration, with the contents of the nucleus being separated from the remains of the disc and falling into the spinal canal, where it can move relatively freely, squeezing the roots of the spinal nerves and causing excruciating pain, as well as paresis or paralysis of the extremities.

Most often (in 90% of cases) the hernia is formed in the lumbar spine. This is due to the fact that it is the lower part of the lumbar region and the joint with the sacrum that take the greatest loads - and when walking, and when lifting weights, and when tilting or turning. Much less often - in 8% of cases - intervertebral hernias are formed in the cervical region, and only 2% falls on the thoracic department. Hernia in the thoracic region reports a permanent pain on the spot, especially in the most familiar sitting position. Hernia in the cervical region can be manifested by headaches, unexpected jumps in blood pressure, dizziness, pain in the hands or shoulders, numbness in the fingers. But the most typical picture is associated with protrusion in the lumbar region. Not too much pain in the lower back, which arose after an awkward movement, a rise in gravity, etc., few worries, despite the fact that something "crunched" in the back. Then within a day, pain and weakness spread along the leg, less often both. Depending on the point of protrusion, numbness and loss of sensation may be observed. Attacks of pain both in the back and in the leg are constantly repeated, intensifying with movements, especially those associated with the tension of the muscles of the back and abdomen - coughing, sneezing, straining in the toilet, etc.

The most correct position in such cases - lying (strict bed rest), preferably on the back, with slightly raised legs: you can put a pillow, a folded blanket. And it is necessary to call a doctor to determine the exact cause of the pain.

How to find and how to treat?
To accurately determine the location and size of the hernia without special examination, one can not do without: consultation of a surgeon, a neurologist, a radiography of the spine; if possible, you need to make a magnetic resonance imaging (MRI) of the affected area and the entire vertebral column. Such a comprehensive examination allows you to exclude the possibility of nerve damage and the appearance of pain for various reasons - for example, because of radiculitis, bony growths on the vertebrae, displacement of the vertebrae, etc. The accuracy of the diagnosis in the treatment of intervertebral hernia is very important, because the error can lead to such complications as paralysis of the lower limbs and impaired functions of the pelvic organs.

At small (up to 5 mm for lumbar vertebrae) protrusions it is quite possible outpatient treatment with the use of physiotherapy exercises and procedures of spinal traction. In the early stages, when the fibrous ring has not yet been destroyed, the development of the hernia can be stopped and even reversed, the body has the opportunity for self-healing. But the larger the size of the hernia - the more difficult it is to make, the more difficult will be the treatment, and in case of a large prolapse and especially sequestering, the patient's hernia needs to be placed in a hospital. If the symptoms of compression of the spinal cord develop, an immediate operation is required to remove the hernia!

In 90% of cases the hernia is formed in the lumbar spine

However, in most cases, treatment begins with the elimination of the most disturbing symptom - pain, which can make the patient's life unbearable. In addition, an important task is to remove the inflammation that occurs in response to trauma, as well as improve nutrition and blood supply to damaged tissues. Usually, first of all, NSAIDs - diclofenac, ibuprofen, indomethacin, etc., are prescribed, both inside and outside. At the same time, various anti-inflammatory and analgesic ointments, gels, etc. alone do not apply - only in combination with tablets or injections. Another feature of the use of external means with intervertebral hernia - they should be applied carefully, without trying to massage the sore spot. With severe pain, blockade with solutions of novocaine, lidocaine and the like can be prescribed. To improve nutrition and blood supply, reduce inflammation and accelerate recovery, pentoxifylline and Actovegin may be prescribed. In addition, with the reduction of pain (in the subacute period), electrophoresis and phonophoresis with various drugs, magnetotherapy, etc. are prescribed.

Approximately one month after the beginning of hernia treatment, a recovery period may begin. The dosage of medicines decreases, more attention is paid to physiotherapy, therapeutic massage, special gymnastics complexes. During this period, pain usually passes completely, but this does not mean that the disease can be forgotten. The recovery period takes up to six months, and if the patient violates the medical prescriptions, the hernia may well "return". So the general recommendation for convalescents is: do not sit for long periods without moving, do not sleep on too soft, corroded beds and mattresses, protect your back from twisting movements and lifting weights. In general, any physical load in this period is better to perform by wearing a special soft corset, fixing the belt, and with the neck hernia - a soft fixing collar. If there are such in your pharmacy - do not forget to offer them to patients who get funds from back pain.

Modern antidepressants

Antidepressants - a group of psychotropic drugs that affect depressive affect. For the first time, the use of antidepressants (iproniazide, a class of MAO inhibitors and imipramine, a class of tricyclic antidepressants, a monoamine-type reuptake inhibitor of mixed type) was recorded in 1957.

Pharmacological effects of antidepressants are carried out at the level of synapses. The two main ways of their work are the blockade of the decay of the mediators and their re-uptake by the presynaptic membrane; and in both cases there is an increase in the concentration of mediators (norepinephrine, serotonin, dopamine) in the synaptic cleft and, as a consequence, their longer and higher functional activity. In recent years, a number of drugs have been shown to act directly on the postsynaptic membrane receptors, in particular, the sensitivity of receptors and their blockade. The real pharmacological action of antidepressants is much broader, however, as a rule, their side effects are associated with it.

With each form of pharmacological activity of antidepressants, certain clinical effects (including side effects) are associated. Note that the actual antidepressant effect is manifested only in four of the ten mechanisms of action of antidepressants.

The blockade of norepinephrine reuptake (1) is accompanied by a decrease in psychomotor inhibition, an improvement in mood, tremor, tachycardia, an erection disorder; blockade of reuptake of serotonin (2) - correction of low mood, decreased vital anguish, decreased phobic symptoms, mild analgesic effect, decreased anxiety (in therapeutic doses), appetite, craving for alcohol, tobacco, and other substances that cause dependence , aggressive behavior, it provokes nausea, headaches, tremors, dysarthria; blockade of dopamine reuptake (3) is manifested by psychomotor activation, increased hallucinatory and delirious activity (if any); blockade of histamine (H1) receptors (4) is accompanied by sedation, drowsiness, lowering of arterial pressure; blockade of muscarinic receptors (5) is accompanied by double vision, dry mouth, tachycardia, constipation, urinary retention; blockade of alpha-adrenergic receptors (6) causes dizziness, orthostatic collapse, sedation, drowsiness, priapism; blockade of dopamine receptors (7) leads to a decrease in psychotic symptoms, a violation of libido and erection in men, extrapyramidal disorders; blockade of serotonin receptors (8) leads to a decrease in anxiety (anxiolytic effect), reduces the manifestation of negative symptoms in schizophrenia, reduces depressive symptoms, improves sleep quality, lowers blood pressure; inhibition of MAO type A (deamination of serotonin, norepinephrine, dopamine) (9) leads to an activating effect, an antidepressant effect, accompanied by an increase in anxiety, insomnia, hypertension, tyramine reactions (they are caused by intolerance to beans, cheese, coffee, smoked products, beer, red wine); inhibition of MAO type B (deamination of beta-phenylethylamine, benzylamine, dopamine) (10) associated hemodynamic disorders, hypotensive effect, anti-Parkinsonic effect.

At present, it is customary to classify antidepressants according to their pharmacological action. This is due primarily to the nature of their therapeutic effect, depending primarily on the mechanism of influence on the mediator exchange, and not on the chemical nature of the active substance. Today, the clinic uses drugs from four groups.

Group 1. The blockers of presynaptic capture of monoamines (here and below the international names). A. Noradrenalin - Desipramine, Amoxaline, Nortriptyline, Dibenzipine, etc. B. Serotonin - Citaloprim, Fluoxetine, Zimelidin, Trazodone, etc. V. Dopamine - Diclofensin, Bupropion, etc. G. Mixed action (A + B) - Amitriptyline, Clomipramine, Doxepin, and others.

Group 2. Blockers of pathways of metabolic destruction of monoamines (MAO inhibitors - enzyme monoamine oxidase). A. Irreversible actions, non-selective (inhibit MAO by types A and B) - Iproniazide, Nialamide, Isocarboxazide, etc. B. Reversible action (MAO inhibitory, selectively type A) - Pyrazidol, Mok Lobemide, Tetrindol, Befloxaton, etc. In Reversible action (inhibit MAO, indiscriminately, in types A and B) - Caroxazone, Indopan, Sidnofen, etc.

Group 3. Stimulators of receptors of the postsynaptic membrane. A. Noradrenergic - Johimbin, Clonidine, Salbutamol, etc. B. Serotonergic - L-tryptophan, Buspiron, etc. B. Dopaminergic - Levodopa, Bromricrytin, amphetamines, etc. G. GABAergic - Alprozalam, Clonazepam, Carbamazepine and others.

Group 4. Drugs with different mechanisms of action. A. Blockers of serotonin receptors - Ritanserin, Azafen, Tianeptin, etc. B. Holinolitics - Biperidin, Orfenadrin. B. Nootropics - Indeloxazine, Exifon, etc. G. Blockers of dopaminergic receptors (Thymoneuroleptics) - Risperidone, Chloroprotexen, Flupentixol, Pimozid, etc. D. Hormones - endorphins, estrogens, androgens, oxytocin, vasopressin and many others E. With an unknown mechanism actions - lithium salts, calcium channel blockers, metapramine and many others.

Perhaps this classification will not seem very familiar, but it is extremely convenient for predicting the main and side effects of the drug. In addition to proper antidepressants, this classification includes substances that have timoanaleptic and psychostimulating properties, which by chemical classification are very far from antidepressants.

The chemical classification of antidepressants relies on the number of hydrocarbon heterocycles in their structure. Isolate: monocyclic (1) - fluoxetine, bicyclic (2) - trazodone, paroxetine, sertraline, tricyclic (3) - amitriptyline, imipramine, tianeptine, tetracyclic (4) - pyrlinod, Mianserin, and MAO inhibitors (5).

The main guarantee for the success of antidepressant treatment is proper diagnosis. Any depression is a complex of phenomena requiring psychopharmacological, psychotherapeutic and somatic treatment. Antidepressants differ significantly in the effectiveness of action for depression neurotic and psychotic levels. At appointment take into account sedative and stimulating properties of preparations, and also specific selective activity of each of them. Antidepressants are successfully used to treat anxiety, including panic disorders, with somatic pathology, including chronic pain, somatization disorders, alcoholism and drug addiction, phobic disorders. There are recommended doses and intervals of admission, but often practicing specialists with success appoint different doses and frequency of admission. Often antidepressants are used in combination with other drugs, they can enter into complex (and not always predictable) interactions with them, which significantly changes the nature of their action. It should be noted that for most antidepressants a deferred effect for 2-3 weeks is characteristic, which is caused by the peculiarities of accumulation of mediators.

Below, we briefly describe the antidepressants most often used in practice. You will find detailed information on the product on the leaflet. We brought the most common brand names and international ones.

Azone (Trazodone) is a selective inhibitor of presynaptic (reverse) capture of serotonin, produced by Orion, Finland. Used for a wide range of depressions. Contraindicated in pregnancy. Incompatible with MAO inhibitors. Strengthens the effect of alcohol. Side effects - drowsiness, dizziness, weakness, hypotension.

Alprox (Orion, Finland), Xanax (Pharmacia & Upjohn, USA), Neurole (Lechiva, Czech Republic) (Alprazolam) is a stimulator of GABAergic receptors of the postsynaptic membrane, used for neurotic depressions accompanied by anxiety, insomnia, somatization, with panic disorders. Contraindicated in pregnancy, children, with pathology of the thyroid gland. Side effects - headache, drowsiness, dyspepsia, dysarthria, coordination disorders, decreased libido in men and women, addiction.

Amitriline (Lek, Slovenia), Amitriptyline (Polfa, Poland, Slovakofarma, Slovakia, Weimer pharma, Germany) (Amitriptyline) is a tricyclic antidepressant, a blocker of presynaptic capture of monoamines of mixed type, is effective in psychotic and neurotic depressions, endogenous and exogenous, age (also used to treat enuresis). Contraindicated in glaucoma, epilepsy, impassability of the intestine. With caution in pregnancy. Not compatible with MAO inhibitors. Side effects - dryness of mucous membranes, visual impairment, psychotic symptoms, collapse, allergic reactions, constipation, gynecomastia, decreased libido in men, galactorrhea in women.

Aurorix (Roche, Switzerland) (Moclobemide) is an MAO inhibitor of reversible action, type A. It is shown in depression of various etiologies, especially atypical (masked) depressions. Contraindicated in children. Side effects - anxiety, sleep disorders, headache, visual impairment, skin reactions, dyspepsia.

Deprex (Lechiva, Czech Republic), Portal (Lek, Slovenia), Prozac (Lilly, USA), Fluoxonil (Orion, Finland), Fluoxetine (Nycomed, Norway) (Fluoxetine) is a selective inhibitor of presynaptic seizure of serotonin. It is indicated for depression of various genesis, eating disorders. Contraindicated in diseases of the kidneys, prostate adenoma, glaucoma, epilepsy. Not compatible with MAO inhibitors and lithium salts. Side effects - nausea, headache, dyspepsia, sleep disorders.

Doxepin (Polfa, Poland) (Doxepin) - a tricyclic antidepressant, an inhibitor of presynaptic seizure of mixed action, is shown mainly with neurotic depressions, especially accompanied by severe anxiety. Contraindicated in glaucoma, prostate adenoma, not recommended for children. Incompatible with MAO inhibitors, alcohol, lithium salts, barbiturates, morphine and its derivatives (toxic effect). Side effects - headache, insomnia, dyspeptic phenomena, tremor, skin rash.

Zoloft (Pfizer, USA) (Sertralin) is a selective inhibitor of presynaptic seizure of serotonin. It is indicated for neurotic depressions accompanied by anxiety, panic disorders, obsessive-compulsive disorders. Incompatible with MAO inhibitors. Side effects - dyspeptic phenomena, including diarrhea, insomnia or drowsiness, erectile dysfunction and ejaculation.

Coaxil (Servier, France) (Tianeptin) is a stimulant of serotonin reuptake. It is shown in cases of depression of different etiology and character, with somatization disorders, during abstinence with alcoholism. Contraindicated in children. Incompatible with MAO inhibitors. Side effects - decreased appetite, indigestion, headache, insomnia, nightmares, decreased reaction speed, pain in the heart, muscle pains, laryngospasm.

Lerivon (Organon, Holland) Miansan (Zorka, Yugoslavia) (Mianserin) is a tetracyclic antidepressant, a blocker of presynaptic alpha-adrenergic receptors. It is used for all types of depression. Incompatible with MAO inhibitors. Side effects - drowsiness, gynecomastia, impaired blood composition.

Melipramine (Egis, Hungary) (Imipramine) is a tricyclic antidepressant, a monoamine-type reuptake inhibitor of mixed type, shown in endogenous depression: manic-depressive psychosis, used to treat enuresis. Contraindicated in ischemic heart disease, epilepsy, glaucoma, prostate adenoma, pregnancy, in early childhood. Incompatible with alcohol, MAO inhibitors. Side effects - headaches, fainting, visual impairment, epileptic seizures, psychotic symptoms, tremor, decreased libido and erectile dysfunction, gynecomastia, allergic reactions.

Remeron (Organon, Holland) (Mirtazapine) is a blocker of presynaptic alpha-adrenergic receptors. It is indicated for depressions of different genesis. Not compatible with MAO inhibitors. Side effects - drowsiness, inhibition, increased appetite, cramps, tremor, oppression hemopoiesis, edema, dyspepsia, headaches.

Fevarin (Pharmacia & Upjohn, USA) (Fluvoxamine) is a selective inhibitor of presynaptic seizure of serotonin. It is indicated for depression of various genesis. Contraindicated in convulsions, not recommended for children. It is not compatible with MAO inhibitors and tricyclic antidepressants. Side effects - nausea, vomiting, dizziness, headaches, agitation, dyspepsia, erectile dysfunction and ejaculation, decreased appetite.

The appointment of antidepressants is the prerogative of a psychiatrist. Do not try to apply the medication yourself!

Dangerous antidepressants

Over the past 10 years, about 30 people were killed and 62 injured as a result of shooting at schools in developed Western states. Among the most widely known are the shooting in March 2005 at Red Lake School of Indian Reserve Jeff Wace, who took Prozac antidepressant, the shooting at Columbus School, Colorado, Eric Harris, who took the antidepressant Luvox, and the killings in Springfield, Oregon, by Kip Kinkel , who also took Prozac.

Fluoxetine (Fluoxetine)
INN / analogue: Fluoxetine / (Prozac)

Investigations of psychiatric scams

Over the past 16 years, around the world, the Civil Rights Commissions have been asking the drug regulators to look into the face of the fact that psychiatrists hide from the public the ability of drugs to cause suicidal or violent behavior in patients. Over time, this fact began to be recognized by the researchers themselves.

David Healy, director of the Department of North Wales of Psychological Medicine at the University of Cardiff, published a report on the study of Paksil antidepressant in the journal Public Library of Science-Medicine. Healy found that this substance several times increases the risk of suicide of the patient. In his opinion, other antidepressants, such as Prozac, Selex and Zoloft, create the same risk of violence or suicide: "We have gathered compelling evidence that drugs can induce people to violence, and that means that there will be more cases of violence”, - the researcher confirms.

Zoloft ™ (Zoloft) - Sertraline
Manufacturer: Pfizer

What is justified by such risky medical measures? According to some experts in the field of conventional medicine, nothing. "If the psychiatrist claims that you have depression caused by a lack of serotonin in the body's tissues, ask for an appropriate blood test and observe the psychiatrist's reaction," says anatomy professor Jonathan Leo, "the number of people who have come to believe that scientists have demonstrated a depressed serotonin level in depressive people, is an excellent proof of the effectiveness of marketing."

From the western colleagues who are intensively promoting the medication treatment of depression, Russian psychiatrists are not lagging behind. "No healthy person can avoid depression at least once in his life," Tatyana Dmitrieva, director of the Serbsky Institute, complains in an interview, "medicine can cure, there are effective antidepressant drugs." The trouble is that in another - one-third of the world's population they are not available. most antidepressants are on the list of vital drugs that must necessarily be in the pharmacy, in psychiatric institutions, to be released on preferential terms. Should, but ... These are very expensive medicines.

Paxil - Paroxetine

Psychiatric profit

The cost of sophisticated introduction of the "treatment" of depression with new substances into the mass consciousness of psychiatric propaganda amounted to at least $ 70 million over the past decade. What for? But why. "Useful natural substances are scorned by them because you can not patent a natural product, and patented, unnatural compounds bring an indescribable profit, for example, Prozac contains 20 mg of a patented active ingredient." One thousand Prozac capsules costs $ 247, while the cost of an active, patented the ingredient is 11 cents, which brings a profit of 224973%, "says the well-known physician Julian Whitaker.

Trade name of the drug: Neurrol (Neurol)
International Nonproprietary Name: Alprazolam

Xanax (Alprazolam): 1 mg of this particularly lucrative antidepressant is sold at $ 136.79 per 100 pills The patented artificial active substance costs 2.4 cents, that is, xanax generates a profit of 569958% .In the international scale it is about 80 billion dollars a year from psychotropic drugs. Now let's divide it. This is more than 6 billion dollars a month. This is 200 million dollars a day or more than 832 thousand dollars hourly. There are thousands of psychiatrists who provide sales of products of images. There are thousands of psychiatrists who provide sales of drugs with the invention of fictitious mental disorders, i.e. diagnoses, scientific no more than determining the future with the help of fortune telling. Psychiatrists are nothing more than drug dealers masquerading as health workers, "Whitaker said.

In the light of the above data on the predisposition to violence caused by psychotropic substances, the situation looks even more disgusting. It is worth recalling that the group of leading psychiatrists of the country tried to lobby the legalization in Russia of treatment of another fictitious state - child hyperactivity - with drugs pharmacologically identical to cocaine - I tried to guess, not for a pleasant smile. Among the substances suggested for the "treatment" of disobedient school children, there was a remedy for depression - tomoxetine - which was renamed "atomoxetine" and was suggested as a "modern safe remedy" for the treatment of childhood hyperactivity.

The receipt of the treatment for children since the age of 6 was registered by Roszdravnadzor after a number of human rights organizations provided evidence to the authorities and journalists: psychiatrists knew about the ability of atomoxetine to cause suicidal tendencies and violence. They knew, but hid it from the registration authorities of a number of states, including Russia.

It is not surprising that it was in those countries where psychiatrists succeeded in propagating mass "treatment" of their fictitious diagnoses, that the cases of "inexplicable, incomprehensible violence" became something ordinary. For each such case, psychiatrists readily offer the society the solution - to hospitalize and treat the "killer".

The society readily agrees without going into details. So the country enters a vicious circle, when in a week - like today's US - there are three school shootings.

Federal experts in the US in the course of the investigation concluded that the use of adolescent antidepressants of the latest generation leads to an increase in the number of suicides among patients in this age group. American and British doctors have already received a recommendation not to prescribe these drugs to under-age patients.

These investigations seriously threaten the business of the largest Western pharmaceutical companies.

Experts from the US Food and Drug Administration have found that millions of prescriptions for prescribing antidepressants are prescribed to minors. Until now, adolescents were allowed to take only one "Prozac" (the company Eli Lilly). But formally, the rules did not forbid doctors to prescribe to children and other similar drugs.

Now it became clear that there is a definite connection between taking antidepressants and increasing the risk of suicidal behavior in adolescents taking the drug. The developers of such drugs themselves admitted that taking these medications has side effects, indicating in indications for use the need for constant monitoring of the patient "because of the risk of suicide."

The experts' apprehensions intensified after they received research materials on the effects of taking Paksil (GlaxoSmithKline) by young patients. After that, the US federal authorities demanded that any four pharmaceutical companies - the largest producers of antidepressants Eli Lilly, Wyeth (the drug Efferor), GlaxoSmithKline and Pfizer (Zoloft) publish any, even closed, results of the study of the consequences of taking these drugs by children and adolescents.

The annual turnover of the US market for drugs treating mental disorders is estimated at $ 49 billion, of which antidepressants occupy about 17 billion. Although the warning has been sent to only four companies, experts at the London Center for World Market Research believe that the investigation and subsequent developments The new restrictions will definitely hit the business of other, smaller participants in the American market of antidepressants - Forest Laboratories (Bristol-Myers Squibb (Serzon), Selexa), Akzo Nobel ("Remeron") and Solvay ("Luvox").

In the US, antidepressants are a familiar companion for home health-care kits and handbags. In Russia, not the use of drugs to combat stress and depression. Russians are more used to fighting depression with well-known "folk" means. Fooled by psychiatric propaganda still go to a psychologist, but they do not have the right to prescribe such drugs. And Russian psychiatrists prefer to prescribe more effective tranquilizers.

As told in the Center for Marketing Research "Pharmexpert", the dynamic development of the market of antidepressants in Russia is hindered by the prescription nature of their use. The vast majority of sales of antidepressants are accounted for by health organizations. Sales of drugs on the market are growing weak, despite the marketing efforts of foreign companies. In total, the share of imported antidepressants accounts for up to 85% of the market with a volume of 15.5 million dollars.

Red lichen

Red flat lichen is a chronic inflammatory disease, which is characterized by the appearance on the mucous membranes and skin of itching rashes. Sometimes the disease affects the nails. According to statistics, red lichen planus among all dermatological diseases in adults is up to 2.5%. And among diseases of the mucous membrane of the oral cavity - about 35%. The number of patients is increasing year by year.

Red flat lichen is found in both men and women. And men are sick more often at a young age, while women - after 50 years.

There is evidence that in 10-12% of cases, red flat lichen is reborn into a tumor disease.

Causes of red flat lichen: mental trauma, viruses or pathogens, heredity, intoxication (some medications), impaired immune system.

With the flow of red flat lichen can be acute (up to 1 month), subacute (up to 6 months), chronic (from 6 months to several years).

Symptoms of red lichen:
- itching rash;
- mild ailment, weakness, nervous overexcitation;
- irritability, insomnia.

The basis of therapy are drugs that reduce the activity of the immune system, drugs that improve the nutrition of tissues and accelerate their recovery, agents that reduce itching, improve sleep, normalize the work of the nervous system.

Main medicines for treatment

Immunosuppressants: Cyclosporine, Consupren, Panimun Bioral, Ecoral, Sandimmun Neoral, Cyclosporin HEXAL, chloroquine, Delagil, hydroxychloroquine, Immard, Plakvenil, tacrolimus Protopic, etc.

Glucocorticoids: Prednisolone, Medopred, Prednisolone ointment 0.5%, Solu-Decortin H25, Flumethasone, Lorinden, Triamcinolone, Kenalog, Pollortolone, Betamethasone, Acriderm, Beloderm, Celestoderm-B, Celeston, mometasone, Gistan-N, Nazonex, Uniderm, Elokom, Diprosalik, Belosalik lotion, etc.

Synthetic interferons and interphenogens: Oxodihydroacridinilacetate sodium, Neovir, Neovir coated tablets, 0.125 g (soluble in the intestine), sodium ribonucleate, Ridostin, interferon alfa-2b, Allokin-alpha, etc.

Antihistamines: Cetirizine, Zirtek, Parlazin, Cetrin, Clemastin, Rivtagil, Tavegil, chloropyramine, Suprastin, loratadine, Claritin, Lotharen, mebhydroline, Diazolin, dimethindene, Fenistil and others.

Anxiolytics: Bromodihydrochlorophenylbenzodiazepine, Phenazepam, Phenorelaxane, Elzepam, Medazepam, Mezapam, Rudothel, and others.

Additional medicines
Antiaggregants: Pentoxifylline, Agapurin, Pentohexal, Trenpental Trental, Xanthinal Nicotinate, Complinine, Eikonal, etc.

Antiseptics and disinfectants: tar birch, etc.

Biological supplements: OMEGA PREMIUM Life formula, Pumpkin. Oil for food, etc.

Vitamins: Ascorbic acid, Vitamin E, retinol, riboflavin, thiamine, etc.

Dermatotropin funds: Acitretin, Neotigazone, Pimecrolimus, Elidel, Oxoralen, and others.

Regenerants and reparants: Solcoseryl, Actovegin, sea buckthorn oil, Aloe liniment, etc.