What strong antidepressants. Antidepressants available without a prescription

Good antidepressant

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Prescribing antidepressants

The latest pharmacological agents can cope with more than just depression. A good antidepressant can also eliminate irritable bowel syndrome or cope with the consequences of psychosomatic diseases such as bronchial asthma, peptic ulcers, neurodermatitis and a number of other skin ailments.

Remember that only a doctor should choose antidepressants for you! Do not take them on the recommendation of a friend or the review of any other person - it is dangerous to your health!

In addition, drugs of this kind are good at relieving panic attacks, obsessive-phobic disorders, bulimia nervosa or anorexia, and are also good anti-anxiety drugs. Antidepressants are also indispensable for narcolepsy, vegetative-diencephalic crises, various pain syndromes, alcoholism, chronic fatigue, drug addiction and childhood hyperkinetic disorders.

Generations of antidepressants

Antidepressants were first created in 1954. Since that time, the properties of drugs with similar effects have been constantly improved, and today there are four generations of antidepressants, which are divided into the following list:

• tricyclic
• tetracyclic
• selective

The first generation of tricyclic antidepressants are substances such as melipramine, anafranil and amitriptyline. The effectiveness of first generation drugs is quite high.

Previously, these included irreversible monoamine oxidase inhibitors, which are not currently used in the treatment of depression.

The second generation of tetracyclic antidepressants includes mianserin, maprotiline, pirlindole and moclobemide. These antidepressants are somewhat weaker than first-generation drugs, but are much easier to tolerate by the body.

The third generation consists of selective serotonin reuptake inhibitors and is by far the most popular group of antidepressants. It includes drugs such as citalopram, fluoxetine, paroxetine, sertraline and fluvoxamine. The antidepressant effect of the third generation is more pronounced compared to second-generation drugs, but does not reach the power of first-generation antidepressants. They are usually recommended by doctors.

The new, fourth generation of antidepressants selectively acts on the reuptake of norepinephrine and serotonin, which brings their effectiveness closer to the first generation.

The level of side effects of the fourth generation is no different from the third generation of selective serotonin reuptake inhibitors

The new group of drugs are duloxetine, mirtazapine, venlafaxine and milnacipram. Today, the most popular are third-generation antidepressants, however, the fourth is gradually being introduced into medical practice, expanding the range of possibilities for treating depression and emotional disorders. The use of modern antidepressants is designed for at least six months, after which the symptoms of depression are completely suppressed.

Taking the latest medications correctly

When taking modern antidepressants, it is very important to adhere to the dosage prescribed by your doctor. You cannot stop taking the drug on your own, since withdrawal symptoms may occur after stopping it. To prevent it, the doctor will reduce the dose of antidepressants according to a certain scheme until the very end of the treatment course.

Each of the drugs included in the newest antidepressant drugs is produced separately, but it is impossible to select a drug with maximum and universal effectiveness. If one drug does not do the job, it is recommended to choose with the help of a doctor and get a prescription for another antidepressant.

However, like any drug, the latest generation of antidepressants have their risks. Thus, simultaneous use of SSRI drugs with warfarin, aspirin, naproxen and ibuprofen can provoke bleeding in the gastrointestinal tract. Central nervous system disorders are also possible - tremor, dizziness, irritability, insomnia and anxiety.

According to consumer reviews (they can be found via links to thematic forums), a person’s sexual sphere may also suffer from the latest antidepressants - erectile dysfunction, decreased libido and vaginal dryness may occur. Because of this, some herbalists recommend the use of natural, herbal remedies that reduce nervousness, stress, panic and depression. But you should not self-medicate, since in some cases such medications simply cannot cope with the problem that has arisen.

No matter how much you would like to get rid of mental problems on your own, this is not always possible. Depression is a disease that requires consultation and treatment from a specialist. Today, the most effective means of combating it are modern antidepressants.

Some people categorically do not accept taking medications and either do not receive treatment at all or resort to traditional medicine. There are also people (mostly hypochondriacs) who seek out non-existent depression and drink a huge amount of incomprehensible pills. The vast majority of citizens simply try to take a pill (the one that someone recommended or showed in an advertisement) as soon as possible, drowning out mental discomfort.

Due to problems in the healthcare system, many are turning to self-help and self-medication, which, undoubtedly, can be a very dangerous activity. Not seeking help from a doctor when it is necessary and looking for problems when there are none is equally wrong and harmful to health.

Therefore, in the treatment of depression it is immediately necessary dot all the pointsi:

1. If observed short and shallow depression, such forms as subdepression, everyday or seasonal depression (“depressive” seasons - autumn and spring), as well as anxiety, low mood, apathy, drowsiness, decreased ability to work, you can try to cope with the problem yourself.

If psychological methods of combating depression are ineffective, you should contact a pharmacy. There without a doctor's prescription You can buy mild antidepressants.

1. If depression heavy, deep, long lasting(lasts continuously for more than 2 weeks), is accompanied by somatic problems, panic attacks, obsessive fears, thoughts of death and other complex symptoms, you must definitely and as soon as possible contact a psychiatrist or psychotherapist.

Clinical depression is treated in an inpatient or outpatient setting. The doctor prescribes medications that are not available in pharmacies without a prescription.

The sooner you start treating depression, the less likely it is that it will turn from a psychological problem into a mental illness.

What are they, modern antidepressants?

The name “antidepressant” speaks for itself - these are drugs for depression, although they are also prescribed for:

• anxiety disorders,
• panic attacks,
• phobic disorders,
• bulimia nervosa and anorexia,
• alcohol, drug addiction,
• bronchial asthma and many other diseases.

Antidepressants is a type of psychotropic drug.

Psychotropic drugs are medications that affect the mental, emotional and behavioral spheres of the individual. In addition to antidepressants, psychotropic drugs also include neuroleptics, tranquilizers, psychostimulants and other types.

How do antidepressants work? They affect neurotransmitters(biologically active chemicals through which nerve impulses are transmitted in the human body), which are also called “hormones of happiness”, namely on:

• serotonin,
• norepinephrine,
• dopamine

Roughly speaking, an antidepressant blocks the collapse of “happiness hormones”, which physiologically causes the occurrence of depression. By influencing serotonin, norepinephrine and dopamine, the antidepressant fights depression.

Antidepressants were first created in 1954. To date four generations of antidepressants:

Nowadays, doctors most often prescribe drugs third generation, fourth generation antidepressants are not yet very popular and widespread.

Psychotropic drugs are available only by prescription, are used for at least six months, the dosage is determined by the attending physician and changes during the treatment process.

Over-the-counter antidepressants

Mild antidepressants are mostly of natural, plant origin. Of course, there are also tetracyclic and SSRI drugs. Here are some of them:

• Maprotiline/Lyudiomil,
• Prozac/Fluval/Prodep/Profluzac/Fluoxetine,
• Zyban/Nousmoke/Wellbutrin,
• Paxil/Sirestill/Rexetine/Plizil/Adepress.

As of today price The range of these drugs is wide, from approximately $0.50 to $90.

Concerning herbal antidepressants, then ancient healers and healers knew about them. Until the middle of the last century, that is, until the moment when synthetic psychotropic drugs were invented, herbal drugs were used:

• opiates,
• amphetamines,
• bromides,
• barbiturates,
• alkaloids.

Today, many of them are not used in the treatment of depression or are completely prohibited.

Modern natural antidepressants are made from such plants:

• St. John's wort,
• valerian,
• motherwort,
• Melissa,
• peppermint,
• hop,
• elder,
• hawthorn,
• ginseng,
• lemongrass,
• immortelle and many others.

Alcohol tinctures, extracts, and, of course, tablets are made from these herbs. The price of such drugs is relatively low.

Perhaps the best remedy, the effectiveness of which in the treatment of depression has been proven by numerous clinical trials and time - St. John's wort tincture.

St. John's wort is a tall grass with small yellow flowers. It grows as a weed in the temperate climate of the Northern Hemisphere and is familiar to many from childhood. You don’t even have to look for a tincture from this plant in a pharmacy, but make it yourself by collecting this herb in a meadow or field.

St. John's wort is used in the manufacture of such over-the-counter antidepressants How:

• Novo-Passit,
• Negrustin,
• Deprim,
• Persen.

These and other herbal preparations also help with insomnia, irritability, stress, fatigue, low mood, loss of strength, decreased concentration and memory, physical pain of unknown origin, loss of performance, and also strengthen the immune system.

Although today herbal preparations are effectively used to treat mild forms of depression, in the fight against severe depression you simply cannot do without the latest generation of antidepressants!

If you yourself or someone close to you is faced with the problem of depression, these books will help:

1. Danny Penman, Mark Williams “Mindfulness. How to find harmony in our crazy world”
2. Dmitry Kovpak, Leonid Tretyak “Depression. Modern approaches to diagnosis and treatment”
3. Tatyana Trofimenko “Depression without rules”
4. Margit Dahlke, Rüdiger Dahlke “Dark Night” of the Soul. Healing from depression”
5. Charles G. Elliott, Laura L. Smith

Antidepressants are used in the treatment of depression, a list of which can be seen below. Antidepressants are drugs that selectively affect a person’s depressive state. These drugs and antipsychotics for depression can be used to relieve affective-delusional syndromes in children and adults.

The most common mild antidepressants are:

• Moclobemide;
• Bethol;
• Toloxatone;
• Pyrazidol;
• Imipramine;
• Amitriptyline;
• Anafranil;
• Pertofran;
• Trimipramine;
• Azafen;
• Maprotiline;
• Mianserin;
• Fluoxetine;
• Fevarin;
• Citalopram;
• Sertraline;
• Paroxetine;
• Cymbalta.

This is only some of the antidepressants used to combat nervous disorders and depression. All of them are divided into several classifications.

Calming

Anti-depressants are a classification of the most common drugs used to combat depression.

Amitriptyline belongs to the classic type of mild antidepressants with a tricyclic structure. It is distinguished from Imipramine by its rather strong sedative effect. It is used to get rid of depression of anxious and agitated types, which can manifest themselves with “vitality”. This drug is available in the form of tablets and injections.

Another domestic antidepressant is Azafen, or Hypophysin. It is used to combat the symptoms of “minor” depressive disorders of the cyclothymic register. The drug has moderate sedative and thymoanaleptic effects.

Mianserin, or Lerivon, is a drug that has a strong sedative effect when used in small doses. Due to this effect, it can be used to treat cyclothymia in combination with insomnia. It is capable of curing depression with major episodes.

Stimulating

Moclobemide, or Aurorix, is a selective MAO inhibitor. The drug has a powerful stimulating effect on people suffering from inhibited types of depression. It is prescribed for somatized types of depression. But the drug is strictly prohibited for use in anxiety depression.

Imipramine, or Melipramine, is the first fully studied tricyclic antidepressant. It is used in the treatment of severe depression with a high prevalence of sadness and lethargy, and with suicidal thoughts. The drug is available both in the form of tablets and as intramuscular injections.

Fluoxetine is a drug that has a thymoanaleptic effect. Its second name is Prozac. The drug is effective during the treatment of depression with obsessive-phobic symptoms.

This type of medication is called a selective serotonin reuptake inhibitor (SSRI). The drug is devoid of some effects of clinical tricyclic antidepressants:

• antihistamine;
• adrenolytic;
• cholinolytic.

Pertofran is a more powerful version of Imipramine (desmethylated). It has a brighter activating effect. The drug is used to combat depression combined with depersonalization.

Balanced drugs

The second name of Pyrazidol is Pirlindol. The drug is produced in Russia. It is a reversible inhibitor of MAO type A, like Moclobemide. This drug is used to prevent and treat depression of the inhibited type, as well as depressive disorders with pronounced anxiety manifestations. The advantages of the drug are that it can be taken for glaucoma, prostatitis and heart pathologies.

Another powerful drug created as a result of the synthesis and introduction of a chlorine atom into the imipramine molecule is Anafranil. It is used to treat resistant depression and to relieve the affective phases of severe depression.

Maprotiline, or Ludiomil, is an antidepressant with a tetracyclic structure. It has a fairly powerful thymoanaleptic effect when interacting with anxiolytic and sedative components. It can be used for circular depression in combination with ideas of self-blame. The drug is used for involutional melancholia. Maprotiline is produced in the form of oral medications and injections.

Reversible monoamine oxidase inhibitors and selective reuptake inhibitors

Befol is one of the domestic drugs that are prescribed for depressive disorders of asthenic and anergic types. It is used to treat the depressive phase of cyclothymia.

Fevarin and Fluoxetine belong to the classification of drugs with thymoanaleptic action. The drugs have a vegetative stabilizing effect.

Citalopram and Tsipramil are other names for thymoanaleptic antidepressants that can be used to treat depression. They belong to the group of sedating serotonin reuptake inhibitors (SSRIs).

Afobazole is an over-the-counter antidepressant. It is used to combat somatic diseases with adaptation disorders, anxiety, neurasthenia and oncological and dermatological diseases.

The drug has a good effect in treating sleep disorders and relieving PMS symptoms. But it is worth considering that it is contraindicated for children and women during pregnancy and lactation.

Tricyclic

Trimipramine, or Gerfonal, is used in the treatment of depression with increased anxiety. This is one of the most powerful drugs of this kind. Its psychotropic activity is similar to Amitriptyline. When carrying out treatment, it is worth considering the list of contraindications of this antidepressant:

• dry mouth;
• orthostatic hypotension;
• problems with urination.

New generation antidepressants

Sertraline and Zoloft are names of antidepressants with a strong thymoanaleptic effect and a weak stimulating effect. Moreover, the drugs do not have anticholinergic or cardiotoxic properties.

They achieve maximum effect when fighting somatized atypical depression with some manifestations of bulimia.

Paroxetine is a derivative of piperidine. It has a rather complex bicyclic structure. The main properties of Paroxetine are thymoanaleptic and anxiolytic. They appear when there is stimulation.

The drug shows itself well in the fight against endogenous and neurotic depression, their melancholy or inhibited variants.

Venlafaxine is an antidepressant used for depression associated with severe mental disorders such as schizophrenia, etc.

Opipramol is used to treat somatized and alcoholic depression. It is able to prevent vomiting, convulsions and generally stabilize the autonomic nervous system.

Toloxatone, or Humoril, is similar in its effect on the human body to Moclobemide. The drug does not have anticholinergic or cardiotoxic properties. But it copes well with treating depression with pronounced inhibition.

Cymbalta or Duloxetine are used to combat depression with panic attacks.

Side effects

Most antidepressants have a fair number of side effects. Their list is quite long:

• hypotension;
• arrhythmia;
• sinus tachycardia;
• violation of intracardiac conduction;
• suppression of bone marrow functions;
• agranulocytosis;
• thrombocytopenia;
• hemolytic anemia;
• dry mucous membranes;
• violation of accommodation;
• intestinal hypotension;
• problems with urination;
• increased appetite;
• increase in body weight.

Such side effects occur quite often due to the use of tricyclic antidepressants. In contrast, antidepressants that are serotonin reuptake inhibitors have less pronounced side effects. But it could be:

• frequent headaches;
• insomnia;
• anxiety states;
• depotentiating effects.

If combination therapy is used for treatment, that is, drugs of both types are used simultaneously, then serotonin syndrome may occur, characterized by an increase in temperature, signs of intoxication of the body, and disturbances in the functioning of the heart and blood vessels.

Any antidepressants for depression should be taken only after a complete medical examination and an accurate and complete diagnosis.

And for children they are prescribed with extreme caution. Be sure to do this under the supervision of a doctor so as not to harm the body.

More and more people today are faced with such an illness as depressive disorder. Frequent stress, constant conflicts, a fast or even frantic pace of life, domestic quarrels - all this can cause depression. Not a single person is immune from the occurrence of the disease.

Oddly enough, but a child can suffer from such a pathology, which only adults often complain about. Mental disorder can be caused by: misunderstanding in the family, difficult living conditions, loss of a loved one, divorce, financial problems, childhood trauma.

Often, the pathological condition develops against the background of inappropriate or prolonged use of certain medications: corticosteroids, beta blockers, interferon. The disease often occurs in people who abuse alcohol, as well as smokers and those who take drugs.

Depressive disorder can also be provoked by: previous head injuries, the presence of chronic pathologies, in particular diabetes, diseases of the cardiovascular system, and lungs. The disease needs to be treated. The sooner a person realizes that he is sick, the faster he can get rid of the disease.

Today there are many drugs for the treatment of the disease, both herbal and synthetic. Antidepressants are especially effective in the fight against mental disorders.

Before you begin to treat the disease, you need to know for sure that it is depression.

The disorder is accompanied by the following characteristic symptoms:

• constantly low mood;
• decreased interest or enjoyment in previously enjoyed activities;
• decreased libido;
• unreasonable weight loss;
• loss of appetite;
• insomnia;
• psychomotor agitation, anxiety;
• increased irritability;
• rapid fatigue;
• chronic fatigue;
• suicidal thoughts.

The disease may be accompanied by disruptions in the functioning of the gastrointestinal tract: upset stool, nausea, vomiting. Patients are often tormented by guilt, anxiety, and recurring thoughts of suicide. Such people need help not only from family and friends, but also from qualified specialists. If you do not take this condition into account, it is fraught with critical consequences.

The modern pharmaceutical industry has a huge number of drugs for the treatment of mental disorders. Antidepressants are often prescribed to combat depression. Only a doctor can choose the right medicine, treatment regimen, and duration of the treatment course.

What it is

Antidepressants are a designation for a pharmacological group of medications that help relieve symptoms and also prevent depressive disorders. Such medications help in correcting the biochemical activity of the human brain. Nerve cells constantly interact with each other thanks to special substances - neurotransmitters.

A mental disorder, according to one theory, appears due to a significant decrease in the concentration of a certain amine (dopamine, norepinephrine, serotonin) or neurotransmitter in the brain. Antidepressants of any generation are able to regulate or correct processes occurring in the brain by changing the level of one or another amine.

What are they for?

In addition to the fact that such compositions help combat the manifestations of depressive disorder, they show excellent results in the fight against the following problems: painful sensations of unknown etiology, sleep disorders, appetite disorders, fatigue, loss of strength, nervousness, constant tension, problems with concentration, memorization.

Popular modern thymoleptics

There are many drugs that have antidepressant properties. However, we should not forget that such drugs, in addition to their benefits, can cause significant harm to the body. To prevent the negative consequences of taking medications, experts strongly recommend against self-medication.

Only a doctor can select a medicine, dose, regimen, as well as a course of therapy, taking into account the patient’s age, illness, degree of severity, as well as the individual characteristics of the body.

Practitioners are increasingly prescribing drugs from the selective serotonin reuptake inhibitor group to patients. The most popular formulations include: Fluoxetine, Milnacipran, Duloxetine, Velaxin.

Review of popular powerful thymoleptics:

• Fluoxetine has pronounced antidepressant and stimulating properties. The use of the composition helps to: minimize anxiety, combat feelings of fear, improve mood. The drug is effective in the treatment of apathy, depression, and obsessive-compulsive disorder.
• Paroxetine. One of the most powerful, fast-acting antidepressants.
• Wellbutrin. The active component of the drug is bupropion. Helps in increasing the amount of norepinephrine, dopamine in the brain. Drugs with such an active component help not only in the fight against mental disorders, but also in overcoming the emotional consequences of quitting smoking and eliminating nicotine addiction.
• Cymbalta. It is characterized by fast action. The effect after use is noticeable by the end of the first week.

What is the price

Pharmacies offer drugs of different price categories. There are inexpensive drugs, and there are very expensive ones. The doctor, in any case, will select an available remedy.

Approximate prices of thymoleptics:

• The average cost of tricyclic antidepressants: Amitriptyline (Elavela) - 60 rubles, Imipramine (Imizina) - 340 rubles, Clomipramine (Anafranil) - 285 rubles, Maprotiline (Lyudiomil) - 350 rubles;
• Approximate price of selective serotonin reuptake inhibitors: Sertraline (Zoloft) - 700-1300 rubles, Paroxetine (Paxil) - 300-2000 rubles, Fluvoxamine (Fevarin) - 800 rubles, Fluoxetine (Prozac) - 500 rubles.

Interaction with other drugs

Thymoleptics interact with other drugs, even the most familiar and safe ones. To prevent undesirable consequences, before you start taking this or that drug for a depressive disorder, you should make sure that it is possible to combine the use of an antidepressant with drugs from other groups, even sedative herbal infusions, dietary supplements, and vitamins.

Alcohol and antidepressants

Experts strongly recommend that you stop drinking alcohol during treatment. Antidepressants, just like alcohol, have a strong effect on the central nervous system and brain. The combined use of ethanol with thymoleptics is fraught with unpredictable consequences.

Strong antidepressants: classifications of drugs and rules of use

Only a doctor can prescribe the use of a medicine. If the disease is mild, it is quite possible to do without drug treatment. In cases where the disorder is serious, the drug is selected by the doctor after examination.

Classification of drugs according to the principle of effect on the body

There are several types of drugs that have an antidepressant effect. The first classification is based on the clinical effect of the compounds on the central nervous system. Drugs in this group have a sedative, activating, balanced effect.

Thymoleptics, which have a sedative effect, can have a calming effect on the psyche, help eliminate anxiety, and increase the activity of processes in the brain.

Medicines with an activating effect are effective in the fight against apathy and lethargy. Balanced compositions are universal. Strong antidepressants should not be taken without the knowledge of a doctor. This can lead to unpredictable consequences.

Classification according to the principle of biochemical action

This is the traditional classification. Based on the composition of the products, as well as their effect on biochemical processes in the central nervous system:

• Tricyclic antidepressants. Helps increase the activity of neurotransmitters. These drugs are powerful, however, their use is associated with the risk of side effects. Doctors often prescribe the use of: Trimipramine, Amitriptyline, Imipramine, Mianserin, Clomipramine.
  One of the most powerful antidepressants is Amitriptyline. It has an antidepressant and mild analgesic effect. Effective in the fight against depression, sleep disorders, mixed emotional disorders, chronic pain syndrome, migraine, enuresis.
• MAO inhibitors (monoamine oxidase). Timpoleptics 1st generation. Monoamine oxidase is an enzyme that destroys various hormones, in particular neurotransmitters. MAO inhibitors help prevent this process, and, consequently, increase the level of hormones and activate mental processes. These remedies are inexpensive and effective, but have a considerable list of side effects. Taking the compounds is associated with hypotension, hallucinations, insomnia, blurred vision, constipation, presyncope, and sexual dysfunction.
  Doctors often prescribe the use of: Moclobemide, Pyrazidol, Befola, Rasagiline. A prominent representative of the group is Moclobemide. It has antidepressant and immunostimulating properties. Effective in the fight against schizophrenia, social phobia, mini-depressive psychosis, depression, alcoholism.
• Selective serotonin reuptake inhibitors. This is the third generation of thymoleptics. Relatively safe drugs that are practically non-addictive are well tolerated by patients.
  The drugs help to increase the activity of serotonics and normalize brain function. Strong antidepressants in this group: Escitalopram, Sertraline, Fluoxetine.

Fluoxetine is often prescribed. The product helps in quickly eliminating feelings of depression, combating bulimia nervosa, obsessive-compulsive disorders, and depressive states of various origins.

Difference between antidepressants and tranquilizers

Many people do not see the difference between tranquilizers and thymoleptics, so they classify these drugs as one group. In fact, the compositions vary significantly.

Antidepressants are medications with a stimulating effect that help normalize mood and combat mental problems. This group is long-acting. In addition, the drugs do not affect people whose central nervous system is healthy.

As for tranquilizers, these drugs are characterized by rapid action. They can be used to treat depression, but only as an auxiliary method. The essence of such drugs is to suppress the manifestations of negative emotions, and not, like antidepressants, to correct the emotional background. Such medications are often used in the fight against panic attacks, fear, anxiety, and agitation. These are more like anti-anxiety drugs.

Can I buy it without a prescription?

You cannot buy strong thymoleptics without a prescription. The exception is herbal preparations. One of these is Afobazole, a drug that has anti-anxiety and mild antidepressant effects. The drug is over-the-counter.

The dangers of self-medicating depression

Only a psychotherapist or neurologist can analyze all the factors and choose the right drug so that it brings exceptional benefits to the body. Doctors prescribe medications with mandatory consideration of the patient’s health status, physiological characteristics of the body, age, illness and its severity. An ordinary person cannot do this.

Almost all antidepressants, even the most harmless ones, are associated with the risk of side effects. Particularly dangerous is prolonged uncontrolled use of the compounds or the use of high doses. This is fraught with severe intoxication (serotonin syndrome), which can cause death.

How to get a prescription

Everything is simple here. If you suspect a mental disorder, you should consult a doctor. After studying the complaints and symptoms, he will prescribe medicine and write a prescription.

New generation antidepressants: 1st, 2nd, 3rd, 4th generation agents

Drugs with antidepressant effects were discovered in the mid-twentieth century. Today, depending on the time of invention, several generations of products are distinguished.

First generation drugs

1st generation drugs are tricyclic thymoleptics of cyclic action, discovered in the fifties of the last century. These include: Amitriptyline, Nefazodone, Anafranil, Melipramine. The compositions help block the reuptake of norepinephrine and increase its level.

This group includes monoamine oxidase inhibitors Isocarboxazid, Tranylcypromine, Iproniazid. They suppress the activity of nerve endings in the brain and increase serotonin levels.

New generation antidepressants are widely used. The drugs are effective, but they can only be used with the knowledge of a doctor.

Second generation

Represented by tetracyclic irreversible as well as reversible monoamine reuptake inhibitors. Among this group, the use of Lerivon and Pyrazidol is often prescribed. But in general, compounds in this group, due to the many side effects, are rarely prescribed - only in cases of urgent need. More and more doctors today are prescribing new generation antidepressants.

Third generation products

The third generation is represented by selective serotonin reuptake inhibitors: Zoloft, Citaloprom, Prozac, Cipralex, Paroxetine. They are slightly weaker than 1st generation drugs, but they have a smaller list of side effects.

Fourth generation

Represented by selective norepinephrine and serotonin reuptake inhibitors: Cymbalta, Remeron, Zyban, Effexor. There is no clear opinion regarding the best new generation antidepressant. Drugs are selected individually.

Natural Remedies for Depressive Disorders

The most common herbal remedies for eliminating the blues consist of the following components: chamomile, mint extract, motherwort, valerian. The most popular and effective are products based on St. John's wort.

Hypericin, which is part of St. John's wort, helps accelerate the synthesis of norepinephrine from dopamine. The plant is also endowed with other substances that have a beneficial effect on the central nervous system and other body systems: essential oils, tannins, flavonoids.

Herbal preparations are many times weaker than synthetic ones, therefore they help in the treatment of mild mental disorders. The products are sold without a prescription and are inexpensive. These include Neuroplant, Deprim, Negrustin.

A prominent representative of natural thymoleptics is Negrustin. The product has anti-anxiety and antidepressant properties. Effective in the fight against mild to moderate depression, anxiety, and chronic fatigue.

Antidepressants - a list of the best produced in Russia and Ukraine:

• Escitalopram - produced by the Berezovsky Pharmaceutical Plant;
• Citalopram - ALSI Pharma;
• Trittico - produced by C.S.C. Ltd.;
• Stimuloton - Egis Rus;
• Ixel - Sotex;
• Siozam - VeroPharm;
• Azafen - produced by MAKIZ Pharma;
• Adepressa - VeroPharm.

Amitriptyline, Afobazole, Heptor, Clomipramine are drugs manufactured in Russia and Ukraine. This is not a complete list of the best antidepressants.

Drugs with antidepressant properties can lead to critical consequences if taken incorrectly. You should not self-medicate. Only a doctor can select the correct composition.

Recently, the number of people suffering from depression has increased significantly. This is largely due to the frantic pace of modern life and the increased level of stress. Added to this are also economic and social problems. All this cannot affect the mental and emotional health of people.

People feel changes in their psyche when they affect their performance and social relationships. They turn to a doctor for advice, and often he diagnoses them with depression.

First of all, it should be noted that you should not be afraid of this diagnosis. The disease does not indicate that the sufferer is mentally or mentally disabled. It does not affect the cognitive functions of the brain, and in most cases it can be cured.

However, depression is not just a bad mood or sadness that can affect healthy people from time to time. With depression, a person loses all interest in life, feels overwhelmed and tired all the time, and cannot make a single decision.

Depression is dangerous because it can affect the entire body, causing irreversible changes in individual organs. In addition, with depression, relationships with others deteriorate, work becomes impossible, thoughts of suicide appear, which can sometimes be carried out.

Depression is actually not a consequence of a person’s weak will, or his insufficient efforts to correct the situation. In most cases, it is a biochemical disease caused by metabolic disorders and a decrease in the amount of certain hormones in the brain, primarily serotonin, norepinephrine and endorphin, which act as neurotransmitters.

Therefore, as a rule, depression cannot always be cured with non-drug measures. It is well known that when a person is in a depressed mood, a change of environment, relaxation methods and auto-training, etc. can help. but all these methods require significant effort on the part of the patient, his will, desire and energy. But with depression, they just don’t exist. It turns out to be a vicious circle. And it is often impossible to break it without the help of drugs that change biochemical processes in the brain.

Classification of antidepressants according to the principle of action on the body

There are several options for classifying antidepressants. One of them is based on exactly what clinical effect the drugs have on the nervous system. There are three types of such actions:

• Sedative
• Balanced
• Activating

Sedative antidepressants have a calming effect on the psyche, relieving anxiety and increasing the activity of nervous processes. Activating drugs fight well against such manifestations of depression as apathy and lethargy. Balanced drugs have a universal effect. As a rule, the sedative or stimulating effect of drugs begins to be felt from the very beginning of administration.

Classification of antidepressants based on the principle of biochemical action

This classification is considered traditional. It is based on what chemicals are included in the drug and how they affect the biochemical processes in the nervous system.

Tricyclic antidepressants (TCAs)

A large and diverse group of drugs. TCAs have long been used in the treatment of depression and have a solid evidence base. The effectiveness of some drugs in the group allows them to be considered a standard for antidepressants.

Tricyclic drugs can increase the activity of neurotransmitters - norepinephrine and serotonin, thereby reducing the causes of depression. The name of the group was given by biochemists. It is associated with the appearance of the molecules of substances of this group, consisting of three carbon rings connected together.

TCAs are effective drugs, but have many side effects. They are observed in approximately 30% of patients.

The main drugs of the group include:

• Amitriptyline
• Imipramine
• Maprotiline
• Clomipramine
• Mianserin

Amitriptyline Tricyclic antidepressant. Has both antidepressant and mild analgesic effects Composition: 10 or 25 mg amitriptyline hydrochloride Dosage form: dragees or tablets Indications: depression, sleep disorders, behavioral disorders, mixed emotional disorders, chronic pain syndrome, migraine, enuresis. Side effects: agitation, hallucinations, visual disturbances, tachycardia, blood pressure fluctuations, tachycardia, stomach upset Contraindications: heart attack, individual intolerance, lactation, intoxication with alcohol and psychotropic drugs, cardiac muscle conduction disorders. Application: immediately after meals. The initial dose is 25-50 mg at night. Gradually the daily dose is increased to 200 mg in three doses.

Monoamine oxidase inhibitors (MAO inhibitors)

These are first generation antidepressants.

Monoamine oxidase is an enzyme that destroys various hormones, including neurotransmitters. MAO inhibitors interfere with this process, due to which the amount of neurotransmitters in the nervous system increases, which in turn leads to the activation of mental processes.

MAO inhibitors are quite effective and cheap antidepressants, but have a large number of side effects. These include:

• Hypotension
• Hallucinations
• Insomnia
• Agitation
• Constipation
• Headache
• Dizziness
• Sexual dysfunction
• Visual impairment

When taking certain medications, you must also follow a special diet to avoid introducing potentially dangerous enzymes into your body that are metabolized by MAO.

The most modern antidepressants of this class have the ability to inhibit only one of two types of enzyme - MAO-A or MAO-B. These antidepressants have fewer side effects and are called selective inhibitors. Non-selective inhibitors are currently rarely used. Their main advantage is their low price.

Main selective MAO inhibitors:

• Moclobemide
• Pirlindol (pyrazidol)
• Bethol
• Metrolindole
• Garmaline
• Selegilin
• Rasagiline

Selective serotonin reuptake inhibitors (SSRIs)

These drugs belong to the third generation of antidepressants. They are relatively easily tolerated by patients and have fewer contraindications and side effects compared to TCAs and MAO inhibitors. Their overdose is not as dangerous as compared to other groups of drugs. The main indication for drug treatment is major depressive disorder.

The principle of operation of the drugs is based on the fact that the neurotransmitter serotonin, which is used to transmit impulses between neuron contacts, when exposed to SSRIs, does not return back to the cell transmitting the nerve impulse, but is transferred to another cell. Thus, antidepressants such as SSRIs increase the activity of serotonin in the nerve circuit, which has a beneficial effect on brain cells affected by depression.

As a rule, drugs in this group are especially effective for severe depression. For depressive disorders of minor and moderate severity, the effect of the drugs is not so noticeable. However, a number of doctors have a different opinion, which is that for severe forms of depression it is preferable to use proven TCAs.

The therapeutic effect of SSRIs does not appear immediately, usually after 2-5 weeks of use.

The class includes substances such as:

• Fluoxetine
• Paroxetine
• Citalopram
• Sertraline
• Fluvoxamine
• Escitalopram

Fluoxetine Antidepressant, selective serotonin reuptake inhibitor. Has an antidepressant effect, relieves feelings of depression Release form: Tablets 10 mg Indications: depression of various origins, obsessive-compulsive disorder, bulimia nervosa Contraindications: epilepsy, tendency to seizures, severe renal or liver failure, glaucoma, adenoma, suicidal tendencies, taking MAO inhibitors Side effects: hyperhidrosis, chills, serotonin intoxication, stomach upset Application: regardless of food intake. The usual regimen is 20 mg once a day, in the morning. After three weeks, the dose can be doubled. Fluoxetine analogues: Deprex, Prodep, Prozac

Other types of drugs

There are also other groups of drugs, for example, norepinephrine reuptake inhibitors, selective norepinephrine reuptake inhibitors, noradrenergic and specific serotonergic drugs, melatonergic antidepressants. Among such drugs are Bupropion (Zyban), Maprotiline, Reboxetine, Mirtazapine, Trazadone, Agomelatine. All of these are good antidepressants, proven in practice.

Bupropion (Zyban) Antidepressant, selective norepinephrine and dopamine reuptake inhibitor. An antagonist of nicotinic receptors, due to which it is widely used in the treatment of nicotine addiction. Release form: Tablets 150 and 300 mg. Indications: depression, social phobia, nicotine addiction, seasonal affective disorder. Contraindications: allergy to components, age under 18 years, concomitant use with MAO inhibitors, anorexia nervosa, convulsive disorders. Side effects: an overdose of the drug is extremely dangerous, which can cause epileptic seizures (2% of patients at a dose of 600 mg). Urticaria, anorexia or lack of appetite, tremor, and tachycardia are also observed. Application: the medicine should be taken once a day, in the morning. The typical dose is 150 mg, the maximum daily dose is 300 mg.

New generation antidepressants

These are new drugs, which mainly include antidepressants of the SSRI class. Among the drugs synthesized relatively recently, the following drugs have performed well:

• Sertraline
• Fluoxetine
• Fluvoxamine
• Mirtazaline
• Escitalopram

Difference between antidepressants and tranquilizers

Many people believe that tranquilizers are a good way to combat depression. But in fact, this is not the case, although tranquilizers are often used to treat depression.

What is the difference between these classes of drugs? Antidepressants are drugs that, as a rule, have a stimulating effect, normalize mood and relieve mental problems associated with a lack of certain neurotransmitters. This class of drugs acts for a long time and does not affect people with a healthy nervous system.

Tranquilizers, as a rule, are quick-acting drugs. They can be used to combat depression, but mainly as adjuvant drugs. The essence of their effect on the human psyche is not to correct his emotional background in the long term, like drugs for depression, but to suppress the manifestations of negative emotions. They can be used as a means to reduce fear, anxiety, agitation, panic attacks, etc. Thus, they are anti-anxiety and anti-anxiety drugs rather than antidepressants. In addition, during a course of treatment, most tranquilizers, especially diazepine drugs, are addictive and dependent.

Can you buy antidepressants without a prescription?

According to the rules for the dispensing of medicines in Russia, in order to obtain psychotropic drugs in pharmacies, a doctor’s prescription is required, that is, a prescription. And antidepressants are no exception. Therefore, theoretically, strong antidepressants cannot be purchased without prescriptions. In practice, of course, pharmacists may sometimes turn a blind eye to the rules in the pursuit of profit, but this phenomenon cannot be taken for granted. And if you are given a medicine without a prescription in one pharmacy, this does not mean that the same situation will happen in another.

You can only buy drugs for the treatment of mild depressive disorders such as Afobazole, “daytime” tranquilizers and herbal-based drugs without a doctor’s prescription. But in most cases it is difficult to classify them as real antidepressants. It would be more correct to classify them as sedatives.

Afobazole Russian-made anti-anxiety, anxiolytic and mild antidepressant without side effects. Over-the-counter drug. Release forms: Tablets 5 and 10 mg Indications: anxiety disorders and conditions of various origins, sleep disorders, neurocirculatory dystonia, alcohol withdrawal. Side effects: Side effects while taking the drug are extremely rare. These may be allergic reactions, gastrointestinal disorders, headaches. Application: it is advisable to take the drug after meals. The single dose is 10 mg, the daily dose is 30 mg. The course of treatment is 2-4 weeks. Contraindications: hypersensitivity to the components of the tablets, age under 18 years, pregnancy and lactation

The dangers of self-treatment for depression

There are many factors to consider when treating depression. This is the patient’s health status, the physiological parameters of his body, the type of disease, and other medications he is taking. Not every patient will be able to independently analyze all the factors and choose a medicine and its dosage in such a way that it would be useful and would not cause harm. Only specialists - psychotherapists and neurologists with extensive practical experience - will be able to solve this problem and tell which antidepressants are best to use for a particular patient. After all, the same medicine, used by different people, will lead to a complete cure in one case, will not have any effect in another, and may even worsen the situation in a third.

Almost all medications for depression, even the mildest and safest ones, can cause side effects. But strong drugs without side effects simply do not exist. Particularly dangerous is long-term uncontrolled use of drugs or excess dosage. In this case, the body may become intoxicated with serotonin (serotonin syndrome), which can be fatal.

How to get a prescription for the drug?

If you believe that you are depressed, it is recommended that you consult a psychotherapist or neurologist. Only he can carefully examine your symptoms and prescribe the drug that is appropriate for your case.

Herbal remedies for depression

The most popular herbal preparations today to lift your mood contain extracts of mint, chamomile, valerian, and motherwort. But preparations containing St. John's wort have demonstrated the greatest effectiveness in treating depression.

The mechanism of the therapeutic effect of St. John's wort has not yet been precisely clarified, but scientists believe that the enzyme hypericin contained in it is capable of accelerating the synthesis of norepinephrine from dopamine. St. John's wort also contains other substances that have a beneficial effect on the nervous system and other body systems - flavonoids, tannins, essential oils.

St. John's wort preparations are mild antidepressants. They will not help with all depression, especially with its severe forms. However, the effectiveness of St. John's wort for mild and moderate depression has been proven by serious clinical studies, in which it has shown to be no worse, and in some respects even better, than popular tricyclic drugs for depression and SSRIs. In addition, St. John's wort preparations have a relatively small number of side effects. They can be taken by children from 12 years of age. Among the negative effects of taking St. John's wort, the phenomenon of photosensitivity should be noted, which means that when the skin is exposed to sunlight during the course of treatment with the drug, rashes and burns may appear on it.

Medicines based on St. John's wort are sold without a prescription. So if you're looking for depression medications that you can take without a prescription, this class of drugs may be your best choice.

Some preparations based on St. John's wort:

• Negrustin
• Deprim
• Gelarium Hypericum
• Neuroplant

Negrustin Antidepressant and anti-anxiety agent based on St. John's wort extract Release form: there are two release forms - capsules containing 425 mg of St. John's wort extract and a solution for internal use, bottled in 50 and 100 ml bottles. Indications: mild and moderate depression, hypochondriacal depression, anxiety, manic-depressive states, chronic fatigue syndrome. Contraindications: photodermatitis, endogenous depression, pregnancy and lactation, simultaneous use of MAO inhibitors, cyclosporine, digoxin and some other drugs. Side effects: eczema, urticaria, increased allergic reactions, gastrointestinal disorders, headaches, iron deficiency anemia. Application: take Negrustin capsule or 1 ml of solution three times a day. Children under 16 are prescribed 1-2 capsules per day. The maximum daily dose is 6 capsules or 6 ml of solution.

List of popular drugs in alphabetical order

Name	Active substance	Type	Special properties
Amitriptyline		TCA
Agomelatine		melatonergic antidepressant
Ademetionine		mild atypical antidepressant	hepatoprotector
Adepress	Paroxetine
Azafen	Pipofezin
Azilect	Rasagiline
Aleval	Sertraline
Amizol	Amitriptyline
Anafranil	Clomipramine
Asentra	Sertraline
Aurorix	Moclobemide
Afobazole		anxiolytic and anti-anxiety drug	can be used for mild depression, over-the-counter
Bethol
Bupropion		atypical antidepressant	used in the treatment of nicotine addiction
Valdoxan	Agomelatine
Wellbutrin	Bupropion
Venflaxin
Herbion Hypericum	hypericin
Heptor	Ademetionine
Hypericin		atypical antidepressant	herbal product, over-the-counter
Deprex	Fluoxetine
Deprefault	sertraline
Deprim	hypericin
Doxepin		TCA
Zyban	Bupropion
Zoloft	sertraline
Ixel	Milnacipran
Imipramine		TCA
Calixta	Mirtazapine
Clomipramine		TCA
Coaxil	Tianeptine
Lenuksin	Escitalopram
Lerivon	Mianserin
Maprotiline		tetracyclic antidepressant, selective norepinephrine reuptake inhibitor
Melipramine	Imipramine
Metrolindole		reversible selective inhibitor of MAO type A
Miansan		Mianserin
Mianserin		TCA
Miaser		Mianserin
Milnacipran		selective serotonin and norepinephrine reuptake inhibitor
Miracitol	Escitalopram
Mirtazapine		noradrenergic and specific serotonergic antidepressant	new generation drug
Moclobemide		selective MAO type A inhibitor
Negrustin	hypericin
Neuroplant	hypericin
Newwelong	Venflaxin
Paroxetine		SSRIs
Paxil	paroxetine
Pipofezin		TCA
Pyrazidol	Pearlindol
Pearlindol		reversible selective inhibitor of MAO type A
Plizil	paroxetine
Prodep	fluoxetine
Prozac	fluoxetine
Rasagiline
Reboxetine		selective norepinephrine reuptake inhibitor
Rexetine	Paroxetine
Remeron	Mirtazapine
Selegilin		selective MAO type B inhibitor
Selectra	Escitalopram
Serenata	Sertraline
Surlift	Sertraline
Sertraline		SSRIs	new generation drug
Siozam	Citalopram
Stimuloton	Sertraline
Tianeptine		atypical TCA
Trazadone		serotonin antagonist/reuptake inhibitor
Trittico	Trazadone
Thorin	Sertraline
Fevarin	Fluvoxamine
Fluvoxamine		SSRIs	new generation drug
Fluoxetine		SSRIs
Cipralex	Escitalopram
Cipramil	Citalopram
Citalon	Citalopram
Citalopram		SSRIs
Asipi	Escitalopram
Elycea	Escitalopram
Escitalopram		SSRIs

List of antidepressants produced in Russia and Ukraine:

Azafen	MAKIZ Pharma
Adepress	Veropharm
Amitriptyline	ALSI Pharma, Moscow Endocrine Plant, Alvivls, Veropharm
Afobazole	Pharmstandard
Heptor	Veropharm
Clomipramine	Vector Farm
Melipramine	Egis Rus
Miaser	Pharma Start
Ixel	Sotex
Paroxetine	Berezovsky Pharmaceutical Plant, Alvils
Pyrazidol	Pharmstandard, Lugansk Chemical Plant
Siozam	VeroPharm
Stimuloton	Egis Rus
Thorin	Veropharm
Trittico	C.S.C. Ltd.
Fluoxetine	Vector Medica, Medisorb, Medicine Production, Valeant, Ozone, Biocom, Russian Cardiology Research and Production Complex, Vector Pharm
Citalopram	ALSI Pharma
Asipi	VeroPharm
Escitalopram	Berezovsky Pharmaceutical Plant

Approximate price of drugs

Name	Price from
Adepress	595 rub.
Azafen	25 rub.
Amitriptyline	25 rub.
Anafranil	331 rub.
Asentra	732 rub.
Afobazole	358 rub.
Valdoxan	925 rub.
Heptor	979 rub.
Deprim	226 rub.
Zoloft	489 rub.
Ixel	1623 rub.
Calixta	1102 rub.
Clomipramine	224 rub.
Lenuksin	613 rub.
Lerivon	1060 rub.
Melipramine	380 rub.
Miratazapine	619 rub.
Paxil	728 rub.
Paroxetine	347 rub.
Pyrazidol	171 rub.
Plizil	397 rub.
Rasagiline	5793 rub.
Rexetine	789 rub.
Remeron	1364 rub.
Selectra	953 rub.
Serenata	1127 rub.
Surlift	572 rub.
Siozam	364 rub.
Stimuloton	422 rub.
Thorin	597 rub.
Trittico	666 rub.
Fevarin	761 rub.
Fluoxetine	31 rub.
Cipramil	1910 rub.
Cipralex	1048 rub.
Citalopram	386 rub.
Asipi	439 rub.
Elycea	597 rub.
Escitalopram	307 rub.