Side effects of antidepressants. Antidepressants: side effects, reviews When the side effects of antidepressants go away

Antidepressants are often prescribed for VSD in order to reduce its unpleasant manifestations, mainly depressive mood, anxiety and irritability.

These drugs are highly effective and have an equal number of side effects, which are especially common when the recommended dosage is violated or the drug is prescribed without authorization.

How do antidepressants work?

The effect of antidepressants on the human body is the result of the multifaceted effects of active substances, it is expressed as follows:

• increasing the concentration of serotonin in the blood and slowing down the processes of its breakdown;
• an increase in the amount of neurotransmitters such as dopamine and norepinephrine, which are responsible for a person’s positive mood;
• reduction in symptoms of anxiety;
• stimulation of the psyche (in the presence of lethargy or apathy)

There are several groups of antidepressants:

1. Tricyclic (Amitriptyline, Imipramine, Mianserin).
2. Monoamine oxidase inhibitors (Nialamide, Pirlindol, Maclobemide).
3. Selective inhibitors responsible for serotonin reuptake (Fluoxetine, Paroxetine, Sertraline).
4. Selective norepinephrine reuptake inhibitors (Maprotiline).
5. Other types (Mirtazapine, Ademethionine).

In addition to the classification indicated above, antidepressants are divided according to the types of effects they have:

• sedatives (Amitriptyline, Pipofesin);
• giving a balanced effect (Pyrazidol, Paroxetine);
• stimulants (Maclobemide, Imipramine).

Purpose of antidepressants

Each type of such drugs is responsible for performing a specific task, be it the functions of reuptake of norepinephrine or serotonin, their purpose differs according to the specific characteristics.

Tricyclics

This is the first generation of antidepressants that have proven effective in treating moderate to severe depression. Achieving a visible effect can be seen after 14-21 days of taking the medicine:

• eliminate sleep disturbances;
• calm down;
• reduce symptoms of depression;
• reduce excitement;
• eliminate the likelihood of suicide attempts.

The harm of antidepressants of this type lies in the following risks:

• arrhythmias;
• atrial fibrillation;
• sudden cardiac arrest;
• decreased blood pressure;
• the appearance of dryness of the oral mucosa;
• the occurrence of vision problems.

Drugs in this group have a stimulating effect on the nervous system, while simultaneously relieving a person of depressed mood and excessive lethargy.

The results of taking antidepressants can be:

• decrease in blood pressure numbers;
• toxic effects on the liver;
• insomnia;
• increasing anxiety.

While taking inhibitors of this group, the consumption of bananas, wine, chocolate, cheeses and smoked meats is prohibited. Otherwise, there is a high probability of getting a persistent increase in blood pressure.

Selective serotonin reuptake inhibitors

Drugs in this group have the ability to block the reuptake of the hormone serotonin without causing a sedative effect on the body. These drugs are somewhat easier to tolerate, mainly due to the lack of cardiotoxicity.

Side effects of antidepressants of this group include the following reactions:

• sexual activity disorders;
• digestive disorders;
• decreased appetite;
• sleep disorders.

Antidepressants of this group are not prescribed together with MAO inhibitors, which is fraught with increased blood pressure, seizures and coma.

Selective norepinephrine reuptake inhibitors

The antidepressant effect of these drugs is no lower than that of the tricyclic group. However, there is no pronounced inhibitory effect and cardiotoxicity.

Other types of antidepressants

Absolutely all groups of these medications have an effect on the human body. The remaining types of drugs block adrenergic receptors and increase the amount of serotonin entering the blood.

Antidepressants of this group are indicated in the presence of mild or moderate depressive conditions. These medications are quite easily tolerated without causing significant harm to the body.

Effect of antidepressants

When taking antidepressants, the benefits of which will appear if the necessary conditions for their use are observed, you should remember the possibility of addiction to such drugs.

Antidepressants help in the treatment of such pathologies:

• depressive states of varying severity;
• anxiety disorders;
• obsessive-compulsive disorders;
• pain of a chronic nature and phantom type;
• exacerbations of existing neuroses;
• eliminating hallucinations that occur due to alcohol intoxication;
• prevention of suicidal tendencies in patients in a state of severe depression.

Antidepressants or thymoanaleptics are taken for a long time. The minimum therapeutic course is 14 days.

If a patient stops taking a medication that, in his opinion, did not have an effect, without waiting for positive dynamics to occur, there is a high probability of developing adverse reactions from the body and even exacerbation of the existing condition with the occurrence of a depressive disorder of high severity.

Antidepressants have a direct effect on the central nervous system, normalizing the concentration of monoamines contained in neurons. This effect is quite strong, so dosage accuracy is very important when prescribing antidepressants.

A possible overdose of the active substance of thymoanaleptics can cause the death of the patient.

Children, even if they have symptoms of VSD, are practically not prescribed antidepressants. The immaturity of the central nervous system may be affected by the concentration of these substances, which will cause the development of mental disorders in the future.

Antidepressants are prohibited for use during pregnancy and lactation. They easily penetrate both the placental barrier and into breast milk, negatively affecting the development of the fetal nervous system and the infant’s mental state.

The main task of antidepressants is to create and maintain a balance of certain chemical elements contained in the human brain.

A wide variety of such drugs affect certain elements. The medicine prescribed by the doctor does not always give the expected effect. In this case, the patient has to try other remedies until the optimal active ingredient is selected.

As a rule, a person can feel significant changes in his condition after 14 days of taking the drug; in other cases, at least two months of its use are required. If during this period there are no visible changes in the condition, you should contact a specialist to replace the medicine.

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Antidepressants in Russia

There are several brands of antidepressants, the most common in Russia. The effectiveness of treatment with these drugs depends on the accuracy of the selected treatment and the individual reaction of each person to the active substance.

1. Prozac (Fluoxetine) is produced by the Cardiological Scientific and Educational Complex of Russia. This drug belongs to the group of serotonin reuptake inhibitors. It relieves depressive moods, has a stimulating effect on the central nervous system, improves mood, eliminates increased anxiety and tension, and unreasonable fear. Does not have a sedative effect on the body, is not toxic to the heart and blood vessels.
2. Amitriptyline is produced by ALSI Pharma CJSC. It belongs to a number of tricyclic antidepressants, has a sedative and hypnotic effect on the patient, and relieves anxiety.
3. Paroxetine (Paxil), manufactured in France. It has a pronounced anti-anxiety effect and belongs to the group of serotonin reuptake inhibitors.

In addition, the following drugs are often prescribed in Russia:

• Fevarin (made in the Netherlands);
• Sertraline (made in Italy);
• Coaxil (made in France);
• Anafranil (made in Switzerland);
• Azafen (made in Russia);
• Pyrazidol (made in Ukraine).

Self-medication with antidepressants is dangerous

According to recent studies by Canadian scientists, the widespread prescription of antidepressants to the population (even for the treatment of certain conditions of vegetative-vascular dystonia) is not scientifically justified.

The risks of adverse reactions and the body becoming accustomed to the active substances contained in such products are too great, which is why they do more harm than good.

Only a psychiatrist with sufficient qualifications can make a decision about the possibility of treatment with antidepressants. Naturally, unauthorized decision-making on the prescription of such funds is impermissible.

On your own initiative, you can only take vitamin complexes or placebo drugs, while antidepressants can cause serious damage to the nervous system.

From the point of view of American scientists, the safest are those that cause the synthesis of serotonin in the brain; they do not have a detrimental effect on neurons and contribute to the development of a minimum of adverse reactions.

Canadian scientists have confirmed that taking antidepressants increases the risk of heart attack or stroke by 14%. Moreover, even in people who have not previously had somatic diseases of the cardiovascular system.

Prevention of depression

Depression, a condition that often develops when a person has vegetative-vascular dystonia, is characterized by the following symptoms:

• depression;
• Bad mood;
• lack of interest in life;
• guilt;
• hopelessness;
• drowsiness;
• loss of strength;
• absent-mindedness;
• decreased libido;
• loss of appetite;
• arrhythmia;
• decreased performance.

Depending on the type of depressive disorder, the following characteristic symptoms of depression are distinguished:

1. Agitated disorder: overexcitement, constant hysterics, revealing negative emotions.
2. Adynamic: complete loss of strength for life, loss of mood, drowsiness, lack of will.
3. Dysphoric: constant grumbling, fear of human society, irritability, causeless anger.
4. Postpartum: decreased self-esteem, increased suspiciousness, increased tearfulness and sensitivity, self-pity.

A person in a state of depression is more susceptible to developing phobias and fears that have no basis, uncontrollable aggressive outbursts and very severe psychoses that undermine the nervous system.

There is no way to protect yourself from depression; it can happen to anyone. However, everyone can reduce the likelihood of such a condition; for this it is important to adhere to the following rules.

Preventing the onset of depression:

• drawing up and maintaining a reasonable daily routine, in which the load will be distributed extremely competently, without allowing a person to get physically tired or experience serious stress. If a person sets a plan for himself that he will stick to, it is easier for him to assess his own strengths and avoid overwork;
• Get proper rest every day. Night sleep is very important, during which serotonin is produced, which is responsible for a good mood. A well-rested person is better able to withstand stressful situations and irritants;
• Get physical activity regularly. Playing sports allows you to increase self-esteem; in addition, during training, adrenaline is released, which increases the tone of the body;
• eat right, including all necessary vitamins and elements in your daily diet. For this purpose, you should more often consume fresh fruits and vegetables, seafood, cereals, herbs and legumes. In addition to health benefits, proper nutrition helps you avoid obesity, which negatively affects overall self-esteem and can lead to the development of depressive mood;
• lead a healthy lifestyle, in which there is no place for smoking, drugs and excessive alcohol consumption;
• receive positive emotions while communicating with loved ones, playing together outdoors with children and pets.

If a person adheres to the rules of a healthy lifestyle, then depression may well bypass him. Otherwise, if VSD is aggravated by a depressive disorder, you should seek help from a psychotherapist who will prescribe antidepressants.

It is not permissible to begin self-medication using such drugs, so as not to cause serious harm to your own body.

Since 1990 TCA antidepressants are replaced with SSRI antidepressants. With relatively the same level of effectiveness, SSRIs are safer than TCAs. However, SSRIs have side effects that may affect your treatment.

Tolerability and side effects are different, but very closely related concepts. One of the main reasons for stopping treatment with antidepressants is the severity of their side effects. 43% of people with depression stop taking antidepressants due to side effects. Patients taking TCAs are more likely to discontinue treatment and experience more side effects than patients taking SSRIs.

More information about the main side effects:

Bleeding

– SSRIs are thought to influence hemostasis by affecting the uptake of serotonin by platelets. The more strongly antidepressants act on serotonin uptake, the higher the risk of bleeding. This applies to SSRIs and venlafaxine, the antidepressant with the most potent serotonergic effect of the SSRI group.

– SSRIs increase the risk of gastrointestinal bleeding.

– The risk of bleeding is increased by SSRIs, but not by TCAs.

– The risk of bleeding increases the simultaneous use of SSRIs and aspirin, SSRIs and non-steroidal anti-inflammatory drugs.

Side effects on the cardiovascular system

– SSRIs were originally introduced as a safe alternative to TCAs. Recently, there is emerging evidence that SSRIs produce cardiovascular side effects, such as prolonging the QT interval, thereby increasing the risk of ventricular arrhythmias. However, TCAs prolong the QT interval more significantly than SSRIs. Among the SSRIs, citalopram has the strongest effect on the QT interval.

– TCAs are more likely to cause cardiovascular adverse reactions than SSRIs; Mirtazapine has a very low risk of these types of side effects; SSRIs have the highest risk of increasing blood pressure; among SSRIs, venlafaxine (at a dosage of 150 mg/day) has the highest risk of increasing blood pressure; Increased blood pressure due to SSRI use is very rare.

– All antidepressants except SSRIs increase resting heart rate and reduce heart rate variability; This effect is most significant when taking TCAs.

Dry mouth

– Dry mouth is a common side effect of TCAs.

– SSRIs, SSRIs, bupropion – all of them can cause dry mouth; SSRIs increase the risk of dry mouth more than SSRIs; Fluvoxamine and vortioxetine do not increase this risk.

Disruption of the gastrointestinal tract

– Serotonin plays an important role in digestion, especially with regard to intestinal motility.

– Fluoxetine is more likely than TCAs to cause gastrointestinal disturbances; fluoxetine is more likely than other SSRIs to cause nausea, vomiting, diarrhea, weight loss, and anorexia; TCAs are less likely to cause nausea, anorexia, and weight loss than fluoxetine, but are more likely to cause constipation and weight gain.

– Venlafaxine is more likely to cause nausea and vomiting than SSRIs.

Hepatotoxicity

– The weakness of MAO and TCA antidepressants was considered to be their hepatotoxicity. Recent research confirms this idea and, in addition, shows the presence of a risk of hepatotoxicity with new antidepressants.

– The risk of hepatotoxicity is relatively higher when taking nefazadone, bupropion, duloxetine, agomelatine; the risk is relatively lower when taking citalopram, escitalopram, paroxetine, fluvoxamine.

– In the TCA group, clomipramine and amitriptyline have high hepatotoxicity.

– Agomelatine has the highest risk of hepatotoxicity.

– Milnacipran increases the risk of hepatotoxicity more significantly than duloxetine.

– SSRIs, compared with other antidepressants, do not significantly increase the risk of hepatotoxicity.

Convulsions

– Bupropion is considered the riskiest drug for seizures. But a lot depends on the dosage form. Bupropion IR (immediate release) at a dose greater than 450 mg increases the risk of seizures by 10-fold. Bupropion SR (extended release) at doses up to 300 mg increases the risk of seizures by only 0.01-0.03%. The same slight increase is observed when taking SSRIs.

– TCAs have a higher epileptogenic potential than bupropion, so antidepressants of this group are contraindicated in patients with a predisposition to seizures.

– Current research complicates the understanding of the risk of seizures. New evidence suggests that all antidepressants appear to increase the risk of seizures.

– The riskiest antidepressants: trazodone, lofepramine, venlafaxine. In the SSRI group, the greatest risk is when taking paroxetine and citalopram, the lowest when taking escitalopram and sertraline.

– According to other data, SSRIs are more dangerous than TCAs and the highest risk of seizures occurs when taking sertraline.

– Large studies, however, show that grand mal seizures occur more often in patients taking TCAs rather than SSRIs.

Suicide

– The FDA in 2004 required manufacturers of antidepressants to place a warning on their packaging about the increased risk of suicide in children and adolescents. The controversy of this rule is that the disease, which is treated with antidepressants, itself increases the risk of suicidal behavior. Limited data on the association of antidepressant use with suicide attempts still does not allow us to draw a clear conclusion.

– A relative increase in suicide risks is observed with venlafaxine, escitalopram, imipramine, duloxetine, fluoxetine and paroxetine.

Overdose safety

– Among those who commit suicide, the most common mental disorder is depression. One in four patients with depression attempts suicide. For this reason, the safety of higher doses of antidepressants is very important.

– The highest hazard index (number of deaths per thousand poisonings with antidepressants) is for amoxapine, maprotiline, and desipramine. All SSRIs and SSRIs have a lower hazard index than TCAs.

– The proportion of deaths in the total number of poisonings for SSRIs is less than for venlafaxine and mirtazapine.

Sexual dysfunction

– Sexual dysfunction in patients with depression is caused by the disease and the medications prescribed to treat it. All antidepressants that affect serotonin or norepinephrine uptake cause sexual dysfunction. There is no evidence that SSRIs and SSRIs are less effective in this area than TCAs.

– The most common causes of sexual dysfunction are citalopram, fluoxetine, paroxetine, sertraline and venlafaxine. Imipramine is the same, but weaker than the five named antidepressants.

– Bupropion has the weakest sexual side effects compared to other modern antidepressants.

Weight gain

– Previously, it was believed that SSRIs and SSRIs contributed to excess weight gain. Among the SSRIs, the riskiest in this regard is paroxetine, and among the TCAs, amitriptyline. However, on average, weight gain occurs similarly with amitriptyline, sertraline, and fluoxetine.

– SSRIs and SSRIs may be associated with weight loss. After 4 months of treatment, this effect disappears, and paroxetine begins to contribute to the gain of extra pounds.

– Amitriptyline and mirtazapine promote weight gain in short-term and long-term treatment.

– Imipramine and bupropion promote weight loss or relatively slow weight gain in short-term and long-term treatment.

– In general, the latest evidence suggests that weight gain occurs to some extent when taking all antidepressants.

Hyponatremia, sleep disturbances, sweating

– The first reports of hyponatremia due to antidepressants involved TCAs. But the risk of hyponatremia is higher with SSRIs than with TCAs.

– The highest risk in the SSRI group is citalopram and escitalopram.

– Venlafaxine has the same risk as SSRIs or higher.

– The risk of hyponatremia when taking antidepressants increases in elderly patients and in cases of concomitant use of diuretics.

– The effect of antidepressants on sleep can vary greatly. The duration of sleep may be reduced, or it may be increased.

– Venlafaxine reduces the REM sleep phase, which is why it is prescribed in the treatment of narcolepsy.

– Many TCAs have a very strong sedative effect.

– Bupropion may cause insomnia.

– Increased sweating occurs with TCAs, SSRIs, and SSRIs.

– Sweating is observed in 10% of patients taking SSRIs, venlafaxine, TCAs.

Mortality

– Antidepressants increase mortality. There is evidence that antidepressants increase the risk of death from heart attack and stroke. On the other hand, the effect on platelets may have a positive effect on cardiovascular health.

– Assessing the effect of antidepressants on the risk of death is difficult for several reasons, including because depression, at any severity, has been shown to reduce life expectancy.

A major concern with the use of MAOIs has been the risk of hypertensive crisis. To avoid it, patients had to significantly change their diet, eliminating foods containing tyramine.

The introduction of TCAs has alleviated the problem of deadly hypertensive crisis, but TCAs have increased the risks of cardio- and neurotoxicity.

SSRIs and SSRIs do not pose a risk of hypertensive crisis, but they are more often associated with bleeding and hyponatremia than TCAs.

SSRIs are better than TCAs when it comes to overdose safety. Also, TCAs are inferior in terms of tolerability and rate of premature treatment discontinuation.

Sexual dysfunction occurs more often with SSRIs than with SSRIs and more often with SSRIs than with TCAs.

Interestingly, when studies are conducted in control groups taking placebo, a remarkable pattern emerges. In safety studies of SSRIs, the control group had fewer side effects. In studies testing the safety of TCAs, there were more side effects in control groups where participants were given a placebo. Apparently, this is explained by the Golem effect - the phenomenon of a self-fulfilling prophecy. Where scientists were confident in the benefits of SSRIs, studies even at the stage of collecting data on the effect of placebo spoke in favor of SSRIs.

Source : Wang SM, Han C, Bahk WM, Lee SJ, Patkar AA, Masand PS, Pae CU. Addressing the Side Effects of Contemporary Antidepressant Drugs: A Comprehensive Review. Chonnam Med J 2018 May;54(2):101-112.

Antidepressants are medications that are active against depressive conditions. Depression is a mental disorder characterized by decreased mood, weakened motor activity, intellectual poverty, erroneous assessment of one’s “I” in the surrounding reality, and somatovegetative disorders.

The most likely cause of depression is the biochemical theory, according to which there is a decrease in the level of neurotransmitters - nutrients in the brain, as well as a decreased sensitivity of receptors to these substances.

All drugs in this group are divided into several classes, but now let’s talk about history.

History of the discovery of antidepressants

Since ancient times, humanity has approached the issue of treating depression with different theories and hypotheses. Ancient Rome was famous for its ancient Greek physician named Soranus of Ephesus, who proposed lithium salts for the treatment of mental disorders, including depression.

As scientific and medical progress progressed, some scientists resorted to a variety of substances that were used against the war against depression - from cannabis, opium and barbiturates to amphetamine. The last of them, however, was used in the treatment of apathetic and lethargic depression, which was accompanied by stupor and refusal to eat.

The first antidepressant was synthesized in the laboratories of the Geigy company in 1948. This drug became. After this, clinical studies were carried out, but they did not release it until 1954, when it was obtained. Since then, many antidepressants have been discovered, the classification of which we will talk about later.

Magic pills - their groups

All antidepressants are divided into 2 large groups:

1. Thymiretics– drugs with a stimulating effect, which are used to treat depressive conditions with signs of depression and depression.
2. Thymoleptics– drugs with sedative properties. Treatment of depression with predominantly excitatory processes.

Indiscriminate action:

Selective action:

• block serotonin uptake– Flunisan, Sertraline, ;
• block norepinephrine uptake— Maproteline, Reboxetine.

Monoamine oxidase inhibitors:

• indiscriminate(inhibit monoamine oxidase A and B) – Transamine;
• electoral(inhibit monoamine oxidase A) – Autorix.

Antidepressants of other pharmacological groups - Coaxil, Mirtazapine.

Mechanism of action of antidepressants

In short, antidepressants can correct some processes occurring in the brain. The human brain is made up of a colossal number of nerve cells called neurons. A neuron consists of a body (soma) and processes - axons and dendrites. The neurons communicate with each other through these processes.

It should be clarified that they communicate with each other by a synapse (synaptic cleft), which is located between them. Information from one neuron to another is transmitted using a biochemical substance - a mediator. At the moment, about 30 different mediators are known, but the following triad is associated with depression: serotonin, norepinephrine, dopamine. By regulating their concentration, antidepressants correct impaired brain function due to depression.

The mechanism of action differs depending on the group of antidepressants:

1. Neuronal uptake inhibitors(non-selective action) block the reuptake of mediators - serotonin and norepinephrine.
2. Neuronal serotonin uptake inhibitors: Inhibit the process of serotonin uptake, increasing its concentration in the synaptic cleft. A distinctive feature of this group is the absence of m-anticholinergic activity. There is only a slight effect on α-adrenergic receptors. For this reason, such antidepressants have virtually no side effects.
3. Neuronal norepinephrine uptake inhibitors: prevent the reuptake of norepinephrine.
4. Monoamine oxidase inhibitors: monoamine oxidase is an enzyme that destroys the structure of neurotransmitters, resulting in their inactivation. Monoamine oxidase exists in two forms: MAO-A and MAO-B. MAO-A acts on serotonin and norepinephrine, MAO-B acts on dopamine. MAO inhibitors block the action of this enzyme, thereby increasing the concentration of mediators. The drugs of choice for treating depression are often MAO-A inhibitors.

Modern classification of antidepressants

Tricyclic antidepressants

There is evidence of the effective use of antidepressants as auxiliary pharmacotherapy for early ejaculation and smoking.

Side effects

Since these antidepressants have a diverse chemical structure and mechanism of action, side effects may vary. But all antidepressants have the following common symptoms when taking them: hallucinations, agitation, insomnia, and the development of manic syndrome.

Thymoleptics cause psychomotor retardation, drowsiness and lethargy, and decreased concentration. Thymiretics can lead to psychoproductive symptoms (psychosis) and increased.

The most common side effects include:

• constipation;
• mydriasis;
• urinary retention;
• intestinal atony;
• violation of the act of swallowing;
• tachycardia;
• impairment of cognitive functions (impaired memory and learning processes).

Elderly patients may experience - disorientation, anxiety, visual hallucinations. In addition, the risk of weight gain, the development of orthostatic hypotension, and neurological disorders increases (,).

With long-term use - cardiotoxic effects (cardiac conduction disturbances, arrhythmias, ischemic disorders), decreased libido.

When taking selective inhibitors of neuronal serotonin uptake, the following reactions are possible: gastroenterological - dyspeptic syndrome: abdominal pain, dyspepsia, constipation, vomiting and nausea. Increased anxiety levels, insomnia, increased fatigue, tremors, impaired libido, loss of motivation and emotional dulling.

Selective norepinephrine reuptake inhibitors cause side effects such as insomnia, dry mouth, dizziness, constipation, bladder atony, irritability and aggressiveness.

Tranquilizers and antidepressants: what's the difference?

From this we can conclude that tranquilizers and antidepressants have different mechanisms of action and differ significantly from each other. Tranquilizers are unable to treat depressive disorders, so their prescription and use is irrational.

The power of "magic pills"

Depending on the severity of the disease and the effect of use, several groups of drugs can be distinguished.

Strong antidepressants - effectively used in the treatment of severe depression:

1. – has pronounced antidepressant and sedative properties. The onset of the therapeutic effect is observed after 2-3 weeks. Side effects: tachycardia, constipation, difficulty urinating and dry mouth.
2. Maprotiline,– similar to Imipramine.
3. Paroxetine– high antidepressant activity and anxiolytic effect. Taken once a day. The therapeutic effect develops within 1-4 weeks after the start of administration.

Mild antidepressants - prescribed in cases of moderate and mild depression:

1. Doxepin– improves mood, eliminates apathy and depression. A positive effect of therapy is observed after 2-3 weeks of taking the drug.
2. - has antidepressant, sedative and hypnotic properties.
3. Tianeptine– relieves motor retardation, improves mood, increases the overall tone of the body. Leads to the disappearance of somatic complaints caused by anxiety. Due to the presence of a balanced action, it is indicated for anxious and inhibited depression.

Herbal natural antidepressants:

1. St. John's wort– contains hepericin, which has antidepressant properties.
2. Novo-Passit– it contains valerian, hops, St. John's wort, hawthorn, lemon balm. Contributes to the disappearance, and.
3. Persen– also contains a collection of herbs: peppermint, lemon balm, and valerian. Has a sedative effect.
   Hawthorn, rose hips - have sedative properties.

Our TOP 30: the best antidepressants

We analyzed almost all antidepressants that were available for sale at the end of 2016, studied reviews and compiled a list of the 30 best drugs that have virtually no side effects, but at the same time are very effective and perform their tasks well (each to their own):

1. Agomelatine– used for episodes of major depression of various origins. The effect occurs after 2 weeks.
2. – provokes inhibition of serotonin uptake, used for depressive episodes, the effect occurs after 7-14 days.
3. Azafen– used for depressive episodes. The treatment course is at least 1.5 months.
4. Azona– increases the content of serotonin, is part of the group of strong antidepressants.
5. Aleval– prevention and treatment of depressive conditions of various etiologies.
6. Amizol– prescribed for agitation, behavioral disorders, and depressive episodes.
7. – stimulation of catecholaminergic transmission. It has adrenergic blocking and anticholinergic effects. Scope of application: depressive episodes.
8. Asentra– a specific serotonin uptake inhibitor. Indicated for the treatment of depression.
9. Aurorix– MAO-A inhibitor. Used for depression and phobias.
10. Brintellix– antagonist of serotonin receptors 3, 7, 1d, agonist of serotonin receptors 1a, correction of depressive states.
11. Valdoxan– a stimulator of melatonin receptors, to a small extent a blocker of a subgroup of serotonin receptors. Therapy.
12. Velaxin– an antidepressant of another chemical group, enhances neurotransmitter activity.
13. – used for mild depression.
14. Venlaxor– a powerful serotonin reuptake inhibitor. Weak β-blocker. Treatment of depression and anxiety disorders.
15. Heptor– in addition to antidepressant activity, it has antioxidant and hepatoprotective effects. Well tolerated.
16. Herbion Hypericum– a herbal-based drug, part of the group of natural antidepressants. Prescribed for mild depression and.
17. Deprex– an antidepressant has an antihistamine effect, used in the treatment.
18. Deprefault– a serotonin uptake inhibitor, has a weak effect on dopamine and norepinephrine. There is no stimulating or sedative effect. The effect develops 2 weeks after administration.
19. – antidepressant and sedative effects occur due to the presence of St. John's wort herb extract. Approved for use in the treatment of children.
20. Doxepin– blocker of H1 serotonin receptors. The action develops 10-14 days after the start of administration. Indications -
21. Miansan– stimulator of adrenergic transmission in the brain. Prescribed for depression of various origins.
22. Miracitol– enhances the effect of serotonin, increases its content in the synapse. In combination with monoamine oxidase inhibitors, it causes severe side effects.
23. Negrustin– an antidepressant of plant origin. Effective for mild depressive disorders.
24. Newwelong– serotonin and norepinephrine reuptake inhibitor.
25. Prodep– selectively blocks the uptake of serotonin, increasing its concentration. Does not cause a decrease in the activity of β-adrenergic receptors. Effective for depression.
26. Citalon– a high-precision serotonin uptake blocker with minimal effect on the concentration of dopamine and norepinephrine.

There's something for everyone

Antidepressants are most often not cheap, we have compiled a list of the most inexpensive of them in ascending order of price, with the cheapest drugs at the beginning and the more expensive ones at the end:

The truth is always beyond theory

To understand the whole point about modern, even the best, antidepressants, to understand what their benefits and harms are, it is also necessary to study the reviews of people who had to take them. As you can see, there is nothing good in taking them.

I tried to fight depression with antidepressants. I quit because the result was depressing. I looked for a lot of information about them, read many sites. There is contradictory information everywhere, but everywhere I read it, they write that there is nothing good about them. I myself experienced shaking, pain, and dilated pupils. I got scared and decided that I didn’t need them.

Three years ago, depression began, while I was running to clinics to see doctors, it was getting worse. There was no appetite, she lost interest in life, there was no sleep, her memory deteriorated. I visited a psychiatrist, he prescribed Stimulaton for me. I felt the effect after 3 months of taking it, I stopped thinking about the disease. I drank for about 10 months. Helped me.

Karina, 27

It is important to remember that antidepressants are not harmless drugs and you should consult your doctor before using them. He will be able to choose the right drug and its dosage.

You should monitor your mental health very carefully and contact specialized institutions in a timely manner so as not to aggravate the situation, but to get rid of the disease in time.

“The main reason for not taking medication for depression is the side effects of antidepressants.”

Nikolay Nikitenko

WITH TIME We increasingly understand that antidepressants are not just recreational drugs. And also, unfortunately, the combination of the state of depression and the drug effect, as it turned out through trial and error, causes many problems due to the specifics of the condition itself.

The response to antidepressants, like any other medication, varies from person to person: some patients do not tolerate antidepressants well, while others experience few or no side effects. Of course, the irony is that for some antidepressants beneficial, but side effects may worsen depression.

Due to the lack of evidence of the comparative advantage of one antidepressant over another, when prescribing a drug, doctors are often guided by a list of possible side effects!

The widespread use of SSRIs (selective serotonin reuptake inhibitors) is due to their apparent “safety” when used incorrectly compared to other, more toxic drugs. Some tricyclics, such as Dopamine, Amitriptyline and Imipramine, become toxic in overdose.

In addition, a connection has been established between suicide, aggressive behavior and SSRI use.

In fact, all the effects of using the drug, even the desired ones, can be regarded as side effects of taking the pill. The reason for identifying a huge number side effects when taking antidepressants lies in the lack of a complete understanding of exactly how antidepressants and depression affect the brain.

In each case, this impact is individual. Even representatives of pharmaceutical companies admit that they do not fully understand how exactly these drugs work!

The use of antidepressants is often like “shooting sparrows with a cannon,” especially for mild to moderate depression. Prolonged interference with the operation of a complex and carefully tuned system using external chemical influences will inevitably entail unpleasant side effects. One desirable side effect is a change in the mood of a person taking antidepressants.

Application of St. John's wort(hypericum) has shown the same effectiveness as the use of antidepressants, and in this case there are fewer side effects.

Common side effects of drug treatments for depression

Here are just a few of the various side effects of various antidepressants:

• Dry mouth
• Urinary retention
• Visual impairment
• Constipation
• Retardation (affects the ability to drive a car and operate various mechanisms)
• Sleep disorders
• Weight gain
• Headache
• Nausea
• Gastrointestinal irritation/diarrhea
• Abdominal pain
• Erection disorders
• Inability to achieve orgasm (occurs in both men and women)
• Disappearance of sexual desire
• Excitation
• Anxiety

Below are the side effects of each type of antidepressant.

New facts about SSRIs

General practitioners and psychiatrists often prescribe SSRIs (such as Paxil, Prozac, Luvox, Zoloft, Celexa (Citalopram)) to their patients because they are not as dangerous in case of overdose as other classes of antidepressants. Of course, this is good, because the most common method of suicide is an overdose of antidepressants intended to treat depression.

However, there are two real dangers with SSRIs, one of which recently led to a historic trial in the United States:

• Due to the pharmacokinetic and pharmacodynamic properties of SSRIs, combining them with other drugs is dangerous. For example, concomitant use of SSRIs and MAOIs can be fatal.
• Despite the relative safety of SSRIs in case of overdose, their use has been shown to cause thoughts of suicide and self-harm in the patient.

Other side effects of SSRIs

Nausea, diarrhea, headaches. Also, when using SSRIs, problems in intimate life often arise: loss of sexual desire, inability to achieve orgasm and erectile dysfunction. Serotonergic syndrome is also often associated with SSRI use.

Side effects of TCAs (tricyclic antidepressants)

The most common recorded side effects of this group of drugs are dry mouth, blurred vision, drowsiness, dizziness, tremors, sexual problems, rash, weight gain or loss.

Side effects of MAOIs (monoamine oxidase inhibitors)

Extremely rare side effects with MAOIs such as phenelzine (trade name: Nardil) and tranylcyclomine (trade name: Parnate) include liver inflammation, heart attack, stroke, and seizures.

While taking MAOIs, the patient should be careful when consuming certain smoked, fermented or salted foods, avoid drinking certain drinks and taking certain medications, because in combination with these antidepressants, their use leads to a dangerous increase in blood pressure. Less serious side effects include weight gain, constipation, dry mouth, dizziness, headaches, drowsiness or insomnia, and sexual dysfunction (problems with arousal and satisfaction).

There are fewer side effects with SSRIs and SSRIs (selective norepinephrine reuptake inhibitors) and these include nausea, nervousness, insomnia, diarrhea, rash, agitation, or sexual dysfunction (problems with arousal and satisfaction).

Bupropion generally causes fewer side effects than TCAs and MAOIs. Possible side effects include restlessness, insomnia, headaches or worsening of pre-existing migraines, tremors, dry mouth, agitation, confusion, increased heart rate, dizziness, nausea, constipation, menstrual irregularities, and rash.

Bupropion (Wellbutrin) was temporarily withdrawn from the market after the occurrence of epileptic seizures in some patients. However, studies have shown that seizures were associated with overdose (exceeding the maximum daily dose of 450 mg), a history of epilepsy or traumatic brain injury, an eating disorder, alcohol abuse, or taking other drugs that increased the risk of seizures. If you follow the instructions for use and the new, reduced dosage, the risk of developing epileptic seizures is significantly reduced.

So, if you are concerned about possible side effects of drug treatment or you would like to learn about other ways to control your condition or get rid of depression, check out the results of research in the field

Depression, known to doctors since ancient times, steals good mood, makes joy inaccessible and distorts thinking. There are enough reasons to talk about treating this condition as a disease. For depressive disorders, drugs that can “recapture” the body’s lost serotonin, or the “happiness hormone,” have a good effect. Such drugs, in comparison with other drugs, are safe in case of overdose - this is one of the reasons why doctors recommend them to their patients.

If you take several medications for depression at the same time, the consequences can be very serious - death is possible. Please note that drugs that preserve serotonin often cause suicidal feelings. There can be no unauthorized handling of such drugs; without consultation with doctors, you can make an irreparable mistake. Since taking medications for depression often causes drowsiness during the day and insomnia at night, this fact should be taken into account by anyone who spends a lot of time behind the wheel, whose work involves increased safety requirements.

For many people, the side effects of antidepressants become insurmountable obstacles to their use. Which is not surprising: who, for example, would want, while being treated for depression, to feel such unpleasant symptoms as dry mouth, weight gain, constipation, difficulty urinating, pain, and visual disturbances. In men, the side effects of antidepressants can result in symptoms similar to symptoms. You need to know about all these nuances in advance. And if the doctor, when prescribing such a medicine, does not warn you about the possible consequences of taking it, ask him about it yourself.

It is known that most often adverse events when taking medications for depression occur during the first two weeks and then disappear. The body adapts to unusual external influences. If there is an urgent need to take such medications, doctors can recommend how to cope with side effects that appear after two weeks. Another way out is to reduce the dosage of the medication or replace it with a drug that is similar in effectiveness.

To minimize the side effects of antidepressants, doctors recommend following several rules. The diet during treatment should be enriched with bran, whole grain flakes, broccoli, prunes, and apples. It is better to exclude everything spicy and fatty from the menu while taking medications. You need to eat little, but often, and before eating, a walk in the fresh air is recommended for appetite. Drinking plenty of fluids is encouraged. A sip of water, low-sugar candy, or chewing gum will help prevent a dry mouth.

To normalize sleep faster, you will have to give up coffee, cigarettes and alcohol. Plan your workouts and sports activities for the first half of the day.

You should not abruptly stop taking the medication, otherwise the depressed state may return, and the symptoms will worsen. The transition to a new drug should be gradual, and always under medical supervision.

Despite the side effects of antidepressants, there are many situations in which they cannot be avoided. But when starting treatment, you should weigh all its nuances - and, at a minimum, be prepared for them!