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Does lamictal help with anxiety


What is Lamictal (Lamotrigine): Uses, Dosage, Interactions, & Side Effects

Lamictal is a prescription medication that goes by the generic name Lamotrigine. It comes in four forms that are all taken by mouth: immediate-release oral tablets, extended-release oral tablets, chewable oral tablets, and orally disintegrating tablets.

Lamictal (Lamotrigine) belongs to a class of medications called anticonvulsants, or antiepileptic drugs (AEDs). These types of drugs work by altering electrical activity in neurons or altering chemical transmission between neurons. This decreases excitation of certain mechanisms in the brain that may lead to seizures.

For that reason, Lamictal is most commonly prescribed to treat seizures or epilepsy. However, it has also been used for long term mood disorders such as bipolar disorder, and shows promise in being effective for treating anxiety.

If you’re thinking of taking Lamictal (lamotrigine), it can be helpful to have some background information before speaking to your doctor to see if it might be right for you. Here’s everything you need to know.

Lamictal (Lamotrigine) for Depression

Lamictal is not normally prescribed for treating depression on its own. Instead, it has a distinct place in pharmacology for treating bipolar disorder. Bipolar disorder is marked by shifts in mood, usually fluctuating between symptoms of depression and symptoms of mania.

There are a number of mood stabilizing medications available, but what makes Lamictal unique is that it is the only one that lifts the depressive symptoms rather than suppressing the manic symptoms. This is because it is believed to act on serotonin reuptake. 

For that reason, it can be useful for treating those on the bipolar spectrum, as the depressive symptoms often outweigh the manic ones. Plus, Lamictal doesn’t tend to come with many of the unwanted side effects that are common among other antidepressant medications.

Lamictal (Lamotrigine) for Anxiety

The Food and Drug Administration (FDA) has approved the use of Lamictal for treating seizures and bipolar disorder. However, it has not been approved to treat anxiety disorders. If a doctor prescribes this medication for your anxiety, it is known as an “off-label” use.

There are few studies that show the efficacy of Lamictal for anxiety on its own. 

With that said, some research suggests that it works especially well for individuals who experience symptoms of anxiety as a byproduct of their bipolar disorder.

Lamictal has also been used in combination with SSRIs (selective serotonin reuptake inhibitors) for people who are resistant to other types of treatment for mixed anxiety and depression symptoms.

Lamictal (Lamotrigine) Dosage

If your doctor prescribes you lamotrigine, you’ll likely start on a low dose and gradually increase over several weeks. The typical dose falls somewhere between 25 mg and 400 mg. Oral tablets are usually taken once or twice daily with or without food.

If you miss a dose, you shouldn’t double the dose or take extra to make up for forgotten doses.

Lamictal needs to be taken for some time before you start seeing the most positive results. Treatment of bipolar disorder usually requires lifelong commitment. If you happen to miss more than three days of your medication, contact your doctor, as they may need to adjust your dose.

Always follow your prescribing physician’s dosing instructions. 

Lamictal (Lamotrigine) Side Effects

As with any medication, Lamictal can come with some side effects. Some of the most common side effects include:

  • Drowsiness
  • Dizziness
  • Headache
  • Blurred vision
  • Nausea
  • Dry mouth
  • Sore throat
  • Fever
  • Tremors
  • Symptoms of anxiety

There are also more serious side effects that can occur from taking Lamictal. One that is most noteworthy is a life-threatening skin rash, also known as Stevens-Johnson syndrome. This is a rare, but serious condition that causes a rash on the skin that spreads and blisters over time.  

If you have hives, painful sores, shortness of breath, or blisters in and around your mouth, contact an emergency service immediately.

Another rare, but serious, possible side effect of taking Lamictal is aseptic meningitis. This causes serious inflammation of the protective membrane that covers the brain and spinal cord. If you experience intense headaches, fever, chills, vomiting, stiff neck, rash, unusual sensitivity to light, or confusion, you should see an emergency healthcare provider right away.

Some reports of a serious multi-organ hypersensitivity reaction have been associated with taking Lamictal. This may lead to kidney, liver, or heart damage. If you experience enlarged lymph nodes, fever, or rash, you should contact a doctor immediately.

Also, if you suddenly stop taking Lamictal without proper guidance from a doctor, it can cause seizures. You should never stop taking this medication without first speaking to your healthcare provider.

Drug Interactions with Lamictal (Lamotrigine)

Keep in mind that everyone’s body chemistry is different. You might not have a reaction if you combine Lamictal with other medications. Talk to your doctor for a comprehensive list of possible interactions that might be more in line with your individual risk factors.

This medication can interact with other medications. Namely, taking antiseizure drugs with Lamictal can decrease the effectiveness of both medications in your body. On the other hand, Depakote (Sodium Valproate), an anticonvulsant, can increase the effects of Lamictal.

Lamictal also shouldn’t be taken with certain heart arrhythmia medications, such as Tikosyn (Dofetilide). When used together, it can increase the levels of Tikosyn and lead to irregular or fatal arrhythmias.

Finally, taking Lamictal with oral contraceptives may affect how well either medication functions. If you’re on birth control, you may want to talk to your doctor about possible alternatives to Lamictal.

In Conclusion

Lamictal (Lamotrigine) is an anticonvulsant medication that is often prescribed to help reduce seizures or epilepsy. However, it is also FDA-approved to treat bipolar disorder and has shown some effectiveness as an off-label treatment for anxiety and depression.

Lamictal has some mild side effects, but there are some serious rare side effects that are possible. One is Stevens-Johnson syndrome, a deadly skin rash. Other possible serious side effects include aseptic meningitis or organ damage.

This medication should not be taken alongside other drugs without first speaking to your doctor. Its effects can be diminished if taken with certain anticonvulsants, heart arrhythmia medications, or birth control medications.

If you’re struggling with mental health issues, YANA Mental Health can get you on the path to recovery by pairing you with a doctor who will develop a personalized treatment plan just for you. If prescribed, medication will be sent straight to your door — quickly and discreetly. YANA provides quality mental health care on your terms, at your own pace.

Sources:

Neurology : Antiepileptic medications | The Royal Children’s Hospital Melbourne

The role of lamotrigine in the management of bipolar disorder | NCBI

Treating comorbid anxiety and depression: Psychosocial and pharmacological approaches | NCBI

Lamictal (Lamotrigine) | National Alliance on Mental Illness

Stevens-Johnson syndrome – Symptoms and causes | The Mayo Clinic.

Psychiatric Uses of Lamotrigine

Lamotrigine (Brand names: Lamictal, Lamictal CD, Lamictal ODT, Lamictal XR)

Like other mood stabilizers, lamotrigine was originally developed as an anticonvulsant to treat seizures and is often used with other medications in the treatment of bipolar (manic-depressive) disorder. For the latest information on the use of lamotrigine, Psycom spoke with Joseph Goldberg, MD, Clinical Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai in New York, and co-author of Managing the Side Effects of Psychotropic Medications, 2nd Ed, a textbook published by American Psychiatric Association Publishing and Christopher Aiken, MD, the director of the Mood Treatment Center in North Carolina.

Lamotrigine is the only mood stabilizer that calms mood swings by lifting the depression rather than suppressing the mania, says Dr. Aiken. "That makes it a great choice for the bipolar spectrum, where the depressive symptoms usually outweigh the manic ones. Its greatest benefit is in prevention. It can prevent both the depressive and manic side, but its benefits are much stronger for depression and it does not treat active mania or hypomania."

Dr. Aiken adds that part of the reason patients prefer lamotrigine is that it’s generally well tolerated. "In the original research studies people reported more side effects on the placebo than on lamotrigine. That may sound impossible, but it’s likely that lamotrigine helped them feel better physically by treating their depression," explains the mood disorder expert adding that lamotrigine is also largely free of the “medicated” feelings that people dislike with mood stabilizers. "People don’t tend to feel dull, flat, or groggy on it."

In some research studies comparing a placebo to the medicine, the results were exceptional. "Lamotrigine is the only medicine we know of where patients were unable to tell they were taking the medication," he explains. "It didn’t make them feel medicated, and its benefits built up very gradually. After 2 years, people taking lamotrigine had half as many days of depression as those who did not take it."

Which conditions are treated with lamotrigine?

Although lamotrigine is not considered an antidepressant, it is used as a maintenance treatment for bipolar I disorder in patients 18 and older to help stabilize mood changes by delaying the time to occurrence of mood episodes in patients treated for acute mood episodes with standard therapy. (Bipolar I disorder is characterized by manic episodes.)¹˒²

It is considered second-line therapy. “The drug manufacturer’s original studies of lamotrigine in bipolar depression found that improvements were stronger in bipolar 1 than bipolar II disorder,” Dr. Goldberg recalls. (Bipolar II disorder is characterized by longer episodes and more frequent occurrence of major depression and hypomania.) Newer research suggests, however, that lamotrigine may be even more effective as a mood stabilizer in preventing relapses in treating bipolar II disorder. ²

There are also conditions lamotrigine treats off-label including borderline personality disorder, schizoaffective disorder, and obsessive-compulsive disorder (OCD), Dr. Aiken says.

How does lamotrigine work?

While the exact mechanism of action is not entirely understood, lamotrigine delays the time between mood changes and manic or depressive states in people with bipolar disorder by decreasing the intensity of irregular electrical activity in the brain. People with bipolar disorder are at high risk of experiencing recurrent and relapsing episodes of mood change. Maintenance treatment with lamotrigine helps reduce the risk by preventing or delaying these recurrences and relapses.

“Many clinicians think that lamotrigine helps achieve and sustain even moods over time by virtue of its antidepressant properties, rather than anti-manic (mood-stabilizing) properties,” says Dr. Goldberg. “It works with mood stabilizers like lithium and Divalproex, but it’s not interchangeable with these drugs and cannot be used in their place. ”

The efficacy of lamotrigine appears to be similar to the effects of lithium, yet is better tolerated.

Lamotrigine is used over time as a preventative medication. Clinical trials that looked at lamotrigine’s potential for treating acute (in-the-moment) episodes of mania found no difference between the medication and placebo.²

Is there a typical dose of lamotrigine?

Your doctor will initially prescribe a low dose of lamotrigine and gradually increase your dose every week or two for several weeks, until you reach an effective dose level.

“Treatment guidelines for target blood levels of lamotrigine have not been established for conditions other than epilepsy,” Dr. Goldberg points out. “In relapse prevention studies conducted by its manufacturer, however, 200 mg/day was found to be a better target dose than 50 mg/day, while higher doses (400 mg/day) did not provide greater benefit against relapse.”

The dosing regimen of lamotrigine can depend on which other medications you are taking to treat bipolar disorder, and is adjusted when you wean off and discontinue other medications. It may also depend on indication and patient age.

“Some medicines slow down the metabolism of lamotrigine (notably, Divalproex), requiring a slower rate of increase and a lower target dose,” notes Dr. Goldberg. “Others speed up its metabolism (notably, carbamazepine), requiring a faster-than-usual dose increase and a higher-than-usual target dose.”

Also, estrogen derivatives (including hormonal contraceptives) induce lamotrigine metabolism. Dosage adjustments will be necessary in most patients who start or stop taking estrogen-containing oral contraceptives while taking Lamictal.

Lamotrigine comes in several forms for treating bipolar disorder: Tablets, chewable tablets, dissolving tablets. Your doctor may tell you to take tablets once a day, twice a day or every other day.

If you miss a dose of lamotrigine, take the missed dose as soon as you remember. If it is close to the time of your next dose, however, skip the missed dose and continue with your usual schedule. Never take a double dose of lamotrigine.

How long does it take to work?

In certain cases, the antidepressant and antimanic benefits of lamotrigine are noticed pretty early on in the treatment cycle, says Dr. Aiken. "For some other patients, though, effects are seen after about a month of being on lamotrigine treatment. But there will always be others that take a bit longer to experience the positive effects."

Cost of Lamictal/Lamotrigine

When ordered in lots of 100 tablets, here is the breakdown in pricing for one tablet of the medication in the following doses (Note: pricing information generated April 2011):

  • $4.83 for 25 mg tablet

  • $5.43 for 100 mg tablet

  • $5.93 for 150 mg tablet

  • $6.67 for 200 mg tablet

Generic cost (lamotrigine) is as follows:

  • $0.3 for 25 mg tablet

  • $0.3 for 100 mg tablet

  • $0.53 for 150 mg tablet

  • $0.53 for 2000 mg tablet

Advantages of Lamotrigine

Dr. Aiken reports there are some major advantages of lamotrigine including:

  • It's effective in a majority of bipolar patients Almost two-thirds of patients who are suffering from bipolar mood disorders have responded extremely well to lamotrigine.

  • It's ideal for mixed states People who, due to mania switches during intense cycling, have not been able to rely on other antidepressants have responded well to lamotrigine when given in therapeutic doses.

  • It's good for patients who respond to nothing else Patients who fail to respond to any other mood stabilizers and lithium have shown good results when treated using lamotrigine.

  • There are minimal side effects Lamotrigine has minimal side effects that usually fade away after some time.

Who can (and cannot) take lamotrigine for bipolar disorder?

Doctors may prescribe lamotrigine to adults or adolescents who are otherwise being treated for bipolar disorder or weaning off other medications used to treat bipolar disorder. Older adults may be more sensitive to the effects of lamotrigine and prescribed lower doses. "When people respond to lamotrigine, they often say they can see things in perspective better and are less reactive under stress. They usually still have days of depression, but these tend to be shorter and less frequent," says Dr. Aiken.

Children under age 18 are at higher risk of developing a skin rash from lamotrigine if dosed too rapidly. In spite of the potential side effects, however, Dr. Goldberg points out that many studies support the use of lamotrigine for treating bipolar disorder in youth.

Definitive information about the safety of lamotrigine in pregnancy is not available, as there are no adequate studies in a pregnant woman population, but according to Dr. Goldberg, many doctors perceive it to be among the safer options when treatment benefit outweighs risk to the fetus, especially in women who are more prone to depression than mania. Like many psychotropic drugs, lamotrigine is secreted into breast milk, so women are advised to discuss with their doctors the risk and benefits of breastfeeding while taking lamotrigine.

Lamotrigine is not recommended in patients who have demonstrated hypersensitivity to the medication or any of its ingredients.

As with any medication, Dr. Goldberg adds, allergic reactions to lamotrigine can occur. Get immediate emergency help if you show any signs of an allergic reaction, such as hives, facial or throat swelling, or difficulty breathing. Notify your doctor if you develop a skin rash, especially if it occurs within your mouth or on soft body tissue such as eyelids or around nasal openings, and if it is blistering, peeling, painful, burning, or involves a fever or sore throat. Be sure to report all medications you are taking to medical staff.

Lamotrigine Side Effects

Some people who take lamotrigine may experience adverse reactions or side effects. Serious side effects that should be reported immediately to your doctor include:

  • Any skin rash, blistering or peeling of skin

  • Painful (burning) sores in or around the mouth, eyes or genitals

  • Jaundice (yellowish skin or eyes)

  • Swollen gland, fever, severe muscle pain

  • Weakness, drowsiness, confusion

  • Stiff neck, headache

  • Increased sensitivity to light

  • Mood or behavior changes, such as depression, anxiety, agitation, hostility, restlessness, mental or physical hyperactivity, suicidal thoughts

Common side effects of lamotrigine that are not emergencies but should also be reported to your doctor include:

  • Headache or dizziness

  • Blurred or double vision

  • Dry mouth

  • Gastrointestinal distress such as nausea, vomiting, diarrhea or stomach pain

  • Fever, sore throat, runny nose

  • Drowsiness or fatigue

  • Tremor

  • Insomnia

The biggest risk with lamotrigine is a rare allergic reaction called Stevens-Johnson Syndrome, which can be fatal if left untreated. First a patient may experience flu-like symptoms of fever, cough or sore throat, then a rash or skin blistering will follow.

Most rashes have occurred within two to eight weeks of initiating treatment, and is more common in the pediatric population compared to adults. The risk of rash increases with higher starting doses, higher escalating doses and use of lamotrigine in combination with valproate. Early clinical trials and follow-up research showed that the overall incidence of any skin disorders was 11% to 12% in both bipolar I and bipolar II patients treated with lamotrigine. ²

Many medications can cause this reaction, including antibiotics like Bactrim and penicillin and over-the-counter medications like Tylenol and Motrin. Some ways to try to prevent lamotrigine rash include:

  1. Dosing increases must be raised very slowly.

  2. It should be stopped if any new rash or skin changes occur while you’re starting the medication, unless the rash is clearly known to be non-drug-related. (After the first 3 months the risk of Stevens-Johnson Syndrome declines to almost zero).

  3. To avoid false-alarm rash confusion, the use of new soaps, getting a sunburn, exposure to poison ivy and starting any other new medications should be avoided during the first 3 months of starting lamotrigine.

With those steps, the risk of this severe rash is about 1 in 3,000 in adult patients; without them, it’s more like 1 in 100. "Unfortunately, there is still a high risk of non-serious, benign rashes (10% chance), so many people have to stop lamotrigine to be on the safe side," Dr. Aiken explains. "If you responded to lamotrigine but had to stop it because of a rash, it may be possible to restart at a lower dose."

Does lamotrigine interact with any medications or other substances?

Certain other drugs can affect the way lamotrigine works in your body by decreasing its effectiveness or delaying its excretion from your body. These include hormonal birth control methods, estrogen-containing contraceptives, hormone treatments, the antibiotic rifampin, seizure medications such as phenobarbital, and valproic acid, which is also used to treat bipolar disorder.

Your doctor will carefully prescribe and monitor your dosage when lamotrigine is taken with other treatments. Avoid alcohol, cannabis, and other substances that can increase dizziness or drowsiness while taking lamotrigine. To rule out dangerous side effects, discuss all other medications or mind-altering substances you consume with your doctor before taking lamotrigine.

One recent British study found that folic acid supplements can cancel out lamotrigine’s benefits (Geddes et al., 2016). "No one expected that result, as folic acid usually helps depression, and other medications, like valproate (a mood stabilizer approved for mania associated with bipolar disorder, seizures/epilepsy, and migraine headaches)," says Dr. Aiken. "More research is needed before we can fully trust this result, but until then, we recommend taking lamotrigine without any folic acid supplements, including those found in multivitamins. Once you’re doing well on lamotrigine, if you decided to add folic acid, watch out for a potential loss of benefits. "

Is it OK to suddenly stop taking lamotrigine?

It is NOT recommended to discontinue lamotrigine abruptly, as this may increase risk of seizures. Consult your doctor before stopping lamotrigine. If you do stop for more than a few days, DO NOT restart at your current dose. Call your doctor to review your dosing schedule.

  1. MedlinePlus. Lamotrigine. Last revised January 15, 2019. Available at: https://medlineplus.gov/druginfo/meds/a695007.html. Accessed October 10, 2019.
  2. Terao T, Ishida A, Kimura T, Yarita M, Hara T. Preventive effects of lamotrigine in bipolar II versus bipolar I disorder. The Journal of Clinical Psychiatry. September 1, 2017; 78(8): e1000-e1005. Available at: www.psychiatrist.com/JCP/article/Pages/2017/v78n08/16m11404.aspx. Accessed October 10, 2019/

Notes: This article was originally published January 24, 2016 and most recently updated June 8, 2022.

Lamictal customer reviews and experiences

Lamictal reviews

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Thinks bad

from 1 145 ₽

was taken as a mood regulator. was depressed with great anxiety. The drug itself is nothing at all. there was agitation in the first week of admission, then left. The drug didn't help at all. additional prepprats were prescribed. helps other drugs work, but from the very point of zero.

Thinks the product is excellent

from 2 070 ₽

I can give a positive review of this drug. Lamictal is a blackcurrant-flavored anticonvulsant tablet that is prescribed for epilepsy or bipolar disorder. Since it is rarely used in monotherapy, I have it with Cipralex. Got better. I read the instructions and reviews and was very afraid that I would have allergies, swelling or worse, but in fact there was nothing. I drank and was afraid, but everything went extremely well. There wasn’t even the smallest rash, I didn’t feel sick, I didn’t notice irritability or breakdowns either. The maximum that was - a cramp cramped my fingers on my right leg, but I had this before, it just became more frequent with pills. In short, I am satisfied with the tablets. Ask your doctor about them (prescribed), he will tell you and make a decision - it is necessary / not necessary.

Thinks the product is terrible

from 2,070 ₽

Good afternoon! This is a very allergic drug. One that had to be canceled in one go. The whole back was covered not just with hives, a small red rash, but with huge itchy spots. My ears itched so much that I thought I would tear them off. And when all this got on my face, and the anti-allergic drugs did not work, I quickly went under a dropper with Prednisolone to relieve this attack. and so it turned out that Lamictal is anticonvulsant, but leading to such allergic reactions. Honestly, it was very scary. So, maybe he helps someone, but it's definitely not me. We will talk with the epileptologist about another treatment, but I will not touch Lamictal again.

Thinks the product is excellent

from 1,145 ₽

My daughter suffers from convulsions, we have a very difficult EEG and a lot of problems. But we are moving in small steps towards a healthy life. I want to praise these anticonvulsant pills, they are prescribed to us in combination with Epix and Sabril. At first, my daughter felt nauseous and vomited, but then, when the body got used to it, everything went away. The tablets are small, but the most important plus is that they can be dissolved in water (easy, no need to crush) and get some water with a currant smell, the daughter drinks without whims. I just divide them into two halves. It is cheaper to buy 50 mg and divide by the required 25 mg. Their price is generally acceptable, especially for such efficiency. We were afraid that there would be a side effect from the central nervous system, but in general we did without it. It is better to take the drug after a prescription and under the supervision of a doctor to avoid side effects. Health to you and your children!

Thinks the product is excellent

from 1,145 ₽

Hello everyone. I take Lamictal in a maintenance dose of 50 mg, as I have been suffering from epilepsy for a long time. Therapeutic treatment was chosen for a long time, but it was worth it. There were no seizures for 6 years. The active ingredient in the drug lamotrigine. It must be carefully and under the supervision of a doctor combined with other drugs that you may be prescribed. Because with some of them you will quickly catch cramps and other troubles. So first you need to visit a doctor (the medicine, by the way, is a prescription). I was a little afraid to take Lamictal, as the instructions stated a lot of side effects. But all I had was nausea and a headache. So I can say that these pills came up to me, but only after a long and very detailed consultation with a doctor.

Thinks the product is excellent

from 1,145 ₽

These pills help to stop epilepsy attacks. But they have a number of disadvantages: the price, it is impossible for people with lactose intolerance, it is allergic and not very effective in monotherapy. We tolerate lactose, the price is not so terrible (a certain category of citizens receives the medicine for free), plus complex therapy with Depakine Chrono. Started with a small dose and increased it every 2 weeks under the supervision of a physician. It turned out without consequences and side effects. What we most feared - allergies, was. But it's just a little hives on the back. But we took it off with antihistamines. After the first iteration, all the rash has already disappeared and has not returned. So for the pills I can say that they are good. But first you need to go to the doctor and clarify everything, paint. Stay safe and take care of yourself and your children!

Fighting depression: 10 modern drugs

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Fighting depression: 10 modern drugs

Depression is an urgent problem, the number of visits to doctors is growing every year. It can be solved by contacting a psychotherapist and taking antidepressants . These are drugs that regulate the production of hormones and biochemical processes in the body. It is strictly forbidden to prescribe them to oneself, as these are complex drugs with certain restrictions, side effects effects . The doctor must authorize their appointment and control the intake. We will tell you which of them are the most effective and common in medicine, how many they have pluses and minuses.

What is meant by

depression

Doctors have known it since ancient Greece and Egypt. Hippocrates described it as melancholy - a condition that is accompanied by anxiety, despondency, insomnia, refusal of food, irritability. Most often, the cause is childhood trauma or severe, frequent stress in adulthood. There are many provoking factors: the death of a loved one, deterioration of living conditions, alcoholism, brain diseases. Such cases are referred to as psychogenic depression.

The second type is endogenous. The problem appears not from large external shocks, but because of internal causes. A person is constantly dissatisfied with himself, subjecting himself to criticism. Many patients have panic attacks , haunted by a feeling of fear, anxiety.

How long the period of depression lasts

Many people mistake ordinary periods of low mood for depression. If they do not last long and are quickly replaced by periods of recovery, then we are not talking about a depressive state. The problem is obvious when the symptoms persist for months and dramatically change a person's life. Then you need to see a doctor.

What happens to the body

The most common theory is that there is a malfunction of neurotransmitters located in the brain. These substances transmit signals from neuron to neuron and are responsible for a person's mood. Dysfunction leads to a slowdown in the rate of this transmission and a decrease in the number of neurotransmitters themselves. Serotonin, which is called the "hormone of happiness", suffers the most. For clarity, this biochemical process can be compared, for example, with a drop in blood sugar levels in diabetes mellitus.

How is

treated depression

Depression has been treated in different ways. In the ancient world - emetics and laxatives. In the Renaissance - wine and sunbathing. In the Age of Enlightenment - external stimuli, for example, insects. The 19th century brought new recipes - in particular, a solution of camphor in tartaric acid. The treatment also included the use of drugs, which are now no longer allowed for sale, and some are recognized as narcotic.

Obviously, all these drugs had no effect on increasing the amount of serotonin. And the treatment is precisely to normalize its production. This was done after creating modern antidepressants , which have a minimum of side effects, are safe for the body and are not addictive. These are drugs, the action of which is aimed specifically at balancing the disturbed balance of neurotransmitters: serotonin, norepinephrine, dopamine.

Prescription

If a healthy person takes antidepressants , there will be no effect . For a depressed patient, taking them will help:

  • improve psychological state;
  • get rid of irritability;
  • panic fear;
  • increase mental and physical activity;
  • to overcome the dreary mood.

Psychiatrists prescribe antidepressants for chronic back pain, headaches. And also with irritable bowel syndrome, incontinence and other cases when the body stops producing its own painkillers. Medication helps restore pain suppression mechanisms.

You can only take these drugs with a doctor's prescription, as many of them are strong stimulants. Self-administration may cost dearly - the condition may worsen. Only a doctor will correctly calculate how many medicines to take per day. In parallel with the treatment by a psychiatrist, a neurologist, a consultation of a psychotherapist is required.

Precautions

  • Prescribed drug start drinking from a small dose - the first couple of days they take a quarter of a tablet. Gradually increase the dose to normal. So the body adapts better. Finish the course by reducing the dose.
  • The first effect of appears only 2 weeks after the start of administration. Steady action - six months later. All this time, you need to take the remedy without making passes, breaks.

  • Products are not combined with melatonin, St. John's wort, products and dietary supplements based on sibutramine, 5-HTP. Their combination can raise serotonin to dangerous levels. Also, you can not combine them with monoamine oxidase inhibitors, for example, Cipralex. When writing a prescription, the doctor takes these points into account.

  • Drinking antidepressants is better in parallel with visits to a psychotherapist. If the drugs normalize the biochemical processes in the body, then this doctor will help normalize the psychological state after depression.

The best antidepressants

In medicine, they have long argued that some drugs give only a placebo effect. The purpose of the study was to find out which of them are the most effective and valid . The project involved 116 thousand patients, and its results were published by the authoritative edition of the Lancet. We offer a list of the best.

1. Agomelatine

New generation drug. Agomelatine is used for severe depressive disorders, high levels of anxiety. Enhances the release of dopamine and norepinephrine, stimulates melatonin receptors. The standard therapeutic dose is 25-50 mg 1 time / day. Helps to restore the normal structure of sleep, get rid of anxiety and panic attacks attacks

Pros

+ Does not adversely affect attention and memory.

+ No lethargy during the day.

+ No sexual deviations.

+ No correlation with blood pressure.

+ Do not reduce dosage upon discontinuation.

Cons

— In 1-10% of cases, increased sweating, diarrhea, constipation.

- Possible increased fatigue, drowsiness.

- There are no evidence-based safety studies for people with renal or hepatic insufficiency, therefore, such patients are advised to refrain from taking drugs with active ingredient agomelatine.

2. Amitriptyline

Tricyclic antidepressant. Moreover, the World Health Organization considers Amitriptyline the most reliable in this group. The standard dose is 200-250 mg / day. The action is to block the reuptake of neurotransmitters. A good remedy for moderate to severe disorders of the endogenous type. Additionally, it has a sedative and hypnotic effect. Effective in the treatment of neuropathic pain, for the prevention of migraine.

Pluses

+ Drugs with active ingredient amitriptyline are inexpensive.

+ High reliability, minimum side effects.

+ Relatively safe during breastfeeding.

Cons

— Possible side effect in the form of blurred vision, dry mouth.

- Lowering blood pressure.

- Some patients experience constipation.

- Drowsiness.

3. Escitalopram

It belongs to the group of modern serotonin reuptake inhibitors (SSRIs). Most often, it is recommended to take for anxiety, panic attacks. It is taken once, the standard dose is 10 mg per day. Escitalopram has a milder effect and is prescribed to patients for whom tricyclic drugs are contraindicated.

Pluses

+ A lasting effect occurs after 3 months.

+ Indicated for patients with disorders of the cardiovascular system.

+ Soft action.

Cons

- In some patients, the functions of the gastrointestinal tract are disturbed, which is most often expressed in diarrhea.

— Anxiety may increase in the first 2 weeks, therefore it is recommended to start treatment with low doses and gradually increase them.

- Contraindicated in pregnancy and lactation.

4. Mirtazapine

A drug of the tetracyclic group. Mirtazapine - good stimulant for anxious depressions, has a moderate sedative effect. The average amount is 30 mg / day, it must be consumed once. Usually it is prescribed to patients who lose interest in life, cease to experience joy, pleasure. Effective in the correction of sleep, in particular, early awakenings.

Pros

+ Earlier onset of action than SSRIs (1 week).

+ Combines well with most drugs in the general group.

+ Full effect in 4 weeks.

+ Does not affect sexual function.

Cons

- The active substance mirtazapine is contraindicated in diabetes mellitus, arterial hypotension, increased intraocular pressure.

— During the admission period, you must drive carefully and engage in potentially dangerous types of work.

- 18% of patients experience drowsiness, 15% dry mouth, 5% weight loss. Other side effects occur in 1-3% of cases.

5. Paroxetine

Belongs to the SSRI group, is used most often for severe anxiety, panic, social phobia, nightmares, stress after trauma. Paroxetine can resolve the problems of anxious depression, anxiety-phobic disorders. Take once a day at a dose of 20 mg.

Pros

+ The most powerful stimulant among SSRIs.

+ Anxiety and insomnia pass quickly.

+ Minimal side effects in the form of vomiting, diarrhea.

+ Suitable for patients with cardiovascular problems.

Cons

— Not suitable for patients with severe motor, mental inhibition.

- Reduces libido.

- Harmful to the fetus when taken during pregnancy.

6. Fluoxetine

One of the most widely used antidepressants in the SSRI group. Known as Prozac. Fluoxetine is also known as a good mood stimulant. Patients have a feeling of fear, tension, anxiety, gloomy dislike for others. Depending on the indications, the average daily dose is 20-60 mg.

Pluses

+ There is practically no effect on the work of the heart.

+ Does not cause sedation.

+ Effective for patients with motor retardation and excessive daytime sleepiness.

Cons

- May cause weight loss.

— Hypoglycemia is possible in diabetes mellitus.

- Contraindicated in severe renal impairment.

7. Fluvoxamine

Another SSRI drug. Fluvoxamine is similar to Prozac Fluoxetine but is fast acting and may cost cheaper. The effect is in a more active slowing down of the reuptake of serotonin by neurons. It is indicated for depression of various origins, as well as obsessive-compulsive disorders. The average daily dose is 100 mg.

Pros

+ Lower price than traditional Prozac.

+ Faster action than him.

+ Relatively minor side effects (diarrhea, dry mouth, drowsiness).

Cons

- Contraindicated in diabetes.

- Pregnant women - with caution, lactation - prohibited.

- Causes nausea in some patients.

8. Sertraline

One of the widely used and universal drugs of the SSRI group. They treat almost any depressive condition, panic disorder, social phobia. However, in severe clinical cases, sertraline may not be effective enough. The standard dose is 50 mg/day.

Pros

+ No cardiotoxicity.

+ The patient's psychomotor activity does not change.

+ Does not increase body weight.

+ Combines well with other groups of antidepressants.

Cons

— In the first 2 weeks there may be problems with sleep, diarrhea.

- Side effects of a sexual nature.

- Contraindicated in pregnant women.

9. Escitalopram

The drug is classified as an SSRI. Its difference is in its effectiveness in depression, which is accompanied by involuntary movements (tic, tremor, chewing, smacking). Escitalopram is prescribed to patients with panic, anxiety, phobias, obsessive thoughts or actions. The daily dose is 20 mg.

Pluses

+ Effective in tardive dyskinesia.

+ One of the most powerful SSRIs.

+ More pronounced thymoleptic effect (improvement of mood) compared to many antidepressants of the same group.

Cons

- In some patients, anxiety increases within 2 weeks after starting treatment.

- Gastrointestinal disorders, insomnia, agitation are possible.

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