Trazodone is used for depressive disorders, a popular means of Trazodone has a pronounced anti-depressive effect, has a tranquilizing and anxiolytic effect. This substance is an antidepressant, serotonin reuptake antagonist. It has the appearance of a white crystalline powder, which does not have a specific smell, the drug is highly soluble in water.
What is depression
Depression is a mental disorder characterized by despondency (loss of Joy), disruption of thinking and inhibition.
One of the main, and frequent causes of depression is stress, or a prolonged situation traumatic nervous system. The secondary factor that leads a person to a depressive state is the inability of a person to solve certain situations, to come out of various difficulties. If the main causes of depression are primarily a problem that has arisen in the present time, the secondary factors-problems from childhood, when a person, at an early age, together with the upbringing takes the model of his behavior for the remainder of his Life.
It happens that depressive disorders hide under a mask of bad mood or character peculiarities, and if these conditions do not separate and direct efforts on treatment of depression, it can suffer not only the person, but also surrounding people.
The concept of "severe depression" in modern psychiatry.
At the present stage of development of general psychopathology, severe depression means the severity level of the depressive syndrome with severe impairments of affect and depressive disorders of self-awareness, severe psychomotor disorders. The severity of symptoms significantly limits social functioning and biological needs.
Actual problems of modern treatment and rehabilitation.
Life-threatening clinical manifestations and complications, high suicidal danger, severe depression is close to urgent pathology.
Immediate administration of an individually adequate one is required, in all cases of intensive therapy.
The appointment of differentiated treatment requires a comprehensive assessment of the patient’s condition, including a clinical-psychopathological assessment of depression.
Only complex treatment with prescribing drugs of different groups and non-drug therapy will be effective. Inevitably, the use of treatment methods with a high therapeutic effect but with a poor tolerability profile will be necessary. A flexible approach to the implementation of the recommendations of clinical protocols, risk assessment of side effects, requires a long course of application of methods to continue treatment with means.
A depressive episode has a protracted treatment. After elimination of a serious condition at the first stage of therapy, the problem is further treatment. Therapy is needed to reduce the symptoms of the current episode and prevent its exacerbation and prophylactic treatment to prevent relapses.
Diagnosis of severe depressive episode.
The International Statistical Classification of Diseases, Injuries and Causes of Death of the 10th Revision (ICD-10) defines a depressive episode as a condition when a patient suffers from a reduced mood, loss of interests and pleasure, a decrease in vigor, which leads to increased fatigue and decreased activity, even little effort.
Clinical descriptions and diagnostic indications of ICD-10 identify a group of other symptoms of a depressive episode:
- Reduced focusing ability;
- Reduced self-esteem and self-confidence;
- Ideas of guilt and self-deprecation;
- A dark and pessimistic vision of the future;
- Ideas or actions on self-harm or suicide;
- Disturbed sleep;
- Reduced appetite.
Research diagnostic criteria ICD-10 distinguish three groups of diagnostic criteria for a depressive episode.
The main symptoms of a depressive episode include:
- Depressed mood of the patient most of the time of the day;
- A distinct decline in interest in a previously enjoyable activity;
- Reduced energy or increased fatigue.
Additional symptoms of a depressive episode include:
- Reduced self-esteem and loss of self-confidence;
- Unreasonable censure and excessive guilt;
- Repeated thoughts of death or suicide;
- Impairment of ability to think or concentrate, indecision and hesitation;
- A change in the level of psychomotor activity, inhibition or agitation;
- Sleep disturbance;
- Increase or decrease in appetite and body weight. The manifestations of the severity of depression include the signs of the so-called somatic syndrome depressive episode:
- A pronounced loss of interest in previously interesting activities and the ability to enjoy;
- Lack of response to events and actions that caused an active response;
- Waking up in the morning two or more hours earlier;
- Increased depression in the morning;
- Objective signs of the severity of psychomotor inhibition or agitation;
- A marked decrease in appetite;
- Loss of body weight by 5% or more per month;
- Loss of libido.
Treatment of depression and anxiety, how to recognize and what to do
Depression is a severe mental disorder, is thrown in people of all ages and a warehouse of character because of constant nervous overexertion, frequent stress or on the background of severe experiences.
Depression is one of the most ambiguous and mysterious diseases. The worst thing is that often the patient himself does not find the strength or desire to be treated, and his family and friends do not understand all the danger of the situation and do not seek professional help until the disease will progress.
Many people who think of suicide believe that they have depression. In many cases, this is true. In the broad understanding of depression diagnosis It is sick about half of humanity. Perhaps, depression is the most common disease of modern times.
It is possible to distinguish a real depression on triade of classical signs:
- Reduced mood – constantly lowered mood, frequent tears, feelings, irritation or indifference. At the beginning of the disease in the patient there are periods of negativity, it pleases nothing, habitual affairs and occupations do not bring positive emotions. Gradually the condition is aggravated, fears, feelings, depression appear.
- Reduction of motor activity-if at the beginning of the disease a person does not want to do anything, then in the midst of the disease can no longer. In case of depression, the patient tries to reduce any kind of activity, he refuses invitations anywhere, spends all his free time at home, and not doing something specific, and as the weight of the state, can generally refuse to leave the house or Leave the bed.
- Apathy is characterized by a complete disappearance of interest in anything. Favorite work, home, family, close people-all this ceases to bring joy and in general somehow interested in the patient. In the beginning of the illness the person performs only daily, routine affairs, and as the increase of apathy and reduction of motor activity, he ceases to do anything.
Manifestation of all these signs depends on the severity of the disease, with a mild degree of the patient feels constant depression, dissatisfaction with his life, he feels worse, most of the time spends alone, doing nothing. Depression medium and severe causes not only mental, but also physical deterioration of the patient, he, most often, does not leave the house, refuses to perform any action, most of the day and night spends in bed and does not communicate with Family.
This behavior does not always cause the correct reaction from others, but the patient depression also needs treatment, as well as a person with diabetes or hypertension. Disorder of the nervous system leads to the fact that in his body ceases to produce enough hormones and neurotransmitters, because of which the normal behavior of the person is impaired, mood decreases and apathy arises. But if in the midst of the disease such changes in the central nervous system occur in all patients, then provoke the onset of the disease, in 90% of cases, still a severe nervous shock, severe stress or prolonged nervous exhaustion. Therefore, an integrated approach is important.
The first thing you need to know is that depression is curable. Depression is not a verdict. It's the same disease as the others. Even the most severe forms of depression are successfully cured if the patient uses effective means, which offer psychiatry and psychotherapy.
In addition to drug therapy, it is obligatory and psychotherapeutic help, and change of lifestyle. Only in complex treatment can achieve a stable remission and recovery, otherwise there is always a risk of re-occurrence of the disease.
In the treatment of depression secrete methods of active and preventive therapy. Active therapy is aimed at cupping the symptoms of the disease during the attack of depression. Preventive therapy is the lengthening of the achieved remission. The nature of the effects distinguish drug treatment and psychotherapy.
Drug treatment of depression
In the treatment of depression are used drugs, called antidepressants, which are prescribed both in the period of active treatment, and after. There are several groups of these drugs that differ in both the chemical formula and the principle of action, as well as the effect produced.
First-and second-generation antidepressants.
First generation antidepressants
Drugs from this group are effective in severe depressions. Their efficiency reaches more than 70 percent. They are used when other antidepressants do not give a clinical effect. However, treatment with these drugs is accompanied by numerous side effects. Currently, this group of drugs is rarely used because of the serious side effects (e.g., hypertension crisis) and the diet to be followed while taking these medications.
Second generation antidepressants
This group includes the means possessing a large neurochemical selectivity. The efficacy of these drugs is much lower and therefore they are applied in light and moderate degrees of severity. However, they are transferred much easier, producing not so many side effects. However, most of the latest drugs have recently been banned due to the fact that their inversion effect has been proved. This means that some drugs in this group are capable of provoking suicidal behavior. The maximum risk of this side effect is observed in the younger generation.
Stages of treatment of depression
In the treatment of depressive states distinguish several stages.
One antidepressant is appointed in the middle therapeutic dose. It can be fluoxetin, Sertralin or Paroxetin. In the absence of positive dynamics within 2 – 3 weeks The next step is to increase the dose of the antidepressant to the maximum.
If after increasing the dose of the drug is not improved, it is recommended to change the antidepressant. It is recommended to choose a drug from a group with a similar mechanism of action, staying within the same group.
In the absence of positive dynamics in the second stage is recommended transition from monotherapy (treatment with one drug) to the combination therapy (treatment with several drugs). Most often it is a combination of two antidepressants or an antidepressant and a tranquilizer. In severe endogenous depression recommended combination of antidepressants and neuroleptics.
It involves the use of electroconvulsive therapy. This method is carried out in the case of depression, which has proven to be resistant to pharmacotherapy.
After edema of depressive episode pass to the stage of supporting therapy. This stage is to continue taking antidepressants, the dose of which is set individually. It is necessary to know that premature cessation of treatment leads to relapse of depression in 50% of cases. Maintenance therapy should last at least six months.
The mechanism of action of Trazodona.
Trrazodon does not refer to tricyclical, tetryclical and other types of antidepressants. Trazodone has no odor, white powder, well dissolved in water.
The remedy has anti-depressive effect and strong tranquilizers. Тrazodon pharmacological properties differs from other drugs. Тrazodone blocks Alpha-adrenoretseptory. Other drugs inhibit the substance or stimulate the central nervous system.
The drug Тrazodon effectively eliminates:
- Reduces sweating
- Effective tension
Patients receiving Trazodone are improving the quality and duration of sleep. The drug can selectively inhibit the reverse takeover of serotonin in the brain. Тrazodon acts as an antagonist of 5-HT2A/2C receptors.
After receiving the drug in half an hour begins the action, and the necessary concentration of the drug is reached in 2 hours. When taking medication at the same time with food intake rate decreases, the substance longer displays the concentration of it below. Trazodone is recommended to take an empty stomach. Тrazodon easily overcomes histohematic barriers, it has a high degree of binding with a protein of blood plasma 87 – 96%. In a single admission of Trazodona, the drug is excreted in the course of 3 to 6 hours, with a systematic admission to 9 hours. The whole drug of Trazodone is excreted in 98 hours.
Tricyclical antidepressants what is it?
The most important condition for the treatment of Depresisi is the selection of antidepressants for the patient. A few weeks after the start of the course of treatment can determine the positive or negative result of the use of antidepressants.
Tricyclical drugs-a modern method, they give a long positive effect in the course of treatment at least half a year. However, changes are coming in 2 to 3 weeks. These antidepressants are not recommended to be consumed without the control of your doctor. Improper dosage or stopping of treatment can lead to non-fatal consequences, only long-term treatment under supervision. This is a feature of tricyclic drugs.
With the proper intake of tricyclic drugs are extremely rarely observed side effects. At the end of the course of the drug, later appointed in smaller doses. This helps to avoid the withdrawal syndrome or eliminate it.
The use of tricyclic drugs in medicine.
Tricyclic drugs not only treat depression. They are appointed with diagnoses:
- Pain symptoms of different etiology,
- Panic attacks,
- A discursive-compulsive disorder,
- Headaches of a regular nature.
Tricyclical antidepressants are successfully used in the treatment of sleep disorders. Competent influence on the chemical processes of the brain is the main feature of these drugs, and the ability to treat a large range of diseases. The name of the group is derived from the structure of its chemical compound consisting of three cycles.
It is necessary to remember that tricyclical preparations are not the solution of all problems. Individual approach is necessary.
The effectiveness of the drug depends on factors:
- Depression depth
- Compatibility with other drugs
- Somatic condition of the patient
- Regularity of application
- Previous treatment Courses
- Possible Side effects
Choice of antidepressants "strong" or "weak"?
What antidepressants appoint: strong or weak, determines the doctor. Sometimes a long-term treatment with weak drugs, and sometimes apply strong antidepressants, but a short time.
Usually to determine the drug, you have to test several types of drugs. The peculiarity of tricyclic preparations is their appointment in small doses, with further increase in doses.
The appointment of tricyclic antidepressants.
Depression needs to be cured. If it is not cured, it will be a relapse, temporary improvement does not mean cure. If a patient has a relapse after treatment, the next course of treatment should be longer than the previous one.
Tricyclical drugs are not suitable for everyone. Due to prolonged operation. For example, patients prone to suicide will not feel the relief of treatment with these antidepressants. Overdose of these drugs is dangerous fatal. Tricyclical drugs are contraindicated in some chronic diseases.
- The Lofepramine.
Ideal drugs do not exist, but tricyclical drugs often achieve resistant effect.
Side effects of Trazodona
Possible side effects on the central nervous system:
- Muscle twitching,
- Blurred vision,
- Big convulsive seizures,
- Congestive heart failure,
- Of Bradidiology,
- Leukocytosis or Leucopenia,
- Arterial hypotension,
- Orthostatic hypotension.
- Ectopic ventricular rhythms,
- Hemolytic anemia,
- Atrial fibrillation,
Organs of the gastric tract:
- Increased appetite,