Depression is a psychological disorder, which may occur at any age. Causes of depression may be different: death of someone close to you, divorce or serious disease. Besides this, every person is under great stress in this modern world. The thing is that successful person is assessed by his wealth, career and attractive appearance. If person fails and simply cannot fit the strict rules of modern society, then he suffers from chronic stress, followed by severe depression.
At the moment there are effective methods for depression treatment, for instance, depression medications that allow people to get their normal mental state back and keep living an active social life.
Depression medications are divided into several groups:
• Selective serotonin and norepinephrine reuptake inhibitors (SNRIs) • Selective serotonin reuptake inhibitors (SSRIs) • Tricyclic antidepressants • Monoamine oxidase inhibitors (MAOIs) • Atypical antidepressants
Each group of depression medications has its own peculiarities. In addition, each person reacts on one or another medication in a different way. Thus one should carefully choose the most effective antidepressant for himself, considering clinical picture of depression, as well as the individual reaction of the body.
Selective serotonin and norepinephrine reuptake inhibitors (SNRIs) Specialists assume that the major role in depressive states, belongs to impaired neurotransmission of norepinephrine and (or) serotonin in the brain structures. Selective serotonin and norepinephrine reuptake inhibitors (Cymbalta, Pristiq) are prescribed to adults for treatment and prevention of depression and anxious disorders of different origin. Clinical trials have shown that SNRIs allow to achieve antidepressant effect even in patients, resistant to Selective serotonin reuptake inhibitors (SSRIs). Unlike SSRIs and tricyclic antidepressants, SNRIs rarely change the body weight. However SNRIs can provoke high blood pressure. It is known that risk of high blood pressure with SNRIs is much higher than with SSRIs. Clinical effect of SNRI is achieved within 12 weeks of use. Still in order to get therapeutically significant improvement of psychoemotional state, patient should use SNRIs within 4-6 months.
Selective serotonin reuptake inhibitors (SSRIs)
Selective serotonin reuptake inhibitors (Paxil, Zoloft, Prozac) improve psychoemotional state of a patient by enhancing serotonin levels in the brain. Usually SSRIs are prescribed for the treatment of obsessive-compulsive and panic disorders, as well as for long-term therapy of depression. SSRIs can be used to cure depressive disorders during pregnancy. However if taken in the last stages of pregnancy, SSRI might provoke withdrawal syndrome in newborn with such main symptoms as restlessness and crying. When using SSRIs during lactation, woman should transfer the child to bottle feeding.
Tricyclic antidepressants (Pamelor, Norpramin, Anafranil, Norpress) are used for the treatment of depressive states since 1960’s. Unlike other depression medications (SNRIs and SSRIs), tricyclic antidepressants provoke side effects more often.
Given that tricyclic antidepressants increase the levels of norepinephrine in the central nervous system, the heart rate frequency and blood pressure may change after their use.
The likelihood of tricyclic antidepressants side effects in elderly patients is higher than in middle-aged patients. Therefore tricyclic antidepressants are rarely prescribed to elderly patients (over 65 years old) as well as to those with cardiovascular disorders.
Tricyclic antidepressants are administered to cure moderate and severe forms of depression, recommended for patients, who are resistant to other kinds of depression medications.
Monoamine oxidase inhibitors (MAOIs)
Monoamine oxidase inhibitors (Marplan, Parnate, Emsam, Nardil) slow down the activity of monoamine oxidase enzyme, which destroys norepinephrine neurotransmitter. MAOIs have a strong antidepressant effect, which makes them effective in the treatment of atypical depressions.
One of the drawbacks of MAOIs is that its regular use may cause the increase of body weight and hypotension. In order to avoid unwanted side effects when taking MAOIs, patient should follow a special diet without taking foods high in thyronine (like cheese, liver, whiskey, cognac, red wine).
The interaction between MAOIs and thyronine may sharply change the blood pressure. When transferring from MAOIs onto other depression medications, patient should take a 2 to 6 weeks break, because MAOIs are excreted from the body for long time. Otherwise, the patient may develop serotonin syndrome, which symptoms are muscle rigidity, fever and loss of awareness.
Atypical antidepressants (Lyudiomil, Trazodone, Nefazodone, Psymion) are close to tricyclic antidepressants by their structure, yet have a different mechanism of action. Atypical antidepressants enhance the effect of norepinephrine and adrenaline, providing moderate anxiolytic and sedative effect. Atypical antidepressants are prescribed for the treatment of various forms depressions, accompanied by fear and irritability.
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