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Vyvanse side effects depression


Side Effects and What to Do About Them

If you’re looking for treatment options for attention deficit hyperactivity disorder (ADHD) or binge eating disorder (BED), your doctor might suggest Vyvanse (lisdexamfetamine).

Vyvanse is a prescription medication that’s used to treat:

  • ADHD in adults and certain children
  • moderate to severe BED in adults

For both of these uses, Vyvanse is typically used as a long-term treatment. Vyvanse is taken by mouth and is available as a capsule or a chewable tablet.

For more information about Vyvanse, including details about its uses, see this in-depth article.

Like other drugs, Vyvanse can cause mild or serious side effects. Keep reading to learn more.

Some people may experience mild or serious side effects during their Vyvanse treatment.

These are just a few of the more common side effects reported by people who took Vyvanse in studies. These side effects can vary depending on which condition the drug is being used to treat.

More common side effects in people taking Vyvanse for ADHD include:

  • decreased appetite or loss of appetite
  • sleep problems*
  • dry mouth
  • diarrhea
  • weight loss
  • anxiety

More common side effects in people taking Vyvanse for binge eating disorder include:

  • dry mouth
  • decreased appetite
  • constipation
  • anxiety
  • sleep problems*

* To learn more about this side effect, see the “Side effects explained” section below.

Like most medications, taking Vyvanse may cause mild side effects. Examples of mild side effects that have been reported with Vyvanse include:

  • belly pain
  • constipation
  • decreased appetite or loss of appetite
  • diarrhea
  • dizziness
  • dry mouth
  • anxiety
  • irritability
  • feeling jittery
  • headache*
  • nausea and vomiting
  • sleep problems*
  • weight loss

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed, too. But if you have any symptoms that are ongoing or that bother you, talk with your doctor or pharmacist. And don’t stop taking Vyvanse unless your doctor recommends it.

Vyvanse may cause mild side effects other than the ones listed above. See the Vyvanse prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Vyvanse, visit MedWatch.

Although it’s uncommon, taking Vyvanse may cause serious side effects in some people.

Serious side effects that have been reported with Vyvanse include:

  • blood flow problems in your fingers and toes, including Raynaud’s phenomenon
  • heart problems, such as high blood pressure, heart attack, stroke, and in rare cases, sudden death
  • mental health conditions, such as psychosis (loss of contact with reality) or mania (periods of extreme excitement and energy)
  • serotonin syndrome (a condition caused by high serotonin levels)
  • slowed growth in children taking the drug
  • depression*
  • allergic reaction†
  • dependence and misuse,‡ which may lead to thoughts of harming yourself or others

If you develop serious side effects while taking Vyvanse, call your doctor right away. If the side effects seem life threatening or if you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.
† An allergic reaction is possible after using Vyvanse. But this side effect wasn’t reported in studies.
‡ Vyvanse has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.

SUICIDE PREVENTION

If you think someone is at immediate risk of self-harm or hurting another person:

  • Call 911 or your local emergency number.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Vyvanse typically causes the same side effects in both females* and males.* There haven’t been reports of any side effects being different in females and males.

But Vyvanse can have harmful effects if taken during pregnancy. For more information, see the “Warnings for Vyvanse” section below.

* In this article, we use the terms “female” and “male” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Although not common, taking Vyvanse can cause long-term side effects. This includes side effects that may continue even after treatment ends, or side effects that occur after taking the drug for a long time.

Long-term side effects of Vyvanse may include:

  • blood flow problems in your fingers and toes, including Raynaud’s phenomenon
  • heart problems, such as high blood pressure, stroke, or heart attack
  • mental health conditions, such as psychosis (loss of contact with reality) or mania (periods of extreme excitement and energy)
  • slowed growth in children taking the drug

If you have questions about possible long-term side effects of Vyvanse, talk with your doctor or pharmacist.

Vyvanse is used to treat attention deficit hyperactivity disorder (ADHD) in children ages 6 years and older. Children may be more likely to have certain side effects than adults.

Examples of these side effects include:

  • weight loss
  • decreased appetite
  • sleep problems*
  • irritability
  • abdominal (belly) pain

* To learn more about this side effect, see the “Side effects explained” section below.

In studies, sudden changes in emotion or mood were also reported in children ages 6 to 12 years old who took Vyvanse. Examples of these types of changes may include crying uncontrollably or laughing at inappropriate times. Emotional changes or mood changes weren’t reported in people ages 13 years and older who took Vyvanse in the studies.

Vyvanse may cause slowed growth (height and weight) in children. Your child’s doctor will closely monitor their height and weight and compare it with average growth rates for your child’s age. If they note signs of slowed growth, your child’s doctor may temporarily or permanently have your child stop taking Vyvanse.

If you have questions about Vyvanse’s side effects in children, talk with your child’s doctor or with a pharmacist.

Get answers to some frequently asked questions about Vyvanse’s side effects.

Can Vyvanse’s side effects differ depending on the strength of my dose (10 mg, 20 mg, 30 mg, 40 mg, 50 mg, 60 mg, 70 mg)?

It’s possible. For example, studies found weight loss to be more likely with higher Vyvanse doses.

These studies didn’t always compare side effects across different Vyvanse strengths, so it’s not known if other side effects may differ depending on strength.

If you experience side effects from taking Vyvanse, lowering your dose may help relieve the side effect. But you shouldn’t change your Vyvanse dose unless your doctor tells you to do so. Always take Vyvanse exactly as your doctor prescribes.

If you have other questions about how your dose may affect your risk of side effects, talk with your doctor or pharmacist.

Does Vyvanse cause anger or other emotional side effects?

Yes, Vyvanse can cause emotional side effects, including anger.

Certain emotional side effects were reported by people taking Vyvanse in studies, including:

  • anger
  • depression*
  • irritability
  • mental health conditions, such as psychosis (loss of contact with reality) or mania (periods of extreme excitement and energy)
  • mood changes

* To learn more about this side effect, see the “Side effects explained” section below.

If you’re concerned about emotional side effects with Vyvanse, talk with your doctor or pharmacist. They can discuss how to treat these side effects.

How long do Vyvanse’s side effects tend to last?

In many cases, side effects caused by Vyvanse should be temporary. And mild side effects often go away on their own or can be easily treated.

But if you have any symptoms that don’t go away or that bother you, talk with your doctor or pharmacist. They may suggest stopping your Vyvanse treatment and switching to a different drug.

Learn more about some of the side effects Vyvanse may cause.

Sleep problems

Sleep problems can occur during Vyvanse treatment. Sleep problems reported in the drug’s studies included insomnia (trouble sleeping) and nightmares. Insomnia was among Vyvanse’s more common side effects. In rare cases, people stopped taking Vyvanse due to insomnia.

In the studies, insomnia occurred more often in adults, but it was also reported in children taking Vyvanse.

It’s important to note that sleep problems can also be a symptom of serious side effects that Vyvanse may cause. Examples of these serious side effects include mental health conditions, such as mania, depression, and psychosis.

What might help

Vyvanse is a central nervous system stimulant that can keep you awake if taken later in the day. To help prevent sleep problems such as insomnia while taking Vyvanse, avoid taking your dose in the afternoon. Take Vyvanse in the morning instead.

If you have sleep problems while taking Vyvanse, talk with your doctor. They may suggest treatment for this side effect, which may include a new prescription or over-the-counter (OTC) medication. Or they may have you stop taking Vyvanse and switch to a different treatment for your condition.

Headache

Some people may experience headaches during their Vyvanse treatment. This side effect was rare in studies, but some people did stop taking Vyvanse due to headache.

What might help

Headaches from Vyvanse may go away on their own. But if you experience headaches that bother you or won’t go away, talk with your doctor or pharmacist. They may suggest treatment for this side effect, such as a new prescription or OTC drug. Or they may suggest that you stop taking Vyvanse and try a different treatment for your condition.

Depression

In some cases, depression can occur with Vyvanse use. In studies, depression was reported in people using Vyvanse, but it wasn’t common.

Symptoms of depression can include:

  • changes in appetite
  • feeling agitated or restless
  • feeling guilty or worthless
  • losing interest in activities you normally enjoy
  • sleeping too much or too little
What might help

If you notice symptoms of depression while taking Vyvanse, it’s important to talk with your doctor. They can suggest treatment options, such as prescription medications, cognitive behavioral therapy, or a combination of treatments. Your doctor may also suggest that you stop taking Vyvanse and try another treatment for your condition.

Misuse and dependence risk

Vyvanse has a boxed warning for the risk of misuse (also called abuse) and dependence. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Treatment with Vyvanse may lead to physical dependence or misuse. With dependence, your body needs a drug to feel normal. Misuse, on the other hand, means taking a drug in a way other than how your doctor prescribes. This includes taking a medication for non-medical purposes.

Misuse can lead to addiction. Some people may also develop addiction when taking Vyvanse as prescribed. With addiction, it’s difficult to stop taking a drug even though it may be causing harm.

Symptoms of Vyvanse misuse can include:

  • aggressive or hostile behavior
  • excessive sweating
  • heavy breathing
  • high blood pressure
  • sleep problems, including insomnia
  • thoughts of harming yourself or others
What might help

Before prescribing Vyvanse, your doctor will review your medical history. They’ll look for any risk factors for misuse or dependence. They’ll also monitor you for any symptoms of misuse or dependence during your treatment.

Call your doctor right away if you’re concerned about misuse or dependence while taking Vyvanse. They may lower your dose or have you switch to a different drug for your condition.

Because Vyvanse can cause dependence, it’s important that you don’t stop taking the drug unless your doctor tells you to. If you need to stop your treatment, your doctor will lower your dose over time. This can help prevent withdrawal symptoms (side effects that can happen when you stop taking a drug that your body has become dependent on).

If you have questions about stopping your Vyvanse treatment or about your risk for misuse or dependence, talk with your doctor or pharmacist.

Allergic reaction

Like most drugs, Vyvanse can cause an allergic reaction in some people. But this side effect wasn’t reported in studies. It has been reported since the drug was approved for use, though.

Symptoms can be mild or serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe
What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest an over-the-counter oral antihistamine, such as Benadryl (diphenhydramine), or a topical product, such as hydrocortisone cream, to manage your symptoms.

If your doctor confirms you had a mild allergic reaction to Vyvanse, they’ll decide if you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you had a serious allergic reaction to Vyvanse, they may have you switch to a different treatment.

Keeping track of side effects

During your Vyvanse treatment, consider keeping notes on any side effects you’re having. Then, you can share this information with your doctor. This is especially helpful to do when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of drug you were taking when you had the side effect
  • how soon after starting that dose you had the side effect
  • what your symptoms were from the side effect
  • how it affected your daily activities
  • what other medications you were also taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help your doctor learn more about how Vyvanse affects you. And your doctor can use this information to adjust your treatment plan if needed.

Before deciding to take Vyvanse, there are certain warnings to consider. See below for more details.

Boxed warning: Misuse and dependence risk

Vyvanse has a boxed warning for the risk of misuse and dependence. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Taking stimulant drugs such as Vyvanse can lead to misuse and dependence. This can occur even at recommended doses.

To learn more, see the “Side effects explained” section above.

Other warnings

Vyvanse may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Vyvanse. The list below includes factors to consider.

Blood flow problems. Vyvanse can cause blood flow problems to your fingers and toes, including a condition called Raynaud’s phenomenon. If you already have blood flow problems, taking Vyvanse may worsen your condition. Your doctor can help determine whether Vyvanse is safe for you to take.

Heart problems. In rare cases, Vyvanse can cause heart-related side effects, including heart attack, stroke, high blood pressure, or sudden death. You may have a higher risk for these side effects if you already have heart problems such as an abnormal heart rhythm or heart disease. Your doctor can help determine whether Vyvanse is safe for you to take with your heart condition.

Kidney problems. Before taking Vyvanse, tell your doctor if you have kidney problems, such as chronic kidney disease. Having kidney problems could cause the drug to build up in your body, which can raise your risk of side effects. Your doctor may need to prescribe a lower dose of the drug for you.

Mental health conditions. Vyvanse can cause certain mental health conditions, including mania, depression, and psychosis. If you or a family member have a mental health condition, you may have a higher risk for these side effects if you take Vyvanse. Your doctor can determine whether Vyvanse is safe for you. They can also advise you on symptoms to watch for if they prescribe Vyvanse for you.

Allergic reaction. If you’ve had an allergic reaction to Vyvanse or any of its ingredients, your doctor will likely not prescribe Vyvanse. Ask your doctor what other medications are better options for you.

Alcohol use and Vyvanse

There are no known interactions between alcohol and Vyvanse. But Vyvanse has a boxed warning for the risk for misuse and dependence. (For more information, see “Side effects explained” above).

If you’ve ever misused or been dependent on alcohol, your doctor may decide to prescribe a different medication other than Vyvanse. This is because you may have a higher risk for misuse or dependence with Vyvanse.

If you drink alcohol, talk with your doctor before taking Vyvanse. They can tell you how much alcohol (if any) is safe for you to drink during your treatment.

Pregnancy and breastfeeding while taking Vyvanse

There is limited data available on the use of Vyvanse during pregnancy. But taking Vyvanse while pregnant may cause harm to a fetus.

If you have questions about using Vyvanse during pregnancy, talk with your doctor. If you do take Vyvanse while pregnant, consider signing up for The National Pregnancy Registry for ADHD Medications. Pregnancy registries collect information on the safety of certain drugs when taken during pregnancy.

You should not breastfeed while taking Vyvanse. This is because the drug passes into breast milk. The drug could cause serious side effects in a breastfed child. If you have questions about using Vyvanse while breastfeeding, talk with your doctor.

If you’re looking at treatment options for attention deficit hyperactivity disorder (ADHD) or an eating disorder, your doctor may suggest Vyvanse. Like most medications, taking Vyvanse can cause side effects in some people.

If you’re considering treatment with Vyvanse, talk with your doctor. Some examples of questions you may want to ask include:

  • How do Vyvanse’s side effects compare with other medications that could treat my condition?
  • Can taking Vyvanse cause sexual side effects?
  • If I have side effects while taking Vyvanse, will taking a lower dose help?

If you’re taking Vyvanse to treat ADHD, consider subscribing to Healthline’s online newsletter. This resource offers guidance for managing your condition and provides answers to frequently asked questions.

Q:

If I need to stop taking Vyvanse, will I have withdrawal symptoms?

Anonymous

A:

If you stop your Vyvanse treatment suddenly, this could lead to withdrawal symptoms. Because your body can become dependent on Vyvanse, it’s important that you don’t stop taking the drug unless your doctor recommends it. (With dependence, your body needs a drug to feel normal.)

Withdrawal symptoms are side effects that occur when you stop taking a drug that your body has become dependent on. Examples of these symptoms include:

  • extreme fatigue (low energy)
  • depression
  • intense cravings
  • mood changes
  • chills

If you and your doctor decide to stop your treatment, your doctor will lower your dose slowly over time. This helps prevent withdrawal symptoms.

If you have questions about stopping your Vyvanse treatment, talk with your doctor.

Tanya Kerstman, PharmDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

How to manage the symptoms

Vyvanse is a medication that doctors prescribe to treat attention deficit hyperactivity disorder or binge eating disorder. It is a stimulant, which helps a person to concentrate.

Because Vyvanse is a stimulant, a person may feel depressed or fatigued when it begins to wear off. This is known as a Vyvanse crash.

A person who takes Vyvanse in the morning may experience a midday crash as the drug begins to leave their system. The crash may make a person’s symptoms challenging to manage.

In this article, we look at the symptoms of Vyvanse crash and tips on how to cope with or avoid the comedown.

Share on PinterestA Vyvanse crash can cause a person to feel irritable and fatigued.

The active ingredient in Vyvanse is an amphetamine called lisdexamfetamine dimesylate that stimulates the central nervous system. Vyvanse affects the dopamine and norepinephrine systems in the brain in the same way as Adderall, which is another ADHD medication.

A few hours after a person stops taking Vyvanse, it starts to leave their system, which leads to a chemical imbalance in the brain. Because Vyvanse is a stimulant, when the drug leaves the body, some people may feel effects that are opposite to stimulation, such as fatigue and irritability.

Because the symptoms of attention deficit hyperactivity disorder (ADHD) sometimes resolve as a person ages, a doctor may recommend that a person takes a ‘Vyvanse holiday’ to see the extent of their ADHD symptoms without the drug. This withdrawal can also result in a Vyvanse crash.

In addition to improving concentration, other effects of taking Vyvanse include faster breathing, a more rapid heart rate, increased blood pressure, and higher blood sugar levels.

When a person stops taking Vyvanse suddenly, they may experience the following symptoms:

  • a craving for Vyvanse
  • difficulty sleeping
  • fatigue
  • feelings of depression and irritability
  • mood swings
  • shakiness
  • anxiety

A person can experience sleep problems for a few days after a Vyvanse crash. They may feel exhausted but have trouble getting restful sleep.

Not all people experience a Vyvanse crash or any symptoms at all when they stop using it. As a general rule, the longer a person has used Vyvanse, or the more they have taken, the more significant their withdrawal symptoms are likely to be.

Some of the expected early symptoms associated with Vyvanse withdrawal include:

  • aches and pains
  • fatigue
  • feelings of depression
  • increased appetite
  • increased sleep needs
  • mood swings that range from anxiety to irritability to anger
  • paranoia or strange thoughts
  • strong urges to return to taking Vyvanse

Most symptoms will subside after about 7 days. However, a person may still experience lingering symptoms known as post-acute withdrawal symptoms. These include:

  • anxiety
  • continued difficulty sleeping
  • mood swings
  • poor energy levels

    Share on Pinterest Avoiding other stimulants, eating healthfully, and getting a good night’s sleep can reduce the effects of a Vyvanse crash.

    When a person knows they are going to be stopping or reducing their use of Vyvanse, they can plan to reduce the symptoms of their comedown.

    Some steps they can take include:

    • Avoid other stimulants. Refrain from using other stimulants, such as cigarettes or caffeinated drinks. These can interfere with the quality of sleep, making a person feel even more tired.
    • Eat well. Staying hydrated and getting a good range of vitamins and nutrients can have a powerful effect on a person’s overall mood.
    • Get a good night’s sleep. Make a plan for bedtime and create a good sleeping environment. A person may also wish to place a few drops of aromatherapy oils on their pillow, such as lavender or jasmine.
    • Schedule some downtime. Avoid planning too many activities or stressful situations when a crash is possible. This can help to reduce anxiety or stress.
    • Stress relief. Find some effective stress-relieving or sleep-promoting activities. These may include deep breathing, meditation, or listening to soft music.
    • Avoid depressants. Avoid using drugs that depress the nervous system, such as alcohol. These substances may further disturb a person’s sleep and extend the comedown.

    If a person is considering stopping taking Vyvanse, they should work out a plan with their doctor. Their doctor will recommend a gradual method for reducing and eventually eliminating Vyvanse. This technique allows the drug to leave a person’s system slowly, reducing the side effects of withdrawal.

    There is currently no approved medication to treat a Vyvanse crash. However, if a person is struggling to cope with severe withdrawal symptoms, they can talk to their doctor.

    A doctor may be able to prescribe temporary medications to promote sleep or reduce feelings of depression. These could include benzodiazepines, such as Xanax or Valium.

    If a person experiences depression as a result of Vyvanse withdrawal, they may benefit from interpersonal therapies, such as cognitive behavioral therapy (CBT) or talking therapies. These techniques can help a person overcome cravings caused by a Vyvanse crash and prevent Vyvanse relapse.

    Share on Pinterest A Vyvanse overdose can cause severely high blood pressure and an increased or irregular heartbeat.

    When a person is reducing their intake of Vyvanse, It is essential that they stick to the dosage the doctor has described, even if they experience symptoms of withdrawal.

    A person can overdose on Vyvanse, which can cause symptoms such as:

    • severely high blood pressure
    • increased pulse and irregular heartbeat
    • a temperature
    • agitation
    • convulsions

    A person should seek immediate medical attention if they suspect a Vyvanse overdose.

    The symptoms of a Vyvanse crash do not usually last long. If a person stays hydrated, promotes sleep, and avoids using stimulants and illicit drugs, they should recover quickly from a Vyvanse crash.

    Anyone who experiences extreme symptoms, such as drastic mood changes, should seek immediate medical attention.

    Uncontrolled or recreational use of Vyvanse is not recommended. Vyvanse is not taken consistently, which makes a person more prone to a Vyvanse crash.

    Depression

    Russian Academy of Medical Sciences
    SCIENTIFIC CENTER FOR MENTAL HEALTH









    DEPRESSION (from hope to certainty).
    (INFORMATION FOR PATIENTS AND THEIR FAMILIES)









    nine0003




    MOSCOW
    2008


    Oleichik I. V. - Candidate of Medical Sciences, Leading Researcher of the Department for the Study of Endogenous Mental Disorders and Affective States

    © 2008, Oleichik I.V.
    © 2008, NTsPZ RAMS

    The vast experience accumulated by mankind and reflected in many literary works convincingly shows that sadness (sadness, spleen) has always gone side by side with people, being one of the natural human emotions. None of us is immune from failures, illness, breakups, loss of loved ones, financial collapse. Each person can face something inevitable and inevitable, when it seems that life loses its meaning, and despair becomes boundless. However, normally, sadness, sadness and melancholy, as natural reactions to traumatic events, weaken over time and the person's condition returns to normal without special treatment. The situation is different with depressions, which are mental disorders that differ from natural physiological reactions in greater intensity, special severity of experiences and persistence of manifestations. True depression rarely goes away on its own, requiring persistent, sometimes long-term treatment. nine0003 A depressive state (from the Latin word depressio - suppression, oppression) is a disease that concerns not only an individual specific sick person, but is also a significant burden of modern society, since it is spreading more and more widely in the world, causing enormous damage to the health of the population and the state. economy. And this applies to all countries, regardless of their level of social development. Every year, at least 200 million people in the world fall ill with depression. Perhaps these figures are even higher, since most victims of depression do not seek help because they are not aware of the painfulness of their condition. Scientists have calculated that almost one in five people who have reached adulthood will experience at least one episode of depression during their lifetime. nine0003 In the most general sense, a depressive state is one of the possible forms of a person's response to the impact of stress factors. In some cases, depression can be triggered by external negative influences, for example, mental trauma, excessive educational or work overload, infection or other serious somatic disease, traumatic brain injury, changes in the hormonal background, which is especially important for the female body, regular certain medications, such as hormones, blood pressure medications, alcohol or other drug abuse. In other cases, depressive states develop as a manifestation of such mental illnesses, in which the main influence is heredity or characteristics of the nervous system (cyclothymia, dysthymia, manic-depressive psychosis, schizophrenia, etc.). If, based on the description of depressive symptoms set out later in our brochure, you realize that you have indeed developed a depressive state, do not fall into despair, do not “try to control yourself”, remember that depression is not a manifestation of weakness of will or character, on the contrary, weakening of volitional qualities is one of the main symptoms of depression. Depression is a disease like rheumatism, arthritis or hypertension, it responds well to treatment, resulting in almost always a full recovery. You should not blame yourself for the occurrence of depression, it does not indicate either your fault, or your weakness, or the possible development of a more severe mental pathology. Below we will tell you about the symptoms of depression, which can be extremely diverse. nine0018

    Manifestations of depression

    Manifestations of depression can be very different. Depressive states can be manifested by a violation of almost all aspects of mental life: mood, memory, will, activity, which is expressed in the appearance of sadness, sadness, mental and muscle retardation, lasting at least 2 weeks. Depressed mood during depression can manifest itself as mild sadness, sadness, and boundless despair. Often it is accompanied by a feeling of melancholy, unbearable heaviness in the soul, with excruciating pain behind the sternum, a feeling of hopelessness, deep depression, hopelessness, helplessness, despair and uncertainty. At the same time, the patient is completely immersed in his gloomy experiences, and external events, even the most joyful ones, do not affect him, do not affect his mood, and sometimes even worsen the latter. A constant "companion" of a depressive mood is also anxiety of varying severity: from mild anxiety or tension to violent excitement, riot. Anxiety and bad mood arise at the mere thought of the need to make some kind of decision or change your plans due to suddenly changed circumstances. Anxiety can also manifest itself on the physical (bodily) level in the form of belching, intestinal cramps, loose stools, frequent urination, shortness of breath, palpitations, headaches, increased sweating, etc.
    The picture of depression is complemented by the disappearance of desires, interests, a pessimistic assessment of everything around, ideas of one's own low value and self-blame. Deficiency of vital impulses is manifested in patients with a variety of symptoms - from lethargy, physical weakness to a state of weakness, loss of energy and complete impotence. Where an important decision is required, a choice between different options, human activity is sharply hampered. Depressed people are well aware of this: they complain that insignificant everyday tasks, small issues that used to be solved almost automatically, take on the significance of complex, painful, insoluble problems. At the same time, a person feels that he began to think, act and speak slowly, notes the suppression of instincts (including food and sexual instincts), the suppression or loss of the instinct of self-preservation and the lack of the ability to enjoy life up to complete indifference to what used to be liked evoked positive emotions. nine0003 People suffering from depression often feel "stupid", "mentally retarded", "feeble-minded". Thinking in depression becomes viscous, painful, requires special efforts, one mental image is hardly forced out by the next. The sick person is oppressed by the feeling of his own intellectual insolvency, professional collapse. Depressed patients can hardly describe their painful experiences to the doctor. Only after getting out of depression, many of them say that the mood at that moment was lowered, thinking was slow, all undertakings (including treatment) seemed in vain, and the years lived were empty and useless. However, at the time of the first visit to the doctor, they could not explain this because of the almost complete absence of thoughts in their heads, “para-lich of thinking”. With depression, there are also often complaints of memory loss, which is why those suffering from it assume that they have "Alzheimer's disease", "schizophrenia", "senile dementia", which is not true. Especially often these complaints are found in depressions that develop in adolescence. nine0003 Typical story
    Aleksey, 18 years old, 1st year student of a technical university, describes his condition during depression as follows:
    “From childhood, I was fond of technology and modeling, I could read special literature for hours, won school and regional olympiads in mathematics and physics. After graduating from school, my dream came true - I brilliantly passed the exams to a prestigious university. Then it seemed to me that the whole world was at my feet, I flew with happiness "as if on wings." In September, I happily began to study. At the beginning, everything worked out well, but after 2 months I began to notice that it was becoming increasingly difficult for me to absorb what I read, I did not remember the simplest text, I could not solve problems that I used to “click like nuts”. Trying to achieve success through many hours of brainstorming or drinking a few cups of coffee led to the fact that I completely stopped thinking about anything. It seemed to me that I was "finally and irreversibly stupid." At night I sobbed, wrapped in a blanket and thought about how best to commit suicide. Luckily, I met a senior in the library and shared my problems with him. My new acquaintance said that he experienced something similar and advised me to contact the psychiatrist of the student clinic. After the examination, I was diagnosed with juvenile depression and sent for treatment to a specialized medical center. After 2 months, I felt completely healthy, returned to my studies and caught up with my classmates. nine0018

    Depression can also be accompanied by real setbacks: for example, a decrease in academic performance, the quality of work, family conflicts, sexual disorders and their consequences for personal relationships. As a rule, the significance of these failures is exaggerated and as a result there is a false sense of the irreparability of what happened, "the collapse of all hopes."
    Another generally recognized danger of depression is the possibility of suicidal thoughts, which often lead to suicide attempts. The condition of a person suffering from depression can suddenly deteriorate sharply, which happens either without clear external causes, or under the influence of traumatic situations, unpleasant news. It is during these hours, and sometimes even minutes, that a fatal decision is made. Factors that increase the risk of suicide in depression are past suicide attempts, the severity and duration of the depressive state, the presence of anxiety in its structure, prolonged insomnia, loneliness or alienation in the family, alcohol and drug abuse, loss of work and a sharp change in lifestyle, as well as relatives commit suicide. nine0003 Typical story
    Eugene E., 35 years old, leading manager of the company.
    Almost all my life, my career went “on the ascending”, the goals set were clear, clear and achievable. The marriage was extremely harmonious, two beloved children grew up. He devoted almost all the time to the affairs of the company, occasionally, once every 1-2 months, he escaped with his family out of town, to the country. He often lacked sleep, stayed late at work, took home assignments, and was deeply worried about the affairs of the company. Gradually, irritability, fatigue, insomnia, difficulty concentrating appeared, more and more often he suffered a “fiasco” in intimate life. Thoughts appeared that life was lived in vain, that it is a "chain of tragic mistakes" that led to a dead end. He began to believe that the choice of work, friends, family was wrong, for which now "retribution has come." Analyzing the past years for a long time, he found more and more evidence and examples of his "duplicity, hypocrisy, insincerity, etc. " I realized that the only way to solve all problems is to voluntarily leave this life. At the same time, he believed that by this act he would free the family from the “burden”, “loser”, “loser”. I decided, having locked myself in the garage, to get poisoned by the exhaust gases of the car. However, by chance, in a semi-conscious state, he was discovered by an employee of a garage cooperative. He explained what happened as an "accident". The thought of leaving life did not leave the patient. I decided to shoot myself with a gas pistol, which I had long ago acquired for self-defense. After a shot in the mouth, in a serious condition, he was taken to the Research Institute. Sklifasovsky, from where he was discharged a week later. The alarmed wife, suspecting something was wrong, decided to consult her husband with a psychiatrist. He was admitted to the clinic. He agreed to this only out of respect for family relations, he himself believed that treatment by psychiatrists was completely useless, because. his situation is hopeless and no medicines will help here, but will only "stupefy" his psyche. However, after two weeks of taking a modern antidepressant, the patient's point of view changed. Everything began to look not so bleak and hopeless, interest in work and life in general returned, I began to feel more cheerful, more energetic, interest in intimate life appeared. He took work to the clinic, called up colleagues. After two months of treatment, he fully returned to his usual life. With bewilderment, he recalled his thoughts about insolvency, the collapse of life, suicide. He took the drug prophylactically for about six months, then, on the recommendation of a doctor, he gradually reduced the dose and stopped taking it. Over the next two years, the condition remained stable, career growth continued, another child was born. nine0018

    Depression is also characterized by sleep disturbances, occurring in approximately 80% of patients. As a rule, these are early awakenings with the inability to fall asleep, lack of a sense of sleep, difficulty falling asleep. These disorders, as well as restless sleep with unpleasant dreams, are often the very first symptoms of incipient depression.
    If the depression is not deep, it is sometimes difficult to recognize it. This is due to the fact that people are ashamed to tell others about their problems, to admit to "weaknesses". Quite often, especially in Russia, depressive states are masked by alcohol abuse (“vodka heals”). In addition, often patients suffering from depression, in order to "shake themselves up", "throw into all serious", engage in casual sex, are fond of gambling or extreme sports, leave to serve on a contract in "hot spots", lead an idle lifestyle with constant attendance at entertainment events. Surrounding people, relatives who do not have psychiatric knowledge, often accuse them of debauchery, drunkenness, riotous lifestyle, parasitism. Meanwhile, this behavior is a kind of “cry for help”, an attempt to fill the spiritual emptiness brought by depression with new acquaintances and impressions. nine0003 Depressive conditions can occur in shallow forms that are easily treatable, but at least a third of depressions are more severe. Such depressions are characterized by:
    - ideas of guilt, sometimes reaching the degree of delirium, i.e. unshakable conviction in their sinfulness, low value (patients consider themselves great sinners, believe that because of them all relatives and Mankind will die, that they are “moral freaks” from birth, supposedly deprived of the foundations of morality and a sense of empathy for other people that they have no place on earth They find in their past numerous "confirmations" of what has been said above, they believe that the doctor and other patients are aware of these transgressions and express contempt and indignation with their facial expressions and gestures, but in the words “they hide, deny the obvious.” Both the patients themselves and their relatives must remember this in order to prevent the impending threat in time: remove all firearms, piercing and cutting objects, ropes, potent drugs and poisonous close household fluids, close windows or shutters, do not let the patient go anywhere alone. If these ideas become persistent and cannot be dissuaded, it is urgent to seek advice from a psychiatrist. neurological institution or call a psychiatrist at home. nine0003 - mood swings during the day: in typical cases, the patient, waking up, immediately feels longing. Sometimes, even before full awakening, through a dream he experiences a painful premonition of a heavy coming morning. In the evening, the state of health improves somewhat.
    - the patient may experience a feeling of unmotivated hostility towards relatives, friends, constant internal discontent and irritation, which makes him unbearable for the family.
    - in a number of people suffering from depression, constant doubts, fear for the health and well-being of loved ones, obsessive ones, come to the fore. arising against the will, ideas about the misfortunes and troubles of family members. nine0018

    Typical story
    Dmitry Petrovich, 58 years old, teacher.
    “After minor troubles at work, I began to feel incomprehensible anxiety and agitation. Unpleasant thoughts came into my head that I did something wrong at work, because of which I double-checked everything many times and went home later than everyone else. But even at home, the anxiety did not let go: as soon as the daughter or wife lingered for at least half an hour, terrible pictures of traffic accidents or violence were drawn in the imagination. I fell asleep only in the morning, got up broken and felt sleepy all day. I took Valerian, Corvalol, but it practically did not help. At work, they hinted whether I should take a vacation. Friends advised me to consult a neuropathologist, but he did not find his pathology and sent me to a psychiatrist. I was diagnosed with anxiety depression. After a course of outpatient treatment, I completely recovered.” nine0018

    - in many cases, depression is characterized by unpleasant sensations in the body, disturbances in the activity of internal organs in the absence of objective signs of true somatic, i.e. non-mental illness. At the same time, many patients constantly report pain, internal discomfort. Some complain of headaches, pains in the stomach, joints, lower back, others - of disorders in the intestines: constipation, indigestion, irritation of the colon, others pay attention to a decrease in sexual desire and potency. In women, menstruation often becomes painful and irregular. Approximately 50% of depressed people at the doctor's office complain of such physical ailments, without mentioning the depressed mood or state of mind underlying the depression. Experiencing chronic pain or other unpleasant sensations in the body, patients may not realize that they are suffering from depression, even with severe melancholy, considering the latter a reaction to painful bodily discomfort. nine0003 - some patients are convinced that they have some rare and difficult to diagnose disease and insist on numerous examinations in general medical institutions. Doctors call this condition masked (hidden) depression, in which a person may experience pain in the head, in the limbs, behind the sternum, in the abdomen and in any other parts of the body, he may be haunted by anxious fears, he may suffer from insomnia or, on the contrary, too much sleep. nine0003 - Patients may experience disturbances in the cardiovascular system, skin itching or lack of appetite. All of these are manifestations of depression.
    - the pathological sensations that patients experience during such depressions are quite real, painful, but they are the result of a special mental state, and not an internal disease. It must be remembered that the frequency of latent depressions exceeds the number of explicit ones many times over.
    - with such depression, patients, as a rule, also have a changed attitude towards food: they can go without food for a long time and not feel hungry, and sitting down at the table, eat only 1-2 spoons - they have neither strength nor desire for more . nine0003 - a sign of depression can serve as a weight loss of more than 5 kg. within a month. In some people, especially women, the appetite for depression, on the contrary, increases, sometimes reaching the level of excruciating hunger, accompanied by severe weakness and pain in the epigastric region. In some cases, food is taken in excess due to an increased craving for sweets or attempts to distract oneself from painful thoughts by frequent eating.
    Thus, we see that depression is a disease with many different manifestations that do not go away on their own, requiring special, sometimes long-term, medical intervention. Therefore, when the symptoms described above appear, it is necessary to seek help from a psychiatrist who will prescribe and monitor antidepressant treatment. nine0018

    TREATMENT OF DEPRESSIVE DISORDERS


    To date, it can be argued that the vast majority of cases of depression respond well to treatment. According to modern views, effective treatment of depression consists of a combination of pharmacotherapy, psychotherapy and, if necessary, other types of treatment. At the same time, the main role in therapy, of course, belongs to antidepressants - drugs specially designed for the treatment of various types of depression. nine0003 The creation of antidepressants is based on the discovery of scientists that depression develops as a result of a violation of the mechanism of biochemical transmission of nerve impulses in the brain regions responsible for mood, behavior, response to stress, sleep and wakefulness, appetite and some other functions. To ensure the coordination of the work of all these functional divisions, the brain sends special "commands" to them in the form of chemical impulses transmitted from the processes of one nerve cell (neuron) to the processes of another. This transmission is carried out with the help of chemical mediators (neurotransmitters), which, after transmitting a signal, partially return to the original neuron. This process is called neurotransmitter reuptake. Thanks to him, the number of mediators in the microscopic space between the processes of neurons (in the so-called synaptic cleft) decreases, which means that the necessary signals are transmitted worse. Numerous studies have shown that mediators of various structures, in particular, norepinephrine and serotonin, are involved in the transmission of signals that ensure the normal functioning of the nervous system. The first of them has a general activating effect, maintains the level of wakefulness of the body and takes part in the formation of adaptive reactions, and the second has the main antidepressant effect, controls impulsive actions, anxiety, aggressiveness, sexual behavior, falling asleep, feeling of pain, therefore serotonin is called sometimes a "good mood" regulator. A decrease in the number of mediators in the synaptic cleft causes symptoms of depression, while an increase, on the contrary, prevents their appearance. The ability of some drugs in one way or another to increase the concentration of mediators in the synaptic cleft allows them to be used as antidepressants. nine0003 Now antidepressants are used in Russia, which can be conditionally divided into 4 generations according to the time of creation.
    The first antidepressants to find wide clinical use were tricyclic drugs: amitriptyline and imipramine. They have a fairly powerful effect on most depressive states by blocking the reuptake of both norepinephrine and serotonin. However, the real clinical effect of these drugs is significantly offset by their undesirable side effects, which drastically reduce the quality of life of patients during treatment. Side effects of tricyclic antidepressants arise due to the nonspecificity of their effect on receptor structures. Acting in addition to the serotonin and norepinephrine system and other neurotransmitters (acetylcholine, histamine, dopamine), these antidepressants cause side effects such as urinary retention, dry mucous membranes, constipation, palpitations, fluctuations in blood pressure, confusion, tremor, sexual dysfunction. functions, weight gain. In such cases, it is necessary to prescribe other drugs to correct side effects or reduce the therapeutic dose of drugs, which naturally affects the effectiveness of the antidepressant action. It has been observed that up to 50% of patients refuse to take tricyclic antidepressants due to severe side effects. For the same reason, physicians are less likely to prescribe these drugs to patients on an outpatient basis. nine0003 The situation was somewhat improved by the introduction into practice of drugs of the second generation - tetracyclic antidepressants, which, along with the ability to block the reuptake of norepinephrine and serotonin, could also affect some other receptors. Being analogues of tricyclic compounds, these drugs have antidepressant activity comparable to them, but unlike their predecessors, they are safer, since they cause unwanted side effects much less often. In addition to the antidepressant, mianserin (lerivon) has a clear sedative, anti-anxiety and hypnotic effect. Maprotiline (Ludiamil) has a mild balanced antidepressant effect. In general, these drugs are able to cure mild to moderate depression, but are ineffective in patients with severe depression. nine0003 To date, antidepressants of the 3rd generation, such as fluoxetine (Prozac), fluvoxamine (Fevarin), paroxetine (Paxil), sertraline (Zoloft), citalopram (Cipralex) and some other drugs that selectively (selectively) affect the serotonin metabolism system, have received widespread recognition today. , preventing its reuptake in the synaptic cleft. Based on the mechanism of action, these antidepressants are combined into a group of selective serotonin reuptake inhibitors. In addition to treating depression, they are used to correct eating disorders, level panic disorders, so-called social phobias, various obsessive-compulsive disorders and chronic pain symptoms. These drugs have gained popularity due to the possibility of a once-daily intake, concomitant anti-anxiety effect, the presence of a psychostimulant component and a small number of side effects. In addition, they have low toxicity and are well tolerated by elderly patients. However, some researchers note their lack of effectiveness in the treatment of severe forms of depressive states, probably associated with selective activity in relation to only one neurotransmitter - serotonin. It should be noted that in recent years, some American scientists have associated the use of these drugs with an increased risk of suicide, which, however, is not proven. nine0003 Considering the high frequency of side effects in some of the above drugs and the insufficient antidepressant activity in others, psychopharmacologists have taken the path of developing more effective antidepressants - IV generation drugs that selectively block the reuptake of both serotonin and noradrenaline, without affecting other mediators. system and with minor side effects. Currently, 3 drugs meet these requirements: milnacipran (Ixel), duloxetine (Cymbalta) and venlafaxine (Effexor). Their antidepressant activity in the treatment of patients with severe and moderate depression has been confirmed in a number of specially conducted studies, which at the same time showed that these drugs are well tolerated. nine0003 It should be noted that antidepressants of plant origin (negrustin, gelarium hypericum, deprim, etc.) can be effective in mild depressive states, but there are no reliable data guaranteeing their effectiveness. The opinion of a number of doctors that all depression can be treated with herbs or, say, acupuncture, should be recognized as unfounded.
    For extremely severe depressions that do not improve despite the use of the most powerful antidepressants, electroconvulsive therapy (ECT) can be effective, but this situation is extremely rare and requires careful justification by the commission of doctors and the consent of the patient. nine0003 An important additional role in antidepressant therapy, especially with concomitant anxiety, is played by tranquilizers - anti-anxiety drugs, such as Xanax, phenazepam, diazepam, nitrazepam, atarax, etc. Drugs that can, when taken systematically, prevent mood swings in various depressive disorders include so-called mood stabilizers or mood stabilizers - lithium preparations, carbamazepine, valproic acid salts, lamotrigine, topiramate. With their systematic intake in most patients, the clinical manifestations of depression either completely disappear or become rare and mild, requiring no hospitalization and not significantly affecting the ability to work. nine0003 Antipsychotics play a significant role in the treatment of certain forms of depression. These include both traditional drugs - fluanxol, triftazin, eglonil, teralen, neuleptil, sonapax, and atypical antipsychotics that are gaining more and more recognition among doctors: seroquel, solian, zeldox, rispolept, abilify, serdolect and others.
    In drug therapy of depressive conditions, an unconventional, strictly individual approach is used, with the obligatory provision of fruitful cooperation between the patient and the doctor. Otherwise, there may be a violation of medical recommendations regarding doses and regimens for taking medications. The patient's faith in the possibility of recovery, the absence of prejudice against the "harm" caused by psychotropic drugs, the systematic observance of the prescriptions prescribed by the doctor largely contribute to the achievement of therapeutic success. nine0003 Drug treatment of depression takes time. You should not expect a complete cure already in the first days of taking the drug. It must be remembered that all modern antidepressants begin to act on depressive symptoms no earlier than 1-2 weeks after the start of treatment. Cancellation of an antidepressant, as well as its appointment, should be carried out only by a doctor. Cancellation is usually made no earlier than 6 months from the normalization of the mental state. Even after the complete disappearance of all symptoms of depression, do not rush to stop taking the drug yourself, as there is a risk of an exacerbation of the disease. Therefore, doctors recommend continuing to take the antidepressant for a certain period of time. A common mistake is the premature withdrawal of drugs soon after a significant improvement in the condition or due to "forgetfulness". To avoid this, try to include the drug in the list of daily urgent matters - for example, store it in the bathroom and take it after hygiene procedures. When planning a trip, calculate exactly how many tablets you need for the entire period of absence from home. Breaking therapy is fraught with serious troubles. nine0003 Conducted along with drug treatment, psychotherapy of patients with depressive states implies various systems of influence, including individual conversations, family and group therapy, etc. An important element of social rehabilitation is participation in the work of mutual support groups for patients who have experienced depression. This allows other patients to feel help in understanding their problems, to realize that they are not alone in their misfortune, to see the possibilities of personal participation in rehabilitation activities and in social life. nine0018

    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. nine0018

    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. nine0018

    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. nine0018

    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;
    • overcome a 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. nine0018

    You can only take these drugs with a doctor's prescription, as many of them are strong stimulants. Self-administration can 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. Sustained action - after six months. All this time, you need to take 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. nine0018

    • 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 in 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. nine0018

    Pluses

    + Preparations with active substance 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. nine0018

    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

    + Long-lasting effect occurs after 3 months. nine0018

    + 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.

    Plus

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

    + Combines well with most drugs in the general group. nine0018

    + 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 appointment period, you must drive carefully and engage in potentially hazardous types of work.

    - 18% of patients experience drowsiness, 15% dry mouth, 5% weight loss. Other side effects occur in 1-3% of cases. nine0018

    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. nine0018

    + 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 commonly 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. nine0018

    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. nine0018

    - 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. nine0018

    + 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. nine0018

    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.

    — Use during pregnancy only in extreme cases, incompatible with feeding. nine0018

    10. Venlafaxine

    Belongs to the SNRI group. In addition to blocking the reuptake of serotonin, venlafaxine has a similar effect on another neurotransmitter, norepinephrine. The medicine is prescribed for depressive conditions of various origins, social phobias, anxiety, panic. Usually take 150 mg per day.

    Pros

    + Better tolerated by patients than most tricyclics.

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