Some patients with schizophrenia are treated on an outpatient basis, but neither the patients nor their relatives underestimate the importance of the help of a psychologist and social assistance that the staff of the V.L. One minute to Moscow.
Yes, medications play a critical role in preventing flare-ups of the disease. But it should be constantly monitored and once a month to assess the effects of treatment with psychotropic drugs.
Periodically conducted courses for patients and their relatives – 25-30 sessions with a frequency of twice a week – have a positive effect. After them, the microclimate in the family changes, trust and cooperation with medical personnel, with specialists providing assistance (doctor, psychologist, social worker) is formed. But at the same time, educational courses cannot serve as a reliable means of preventing exacerbations of schizophrenia.
Cognitive-behavioral therapy allows you to cancel treatment with psychotropic drugs earlier or adjust the dose of medication.
Social skills courses include the formation of household and hygiene habits, training in conflict resolution, time management, self-control and planning skills, and vocational rehabilitation. All this is the path to independent and independent living of the patient.
The complex issues of treatment remain open: when is it necessary to cancel psychotropic drugs, change strong drugs to weak ones, what are the cancellation criteria that allow you to effectively resolve these issues?
In our experience, small doses of classical antipsychotics can have a positive effect on the course of schizophrenia on an outpatient basis.
At this point in time, almost lost interest in the theory of the viral origin of schizophrenia. But this is not due to the fact that scientists have shown its inconsistency. On the contrary , more and more data are accumulating on the large role of viruses, especially herpes group, in the pathogenesis of schizophrenia. And the carriage of the herpes virus by a pregnant woman provokes the development of schizophrenia in her children. According to the clinic V.L. Just a minute, the Epstein-Barr virus also increases the likelihood of schizophrenia. Therefore, when using medicines for the treatment of schizophrenia, it is necessary to take medicines for the treatment of viral infections:
· Modulators of the immune response;
· Stabilizers of cellular and humoral responses;
· Antiviral drugs.
For such therapy, diagnostic markers of the initiation of antiviral therapy should be determined, for example: cytokines, gliadin , immunoglobulin G, C-reactive protein.
Many psychotropic drugs affect the immune system, which depends on the chemical structure, dose, and duration of the drug intake.
In the clinic of Professor V.L. For a minute, many mental illnesses are being treated in Moscow, including schizophrenia and accompanying sleep disorders in some cases.
In schizophrenia, various sleep disorders are observed, these are:
· Defects in the continuity of sleep;
Falling asleep disorder;
• dysregulation of the REM phase (reduction in the proportion of REM sleep, decrease in the period of REM latency);
· Reduction of the fourth phase of sleep;
· Lack of information processing during sleep.
There are also variable and invariant sleep parameters in schizophrenia. Variable sleep parameters are REM sleep parameters (REM density and REM latency). They depend on the mental status of the patient, worsening before the exacerbation of psychosis, during psychosis. Sleep invariant parameters are the fourth sleep phase (percentage and duration of slow wave sleep). These parameters do not depend on the phase of the disease (prodromal, exacerbation, stabilization, remission). They are found in all patients with schizophrenia.
According to M. Keshavan with colleagues . (1996), impaired slow wave sleep in humans may be a marker of the risk of developing schizophrenia.
With an increase in the negative symptoms of schizophrenia in young patients, the proportion of “deep sleep” also decreases ( Ganguli R. et al ., 1987).
In patients with schizophrenia, during the period of exacerbation of the disease, there is a disruption in the continuity of sleep, which is measured by the following indicators:
• sleep latency;
· Time of awakening;
· Sleep efficiency;
· Frequency of awakening during sleep;
· Total sleep time;
· Frequency of awakening during the night.
Sleep of schizophrenic patients and healthy people is affected by the state of the dopaminergic system; sleep disturbance indicates its activation, which is characteristic during a psychotic episode and hallucinatory symptoms. At the same time, such indicators as REM latency decrease and decrease in REM sleep density ( Hoyt B., 2005, Feinberg I. et al ., 1965).
In patients with schizophrenia, the processing of information during sleep is also impaired. If light and sound stimuli are sent during sleep to patients with schizophrenia during the night, an increase in theta waves can be detected ( Roschke J. et al ., 1998).
To normalize sleep, patients use clonazepine and other antipsychotics, or hypnotics, tranquilizers.
Scientists have found that even after withdrawal of antipsychotics, sleep changes continue for six weeks ( Neylan T. et al . 1992).
Many researchers associate the study of somnology in patients with schizophrenia with the use of neuroimaging methods . This approach is the most productive and optimal, as it allows you to determine the organic cause of schizophrenia and sleep disorders in this disease.
In patients with schizophrenia, especially before the period of psychosis and in the subacute period, changes in the autonomic nervous system are observed. This requires attention during the diagnosis and treatment of a mental disorder.
The first sign in the development of schizophrenia is a dysfunction of the autonomic nervous system. This is manifested in the presence of pathological processes in the cardiovascular system, gastrointestinal tract, sleep disturbances, disturbances in the sleep cycle – sleep / wakefulness, etc. Therefore, when psychosis occurs, it is necessary to prescribe drugs that affect the autonomic nervous system.
The results of studying the parameters of the autonomic nervous system in patients with schizophrenia indicate that the parasympathetic system prevails over the sympathetic one.
Of course, the appointment of agents, toning the sympathetic nervous system, is to reduce the symptoms of schizophrenia, but at the peak of psychosis set wobble tone and the predominance of the sympathetic nervous system on the parasympathetic with affective-delusional symptomatology, also strengthening the parasympathetic nervous system – with catatonia, which reduces the efficiency simpatomimicheskih drugs and suggests the use of drugs that stimulate the parasympathetic system. It follows from this that the use of sympathicotonics during remission of schizophrenia can take place in order to prevent the recurrence of psychosis. It is known that drugs of the vagoparalytic group, in particular atropine, were previously used in the treatment of neurosis-like , sluggish forms of schizophrenia, and pilocarpine could provoke a relapse of psychosis.
Observations of patients with schizophrenia during remission showed that the duration of remission can be predicted by the severity of the tone of the sympathetic nervous system.
In recent years, patients with schizophrenia have become frequently pregnant. This is due to new principles of treatment and care for such patients, as well as the use of atypical antipsychotics.
It is difficult for a psychiatrist to manage such pregnant women, and it is also difficult for gynecologists. There is a risk of complications for the mother and the fetus, and it is due to both the possibility of a relapse of schizophrenia and the effect of psychotropic drugs on the fetus.
It is known that for the first fifteen years after the onset of schizophrenia, a woman leads an active social and sexual life. And pregnancy does not protect and does not prevent the exacerbation of the disease. A woman can refuse to take psychotropic drugs, but the risk of relapse is great.
Schizophrenia can begin during pregnancy, but this is rare. Most often, personality disorders occur. But if schizophrenia occurs during pregnancy, then the further development of psychosis will be unfavorable. In such patients, preterm labor is more often recorded, and the child has a low body weight.
Schizophrenia can cause congenital anomalies and perinatal mortality. Patients with schizophrenia are advised to become pregnant one year after the onset of the disease. Hormonal drugs ( depomedroxyprogesterone ) can be a contraceptive , but relapses of schizophrenia or depression are possible while taking them.
Oral contraceptives can interact with nicotine and psychotropic drugs ( clonazepine ), increasing their serum levels. First-generation antipsychotics such as haloperidol are considered safer than atypical antipsychotics.
Cancellation of antipsychotics in the first 6-10 weeks of pregnancy can only be practiced in patients with mild forms of schizophrenia. Antipsychotics should be used at the lowest effective dose, while monitoring blood levels of the drug. When treated with olanzapine and clozapine, the CYP 1A2 activity of cytochrome P450 is reduced during pregnancy.
What if someone close to you suffers from depression?
The complaints of the depressed patient should not be ignored and prohibited.
Avoid flat, comforting language or trivial encouragement.
Do not try to cheer up the sick person.
Emphasize the immediacy of the depressive state by instilling hope for an end to the depression.
Do not call for manifestations of the patient’s will, do not tell him: “you must pull yourself together,” you could , if you wanted “, etc.
Do not let the sick person feel helpless and guilty .
Don’t invoke virtues like faith or a sense of responsibility.
Free the depressed patient from the need to make decisions, especially the very important ones.
Behave with the patient calmly, evenly and confidently.
Organize your own visit to the doctor and accompany the patient
Relieve the patient from personal and professional contacts.
Do not change the patient’s cardinal habits.
Do not insist on sick leave, especially if there are no signs of severe depression.
Show your compassion and understanding, and support the patient in their own urgent and real tasks.
To draw the patient’s attention to everything that he manages to do, do not allow yourself at the same time to triumphant intonations.
Monitor the regular adherence to the patient’s regimen, the rhythmic distribution of affairs in the daily routine
Do not let the patient lie in bed in the morning , go to bed early and be alone.
Make sure that the patient looks after himself.
Avoid feigned gaiety.
Do not make reproaches and remarks.
Try to stimulate the patient’s breathing.
Don’t mention the patient ‘s past successes.
Do not self-medicate the patient, seek help from a specialist psychiatrist.
How can depression be treated?
Current treatment for depression involves:
The use of biological methods of therapy ( primarily psychopharmacological drugs). A prerequisite for the effectiveness of treatment is cooperation with a doctor: strict adherence to the prescribed therapy regimen, regular visits to the doctor, a detailed, frank report about your condition and life difficulties.
Psychotherapy (individual, group and family) is not an alternative, but an important adjunct to the drug treatment of depression. In contrast to drug treatment, psychotherapy assumes a more active role of the patient in the treatment process. Psychotherapy helps patients to develop skills of emotional self-regulation and in the future to cope more effectively with crisis situations without sinking into depression.
What usually hinders seeking psychotherapeutic help?
Low awareness of people about what psychotherapy is.
Fear of a stranger’s initiation into personal, intimate experiences.
Skeptical about the fact that “talking” can have a tangible healing effect.
The idea that you need to cope with psychological difficulties yourself, and turning to another person is a sign of weakness.
Helping people close to you to overcome depression
The support of loved ones, even when the patient does not express interest in her, is very important in overcoming depression. In this regard, the following advice can be given to relatives of patients:
Remember that depression – a disease in which the need sympathy, but not in koem case can not sink into the disease with the patient, sharing his pessimism and despair. You need to be able to maintain a certain emotional distance, constantly reminding yourself and the patient that depression is a transient emotional state.
Studies have shown that depression is especially unfavorable in those families where a lot of criticism is made about the patient. Try to make it clear to the patient that his condition is not his fault, but a misfortune, that he needs help and treatment.
Try not to focus on the illness of a loved one and bring positive emotions into your life and into the life of your family. If possible, try to involve the patient in some kind of useful activity, and not remove him from business.
“Feminine character” or a special tendency towards illness?
Depression is a painful condition that manifests itself with characteristic symptoms. Depression is not in any way a sign of weakness of character. This is a serious disease, which is accompanied by disorders of all mental and even bodily (sleep, appetite, body weight, etc.) human functions. Loss or decrease in volitional qualities is one of the symptoms of a depressive illness. Therefore, one should not advise a person suffering from depression to “pull himself together” – he will not be able to overcome the disease without medical help. Depression significantly affects performance, study, social life, relationships with others, including loved ones.
There is a relationship of depression with a female?
Doctors are well aware that women are more likely to suffer from depression than men. This fact is confirmed by the results of numerous fairly large epidemiological studies in different countries, including in Russia. The frequency of depression in women 2- 3 fold higher than in men. In modern medicine, the female sex is one of the factors predisposing to the development of depression.
With what is connected with women’s predisposition to depression?
Depression is largely associated with changes in hormonal levels that occur in the female body during childbearing years. The so-called reproductive (childbearing) cycle goes through a number of stages, starting with the appearance of menstruation and ending with their disappearance: the menstrual cycle, pregnancy, childbirth, premenopausal and climacteric periods. At each of these stages , significant changes occur in the composition and quantity of hormones, which are accompanied by physiological changes in all functions of the female body, including the mental sphere. Therefore, such changes in hormonal levels are associated with an increased risk of developing depression.
How does depression manifest in women?
As stated, the risk of depression increases at every stage of the reproductive cycle. In clinical medicine, there are different variants (syndromes) of depression characteristic of each of the stages of the reproductive cycle – premenstrual syndrome, depressive syndrome of pregnant women, sadness in women in labor, postpartum depression and depression in the premenopausal and climacteric periods. The manifestations of depression can be different. A depressive mood can be manifested as depression, depression and apathy, as well as increased irritability, tearfulness, anxiety, and a feeling of inner tension. Changes in mood are usually accompanied by a decrease in activity, a feeling of loss of energy, increased fatigue, and distraction of attention. Depression in women is often accompanied by a variety of somatic disorders: changes in sleep (insomnia or increased sleepiness), appetite (decreased appetite or increased appetite). Unpleasant sensations of tension and a feeling of pain in the mammary glands, headaches, pain in joints and muscles, pain in the heart and periodic palpitations, weakness in the body, fluctuations in blood pressure, etc. may appear . The duration of depression associated with the reproductive cycle may vary. … Premenstrual depressive syndrome is usually short-lived, about 2 weeks (1 week before and 1 week after menstruation), but has a recurrent nature with monthly exacerbations corresponding to the menstrual cycle. Postpartum depression and depression of the climacteric period can be more protracted and last for several weeks or even months.
How can female depression be treated?
Depression is a treatable disease. With the correct choice of the appropriate drug and its dose, complete relief from the symptoms of depression is possible . Depression is treated only with drugs called antidepressants. Treatment for depression should only be prescribed by a doctor. It is necessary to remember that each person’s depression has its own characteristics associated with both disease severity and with its clinical manifestations. The correct choice of treatment in each specific case requires an assessment of many features of the patient’s condition. Only a doctor – psychiatrist or psychotherapist can correctly identify, evaluate and qualify such features . Nor in any way necessary to resort to the advice of relatives or friends, or to choose a treatment on their own, on the basis that one or the other drug to help someone whom you know. This rule must be observed, especially if the change in mood is accompanied by pronounced changes in general well-being, impaired bodily functions and pain, which is most characteristic of depression associated with the reproductive cycle. In such cases, only a doctor can correctly assess the nature of the symptoms, determine the real state of the internal organs and choose a drug that will be not only effective, but also safe. It is strongly discouraged to take antidepressants on your own during pregnancy and lactation. On Today, there are a large number of anti-depressants. All modern drugs of this class are effective and safe means. However, each of the drugs has its own distinctive features associated with both the therapeutic effect and the methods of its administration and dosage. Depression treatment takes time. You should not wait for a complete cure already in the first days of taking the drug. It must be remembered that all modern antidepressants begin to act on depression no earlier than 1-2 weeks after the start of treatment. During this period, the selection of the required dose of the drug is also carried out. Cancellation of the antidepressant, as well as its appointment, should be carried out only by a doctor. Even after the complete disappearance of all symptoms of depression, it is necessary to continue taking the antidepressant for a certain period of time. This is due to the fact that the risk of exacerbation of depression in case of premature discontinuation of therapy is very high – up to 60-80%. Moreover, exacerbation of depression associated with early discontinuation of treatment tends to be more difficult to treat. The duration of such an additional period of treatment, the purpose of which is to prevent exacerbation, is determined only by the doctor based on the individual characteristics of each patient. Remember that even if you decide to stop treatment before the time specified by the doctor, you must always consult with him.
Seasonal depressions are a variant of recurrent (recurrent) depressions. By seasonal depression include that develop in the autumn-winter season with some regularity – every year for at least 3 years. Much less often, depression occurs in the spring and summer.
Seasonal depression can show the same symptoms as depression not associated with a specific season:
feeling of longing or anxiety
decreased interest in the environment
feelings of joylessness and hopelessness.
Often these symptoms are more pronounced in the first half of the day, while in the evening the condition improves.
There are also a number of season-specific features:
Other symptoms are considered more specific for seasonal depression. Patients with seasonal depression, along with low mood, anxiety and decreased activity, experience drowsiness during the day and an increase in appetite. During depression, they consume more food rich in carbohydrates, gain weight. As a rule, the general tone decreases, weakness appears, various unpleasant sensations in the body.
Asthenic symptoms of seasonal depressions are as follows: a feeling of weakness, lethargy, weakness, general physical illness. Various pains and unpleasant sensations appear in the body, mental performance decreases, memory and attention deteriorate. It is characteristic that the severity of these symptoms practically does not depend on the external load and they are often more pronounced in the morning hours after waking up.
In the development of seasonal depression, the main role is assigned to the metabolic disorders of serotonin , a biologically active substance that regulates mood. Experimental studies have shown that in winter, the serotonin content in the brain is lower than in summer. An important regulator of serotonin metabolism is melatonin , an active substance, the production of which depends on the amount of light.
Light therapy is the classic treatment for seasonal depression . In addition, the high efficiency of antidepressants with a specific effect on the metabolism of serotonin in the brain has been proven . Long-term use of these drugs allows not only to cure an already developed depressive state, but also to prevent their development in the future. As with other depression, psychotherapy is an important element of effective treatment .
Depression is a disease that affects 15% of the population of all countries of the world. The causes of depression are not fully understood. There are many theories explaining this or that aspect of the disease, but only the factors leading to the disease have been identified.
According to the international classification of diseases ICD-10, depression is divided into:
depression in bipolar disorder;
recurrent depressive disorder;
depression with cyclothymia and dysthymia.
Depression also occurs: postpartum, child, adolescence, old age, female and male.
Depression occurs when:
diseases of the endocrine organs;
tumors of other organs.
Symptoms of depression can occur with self-medication and poor-quality therapy for various human diseases.
Depression is caused by drugs that lower blood pressure, some antibiotics, oral contraceptives, some drugs for cancer, and drugs that lower blood cholesterol. Depression can throw a person out of emotional balance for a long time and significantly worsen the quality of his life (work activity, personal relationships, leisure). 70% of patients with depression have suicidal thoughts, 15% attempt suicide.
Causes of depression
Depression can be a response to a previous psychological trauma or negative event – the loss of a job, the death of a loved one.
But depression does not arise only due to external causes, genetic, biochemical factors, imbalance of neurotransmitters, hormones provoke the development of symptoms of depression.
Symptoms of depression are manifested in various areas of the human psyche and somatics.
Emotionally, the signs of depression are:
loss of interest in favorite activities;
lack of emotional closeness with loved ones;
At the physiological level, depression manifests itself:
incorrect perception of colors and sounds;
pain in the heart;
In behavior, depression is characterized by:
The mental sphere in depression is disturbed in the form of:
slowing down the thought processes;
a sense of alienation and dissimilarity in comparison with other people;
decreased concentration of attention;
avoiding decision making;
In men, depression is difficult to recognize and is manifested by the following symptoms:
aggressive and hostile behavior;
passion for extreme sports;
Female depression is more common than male depression. The exact reasons for this are difficult to determine. Although, according to most psychiatrists who study the problem of the onset of depression, gender is not at all a biological prerequisite for the development of depression. Experts tend to attribute a greater percentage of the prevalence of female depression to those social prerequisites that exist in almost any society. Women are more likely to find themselves in stressful situations, and they are more inclined to seek medical help, which explains the statistical picture.
Psychiatry remains a branch of medicine in which the diagnosis of any disease, including depression, remains subjective, based on complaints, signs, and the doctor’s experience. In recent years, special diagnostic questionnaires have been used to assess symptoms and prescribe treatment for depression – the Sung scale, the Beck questionnaire, the Hamilton scale, the Montgomery-Asberg scale, the geriatric depression scale, and the multidisciplinary personality test.
Has your behavior changed in your opinion or the opinion of others in the last month? If so, how?
Signs of depression
Not at all
To a weak degree
Decreased stress tolerance
More aggressive, outwardly directed behavior, difficulty with self-control
Persistent unexplained fatigue
Irritation, worry, tension
Indecision in everyday situations
Sleep disturbance: waking up early, falling asleep with difficulty, restless sleep, overwhelming daytime sleepiness
Impatience, anxiety, feeling awkward, especially in the morning
To relieve stress: alcohol (or medication) abuse, increased activity, exhausting work, increased sports, abundant or poor nutrition
The future looks black, gloomy, hopeless
Previously observed in the family: alcohol, drug or drug abuse, depression or suicidal behavior, engagement in risky activities
0-13 points : in all likelihood, there is no depression.
14-26 points : initial symptoms of developing depression.
27-39 points : obvious depression, you should consult a doctor.
This scale is intended to help the clinician identify depression in patients and save time. The patient fills out the scale on his own, circling the number corresponding to his condition in each of the listed items. The scores are then added up.
You can take depression tests online:
Treatment of depression and therapy of other mental illnesses in modern clinics is based on objective and accurate diagnostic methods. Treatment regimens are not prescribed without assessing the state of human organs at the micro level using a visceral test, determining the immune status, diagnosing diseases:
of cardio-vascular system;
stomach and intestines;
the state of insulin receptors.
Treatment regimens prescribed by doctors by trial and error, without objective criteria, can harm the patient and not cure depression. Diagnostic methods based on objective data allow you to individually select a medicine, predict and eliminate the side effects of treatment. To diagnose depression and prescribe the right treatment, the following are carried out:
general blood analysis;
diagnostics of the condition of the thyroid gland;
identification of traces of alcohol and drugs;
dexamethasone test, which determines the level of cortisol;
tests for viruses and bacteria, so fatigue, malaise caused by infections can be similar to symptoms of depression;
neuroimaging – diffuse tensor image of the brain, near infrared spectroscopy, functional magnetic resonance imaging.
Also used – measurement of body weight, blood pressure, electroencephalography, assessment of sexual health, the state of bone density, the functional activity of the liver.
Of all mental illnesses, depression is the most difficult condition that requires intervention in all areas of a person’s life. According to the WHO, depression is the leading cause of disability and disability. Depressive states often do not respond to therapy, and even depressed patients from wealthy countries may not receive adequate therapy.
That is why you cannot independently purchase antidepressants at the pharmacy, use them uncontrollably. Qualitative treatment regimens involve careful selection of the drug, control of its effectiveness and side symptoms. Moreover, non-drug, instrumental methods, physical therapy and psychotherapy may be more effective in treating depression.
Treatment by psychotherapy methods
For the treatment of depression are used:
cognitive behavioral psychotherapy;
group, individual, family psychotherapy;
Instrumental therapy for depression is sometimes more effective than antidepressant therapy. The methods of instrumental therapy that help with the disease are as follows:
transcranial magnetic stimulation – the effect of a magnetic field on the brain;
Biofeedback – Teaching Emotion Control Skills
light therapy – exposure of the eyes to a source of artificial light,
Treatment with new technologies
In modern depression therapy centers, new technologies are available that allow treatment taking into account new developments by scientists. Treatment regimens using:
light therapy in the near infrared range;
optogenetic stimulation (exposure to photons of light of neurons), can enhance the effect of drug therapy.
Intranasal ketamine treatment
Many antidepressant regimens act on depression symptoms after several weeks or months during which people continue to suffer from depressive symptoms. This delay leads to a high risk of suicide. Ketamine therapy allows you to get a quick effect, and the introduction of the drug intranasally (through the nose) leads to the flow of the drug directly into the brain, bypassing the blood-brain barrier. Ketamine, unlike other antidepressants, does not affect the mediator serotonin, but glutamate.
Ketamine treatment regimens can improve the patient’s condition in a few minutes, and the introduction of the drug through the nose avoids the toxic effects of antidepressants on the organs of the gastrointestinal tract and the liver.
Treatment with non-traditional methods
Non-traditional methods of treatment, methods adopted in oriental medicine, time-tested and modern science, can be an adjunct to drug treatment, and used in the treatment of the disease. Treatment with music, art therapy (art), Bible reading, yoga, acupuncture, physical exercise, Pilates, swimming, communicating with nature, hippotherapy allow a person to relax, change their attitude towards themselves, the world around them, change their worldview and develop skills to behave in a stressful situation
Treatment with medicinal plants and nutrition
The fact that many plants have antidepressant effects cannot be ignored. They were used before the era of pharmacology. Many ancient doctors treated mental illness with food and herbs. So the doctor from Ancient Greece Hippocrates wrote: “Your food should be medicine, and your medicine should be food.”
The introduction of oily fish, nuts, chocolate, legumes, liver, fish oil into the diet prevents depression.
The use of turmeric in a variety of foods can reduce the symptoms of the disease. Kalanchoe leaves give vigor and good mood for the whole day.
Treatment for prenatal depression
Treatment for this type of depression is carried out by a psychotherapist who changes a woman’s mind about many contrived difficulties and problems. Relieves mental stress, reduces anxiety and fear.
Motivation gives strength and improves mood. But in some cases, psychotherapy does not help, therefore medication therapy is carried out. Drugs are prescribed only on strict indications, taking into account the consequences for the child. For depression of pregnant women, omega-3 fatty acids, folic acid, S-adenosylmethionine are prescribed.
When treating with antidepressants, it is important to know that:
the effect of treatment usually occurs in 2-3 weeks;
in the case of the use of antidepressants of the SSRI group, there are no side effects such as blurred vision, urination, weight gain. Sometimes there may be nausea, increased sweating, drowsiness;
to achieve a stable effect, treatment in most cases should be continued for at least 4-6 months.
with repeated depression and suicide attempts, a longer course of treatment is necessary.
Treatment with tricyclic antidepressants
Treatment with tricyclic antidepressants is prescribed individually according to strict indications. They are effective in sleep disorders, migraines, accompanying depression; selection of an effective dose is carried out using a neural test and pharmacogenetic study of cytochrome P450 isoforms.
Tricyclic antidepressants – imipramine, mianserin, doxilin, lofepramine are prescribed in small doses under the control of their concentration in the blood. The decision on their appointment, dosage, cancellation is the competence of a psychiatrist. Currently, treatment with tricyclic antidepressants is fading into the background, as a new class of drugs has appeared – serotonin reuptake inhibitors.
Treatment with serotonin reuptake inhibitors (SSRIs).
Treatment with drugs acting on the reuptake of serotonin affects the level of this neurotransmitter in the brain. It is the lack of serotonin that is one of the mechanisms for the development of depression.
The advantages of treatment with SSRI antidepressants are:
minimal dependence on them;
prescribing immediately in a therapeutic dosage, without increasing concentration;
List of SSRI drugs used in the treatment of depression
fluxen, prozac, deprex
paxil, luxotil, xet
zoloft, emoton, depralin
deprivox, fevarin, sandoz
oropram, citalam, auropram
escitam, tsipralex, tsipram, pandep
Treatment of depression with psychotropic drugs of other groups
Treatment with tranquilizers is prescribed for anxiety, sleep disturbances, irritability. Benzodiazepine derivatives are used:
Tranquilizers of other chemical groups are also used: atarax, afobazole, phenibut, buspirone.
Treatment with neuroleptics is used for suicidal thoughts and delusions, and treatment with nootropic drugs – for fatigue and weakness, impaired concentration.
Depression treatment is the prerogative of the psychiatrist. You cannot use medicines on your own, following the advice of friends, recipes on the Internet, self-medication. Almost all drugs have side effects, and the treatment consists of using different methods and an integrated approach:
To avoid depressive disorders, one must understand that a person is integrated into nature, that many environmental factors can prevent the disease.
First of all, these are:
Light. Solar is not electric!
Fresh air. Walks in the open air!
Movement. After all, movement is life!
Communication. Turn off cell phones and chat live!
Nice images. Do not watch TV that broadcasts political debates, wars, squabbles and any negative things! Don’t waste time on horror movies, thrillers, computer games. Enjoy music, art, nature!
Make plans and get creative.
Remember! Life is not a debt to loved ones, relatives, children, the pursuit of finances. Life is pleasure, it is the realization of oneself, one’s potential and pleasure!
The World Health Organization singles out the problem of suicide as one of the important medical and social problems of modern society. In many countries, suicide is among the top 10 causes of death, and among adolescents and adolescents it is ranked third. Every year, about half a million people die from their own hands, and these figures are undoubtedly underestimated. Over the past decade alone , an increase in the prevalence of suicides has been noted in Russia to 45-56 cases per 100 thousand of the population per year, and in certain regions and population groups – to 90 and more, which is combined with a parallel increase in the frequency of depressive conditions and alcohol abuse. Depression is the cause of 70% of all suicides. Many authors agree that the high number of suicides we have is associated with inadequate treatment for depression. Depressive disorders, in turn, are one of the most common psychopathological conditions. Approximately every tenth inhabitant of the planet carries on throughout their lives depressed, and in each of the twentieth it is repeated.
Thus, for the prevention of suicide, it is necessary to carry out early adequate diagnostic measures in order to timely identify and treat depressive disorders.