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Depression is quite common: according to WHO, more than 300 million people of different ages and gender suffer from it worldwide.

According to the American Psychiatric Association, this serious illness can take many forms, vary in severity among individuals, and co-occur with other conditions that cause similar symptoms, such as anxiety disorders.

Since the causes of depression are associated with disorders of the brain, it is useless to urge patients with depression to “pull themselves together” - its symptoms cannot be overcome by volitional effort, just as it is impossible to influence the functioning of the brain with volitional effort.

“Mood is our subjective experience, that is, what we can be aware of and about which we can give an account. Any psychological phenomenon is based on complex and multi-level processes that occur in our nervous system. In particular, neurochemical ones,” explains senior researcher at the laboratory of scientific foundations of psychotherapy, candidate of psychological sciences Maria Danina.

According to her, according to the monoamine theory, three different monoamine neurotransmitters contribute to depressive symptoms. Moreover, neurotransmitters do not “trigger” the disease on their own, but influence certain processes that, in fact, lead to depression.

Firstly, it is dopamine, which is involved in the motivation system. A lack of dopamine can lead to anhedonia—that is, the inability to experience pleasure.

Secondly, it is norepinephrine. It is involved in regulating our daily activities. Its deficiency is associated with psychomotor retardation (when a person begins to move and speak more slowly than usual).

And thirdly, serotonin. Which is involved in controlling the sensitivity of the pain system, suppresses pain signals and negative emotions.

A lack of serotonin leads to increased pain, negative emotions and anxiety. In addition, due to a lack of serotonin, obsessive states develop, associated with constantly recurring thoughts about the past and the reasons for one’s current condition, which are difficult to get rid of - psychiatrists call this rumination.

“In addition to reducing the level of neurotransmitters, other groups of biologically active substances, for example, glucocorticoids, can also contribute to depression,” notes Maria Danina. “For example, the level of the famous “stress hormone” cortisol also increases during depression - and this in turn leads to a lack of dopamine. Monoamine levels can be influenced by thyroid hormones and sex hormones: estrogen and progesterone.”

However, clinical depression can be triggered by many factors - for example, hereditary predisposition, low self-esteem, difficult life circumstances, severe stress and chronic diseases. And therefore, we cannot “place all the blame” only on disturbances in brain function, emphasizes Maria Danina.

Neurotransmitters and their effects depending on deficiency or excess

I am depressed!

This can often be heard from friends or read on the forum. But, as a rule, the person who makes such statements is mistaken. After all, what is meant by “depression” in a colloquial environment? Usually this simply means a short-term deterioration in mood, irritability, fatigue under the influence of circumstances. Sometimes a person is just having a “bad day” or “got off on the wrong foot” and they call it depression.

Nowadays, people are constantly faced with stress: overload at work, a frantic pace of life, inflated demands on themselves, a huge amount of information that flows from all sources. It is not surprising that many people cannot cope with so many stressors, and this can manifest itself in various symptoms:

• anxiety;
• irritability;
• fatigue;
• sleep disorders;
• obsessive thoughts;
• panic attacks.

If these symptoms are short-lived and go away on their own, do not be too upset. In most cases, just a good rest will help defeat them. But sometimes a vacation is not enough, and the body needs a little help. It is very important to choose the right medications for this.

What are antidepressants and when are they prescribed?

The functioning of our brain, including the general background of mood and emotions, depends on the content of special substances in it - neurotransmitters. One of these substances, serotonin, is called the hormone of joy. It maintains a good mood and creates a feeling of happiness. In people with depression, serotonin levels decrease.

These are purely biochemical processes, and telling a person suffering from depression due to low serotonin levels to “just pull yourself together and start moving” is about as productive as telling a patient with diabetes to maintain the desired sugar level through willpower.

Antidepressants increase the amount of serotonin in the body, restoring a person’s “normal” state.

By the way, they are prescribed not only to lift your mood. Another common area for the use of antidepressants is chronic pain (back pain, headaches, fibromyalgia, irritable bowel syndrome pain, etc.). Against the background of constant pain, the synthesis of the body’s own painkillers is disrupted; doctors call this dysfunction of the antinociceptive system. Antidepressants restore natural pain suppression mechanisms. Moreover, if their main effect - improving mood - takes 2-3 weeks, then the analgesic effect appears literally with 1-2 tablets.

Antidepressants are also recommended for anxiety disorders, premenstrual and premenopausal syndromes, urinary and fecal incontinence, and other pathologies.

What is depression really?

This is a long-term (2 weeks or more) pronounced decrease in mood, which is accompanied by several additional symptoms: decreased activity, slower mental activity, lack of joy in life. That is, if you are no longer touched by the usual joys - hobbies, family, get-togethers with friends, then this is a reason to think, monitor your condition and, perhaps, consult a doctor.

If your usual joys no longer touch you, then this is a reason to think about it and, perhaps, consult a doctor.

True depression is a serious and often severe illness that requires mandatory treatment by a psychiatrist with the prescription of special medications.

How do antidepressants work?

It is believed that during severe psychological conditions, norepinephrine, serotonin and dopamine, which are responsible for a good mood and active work, begin to be produced differently in the brain. Mental conditions arise due to the lack of nerve contacts in one place of the brain and the occurrence of excitation in another. A nerve impulse is transmitted by connecting nerve cells to each other by special processes called synapses. During the transmission of a signal from one cell to another, special substances are produced that transmit nerve signals in the brain. Due to the fact that these substances are destroyed in one place and actively produced in another place in the brain, there are outbreaks of inhibition or excitation reactions.

The chemical molecules of antidepressants are designed in such a way that they bind to enzymes in the receptors of nerve cells and contribute to the uniform distribution of impulses. It should be noted that it is impossible to immediately remove the depressive state. The drugs usually begin to work within 3 weeks. In severe conditions, a couple of drugs from this pharmacological group are prescribed in combination. For the best therapy, a course of treatment of 4-6 months is prescribed to avoid recurrence of depression. In severe situations, other sedative medications or vitamins are prescribed in combination with antidepressants to help improve mood, normalize sleep and appetite.

What drugs are used to treat depression?

They have a common name - antidepressants. It is worth noting that in recent years the indications for the prescription of antidepressants have expanded significantly. Numerous studies have been conducted that have shown the effectiveness of antidepressants not only for depression, but also for anxiety, sleep disorders (insomnia), neuroses and even neuropathic pain. Today, drugs from different groups of antidepressants are widely prescribed by psychiatrists, neurologists and even therapists.

The most commonly used drugs are two groups.

Tricyclic antidepressants

These are old drugs that are considered the most powerful:

• Amitriptyline is a drug with strong sedative and powerful antidepressant effects. In large doses it is used to treat severe depression, in small doses for milder disorders. It relieves anxiety well and has a hypnotic effect.
• Anafranil is a drug of balanced action, usually easier to tolerate than amitriptyline, and also relieves anxiety well. Prescribed for the treatment of depression from mild to severe, various anxiety disorders.
• Melipramine has a stimulating effect and is used to treat apathetic depression.

Selective serotonin reuptake inhibitors (SSRIs)

This is a more modern group of drugs. Their advantages are good tolerability and few or no side effects.

Often from this group are assigned:

• Fevarin has anti-anxiety and good antidepressant effects. With long-term use, it normalizes sleep if it has been disturbed.

• Zoloft is a fairly strong daytime antidepressant. Relieves anxiety and obsessive thoughts without causing drowsiness.
• Paxil relieves anxiety and is often prescribed to treat panic attacks.

There are many more modern antidepressants that have few side effects and are well tolerated:

• Ixel;
• Velaxin;
• Valdoxan;
• Trittico;
• Cymbalta and others.

But strong antidepressants are not sold without a prescription . They can only be prescribed by a doctor: a psychiatrist, a neurologist, or sometimes a therapist.

Neuroleptics

Despite the fact that most antipsychotic drugs depress the nervous system, among them there are drugs with antidepressant effects:

• Flupenthixol (fluanxol).

  It has an antidepressant effect only when administered in small doses (less than 2 mg per day).

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• Aripiprazole.

  Effective for depression in bipolar affective disorder and schizitypal disorders.

• Levomepromazine (tizercin).

  Prescribed for endogenous depression accompanied by insomnia.

Why can't you take antidepressants without a prescription?

• Only a doctor can assess the risk of side effects for a particular patient.
• Different antidepressants have different nuances of therapeutic action. If the medicine is chosen incorrectly, at best it will not help, at worst it will harm.
• Dose selection is carried out individually. If you increase the dose too quickly on your own, you can experience a lot of unpleasant consequences.
• Cancellation should also be carried out gradually and under the supervision of a doctor. Otherwise, you risk withdrawal symptoms.

Review of modern antidepressants

What to do?

There are a number of drugs that are sold without a prescription. They are not effective for clinical depression, but they will help cope with stress, short-term sleep disorders and irritability. With their help, you can try to ease your psycho-emotional state a little:

• Glycine is one of the most popular remedies. Prescribed starting from childhood, for stress, fatigue, emotional overstrain. Sometimes effective for minor sleep disorders.
• Afobazol . It has an anti-anxiety effect, eliminates feelings of fear, tearfulness, and irritability. It is used in the treatment of vegetative-vascular dystonia and even in alcoholism, to alleviate the symptoms of alcohol withdrawal. Not addictive. Please note that it is contraindicated for children under 18 years of age.
• Novo-passit . Quite a strong sedative for nervousness and irritability. Effective in reducing concentration, memory, and fatigue. Helps restore the nervous system during periods of increased stress.

Over-the-counter medications will not cope with clinical depression, but they can alleviate the psycho-emotional state.

• Stressitis . Well calms, relieves irritability, anxiety, improves sleep. During the treatment period, driving and other activities that require increased concentration are not recommended.
• Persen is a herbal medicine. Contains extracts of valerian, lemon balm and peppermint. Has a calming and anti-anxiety effect. It helps well with increased excitability, emotional lability, and tearfulness. Can be used in the complex treatment of mild anxiety and depressive disorders, facilitating the withdrawal of potent drugs.
• Magne B6 . Increases the body's resistance to stress. Magnesium deficiency can lead to an imbalance in the nervous system, irritability, and sleep disturbances, so Magne B6 has a positive effect in these cases.
• Tenoten . It has an anti-anxiety, calming, anti-asthenic effect, helps cope with stress and psycho-emotional stress. Relieves irritability and tension. Can be used for neurotic conditions.

Tranquilizers

• Bromodihydrochlorophenylbenzodiazepine (phenazepam).

  The drug of choice for neurotic conditions with depression and post-stress conditions. That is, in cases where short-term treatment is required.

• Clonazepam.

  Strong anti-anxiety and sedative effect. When taken for a long time it causes dependence.

• Alprazolam.

  Prescribed for anxiety and depression. Recommended for short courses (no more than 10 days) due to the risk of developing addiction and dependence.

When should you see a doctor?

• If a decrease in mood has been observed for more than two weeks, and attempts at self-treatment have been ineffective.
• If you have thoughts about not wanting to live or suicidal thoughts.
• If a depressive state significantly disrupts the usual course of life: you cannot work, fully communicate with your family, or enjoy what previously brought joy.

You can contact a psychiatrist confidentially. Information about the fact of treatment, not to mention the diagnosis and treatment, is a medical secret: it is not reported to work, it is not disclosed. It is better to diagnose depression on time and begin treatment than to bring it to advanced stages.

Literature

1. BAUER M., PFENNIG A., SEVERUS E., WYBROW P.S., ANGST J., MÜLLER H.-YU CLINICAL RECOMMENDATIONS OF THE WORLD FEDERATION OF SOCIETIES OF BIOLOGICAL PSYCHIATRY FOR BIOLOGICAL THERAPY OF UNIPOLAR DEPRESSIVE DISORDERS PART 1: ACUTE AND CONTINUED TREATMENT OF UNIPOLAR DEPRESSIVE DISORDERS AS OF 2013//MODERN THERAPY OF MENTAL DISORDERS Number: 4 Year: 2015 Pages: 33-40
2. Antidepressant therapy and other treatments for depressive disorders. Report of the CINP Working Group based on a review of the evidence. M., 2008; 215 p.
3. Baklanov V.V., Anikeeva A.G., Karataeva Zh.E. METHODOLOGICAL RECOMMENDATIONS FOR DIAGNOSIS AND TREATMENT OF DEPRESSION IN HEALTH INSTITUTIONS PROVIDING PRIMARY HEALTH CARE TO THE POPULATION Syktyvkar, 2011

Nootropics and Metabolic Aids

The remedies in this group help to get out of a depressive state that has developed against the background of stress, overwork, encephalopathy, the consequences of injuries and poisoning. By improving the blood supply to neurons and energy metabolism within cells, they contribute to the activation of cognitive functions and memory. The most effective drugs in this group:

• Phenibut
• Mexidol
• Aminalon (GABA)
• Piracetam (nootropil)
• Picamilon
• Pyriditol (encephabol)
• B vitamins.

Classification of drugs

Scientists have developed the following classification of antidepressants based on their chemical composition and mode of action:

• Monoamine oxidase inhibitors. Such antidepressants are aimed at only one group of reactions or several (selective and non-selective):

1. Non-selective drugs are aimed at preventing mild stages of depression. Reduce pain in chronic diseases, reduce tachycardia and heart pain. increase activity, eliminate lethargy and anxiety.
2. Selective drugs are used in the treatment of manic mental disorders, schizophrenia and even alcoholism. Their effect appears after prolonged use.

• SSRIs. These are agents that prevent the uptake of serotonin. Nowadays they have gained enormous popularity. perfectly reduces feelings of fear and anxiety. Relieves phobias and panic attacks.
• With tertiary formula. They have a selective effect, preventing the uptake of norepinephrine in the synaptic cleft. They have an analgesic effect in chronic diseases. Prescribed for suicidal symptoms. helps stabilize the nervous state and improve sleep.

Comparison table of characteristics

We draw your attention to the comparative characteristics of the drugs:

Side effects

All antidepressants have side effects. Some people show them, some don't. The most common is problems with weight gain. Another negative effect, found in 40% of respondents, is a decrease in sexual desire. In third place is drowsiness and a general decrease in activity, since most of these drugs have a sedative effect. Less common but still common include: nausea, vomiting, headaches, headaches, trembling limbs and dry mouth. Because of all these symptoms, people abandon treatment. Symptoms often go away within 1-2 weeks of starting medication.

The best antidepressants: how to treat depression, apathy and anxiety?

May 12, 2021
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Content

• Antidepressants without a prescription
• Afobazole
• Persen
• Novo-passit
• Tryptophan
• Prescription antidepressants
• Zoloft
• Doxepin
• Paroxetine
• Melipramine

It often happens that a person is in a bad mood, he literally gives up and doesn’t want to do anything. This is usually how a mental disorder begins to develop, so try to listen to your body in order to start treatment on time. Depression is a condition in which a person ceases to experience joy, negative thoughts appear, and physical activity decreases. This situation requires urgent consultation with a psychotherapist and the prescription of antidepressants.