Antidepressants of the latest generation. Antidepressants: Which is better? Reviews of doctors, prices

Today, depression affects not only adults, but also children and adolescents. This disease and methods of dealing with it are devoted to a lot of research of specialists and a huge number of articles and books. If you translate from "scientific" to ordinary language, depression is a loss of strength and a desire to live. Symptoms of this disease are apathy and constantly bad mood, anxiety and fatigue, lethargy and gloominess.

Modern pharmacology offers the antidepressants of the latest generation to fight this disease. How many generations of thymoleptics (so-called means working against depression) exist today, what do they have in common and how do they differ from each other, what is the mechanism of their action? These and other issues will be considered in the article that you have submitted.

What are antidepressants?

These are medicines, due to which it is possible to alleviate the symptoms and even prevent depressive conditions. The main mechanism of their action is aimed at correcting the biochemical activity of the human brain. Nerve cells, its components, constantly interact with each other through special substances - neurotransmitters. According to one theory, depressive disorders occur when, in the brain, for various reasons, the level of any mediator or biogenic amine is significantly reduced: dopamine, norepinephrine, or serotonin. Antidepressants of the last generation, as well as all the preceding ones, have a regulating and corrective effect on the biochemical processes of the brain by changing the concentration of one or another biogenic amine.

What are they needed for?

In addition to the fact that modern antidepressants help cope with the symptoms of depression, they are often used to get rid of such problems:

• Various pains of unexplained origin;
• Impaired appetite or sleep;
• Severe fatigue or loss of strength;
• Nervousness or feelings of constant stress;
• Bouts of nervousness or anxiety;
• Problems of concentration or memorization.

Generations of antidepressants

Before considering how many generations of anti-depression medicines are created by today, it is necessary to remember that antidepressants were discovered only in the middle of the 20th century. To date, depending on the time of the invention and the beginning of use in clinical practice, as well as the action of antidepressants, it is customary to allocate four generations of these drugs.

Preparations of the first generation

The first generation, discovered in the 50s of the last century, is represented by tricyclic thymoleptics of cyclic action (TCA). They include such medicines: "Amitriptyline" (antidepressant, the very first of the open) and its derivatives, as well as preparations "Nefazodon", "Anafranil" and "Melipramine." These compounds block the reuptake of norepinephrine, thereby increasing its concentration. However, TCAs blocked not only norepinephrine (norepinephrine), but all other neurotransmitters on their way, which led to a large number of unpleasant side effects, especially such as a sharp rise in blood pressure and an increase in heart rate. Preparations of this group are quite toxic, and the likelihood of an overdose in their use is very high, which is why they are so little used in the treatment of depressive disorders today.

In addition, the first generation of drugs that are no longer used today, containing irreversible monoamine oxidase (MAO) inhibitors, are Iproniazide, Tranylcipromin, Isocarboxazide. Their action is based on the suppression of the activity of nerve endings of neurons of the brain, as a result of which the concentration of serotonin and norepinephrine increases.

Second Generation Medicines

The second generation, unlike the first, has a more selective, but weaker effect on the neurotransmitters and the neurons themselves. It includes tetracyclic irreversible (MAO-B) and reversible (MAO-A) monoamine reuptake inhibitors, represented by such drugs as "Lerivon", "Ludomil", "Pyrazidol" and others. Due to the fact that when they were taken, a lot of serious side effects occurred, as well as due to interaction with different drugs and unpredictability of the effect, drugs of this group are used extremely rarely. In pharmacies it is rather difficult to find antidepressants from the group of monoamine reuptake inhibitors. But in some cases they are found under other trade names. So, experts say that the drug "Ludomil" is the same tablets "Maprotiline", the price, the manufacturer and the country are the only others.

The third generation

Modern researchers have established that about 30 mediators are involved in the work of the brain and nervous system, but only three of them are involved in depression: serotonin, dopamine and norepinephrine (norepinephrine). The third generation includes selective serotonin reuptake inhibitors (SSRIs), represented by the most commonly used modern antidepressants, such as Zoloft, Citalopram, Prozac, Cipralex, Paroxetine, Plizil, and many others. These medications are blocked by not all mediators, but only one - serotonin. By force of impact, they are inferior to first-generation drugs, but they have fewer side effects than any other predecessors. All SSRI drugs are very effective and should be tolerated by patients approximately equally. However, in each of us the body has its own individual characteristics, and it is because of them that the number and strength of side effects will be different in each case. Doctors say that the most common unpleasant consequences of taking third-generation drugs are insomnia, dizziness, nausea and anxiety.

Costs of SSRIs are quite expensive. So, for a fairly well-known and widely used drug "Tsitalopram", the price in pharmacies, depending on the brand under which it is released, can vary from 870 to 2,000 rubles.

Antidepressants of the fourth generation

They include the drugs of the group SIOZSiN (selective inhibitors of the reuptake of serotonin and norepinephrine). These are the antidepressants of the last generation, such as the medicines "Simbalta", "Milnacipran", "Remeron", "Efferor", which block the seizure of both norepinephrine and serotonin. Preparations "Zyban" and "Velbutrin" do not interact with serotonin, but retain dopamine and norepinephrine. The development of medicines attributed to this group began only in the mid-90s of the last century, and with each year there are more and more new medicines.

Doctors can not unequivocally say that it is in this group that there is the best antidepressant, it is basically impossible, because for treatment of various types of depressive disorders, medicines are selected individually, taking into account the health characteristics of each patient.

Popular modern timolesterics

Knowing the serious effects of drugs of this group on the nervous system, it must be remembered that all possible - both positive and negative - the consequences will be predictable and leveled only by a qualified specialist - a doctor. Given all the individual characteristics and diagnosing, it is the doctor who can prescribe exactly those antidepressants that are best able to help in your particular case, with minimal side effects. In the event that there are any problems when taking the prescribed medication, it is the doctor in charge who will be able to adjust or change the treatment regimen. Today, most practitioners recommend to patients with depressive disorders drugs from the group of selective serotonin and norepinephrine reuptake inhibitors, the effective effect of which has been tested in practice. Such medicines as Milnacipran, Fluxen (Fluoxetine), Duloxetine, Velaxin (Venlafaxine) are the most typical and widely used antidepressants of the latest generation. Consider the most popular in the treatment of depressive disorders of timoleptics.

The drug "Flucosetin"

This drug is one of the first representatives of the SSRI group, it combines both antidepressant and stimulating effects. The drug "Fluxen", it is an antidepressant "Fluoxetine", helps to reduce anxiety and tension, eliminates the feeling of fear and improves mood. The most effective use, in the opinion of practicing psychotherapists, in cases of asthenic depressive disorders with apathy, as well as with depression of varying severity and obsessive states. This drug is also used in the treatment of bulimia. The antidepressant Fluoxetine was first registered in 1974 in the United States, and in the last decade it came in first place for sale in the UK, only under another trade name - Prozac. In Russia, this medication is widely used, and many practitioners confirm that it is the patient or his generics who are assigned to patients under various depressive conditions.

The drug "Paroxetine"

This is the strongest representative of the group of selective inhibitors of selective absorption of serotonin, which is widely used in the treatment of anxiety and depression. Today drugs, the active ingredient of which is paroxetine, quite a lot. This is the Russian drug "Adeptress" from "Veropharm", a drug "Plizil" from the Croatian company Pliva, Hungarian tablets "Reksetin" from Gedeon Richter and many others. Regardless of the name of the drug "Paroxetine", reviews about it, both in patients and doctors, are mostly positive.

Medicinal preparation "Velbutrin"

It is better known as "Ziban" or "Know-Smok". The active substance of all three drugs is bupropion hydrochloride, which increases the amount of dopamine and norepinephrine in the brain. Drugs with this active ingredient not only relieve the symptoms of depression, but also help to overcome the emotional consequences of giving up nicotine. This medicine improves mood and increases efficiency. Reviews of those who got rid of nicotine addiction with drugs such as Velbutrin, NoemSmok and Ziban, talk about the high effectiveness of these drugs during the quitting period.

The medicine of "Simbalta"

The drug of the fourth generation of antidepressants, which inhibits the re-uptake of norepinephrine and serotonin, incidentally carries a minor seizure of dopamine. This drug, the active ingredient of which is duloxetine, differs quite high, in comparison with other antidepressants, the speed of action. According to both doctors and patients, a clear antidepressant effect is manifested by the end of the first - the beginning of the second week of admission. In addition, this drug is characterized by uniformity of action and throughout its use. However, there is a group of patients, according to reviews of which the action of this medicine, if it occurs, is very weak. As already mentioned, the individual characteristics of the course of biochemical reactions often lead to the fact that one or another medication prescribed by a doctor may not have the expected result.

How much is?

Today it is quite difficult to talk about the prices of medicines. This is due to the fact that the currency market is extremely unstable, and new antidepressants mostly come from foreign manufacturers whose prices are in euros. That is why the table below shows the minimum and maximum prices in rubles, since it is simply impossible to average them. Some of the drugs that were received earlier are sold at the old prices, and new incomes are much more expensive.

If you carefully review the table, you can see that it does not contain second-generation drugs, namely MAOI (monoamine reuptake inhibitors). It's not a mistake. The thing is that these antidepressants, which have a lot of unpleasant side effects and incompatibility with many drugs, are practically not used in European countries. In the US, medicines such as Isocarboxazide, Ugeneilzine and Tranylcipromine are rarely used, and in our country they use Nialamid. All of the above medicines are available only under the supervision of psychiatrists.

This table shows well that the price of "classic" tricyclic antidepressants is significantly lower than for newer drugs from SSRIs and SIOZsin. Thus, it is not necessary to talk about the high availability of effective antidepressant drugs for the majority of the population. However, a doctor can help pick up a less expensive drug with similar properties, the so-called generic.

Interaction with other drugs

Antidepressants can interact with other medicines, even those that seem to us absolutely safe and familiar. The most active in this regard are tricyclic thymoanaleptics and monoamine oxidase inhibitors, but the preparations of SSRIs and SIOZsIN groups practically do not interact with other medications. In any case, if the doctor appoints you any medications against depression, be sure to find out if you can combine their reception with other medications, dietary supplements and even tea and herbal decoctions.

Alcohol and antidepressants

Strangely enough, this sounds, but many people who need to take timoleptics for various reasons, ask the question of how often it is possible to combine the reception of "hot" drinks and tablets from depression. To answer this question is quite simple: you want to risk your mental and physical health, and maybe even life, try it! The fact is that both alcohol and antidepressants have a serious impact on the central nervous system and the brain, and this double pressure can adversely affect both the "flight control center" itself, that is, the brain and the organs and systems that subordinate it. It is worth it or not to combine - the decision to take you and only you.

Instead of concluding

Do not hesitate and "puzzle" over what antidepressants are, which is better and more effective. If you feel that every new day it becomes harder to live than the previous one, you do not have enough strength even for the simplest and most ordinary business, contact a specialist! The doctor will be able to diagnose your disease and prescribe the necessary treatment, choosing the most suitable medications for you. It can be not only antidepressants. Arsenal of today's medicine is quite extensive: various types of psychotherapy, exercise and acupuncture, respiratory practice and physiotherapy.