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Every year new online casinos open, and the question of choosing the best place to play is becoming more and more relevant. Finding an honest site with favorable conditions is not easy. You need to pay attention to many criteria: from the availability of a license and original software to bonuses and cashout periods. To help you choose the right place to play, we have compiled a rating of the best online casinos. We invite you to familiarize yourself with them and their selection criteria.
Rating of modern online casinos: how to choose the best establishment
At one time, gambling establishments were widespread throughout Russia. Moscow, St. Petersburg and other large cities were literally flooded with networks of gambling halls of large operators. They were very popular among slot machine fans.
In 2006, the Russian government adopted a ban on gambling. The law came into force at the end of May 2009. Gambling operators had only one option - to move to RuNet. Online casinos are also prohibited by the legislation of the Russian Federation, but sites operating online operate under international licenses and have the right to provide gambling services to gamblers.
It turned out to be easier to play on the Internet - you didn’t have to leave the house to try your luck. But at first, virtual clubs had a meager range of games, and difficulties arose in registering and paying out funds. You could only play with dollars and euros.
Today, the situation with online casinos has completely changed. Well-known clubs offer convenient and favorable conditions to their clients. But we should not forget that, along with reliable sites, there are many fraudulent establishments. And here the player’s task is to avoid choosing a dubious club.
Often scammers save on design and decoration, unlike famous clubs like Vulcan Deluxe
TOP reliable online casinos: customer data security comes first
When choosing a casino, reliability comes to the fore, since the player has to trust the club with his money. If an establishment operates illegally, there is no point in studying its gaming conditions.
Most reliable online casinos operate on the basis of international licenses from the Curacao eGaming gaming commission. To obtain documentation for legal gambling, establishments undergo multi-stage checks. Due to this, clients of licensed gambling clubs are guaranteed fair play.
The document from Curacao eGaming includes several important points:
- The legal name and registration address of the company operating the online casino.
- Email address.
- The main web address of the casino.
- List of services that the operator can provide.
- Permit number.
Licensed casinos not only publish a screenshot of the permit document on their website, but also provide an active link to it. It redirects to the Curacao eGaming website, where you can verify the authenticity of the license issued to the club.
The document opens when you click on the license icon
Casino rules often take precedence in the English version. The translation often turns out to be inaccurate, which causes disputes and refusals of payments. It is better to choose establishments with Russian-language documentation. Then there will be no unnecessary problems.
The best casinos require their customers to undergo verification. The procedure is primarily carried out in order to secure the gaming accounts of gamblers. By confirming your identity and payment method, you can be confident in the safety of your funds. No one except the gambler will be able to withdraw money from his game balance.
Additionally, verification opens up more opportunities and benefits for customers from the game. More promotions become available, withdrawal limits are increased, and cashout periods are reduced.
The most honest online casinos cooperate with independent certification commissions
Honest casinos always cooperate with independent certification commissions. They check the operation of the random number generator. Constant control of the RNG and the presence of certificates guarantees an impartial gaming process.
Global online casinos always publish the results of independent checks in the news sections of their websites. Supporting documents are posted.
It is equally important to study the list of manufacturers of slot machines and other gambling entertainment before registering with the club. The cooperation of casinos with well-known providers speaks in favor of reliability and the provision of games with maximum return.
The best online casinos for money do not seek to take away the last
Well-known and trusted online casinos do not aim to take away the last from players. They create all the necessary conditions for a gambling holiday. If among the clients there are gambling addicts, they are offered responsible gambling. Its conditions are described in detail in the corresponding section of the official casino website.
In particular, responsible gambling provides the opportunity to set limits on the game, block an account for a while or forever. This section contains tips that can help you cope with gambling addiction.
Best casinos by payouts
Popular online casinos offer customers convenient payment methods, including:
- Visa;
- MasterCard;
- WebMoney;
- Qiwi;
- Skrill;
Good gambling establishments do not charge commissions from players. Fees may only be charged by the payment system. Some casinos charge customers commissions to use the money as rewards, but this is not profitable. In essence, gamblers pay their own bonuses.
The best casinos support payments in several currencies: euros, rubles, dollars, hryvnia. Thus, the player himself chooses the option in which it is more convenient for him to place bets and control his bankroll.
Many clubs today accept payments in cryptocurrencies
The timing of withdrawal of winnings is important. Popular clubs offer clients quick cash payments. Cashout takes 24 hours on average. But there are also casinos that provide instant withdrawal - this option is even more convenient for players.
The best online casinos of 2019 by winnings: returns and odds
Paying casinos must also give customers the opportunity to win. The best gambling establishments offer entertainment with a return of 95%. Thus, favorable conditions for the game are provided.
For example, if during the day 100 people played in a machine with a return rate of 95% and invested 100,000, then 5% of the amount will go to the casino’s profit. The rest of the money will go to the pool of players of this slot, where 95,000 will be randomly distributed among them.
Online casino rating 2019 according to user opinions
Theoretical data must always be supported by practice and this is provided by the players. Gamblers actively leave reviews on forums, blogs and other sites, such as rudy1970.livejournal. There they talk about the real payout of slot machines, note cashout periods, advantages and disadvantages of the bonus program.
Thank you
The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!
Use of antidepressants
Antidepressants For many years, they have been widely used in medical practice not only for the treatment of depressive conditions, but also as part of complex therapy for other diseases. Their effect on metabolic processes in the central nervous system is used in psychiatry, neurology and some other areas of medicine. This is partly due to the fact that many antidepressants have quite strong secondary and side effects. Some of them, in addition to their antidepressant effect, cause drowsiness, while others eliminate feelings of anxiety and fear. Of course, the use of drugs with such a wide spectrum of action is possible only as prescribed by specialists. Indications and contraindications for the use of antidepressants
The main indication for the use of antidepressants, based on their name, is depression of varying severity. All drugs in this group effectively eliminate the symptoms, manifestations, and sometimes the causes of this mental disorder. However, antidepressants are often prescribed for other pathologies associated with mental or nervous activity.In certain cases, the following diseases may be considered indications for the use of antidepressants:
- some hormonal disorders, etc.
Since antidepressants have a wide range of side effects and affect, to one degree or another, the functioning of many organs and systems, they have quite a few contraindications. Not all contraindications are listed in the instructions for specific drugs. That is why specialists conduct a thorough diagnosis before prescribing an antidepressant and when selecting the optimal dose. This is necessary to identify associated health problems ( which the patient is sometimes unaware of) and exclude the most serious complications.
Most antidepressants are contraindicated for the following health problems:
- Individual intolerance to the drug. Each person's immune system has its own characteristics. If there is an individual intolerance to certain chemical compounds, the patient may develop an allergic reaction to the prescribed drug. If the patient has already had an allergy to a drug of this group in the past, this may be considered a contraindication to the prescription.
- Glaucoma. Glaucoma is an eye disease in which intraocular pressure increases. A critical increase can lead to damage to the optic nerve and irreversible blindness. Some antidepressants can trigger an attack, so they are not prescribed to patients ( usually elderly) with glaucoma.
- Recovery after myocardial infarction. Some antidepressants may cause heartbeat problems. People who have had a myocardial infarction have weaker heart muscles, and this strain can put their health and life at risk. They try to prescribe antidepressants 4 to 6 months after a heart attack. Such patients require consultation before using them. cardiologist ( sign up) .
- Structural brain damage. After injuries, strokes, and some infections, patients may be left with structural damage to nerve tissue in the brain. This will make it much more difficult to predict the effects of antidepressants.
- Disturbances of intestinal innervation. The smooth muscles of the intestine are responsible for its contractions and partly for the normal digestion of food. Some antidepressants affect the nerves that control smooth muscles. Therefore, problems such as irritable bowel syndrome, chronic constipation or diarrhea may worsen while taking them.
- Urinary disorders. The innervation of the ureters and bladder is also regulated by smooth muscle. Taking antidepressants may cause urinary retention or urinary incontinence. Antidepressants are prescribed to patients with such problems with caution.
- Severe renal or liver failure. The liver and kidneys are vital organs that are responsible for the biochemical transformation and release of many substances, including medications. Severe disruptions to their functioning are a serious contraindication to taking many antidepressants, since the medicine will not be absorbed normally by the body.
- Blood pressure problems. Taking antidepressants may cause periodic increases or decreases in blood pressure ( as a side effect). Patients with hypertension ( high blood pressure) they should be prescribed with caution, under the supervision of specialists.
- Pregnancy and lactation ( for some drugs). For some antidepressants, pregnancy and lactation are an absolute contraindication, as these drugs can cause serious harm to the health of the child.
- Age up to 6 years ( for some drugs). A number of antidepressants are harmful to a growing body. In principle, for serious mental disorders, some drugs in this group can be used for up to 6 years, but only under the supervision of specialists.
It should be noted that not all of the diseases listed above are an absolute contraindication to treatment with antidepressants. In case of severe depression, treatment will still be prescribed, the doctor will simply select exactly the drug, dose and regimen that will not cause serious complications. Also, during the course of treatment, additional consultations, tests or examinations may be needed.
How and in what doses to use antidepressants ( instructions)
The vast majority of antidepressants are designed for long-term use ( months, years), therefore a single dose of the drug will not provide any visible improvement. As a rule, the patient selects the drug, dosage regimen and dose together with the attending physician. In addition, each drug is equipped with instructions for use, which necessarily indicate the optimal doses, as well as the maximum dose, exceeding which can lead to poisoning and serious side effects.The dose and regimen of the drug depend on the following factors:
- Severity of depression. In cases of severe, prolonged depression, doctors usually prescribe stronger drugs, increase the dose and frequency of administration. This allows you to achieve a higher concentration of the drug in the blood and makes the therapeutic effect more noticeable.
- Tolerability of the drug. Sometimes patients do not tolerate the prescribed drug well. This may manifest itself in the form of severe side effects or allergic reactions. In this case, the doctor may, at his discretion, reduce the dose or change the drug.
- Risk of developing addiction. Some antidepressant drugs can cause dependence over time. To reduce the risk of such a complication, doctors select the optimal dose and regimen. If necessary, they are adjusted as treatment progresses ( for example, some antidepressants are not discontinued immediately at the end of the course of treatment, but by gradually reducing the dose).
- Convenience for the patient. This criterion is taken into account in cases where other criteria have already been selected. Some people find it more convenient to take antidepressants once a day ( and sometimes less often). For them, doctors select drugs with long-term ( prolonged) action in higher doses.
Withdrawal syndrome and its symptoms in case of addiction and dependence
Withdrawal syndrome is understood as a set of symptoms that appear in a patient when abruptly withdrawing from a drug to which addiction has developed. Not all antidepressants are so addictive. Moreover, taking drugs in doses prescribed by a specialist rarely causes such a complication. In other words, the risk of becoming dependent on an antidepressant is not that great.In most cases, addiction occurs in patients undergoing treatment with strong antidepressants for several months. However, such addiction is very different from drug addiction. Indeed, if you abruptly stop taking the drug, the nervous system does not have time to restructure itself, and various temporary disturbances may appear. However, there is still no serious health risk in this case.
Withdrawal syndrome when taking antidepressants may be accompanied by the following symptoms:
- general psychological discomfort;
- moderate muscle pain and joint pain;
- sometimes - nausea and vomiting;
- rarely – sudden changes in pressure.
To avoid withdrawal syndrome, most experts recommend completing the course of treatment by gradually reducing the dose of the drug. This allows the body to adapt to new conditions more slowly, and no symptoms will arise at all. In rare cases, when the patient is still concerned about his health after completing the course, he should consult a specialist who will accurately determine whether we are talking about withdrawal syndrome or other health problems.
Overdose and poisoning with antidepressants
Taking an excessive dose of an antidepressant can cause very serious disorders in the body, which sometimes endanger the patient's life. For each drug, the critical dose is slightly different. It is indicated by the manufacturer in the instructions. However, in some cases, when the patient's body is weakened, even a smaller dose can lead to poisoning. Also, the risk of overdose is higher in children.Symptoms of overdose and poisoning affect the functioning of many organs and systems, as the functioning of the central nervous system, which controls them, is disrupted. The diagnosis is usually made based on existing symptoms and disorders. If any atypical body reactions occur after taking a large dose of the drug, you should immediately seek medical help.
The most common symptoms that occur in patients with serious antidepressant poisoning are:
- sudden drowsiness or loss of consciousness ( up to a precomatose state);
- heart rhythm disturbances ( more often with increased rhythm, tachycardia);
- breathing rhythm disturbances;
- deterioration in coordination of movements, sometimes – convulsions;
- drop in blood pressure ( indicates severe poisoning and requires urgent medical attention);
- pupil dilation ( mydriasis);
- deterioration of bowel function and urinary retention.
Treatment of such poisonings is carried out under intensive care conditions in the toxicology department. First of all, doctors will take care of maintaining vital signs. Self-administration of emetics in this case is prohibited, since the organs do not work well and the patient’s condition may worsen ( entry of vomit into the respiratory tract). In the hospital, special agents will be prescribed that will lower the concentration of the drug in the blood and neutralize its toxic effect on the central nervous system.
Is it possible to use antidepressants in children and adolescents?
In principle, depression is not only an adult disease. Psychiatrists note that 6 to 8 percent of children and adolescents also suffer from its various manifestations. In some cases, children may be prescribed antidepressants as treatment. It is believed that the minimum age for most drugs in this group is 6 years, but some, the weakest ones, can be prescribed to younger children.In the case of treating depression in children, the main groups of antidepressants are prescribed as follows:
- Tricyclic antidepressants. Due to the large number of side effects, drugs in this group can have a detrimental effect on a growing organism. They are prescribed to children extremely rarely, only under the strict supervision of doctors.
- Monoamine oxidase inhibitors. These drugs are also quite strong and can lead to a variety of problems in children. They are rarely used.
- Serotonin reuptake inhibitors. Drugs in this group have a selective effect, so they do not have such a wide range of side effects. Most specialists try to prescribe them for childhood depression.
- Drugs of other groups. The drugs are prescribed selectively, sometimes in combination with other drugs.
Is it safe to use antidepressants during pregnancy and lactation ( breastfeeding)?
Among antidepressants, there is a fairly large selection of drugs that are approved for use during pregnancy and lactation. As a rule, this point is indicated by the manufacturer in a separate column of the instructions. Sometimes there is a trimester of pregnancy in which the use of the drug is especially dangerous.In general, it is always better to discuss taking antidepressants during pregnancy with your doctor. It is important to assess the risks of using or not using the drug and compare them. Self-administration of strong antidepressants often leads to various pregnancy complications, as it poses a threat to the child.
Self-administration of antidepressants during pregnancy can be dangerous for the following reasons:
- Possibility of developmental defects. Developmental defects occur in a child in cases where the drug passes the placental barrier between the blood of the mother and the fetus. Some substances inhibit the division and growth of certain cells. It has been noted, for example, that a number of drugs from the SSRI group ( selective serotonin reuptake inhibitors) can lead to developmental disorders of the respiratory system. Other substances may similarly cause irreparable harm to the cardiovascular or nervous system.
- Risk of pregnancy complications. In addition to harm to the fetus, there is a certain risk of complications in a pregnant woman. Changes in metabolism in the body can change the cellular composition of the blood, leading to the accumulation of toxic substances. As a result, a woman’s chronic diseases may worsen, and there is often a threat of miscarriage or premature birth.
- Reduced effectiveness of the drug. Due to hormonal changes in the body, some antidepressants may be less effective for pregnant women than for other patients. It is very difficult to predict this in advance, and the doctor evaluates the effectiveness of treatment after the start of the course.
Do I need to undergo any tests or examinations before prescribing antidepressants?
In principle, patients undergo tests and examinations to confirm a particular diagnosis and detect various health problems. Based on this information, the specialist decides whether to prescribe a specific drug. Antidepressants are designed to combat depression and a number of other mental problems that can accompany it. In the field of psychiatry, laboratory tests and instrumental examinations are of secondary importance. Mental abnormalities can be observed even in completely healthy people ( based on analysis results) people. In this case, the opinion of a qualified specialist is decisive.However, if long-term use of antidepressants is necessary, the doctor usually prescribes a number of tests and examinations for patients. Most often this is necessary to detect concomitant diseases ( besides depression). Almost all drugs from the antidepressant group have many side effects associated with the functioning of the heart, gastrointestinal tract or other internal organs. If you do not take into account the presence of chronic pathologies, taking the drug can seriously harm the patient's health.
To detect concomitant diseases, your doctor may order the following tests before starting antidepressants:
- general blood test;
- biochemical blood test;
- electroencephalography;
- allergy tests;
- ultrasound examination of internal organs ( Ultrasound), etc.
What are the dangers of self-administering antidepressants at home?
Most strong antidepressants with a pronounced therapeutic effect are available with a prescription from a specialist. This measure is intended to limit self-medication with these drugs, as it may pose a danger to the patient. In general, antidepressants have a very diverse effect on the body. The effect of taking them can affect the functioning of many organs and systems. This explains the possibility of developing serious side effects that the patient is unable to predict.Self-medication with drugs from the group of antidepressants can be dangerous for the following reasons:
- Incorrect diagnosis. Antidepressants can be prescribed for various diseases, but only a qualified specialist can make an accurate diagnosis. The patient himself cannot accurately classify his condition. Depression can be combined with other mental disorders, and not all of them can be corrected by taking antidepressants. This type of medication in the absence of indications) will not provide a therapeutic effect, and the risk of various complications increases significantly.
- Presence of chronic diseases and contraindications. Many patients do not know all of their health problems. Some pathologies do not appear and can only be detected during special examinations. At the same time, such diseases are often contraindications to taking antidepressants. That is why these drugs should be prescribed by a doctor after a full examination of the patient, and self-medication can be dangerous.
- Possibility of drug interactions with other drugs. Patients often take several drugs in parallel for different diseases. This combination of drugs can have negative consequences. On the one hand, the therapeutic effect may be weakened or enhanced. On the other hand, the risk of side effects and serious complications increases. The instructions for the drug do not indicate the entire list of unwanted drug interactions. To rule out a dangerous combination of medications, it is better to consult a doctor.
- Wrong dose selection. Calculation of the dose required to treat a patient and the regimen of taking the drug depends on many factors. When prescribing a particular medicine, a doctor is guided by the results of a preliminary examination. Patients themselves, trying to quickly achieve a therapeutic effect, can significantly exceed the permissible dose.
- Lack of specialist supervision. Most antidepressants must be taken under the supervision of a specialist ( in hospital or at periodic consultations). This will allow you to evaluate the therapeutic effect, notice the appearance of side effects in time and more accurately calculate the required dose of the drug. Self-administration without the supervision of a specialist is fraught with delaying treatment, a high risk of side effects and the development of drug dependence.
It should be noted that antidepressants, which can be purchased at a pharmacy without a doctor's prescription, do not pose such a serious threat to the patient. However, their use without prior consultation can in some cases lead to serious consequences. For example, when taken simultaneously with some other psychoactive drugs, their effect on the body may increase, and the patient will have an overdose.
How long does antidepressant treatment last?
The duration of treatment with antidepressants is determined by the disease that caused them to be prescribed. In most cases, the drug is prescribed for several weeks, after which the doctor evaluates its effect on the body, tolerability and effectiveness. If the patient does not experience side effects and there is a tendency to improve, antidepressants may be prescribed for several months. For each individual drug, the duration of treatment may vary. As a rule, drugs of this group are taken for at least 2–3 weeks ( and more often - several months). Otherwise, it will be difficult to assess their effectiveness.The duration of treatment with antidepressants depends on the following factors:
- established diagnosis;
- the patient's condition while taking the drug ( there must be positive dynamics);
- presence of side effects;
- presence of contraindications ( chronic diseases);
- treatment conditions ( in hospital or at home);
- the possibility of regular consultations with a specialized specialist.
Does long-term use of antidepressants harm the body?
Taking antidepressants almost always involves a long course of treatment, which can be associated with some complications. The most serious of them is the development of drug dependence. It may appear when taking certain medications for several months. After completing the course of treatment, certain difficulties will arise with complete withdrawal of the drug ( withdrawal syndrome and its symptoms).Other complications are rarely associated with long-term use. As a rule, problems with the digestive, nervous or cardiovascular system occur within a few weeks after the start of treatment. They are associated with the individual sensitivity of the body to a specific drug.
How long after taking antidepressants can you drink alcohol?
In principle, there is no consensus among experts regarding the compatibility of alcohol and antidepressants. It is believed that some drugs can be combined with alcohol in small doses, but this small dose varies widely for each patient. It depends on the individual characteristics of the body, the type of alcohol and other factors. It is almost impossible to foresee them all in advance and predict exactly what effect the combination of alcohol and antidepressants will have.In general, the effect on the body of alcohol and antidepressants is almost the opposite. Despite the similar effect ( alcohol at the first stage liberates and lifts your spirits), the processes occurring in the central nervous system are very different. Pharmacological drugs have a selective effect on a specific system and, even in the presence of side effects, have a more stable and targeted effect. Alcohol affects many organs and systems. For example, inhibition of liver function leads to a deterioration in metabolism necessary for the nervous system. In addition, the circulation of water in the body is disrupted. This partly explains the appearance of insomnia after prolonged drinking.
Thus, the simultaneous use of antidepressants and alcohol will most often have negative consequences. For example, an antidepressant will not have the desired effect on enzymes, while the risk of side effects will increase. More serious consequences associated with pronounced disturbances in the functioning of the central nervous system are also possible. In severe cases, patients may quickly develop problems with heartbeat and breathing. There is also a high risk of psychosis, neuroses and other acute psycho-emotional disorders. In this regard, it is considered safest to drink alcohol a few days after finishing a course of antidepressant treatment ( The attending physician can advise you on a more precise date.). Abuse of alcoholic beverages during the course of taking the drug simply negates the benefits of taking it.
How long do antidepressants last after use?
The noticeable effect of taking most antidepressants does not occur earlier than a few weeks after the start of treatment. Sometimes this period can last several months. This delayed therapeutic effect is explained by the peculiarities of the action of these drugs. In most cases, a single dose of medication is not felt, since a sufficient concentration of the antidepressant has not yet accumulated in the blood and nerves. Over time, with proper and regular use, a “restructuring” of the nervous system occurs. From this moment the patient begins to feel an improvement in his condition. The therapeutic effect lasts throughout the entire course of treatment as long as the patient continues to take the medicine.After completing the course and stopping treatment, there may be several options:
- Full recovery. For mild depression, the right drug can lead to complete recovery in a few weeks or months. After the end of treatment, the patient no longer faces this problem and leads a normal life.
- Long-term remission. This treatment outcome is the most common. After completion of treatment, the patient’s nervous system continues to function normally for a long time. The period without depression is called remission. It can last from several months to several years. Unfortunately, many patients sooner or later ( usually due to stress or other factors) severe depression develops again, and the course of treatment has to be repeated.
- Return of depression. Unfortunately, this outcome occurs quite often. With serious mental disorders, it is, in principle, very difficult to achieve complete recovery. Severe depression may return and will require a new course of treatment to resolve it. Some patients are forced to take antidepressants for years to maintain normal conditions.
Which antidepressants do not cause addiction or withdrawal symptoms?
The development of dependence on any antidepressant is not an inevitable complication of treatment. Strong addiction to the drug occurs subject to long-term use, a certain dose and some individual predisposition of the body. In addition, when prescribing a particular drug, doctors always try to choose a treatment regimen that will minimize the risk of addiction.In general, not many antidepressants are highly addictive. At the legislative level, their distribution is limited. In other words, almost all antidepressants that are sold in pharmacies with a prescription can be addictive under certain conditions. Lighter drugs that can be purchased independently do not have this property. If they help well with depression, then the dependence may be more likely psychological, and after stopping the use the patient will not have a withdrawal syndrome.
You can check with your doctor about the risk of addiction to a particular drug. This is especially important for people who have suffered from severe addiction in the past ( drug addiction, alcoholism, etc.). Before starting antidepressants, they should always consult with psychiatrist ( sign up) or narcologist ( sign up) .
How do antidepressants affect libido?
Some antidepressants may decrease libido ( sexual attraction) and dull emotions in general. This side effect is characteristic primarily of selective serotonin reuptake inhibitors ( SSRIs). It is usually indicated in the instructions for a specific drug. The doctor also warns about the risk of such problems before prescribing the drug. In the case of long-term use of antidepressants, this effect may remain even after stopping the use of the medication itself. Some experts even identify this disorder as post-SSRI sexual disorder.The side effect of decreased libido should not stop doctors and patients if the patient really needs a course of antidepressants. The patient just needs to be informed, and if such problems arise, contact a specialist.
What can be the consequences of taking antidepressants?
In rare cases, the effects of taking antidepressants can be felt for quite a long time after the end of treatment. This is explained by the fact that during the period of taking medications, the central nervous system “rebuilt” in a certain way and “accustomed” to the regular supply of active substances from the outside.The most noticeable effects of taking antidepressants are:
- Development of drug dependence. Addiction develops gradually due to artificial stimulation or inhibition of certain parts of the nervous system. Sometimes special medical help may be required to overcome this addiction.
- Problems with certain organs and systems. Side effects of some antidepressants may be associated with the functioning of the heart, liver, kidneys, and gastrointestinal tract. After stopping treatment, some patients may experience heart palpitations, diarrhea or constipation, abdominal pain, and other symptoms. As a rule, these disorders do not last too long ( no more than 2 – 3 weeks), after which organ function returns to normal. If symptoms are severe and there is significant discomfort, it is better to seek medical help rather than wait until the problems go away on their own.
- Return of depression. Sometimes the course of treatment does not give a stable result, and the patient, after stopping taking antidepressants, soon returns to a depressed state. In this case, you should definitely contact a psychiatrist. The doctor will objectively assess the patient’s condition and find out why the treatment was not effective. Sometimes the course of treatment is extended ( with or without drug change), and sometimes they simply give the nervous system a little time to return to normal. Of course, the patient is observed by a doctor until complete recovery.
For what diseases and problems are antidepressants prescribed?
Currently, the range of use of antidepressants in medical practice is very wide. They are used not only to treat depression itself, but also for a number of other mental illnesses, syndromes and disorders. This is explained by complex disturbances in the functioning of the central nervous system that accompany many pathologies. Almost every antidepressant has its own advantages and disadvantages. A qualified specialist can combine these drugs with other medications to achieve a good therapeutic effect. The most common antidepressants ( alone or as part of complex therapy) is prescribed for the following diseases:
- depression;
- neuroses;
- panic attacks;
- schizophrenia;
- various psychoses.
Depression
Is it possible to treat depression without antidepressants?
Vegetative-vascular dystonia ( VSD)
Vegetative-vascular dystonia is not considered by many experts as a separate disease, since its manifestations can be very diverse and difficult to classify. The disease usually comes down to a nervous disorder, in which sudden changes in blood pressure, periodic pain, urination problems, sudden changes in heart rate and breathing, and severe sweating are most often observed. A sudden attack can trigger a panic attack in the patient. Currently, many neurologists recommend prescribing antidepressants to patients with similar problems as one of the main medications as part of complex therapy.The following groups of antidepressants are most effective for VSD:
- SSRIs);
- some tricyclic antidepressants;
- tetracyclic antidepressants.
Polyneuropathy
Polyneuropathy is a very serious problem in which patients' peripheral nerves are affected for one reason or another. This can be accompanied by very severe pain, sensory disturbances, and in severe cases, motor disorders ( motor function). Treatment of this disease should be comprehensive, aimed at both eliminating the cause of the disease and combating its manifestations.Some antidepressants are widely used as symptomatic treatment for diabetic polyneuropathy. In particular, amitriptyline and venlafaxine relieve pain more effectively than many traditional painkillers ( nonsteroidal anti-inflammatory drugs).
The effectiveness of antidepressants for polyneuropathy is explained by the following mechanisms:
- dulling of pain occurs at the level of the nervous system;
- the serious condition of patients with advanced diabetes mellitus is often accompanied by depressed mood and depression ( which are also relieved by antidepressants);
- eliminate the root cause ( actual nerve damage) with diabetes is almost impossible, and pain must be dealt with constantly, and antidepressants are designed for long-term use.
Neurosis
Panic attacks
Panic attacks are acute nervous disorders that can manifest in different ways. It is currently believed that cupping ( relief of acute symptoms) panic disorder can be successfully treated with antidepressants. Typically, this initial stage of treatment lasts several weeks. During the period of consolidation of the result, antidepressants are combined with other drugs and psychotherapy, and the full course of treatment can last more than a year.It should be noted that panic attacks are often combined with other mental disorders. They can arise, for example, against the background of various phobias. For full treatment, the patient must undergo a consultation with a psychiatrist and neurologist, who will rule out objective causes of the disorders and clarify the diagnosis. In some cases, antidepressants will be prescribed in combination with other medications.
In the treatment of panic attacks, the following groups of drugs are most often used:
- tricyclic antidepressants ( clomipramine, desipramine, nortriptyline, amitriptyline, etc.);
- selective serotonin reuptake inhibitors ( fluoxetine, escitalopram, etc.);
- MAO inhibitors ( monoamine oxidases) reversible and irreversible action ( pirlindole, phenelzine, etc.).
Do antidepressants help with anxiety and fear ( anti-anxiety effect)?
Many antidepressants have a complex effect on the central nervous system, and they can be used not only for the treatment of depression. Among the drugs in this group there are also those that have a pronounced anxiolytic effect ( relieve anxiety, unreasonable fear, worry). They are quite widely used for anxiety neuroses and similar pathological conditions in psychiatry.Most often, patients are prescribed the following antidepressants with anti-anxiety effect:
- maprotiline;
- azafen;
- mianserin;
- Mirtazapine.
Do antidepressants help with insomnia?
Depressive states can be accompanied by a variety of disorders in the functioning of the central nervous system. Quite often, patients have sleep disorders ( drowsiness or insomnia). In the case of insomnia, the patient's condition greatly worsens due to the depletion of the nervous system. For such conditions, antidepressants that have a sedative effect are used. Their use quickly calms the patient and gives a hypnotic effect. This effect is expressed differently in different drugs in this group.In general, antidepressants with sedative effects ( amitriptyline, imipramine, nortriptyline) are quite widely used to treat insomnia. The effect of their use appears within a few weeks after the start of treatment. However, all patients respond to treatment differently, and to achieve the best effect, it is better to select the drug and dose from a qualified specialist.
Do antidepressants help with menopause ( menopause)?
Menopause normally occurs in women between 40 and 50 years of age. It is characterized by hormonal changes in the body, as a result of which not only the menstrual cycle stops, but also a number of associated disorders and disorders arise. Many of them are associated with the emotional state in general and possible mental disorders ( in some cases). Drug assistance during this period includes a fairly wide range of drugs, including antidepressants.The use of antidepressants is possible throughout menopause. For some women, this period stretches from 3 to 10 – 15 years. To maintain a stable emotional background with the help of antidepressants, it is better to consult a specialist ( gynecologist, psychiatrist). They will help you choose the optimal dose of the drug. As a rule, in these cases, mild antidepressants are prescribed, which have fewer side effects and alleviate the symptoms that arise. Prescription of stronger drugs is necessary only in the case of the development of severe mental disorders.
Antidepressants for menopause help eliminate the following symptoms:
- sudden mood swings ( emotional lability);
- sleep disorders;
- lack of motivation;
- fatigue;
Are antidepressants prescribed for postpartum mental disorders?
Postpartum mental disorders are a relatively common problem. Changes in hormonal levels and lifestyle can cause severe stress in a woman. This is especially true for women whose pregnancy was accompanied by various complications. As a result, after childbirth, certain psycho-emotional problems may be observed for a long time ( depression, irritability, etc.). Sometimes antidepressants are prescribed to correct such disorders.For postpartum depression, antidepressants usually have a good therapeutic effect. The drug and dose are prescribed by the attending physician ( usually a psychiatrist). The main condition is the safety of the chosen medication during breastfeeding. Long courses of treatment with stronger drugs may be necessary for patients in whom pregnancy has led to an exacerbation of existing psychiatric disorders.
Is it possible to take antidepressants for weight loss?
Antidepressants as a group of pharmaceutical drugs have a wide spectrum of action on various body systems. One of the possible effects of taking these drugs is a decrease in appetite and a kind of “motivation” of a person to a more active lifestyle. In this regard, many people use antidepressants to combat excess weight. Moreover, some clinics involved in the fight against obesity include some drugs of this group in their treatment programs.It is very difficult to decide unequivocally whether it is possible to take antidepressants for weight loss. The fact is that each drug has its own characteristics, and only a qualified specialist can predict its effect on a particular patient.
- Side effects. Antidepressants have many serious side effects that can occur even if the drug is taken correctly according to the regimen prescribed by a specialist. Taking these drugs to combat obesity is dangerous, since their main task is still to affect the central nervous system. It has been noted that healthy people who do not have direct indications for taking antidepressants may experience seizures, diarrhea, heart rhythm problems, sleep problems and even suicidal tendencies.
- Availability of alternative treatment regimens. In most cases, patients can choose a safer treatment regimen to lose excess weight. Dietitians can help with this. In some cases, weight gain may be an endocrinological problem. Accordingly, the patient will need to normalize hormonal levels under the guidance of endocrinologist ( sign up) . Antidepressants are needed only for those patients who have begun to gain weight due to emotional or mental disorders.
- Possibility of reverse effect. As practice shows, treatment of obesity with antidepressants is not universal. In some patients, such treatment gives a noticeable effect only at the beginning of the course. In later stages, the patient may begin to gain weight again. To avoid this, it is better to develop a treatment regimen using several methods that complement each other, and not rely only on antidepressants.
Can antidepressants help with headaches?
Chronic headaches can be associated with a variety of diseases and disorders in the body. Sometimes they accompany depression. In these cases, the pain is partly “mental” and conventional painkillers may not be effective. Thus, to properly treat headaches, it is important to determine the cause of their occurrence.Some antidepressants have been shown to reduce or eliminate headaches that are not associated with specific structural damage. In other words, for injuries, tumors or high blood pressure, they will not have any effect. But if the patient has chronic stress or has previously identified mental disorders, antidepressants are sometimes the best solution.
Of course, you cannot take these medications on your own for any headache. In some cases, this can only make the problem worse. It is better to consult a specialist ( therapist, neurologist, etc.), who will prescribe the necessary examinations. He will also be able to recommend a drug that will be most effective in this particular case.
Can I take antidepressants after a stroke?
In principle, antidepressants are recommended after a stroke for many patients as part of complex rehabilitation therapy. Quite often, a stroke is accompanied by disability of the patient, since certain areas of the brain die or temporarily fail to cope with their functions. According to modern research, some drugs from the group of antidepressants accelerate the “adaptation” of the brain to new conditions and accelerate the return of lost skills. This group includes mainly selective serotonin reuptake inhibitors ( SSRIs) - escitalopram and cipralex. In addition, many stroke patients suffer from depression. To eliminate this problem, they may be prescribed a course of treatment with antidepressants from other groups.It should be noted that antidepressants in these cases are prescribed by the attending physician only some time after the stroke ( at a certain stage of recovery). Their immediate use in the first days or weeks may be dangerous due to possible side effects.
What to do if the prescribed remedies do not help?
Almost all drugs that are classified as antidepressants have their own characteristics of use. Even qualified specialists are not always able to select the drug that will help a particular patient the first time. As a rule, the doctor warns the patient about this possibility and negotiates with him in advance the time for a second consultation. The patient himself cannot always correctly assess the effect of using the medicine.If the patient does not feel any improvement within several weeks, you should contact the doctor who prescribed the course of treatment. Sometimes the right drug that works well for a particular patient can only be found on the second or third try. In severe cases, a combination of several drugs is possible that will enhance the therapeutic effect.
Today, depression affects not only adults, but also children and adolescents. A lot of research by specialists and a huge number of articles and books are devoted to this disease and methods of combating it. If translated from “scientific” into ordinary language, depression is a loss of strength and desire to live. Symptoms of this disease are apathy and constant anxiety and fatigue, lethargy and gloom.
Modern pharmacology offers the latest generation of antidepressants to combat this disease. How many generations of thymoleptics (also called drugs that work against depression) exist today, what do they have in common and how do they differ from each other, what is their mechanism of action? These and other questions will be discussed in the article presented to your attention.
What are antidepressants?
Thanks to which you can relieve symptoms and even prevent depressive conditions. The main mechanism of their action is aimed at adjusting the biochemical activity of the human brain. its components constantly interact with each other through special substances - neurotransmitters. According to one theory, depressive disorders occur when in the brain, for various reasons, the level of any neurotransmitter or biogenic amine: dopamine, norepinephrine or serotonin is significantly reduced. Antidepressants of the latest generation, like all previous ones, have a regulating and corrective effect on the biochemical processes of the brain by changing the concentration of one or another biogenic amine.
What are they for?
In addition to the fact that modern antidepressants help cope with the symptoms of depression, they are often used to get rid of the following problems:
- various pains of unknown origin;
- appetite or sleep disturbances;
- severe fatigue or loss of strength;
- nervousness or feelings of constant tension;
- attacks of nervousness or anxiety;
- problems concentrating or remembering.
Generations of antidepressants
Before considering how many generations of drugs against depression have been created to date, we need to remember that antidepressants were discovered only in the middle of the 20th century. Today, depending on the time of invention and the beginning of use in clinical practice, as well as on the effect of antidepressants, it is customary to distinguish four generations of these drugs.
First generation drugs
The first generation, discovered in the 50s of the last century, is represented by cyclic tricyclic thymoleptics (TCAs). These include the following drugs: Amitriptyline (an antidepressant, the very first one discovered) and its derivatives, as well as the drugs Nefazodone, Anafranil and Melipramine. These compounds block the reuptake of norepinephrine, thereby increasing its concentration. However, TCAs blocked not only norepinephrine (norepinephrine), but also all other neurotransmitters that came their way, which led to a large number of unpleasant side effects, primarily such as a sharp increase in blood pressure and an increase in heart rate. Drugs in this group are quite toxic, and the likelihood of an overdose when using them is very high, which is why they are so little used in the treatment of depressive disorders today.
In addition, the first generation includes drugs that are no longer used today and contain irreversible monoamine oxidase inhibitors (MAOIs) - Iproniazid, Tranylcypromine, Isocarboxazid. Their action is based on suppressing the activity of the nerve endings of brain neurons, resulting in an increase in the concentration of serotonin and norepinephrine.
Second generation drugs
The second generation, unlike the first, has a more selective, but also weaker effect on neurotransmitters and the neurons themselves. It includes tetracyclic irreversible (MAO-B) and reversible (MAO-A) monoamine reuptake inhibitors, represented by drugs such as Lerivon, Ludiomil, Pyrazidol and a number of others. Due to the fact that many quite serious side effects occurred when taking them, as well as due to interactions with various drugs and the unpredictability of the effects, drugs in this group are used extremely rarely. It is quite difficult to find antidepressants from the group of monoamine reuptake inhibitors in pharmacies. But in some cases they are found under other trade names. So, experts say that the drug “Lyudiomil” is the same tablets “Maprotiline”, the price, manufacturer and country are just different.
Third generation
Modern researchers have found that about 30 mediators are involved in the functioning of the brain and nervous system, but only three of them are “involved” in depression: serotonin, dopamine and norepinephrine (norepinephrine). The third generation includes selective serotonin reuptake inhibitors (SSRIs), represented by the most commonly used modern antidepressants such as Zoloft, Citalopram, Prozac, Cipralex, Paroxetine, Plizil and many others. These medications do not block all mediators, but only one - serotonin. In terms of their potency, they are inferior to first-generation drugs, but they have significantly fewer side effects than any other predecessors. All SSRI drugs are very effective and should be tolerated approximately equally by patients. However, each of us has its own individual characteristics, and it is because of them that the number and severity of side effects will vary in each specific case. Doctors say the most common side effects of taking third-generation drugs are insomnia, dizziness, nausea and anxiety.
SSRI drugs are quite expensive. Thus, for the fairly well-known and widely used drug “Citalopram”, the price in pharmacies, depending on the brand under which it is released, can vary from 870 to 2000 rubles.
Fourth generation antidepressants
These usually include drugs from the SSRI group (selective serotonin and norepinephrine reuptake inhibitors). These are the latest generation antidepressants, such as Cymbalta, Milnacipran, Remeron, Effexor, which block the uptake of both norepinephrine and serotonin. The drugs Zyban and Wellbutrin do not interact with serotonin, but retain dopamine and norepinephrine. The development of drugs belonging to this group began only in the mid-90s of the last century, and every year more and more new drugs appear.
Doctors cannot say unequivocally that this particular group contains the best antidepressant; this is basically impossible, since for the treatment of various types of depressive disorders, medications are selected individually, taking into account the health characteristics of each patient.
Popular modern thymoleptics
Knowing about the serious impact of drugs in this group on the nervous system, it is necessary to remember that all possible - both positive and negative - consequences can be predicted and mitigated only by a qualified specialist - a doctor. Taking into account all the individual characteristics and having made a diagnosis, it is the doctor who will be able to prescribe exactly those antidepressants that can best help in your particular case, with minimal side effects. If any problems arise while taking the prescribed medication, it is the attending physician who will be able to adjust or change the treatment regimen. Today, most practitioners recommend drugs from the group of selective serotonin and norepinephrine reuptake inhibitors to patients with depressive disorders, the effective effects of which have been tested in practice. Medicines such as Milnacipran, Fluxen (Fluoxetine), Duloxetine, Velaxin (Venlafaxine) are the most typical and widely used antidepressants of the latest generation. Let's consider the most popular thymoleptics in the treatment of depressive disorders.
Medicine "Flucosetine"
This drug is one of the first representatives of the SSRI group; it combines both antidepressant and stimulant effects. The medicine "Fluxen", also known as the antidepressant "Fluoxetine", helps reduce anxiety and tension, eliminates feelings of fear and improves mood. Its most effective use, according to practicing psychotherapists, is in cases of asthenic depressive disorders with apathy, as well as depression of varying severity and obsessive states. This medicine is also used in the treatment of bulimia. The antidepressant Fluoxetine was first registered in 1974 in the USA, and in the last decade it has become a top seller in the UK, only under a different trade name - Prozac. In Russia, this medicine is widely used, and many practicing doctors confirm that they prescribe it or its generics to patients for various depressive conditions.
The drug "Paroxetine"
This is the most powerful representative of the group of selective inhibitors of selective serotonin uptake, widely used in the treatment of anxiety and depression. Today there are quite a lot of medications whose active ingredient is paroxetine. This includes the Russian drug “Adepress” from Veropharm, the drug “Plizil” from the Croatian company Pliva, the Hungarian tablets “Rexetine” from and many others. Regardless of the name of the drug "Paroxetine", reviews of it from both patients and doctors are mostly positive.
The drug "Wellbutrin"
Better known as "Zyban" or "NoSmoke". The active ingredient in all three drugs is bupropion hydrochloride, which increases the amount of dopamine and norepinephrine in the brain. Medicines containing this active ingredient not only relieve symptoms of depression, but also help overcome the emotional consequences of quitting nicotine. This medication improves mood and increases performance. Reviews from those who got rid of nicotine addiction with the help of drugs such as Wellbutrin, KnowSmoke and Zyban indicate the high effectiveness of these drugs during the period of smoking cessation.
Medicine "Cymbalta"
A drug of the fourth generation of antidepressants, which is a reuptake inhibitor of norepinephrine and serotonin, simultaneously carrying out a slight uptake of dopamine. This drug, the active ingredient of which is duloxetine, has a rather high speed of action compared to other antidepressants. According to reviews from both doctors and patients, a clear antidepressant effect appears by the end of the first - beginning of the second week of use. In addition, this drug is characterized by uniform action throughout the entire time of its use. However, there is a group of patients, according to whose reviews the effect of this medicine, if it occurs, is very weak. As already mentioned, individual characteristics of the course of biochemical reactions quite often lead to the fact that one or another medication prescribed by a doctor may not have the expected result.
What is the price?
Today it is quite difficult to talk about prices for medicines. This is due to the fact that the foreign exchange market is extremely unstable, and new antidepressants for the most part come to us from foreign manufacturers, whose prices are presented in euros. That is why the table below presents the minimum and maximum prices in rubles, since it is simply impossible to average them. Some of the drugs that were received earlier are still sold at the old prices, while new ones are much more expensive.
Group | Active ingredient | Trade name | in rubles |
|
Tricyclic antidepressants | amitriptyline | "Elavel" | ||
imipramine | "Imizin" | |||
clomipramine | "Anafranil" | |||
maprotiline | "Lyudiomil" | |||
Selective serotonin reuptake inhibitors (SSRIs) | sertraline | Zoloft | ||
paroxetine | "Paxil" | |||
fluvoxamine | "Fevarin" | |||
fluoxetine | "Prozac" | |||
citalopram | "Cipramil" | |||
escitalopram | "Lenuxin" | |||
Serotonin and norepinephrine reuptake inhibitors (SSRIs) | bupropion | "Wellbutrin" | ||
venlafaxine | "Velaxin" | |||
duloxetine | "Cymbalta" | |||
If you carefully look at the table, you will notice that it does not contain second-generation drugs, namely MAOIs (monoamine reuptake inhibitors). This is not a mistake. The thing is that these antidepressants, which have a large number of unpleasant side effects and are incompatible with many drugs, are practically not used in European countries. In the USA, the medications “Isocarboxazid”, “Ugenelzin” and “Tranylcypromine” are used quite rarely, and in our country the drug “Nialamide” is used. All of the above medications are available only under the supervision of psychiatrists.
This table clearly shows that the price for “classical” tricyclic antidepressants is significantly lower than for newer drugs from the SSRI and SSRI groups. Thus, it is not possible to talk about the high availability of effective antidepressant drugs for the majority of the population. However, your doctor can help you choose a less expensive drug with similar properties, the so-called generic.
Interaction with other drugs
Antidepressants can interact with others, even those that seem absolutely safe and familiar to us. The most active in this regard are tricyclic thymoanaleptics and monoamine oxidase inhibitors, but drugs from the SSRI and SSRI groups practically do not interact with other medications. In any case, if your doctor prescribes you any medications for depression, be sure to find out whether you can combine them with the use of other medications, dietary supplements, and even teas and herbal infusions.
Strange as it may sound, many people who need to take thymoleptics for various reasons ask the question of how often they can combine taking “hot” drinks and pills for depression. The answer to this question is quite simple: if you want to risk your mental and physical health, and maybe your life, try it! The fact is that both alcohol and antidepressants have a serious effect on the central nervous system and the brain, and such double pressure can negatively affect both the “flight control center” itself, that is, the brain, and the organs and systems subordinate to it. Whether or not it is worth combining is a decision that you and only you can make.
Instead of a conclusion
You shouldn’t think and rack your brains about which antidepressants are better and more effective. If you feel that each new day is becoming more difficult to live than the previous one, that you don’t have enough strength even for the simplest and most mundane things, contact a specialist! The doctor will be able to diagnose your disease and prescribe the necessary treatment, choosing the most suitable medications for you. These may not only be antidepressants. The arsenal of today's medicine is quite extensive: various types of psychotherapy, physical activity and acupuncture, breathing practices and physiotherapeutic procedures.
In recent years, depression among people, and especially among residents of large cities, has become quite common. This is largely due to the fast pace of life, disturbed ecology, and constant stress. Some people try to cure depression with alcoholic drinks. But this approach is fundamentally wrong. The problem will not be solved in this way, but gradually becoming an alcoholic is quite possible. Depression is a disease and it must be treated with medications - antidepressants.
Mechanism of action of antidepressants
Currently, the pharmacy chain sells a wide variety of antidepressants belonging to different groups of medicinal substances. But the effect of most of them is the same and is aimed at changing the content of certain chemicals called neurotransmitters in the brain tissue. Their deficiency leads to various disorders of the psyche and central nervous activity, in particular causing the development of depression.
Antidepressants work by either increasing the levels of neurotransmitters in the brain or making brain cells more susceptible to them. All antidepressants are prescribed in fairly long courses. This is due to the fact that they do not begin to show their effect immediately. Often, the positive effect of taking the drug begins to develop only several weeks after the start of its use. In cases where the effect of antidepressants is required to appear more quickly, the doctor may prescribe them by injection.
According to reviews, antidepressants are quite effective medications. Taking them reliably eliminates such manifestations of depression as a feeling of hopelessness, loss of interest in life, apathy, sadness, anxiety and melancholy.
What to do if antidepressants don't help?
You can often hear from people that there is no point in taking these medications due to their ineffectiveness. But most often the problem is that a person purchases antidepressants at a pharmacy without a prescription, and, therefore, without consulting a doctor. In this case, the medicine may simply not be right for you or you may be taking it in the wrong dosage. Contact your doctor and he will prescribe the necessary treatment for you. In addition, do not forget that in order to correctly assess the effectiveness of antidepressant treatment, they should be taken for a long time, at least three months.
Cheap doesn't mean bad
Patients often refuse to take antidepressants due to their high cost. However, in pharmacies you can almost always buy cheaper analogs (generics) that are not inferior to the main drug in their effectiveness, quality or safety. Cheap antidepressants, according to patient reviews, act no worse than their expensive counterparts. But if you still have doubts, you can always consult your doctor about choosing a drug.
How long does antidepressant treatment last?
Doctors usually prescribe antidepressants in long courses from three months to one year. You should not refuse treatment on your own until you complete the course recommended by your doctor.
Some antidepressants not only relieve symptoms of depression, but also have a psychostimulating effect. When taking them, the patient often has problems falling asleep. But even in this case, you should not refuse further treatment with antidepressants. It is necessary to consult a doctor and ask him to change the treatment regimen. For example, your doctor may tell you to take your medications in the morning and at lunch.
Side effects of antidepressants
Taking any medications, including antidepressants, can lead to side effects. Antidepressants, according to reviews, most often cause a slight feeling of nausea, problems falling asleep and, very rarely, disturbances in the sexual sphere. As practice shows, all these side effects are observed in the first days of taking antidepressants and subsequently go away on their own, without requiring any additional treatment.
Majority 
Modern drugs for the treatment of depression practically do not react with other medications taken. But if you buy antidepressants without a prescription and take any other medications, including dietary supplements (dietary supplements), then be sure to consult with a specialist about the safety of taking them together.
Common myths about antidepressants
Many people are wary of antidepressant treatment, believing that these drugs will strip them of all human emotions and thereby turn them into soulless robots. But in reality this is not the case. According to reviews, antidepressants only eliminate feelings of fear, anxiety, and melancholy. But they have no effect on all other emotions.
Another common myth about antidepressants is that once you start treatment with these drugs, you will have to continue it for the rest of your life. In fact, antidepressants do not cause physical addiction or mental dependence. They are simply prescribed by a doctor for a long course.
Antidepressant treatment and exercise
During sports training, the human body begins to intensively produce “hormones of joy” - endorphins. They are good at reducing the severity of depression and improving mood. Therefore, regular exercise goes well with treatment with antidepressants, shortens its duration, and reduces the dosage of the drugs used.
For minor depression, instead of going to the pharmacy and buying antidepressants without a prescription, it is better to go to the pool or gym. Thus, you will not only improve your mood without the use of medications, but will also bring a lot of benefits to your body as a whole.
Ending treatment with antidepressants
If you have started a course of antidepressant therapy, never finish it on your own without the advice of a doctor. This is due to the fact that discontinuation of antidepressants should occur rather slowly and gradually. If you abruptly refuse further treatment for depression, its symptoms almost immediately return again, and often become even stronger than they were before the start of therapy. Therefore, discontinuation of antidepressants should be carried out strictly according to the scheme recommended by the attending physician.
Video from YouTube on the topic of the article:
Sooner or later, a modern person is faced with the need to purchase antidepressant drugs used in complex treatment for a depressed emotional state. Antidepressants are “called upon” to serve a person to elevate mood, create a positive emotional background, and ultimately.
When is a doctor's prescription required for antidepressants?
The dosage and daily regimen of medication is prescribed, of course, by the doctor. Only a qualified specialist will be able to assess the true state of your psyche and accurately calculate and schedule the dosage of medications. Compliance with the prescription when treating depression is one of the components of success in the fight against depression.
A prescription for purchasing antidepressant drugs is required only in the following cases:
- exacerbation of the disease;
- treatment of the most severe forms of depression;
- with an atypical form of the disease.
In this situation, the doctor prescribes monoamine oxidase inhibitors (MAOIs). These are potent antidepressant drugs that are used when other types are ineffective or have severe side effects.
The most effective in treating severe forms of depression are moclobemide, phenelzine, isocarboxazid and tranylcypromine.
Phenelzine, isocarboxazid and tranylcypromine are time-tested drugs, but have been used since the 50s of the 20th century and have many side effects. Moclobemide is a new generation medicine, with a faster effect and fewer associated negative reactions.
Mild antidepressants of a new generation. What's special?
A mild form of depression can be “corrected” with the help of drugs for which pharmacies do not require a prescription. New generation antidepressants, as a rule, do not cause as much harm to the body as drugs produced in the last century. Modern “over-the-counter” antidepressants are fundamentally different from heavy medications and drugs of the older generation.
Advantages of modern antidepressants:
- faster effect on the body and elimination of depression;
- fewer side effects;
- possibility of simultaneous use with many other medications;
- absence of significant addiction to the action of the drug.
Based on the effect the drugs have on a person’s mental state, antidepressants are distinguished between stimulating and sedative properties.
It is very important to accurately determine the nature of the disease and the subsequent correct choice of antidepressant medication (to stimulate or inhibit the central nervous system). The time and effectiveness of treatment largely depends on this.
List of mild antidepressants available without prescription (15 drugs)
Over-the-counter antidepressants are divided into different groups according to the degree and type of their effect. Let us list the main groups and the drugs included in them. Let's start the list by listing stimulant antidepressants.
1. Maprotiline
Drug name: Maprotiline.
Analogues: Ludiomil, Ladiomil, Flexyx.
Indications: endogenous, involutional, psychogenic and neurotic depression, exhaustion, somatogenic, latent, menopausal depression.
Action: reducing apathy, improving mood, relieving psychomotor retardation.
Side effects: headache, lethargy, drowsiness, hearing loss, hallucinations, tachycardia, arrhythmia, vomiting, nausea, dry mouth, urticaria, swelling, weight gain, sexual disorders, stomatitis.
Contraindications: epileptic disease, kidney disease, liver disease, pregnancy.
2. Prozac
Drug name: Prozac.
Analogues: Fluoxetine, Prodel, Profluzac, Fluval.
Indications: depression, bulimia nervosa, obsessive-compulsive disorder (obsessive thoughts and actions).
Action:
- relieves emotional overload and obsessive thoughts;
- will alleviate anorexia nervosa;
- eliminates premenstrual disorders;
- reduce anxiety and panic.
Side effects: at the beginning of treatment and when the dose is increased - anxiety, drowsiness, headache, nausea. Rarely – convulsions. Possible skin rashes, pain in muscles, joints, fever
Contraindications: hypersensitivity, pregnancy, lactation.
3. Paxil
Drug name: Paxil.
Analogues: Rexetine, Adepress, Actaparoxetine, Plizil, Paroxetine hydrochloride hemihydride, Sirestill.
Indications: depression of all types in adults and children 7-17 years old.
Action: in the first weeks of use, symptoms of depression decrease and suicidal thoughts are eliminated. Prevents relapses of depression.
Side effects: drowsiness, insomnia, loss of appetite, tachycardia, nausea, constipation, seizures, sweating.
Contraindications: hypersensitivity to paroxetine and the components of the drug. Pregnancy, lactation.
Drug name: Deprim.
Analogues: Gelarium hypericum, Doppel-Hertz Nervotonic.
Indications: chronic fatigue syndrome, depression, emotional exhaustion, decreased ability to work.
Action: increased performance, mental and physical activity, normalization of sleep.
Side effects: dry mouth, changes in the gastrointestinal tract, fatigue.
Contraindications: children under 6 years old. Individual intolerance. It should be taken with extreme caution during pregnancy and lactation.
Along with medications of chemical origin, herbal preparations can be taken to combat depression. Antidepressants of herbal etiology are herbal infusions that can be purchased at a pharmacy or prepared at home.
5. Leuzea extract
Drug name: Leuzea extract (Raponticum safflower).
Indications: as a complex therapy.
Action: general tonic effect, increased performance, improved mood, increased appetite .
Side effects: headache, irritability, increased blood pressure, allergic reaction, insomnia.
Contraindications: hypersensitivity, epilepsy, chronic sleep disorders, acute period of infectious diseases.
6. Ginseng tincture
Drug name: Ginseng tincture.
Indications: hypotension, increased fatigue, overwork.
Action: increased performance, decreased fatigue, increased blood pressure.
Side effects: insomnia, headache, diarrhea, nausea, nosebleeds.
Contraindications: hypertension, children under 16 years of age, hyperfunction of the thyroid gland.
7. Schisandra tincture
Drug name: Schisandra tincture.
Indications: hypotension, neurasthenia, depression.
Action: stimulating the central nervous system, increasing blood pressure, improving visual acuity.
Side effects: overexcitation of the central nervous and cardiovascular systems.
Contraindications: insomnia, high blood pressure, acute infectious diseases.
Let's take a closer look at the class of sedative antidepressants.
8. Azafen
Drug name: Azafen.
Indications: asthenodepressive syndrome, anxiety-depressive state, alcoholic depression, endogenous depression, exogenous depression, depressive states in chronic somatic diseases.
Action: elimination of anxiety and depression, manifestations of senile depression, smoothing out the negative state caused by long-term use of antipsychotics.
Side effects: nausea, vomiting, headache, dizziness.
Contraindications: hypersensitivity, myocardial infarction, coronary heart disease, diabetes mellitus, pregnancy, acute infectious diseases.
9. Persen
Drug name: Persen.
Indications: poor sleep, irritability, increased nervous excitability.
Action: sedative and antispasmodic effect.
Side effects: allergic reaction. With prolonged use - constipation.
Contraindications: hypersensitivity to the components of the drug, arterial hypotension. Children under 3 years old (tablets), children under 12 years old (capsules)
10. Mianserin
Drug name: Mianserin.
Indications: Depression of various origins.
Action: improved sleep, decreased nervous excitability.
Side effects: drowsiness, hypokinesia, convulsions.
Contraindications: manic syndrome, pregnancy, lactation, childhood (up to 18 years). Liver and kidney failure.
11. Amitriptyline
Drug name: Amitriptyline.
Indications: manic-depressive psychosis, bulimia nervosa, childhood enuresis.
Action: sedative effect, antidiuretic effect for bedwetting, analgesic effect.
Side effects: drowsiness, disorientation, excitability, hallucinations, fatigue, tachycardia, nausea, vomiting, weight gain.
Contraindications: epilepsy, intestinal obstruction, angle-closure glaucoma, pregnancy, breastfeeding.
12. Mirtazapine
Drug name: Mirtazapine.
Indications: depressive states, early awakening from sleep, loss of interest, anxious depression.
Action: restoring the ability to enjoy, adjusting sleep, eliminating suicidal thoughts.
Side effects: drowsiness, dizziness, unusual dreams, tachycardia, nausea, diarrhea, decreased libido, dry mouth, increased appetite.
Contraindications: hypersensitivity to the components of the drug, epilepsy, organic brain damage.
13. Novo-passit
Drug name: Novo-passit.
Indications: neurasthenia, “manager” syndrome, migraine, eczema of psychological etiology.
Action: sedative, relieving nervous excitability of the premenstrual and menopausal periods, eliminating anxiety.
Side effects: allergic reactions, dizziness, drowsiness, slight decrease in muscle tone.
Contraindications: hypersensitivity to the components of the drug, children (up to 12 years), alcoholism, epilepsy, diseases, brain injuries.
14. Hawthorn tincture
Drug name: Hawthorn tincture.
Indications: nervousness, cardiovascular diseases, menopause, high cholesterol.
Action: calming effect on the nervous system, normalization of heart activity, reduction of excitability during menopause.
Side effects: allergic reactions, itching, urticaria.
Contraindications: pregnancy, lactation period, individual intolerance, children under 12 years of age.
15. Valerian tincture
Drug name: Valerian tincture.
Indications: insomnia, migraine, hysteria, increased excitability, smooth muscle spasms.
Action: calming, antispasmodic, choleretic, normalizing effect for the gastrointestinal tract.
Side effects: decreased performance, drowsiness, depression.
Contraindications: individual intolerance.
Contraindications for over-the-counter antidepressants
Antidepressants sold without a prescription have a beneficial effect on the elimination of neurotic conditions of various etiologies. But this does not mean at all that you can take these drugs for a very long time and without negative consequences.
Many antidepressant medications that are freely available in pharmacies may have a number of contraindications.
These “prohibitions” apply to almost all antidepressants:
- individual intolerance to the components of the drug;
- pregnancy;
- breastfeeding period;
- children under 18 years of age.
It must be said that each drug with antidepressant action, along with the contraindications listed above, may also have its own, unique to this medicine.
If you are in doubt about whether or not to take antidepressants, watch a video that will enlighten you and destroy a number of myths about drugs of this kind:
Constant stressful situations and the very fast pace of modern life lead to many people becoming overly irritable, nervous, and susceptible to various types of phobias. Depressive conditions, unfortunately, have ceased to be something unique and isolated.
Nowadays, even young children are familiar with the term “depression.”
The chemical composition and clinical use of these drugs may vary. The search for new pharmacological compounds to combat depression in medical science does not stop.
The first medications to combat depression began to be prescribed to patients in the 50s of the 20th century. The drug iproniazid is at the origins of antidepressants. Currently, there are about 125 drugs with antidepressant effects in pharmacology. Be careful when choosing antidepressants!
