The active substance Trazodone generally has antidepressant activity and a weak anxiolytic and sedative effect. Trazodone does not affect Monoamine oxidase inhibitor. Pharmacodynamics: A high level of interaction to a number of serotonin receptors that do not interact with the active component of trazodone.
Types of depression
Types of depression in severity-light, moderate, heavy
As well as on the International classification:
- Depressive episode
- Recurrent depression
- Depression in bipolar disorder
Today there are many classifications of depression. Emit depression in severity, the type of dominant symptom, and so on.
The variants of complex and simple depressions include:
Simple depressions – melancholic, anxious, dynamic, apathetic;
Complex depressions – Ipohondric depression and depression with delusions and hallucinations.
Characteristic of simple depressions:
Melancholic or dreary depression is characterized by a constantly suppressed mood with oppressive melancholy. Dreary depression is typical for middle-aged people and rarely occurs at a young age. As a rule, it is experienced as a strong mental pain, which is accompanied by painful sensations in the heart. The desire for some activity is absent, most of the time patients spend in bed. All that happens they perceive in grey, in memory always recollect old wrongs and wrong actions. Suicidal thoughts and deeds arise in extremely severe cases.
This is a very common type of depression, which manifests itself in motor excitation against the backdrop of heightened anxiety. Patients are excited, fast and a lot of talk. As in the dreary depression, patients physically feel anguish, and at alarming-anxiety is felt on the physical level. Disorders are manifested by an influx and confusion of thoughts, a quick and unrelated speech. Suicidal thoughts and thoughts of self-accusation also arise.
The name of depression describes the main symptom – Apinyu. This is a sharp decline in strength, accompanied by muscular weakness. The reduction of motor activity can develop up to its complete absence. For this type of disease is also characteristic, impotence, physical retardation. Patients complain about mental impotence. The idea of being guilty is not characteristic of the dynamic depression, but it is characterized by thoughts of its own inferiority and self-pity.
In the clinical picture of this type of disease is the lack of desire and desire for activity (both mental and physical). Lowering the level of motivation leads to the fact that the person ceases to be interested, becomes completely passive person. Such classic symptoms as anxiety, longing and self-accusation ideas are expressed weakly.
Characteristics of complex depressions:
In the structure of this depression are present not only depressive symptoms, but also complaints of painful sensations in the body. Mental pain and anguish, become the second plan. Concerns about their somatic condition are at the forefront. Patients become concerned about their physical health.
Depression including delirium and hallucinations.
Delusional ideas or hallucinations are at the forefront of this depression. Delirium, as a rule, boils down to ideas about suicide.
International Classification of Depression:
Depressive episode (F32)
This is a primary depressive episode that was not preceded by other episodes of depression. Characterized by classic symptoms-decreased mood, falling activity, sleep disturbance. The severity of the symptoms determines the severity of the depressive episode. Mild depressive episode (f 32.0)-the main symptoms expressed poorly, there is insomnia and impaired appetite. Moderate depressive episode (f 32.1)-to the main symptoms joins the decline of social and professional functioning. Severe depressive episode (f 32.2)-to the expressed violations of social functioning join the ideas of self-accusation and suicidal thoughts.
Recurrent correlation (recurrent) depressive disorder (F33)
This disorder is characterized by repeated depressive episodes. Periods between episodes in severe cases can pass without visible improvement. Recurrent depression is not only characterized by affective symptoms. So, cognitive disorders appear with memory and attention disturbance.
Depression in bipolar disorder (F31)
Bipolar affective disorder is characterized by two or more episodes of disturbed mood. In this case there is a periodic change of the increased and lowered mood.
Cyclimium (f 34.0)
It is a stable and unstable mood, which is characterized by periods of elation and reduced mood. However, these fluctuations are minimal and insufficient to be included in bipolar disorder or depressive episode.
Ditimium (f 34.1)
It is a chronic reduced mood, which lasts for several years. But at the same time, the reduced mood does not reach the degree of depressive episode.
In the treatment of depression most commonly used pill forms of drugs. In rare cases, intravenous drip injection of the antidepressant.
Also, drugs from other groups are used in the treatment of depression. Most often these are sleeping aids, tranquilizers and Nootropics. Insomnia, considered by many, is a symptom of depression, which disappears with proper treatment of the disorder itself. Sleeping aids only eliminate insomnia, but not the disease itself. Tranquilizers are the means that come to the aid of a pronounced alarm. Nootropics are designed to stimulate the brain's work.
Psychotherapy in depression
Psychotherapy is an integral part of the treatment of depression. Depending on the form and severity of the disorder psychotherapeutic methods can be applied independently or in combination with medical therapy. There are many methods of psychotherapy. The optimal method is chosen individually for each patient depending on the causes that caused depression. Also, the choice of psychotherapeutic method is influenced by factors such as the severity of symptoms, the general condition of the patient and the presence of other diseases.
Regardless of the method chosen, the purpose of psychotherapy is to eliminate symptoms of the disease and return the patient to a habitual lifestyle. The treatment also allows to form a patient's self-help skills and identify signs of relapse (re-exacerbation of the disease). This allows the patient to successfully withstand depression after treatment.
The most common methods of psychotherapy in depression are:
- Cognitive behavioral therapy;
- Interpersonal therapy;
- Psychodynamic therapy;
- Existential therapy;
- Gestalt therapy.
Cognitive behavioral Therapy
The method of treatment is the assertion that the feelings, thoughts and actions of a person are closely related. A distinguishing feature of cognitive behavioral therapy is the fact that the treatment does not require the establishment of causes that provoked depression. With the help of various techniques the therapist determines, analyzes and corrects the erroneous beliefs of the patient. As a result, the patient's thinking changes, allowing him to cope with situations that previously seemed to him insurmountable.
The skills that the patient acquires in the course of this therapy are:
- Tracking of your own negative thoughts and beliefs;
- Recognition of the connection between destructive thoughts, emotions and behavior;
- The development of true and realistic beliefs;
- Application of acquired knowledge in practice.
The principle of this method of psychotherapy is to improve the patient's relationship with the surrounding world. Interpersonal therapy is most effective in cases where depression is triggered by factors such as divorce, problems in relationships with the opposite sex, or with children. Often this method is used when the cause of the disorder is the loss of the social role due to retirement, loss of employment, severe injury. In the process of treatment the patient acquires the skills of solving problems with close people, learns to develop and maintain communication with his surroundings. Most often interpersonal therapy is conducted in the form of a group, when the treatment takes part not only the patient, but also members of his family.
This type of psychotherapy establishes the relationship between the patient's past and the disturbing depression. The cause of the disorder is experiencing and regretting the events that have occurred. The factor of depression can be traumas, suffered in childhood, or mistakes, committed in youth. During treatment the therapist helps the patient to change the attitude to the past and teaches him to perceive the present correctly.
This method is based on the assertion that human life consists of a number of internal conflicts and its tasks include their resolution. Experiencing the negative experience, man revises the meaning of life and finds new ways for his development. Depression in existential therapy is seen as a necessary stage of loss of life priorities leading to the acquisition of new values. The task of the therapist is to bring the patient to the realization that "getting stuck" at the current stage of his life and not releasing the problems he will not be able to rise to the next stage of his development. The most preferable is existential therapy for cases in which depression develops on the background of age-related crises and problems connected with change of a way of life, transition to new work, decrease of social importance.
Gestalt therapyAccording to Gestalt therapy, the human body has a system of self-regulation, and therefore independently copes with the emerging disorders. In the absence of the opportunity to satisfy any of their needs formed unfinished gestalt. The accumulation of a large number of unclosed gestalts leads to the fact that the mechanism of self-regulation gives a failure and develops depression. During the treatment, the doctor determines which of the patient's unmet needs led to the disease, and works on the closure of the gestalts.
Other treatments for depression
How to treat depression using other therapy methods? Methods such as light therapy, art therapy, sand therapy, musicotherapy, meditation and others can help in the treatment of this disease. It has a positive impact on the human condition by:
Normalization of the state of the nervous system-to help relieve nervous tension and reduce anxiety, fear and irritation can music from depression, yoga or meditation, massage, aromatherapy, swimming in the pool and other activities that bring To the sick rest and pleasure;
The ability to realize their creativity-art therapy, painting sand or any other kind of creativity helps the patient" splash out "their worries and experiences, transfer them to paper, clay or any other kind of material and thus get rid from them;
Increasing the production of" pleasure hormones "-in the fight against depression will help classes that strengthen the development of neuromediators. It is-sports, swimming, walks in the fresh air, proper nutrition and failure of bad habits.
So how do you overcome depression? The most important thing is to remember that treatment of depressive state should be complex, lengthy and only professional. Do not risk health and even human life, trying to cure the disease alone or just buying him the right pills. Only using a few treatments from a competent physician, lifestyle change, help and support from loved ones and friends can help overcome depression quickly and without consequences.
Chemical structure and mechanism of action of Trazodone - tricyclic drug.
Trazodone chemical structure does not apply to tricyclic, tetracyclic and other types of antidepressants. Trazodone hydrochloride is odorless, white, soluble in water, has a molecular weight of 408.33.
The tool has a deep anti-depressive effect. Trazodone has a strong tranquilizing effect. But trazodone is very different in pharmacological properties than other similar drugs. Trazodone blocks alpha1-adrenoreceptors. Other drugs either inhibit the substance or stimulate the central nervous system. This drug Trazodone is qualitatively different from the drugs of its pharmacological group.
The drug Trazodone effectively eliminates anxiety, insomnia, reduces sweating, fear, palpitations, headache, effective tension, myalgia. In patients taking trazodone, the quality of sleep and its duration are improved, and increased anxiety is eliminated. All this is due to the fact that the drug can selectively inhibit the reuptake of serotonin in the brain. Trazodone acts as an antagonist of 5-HT2A / 2C receptors.
The maximum concentration of the drug is reached within 2 hours, after 30 minutes it begins to act. When taking the medication simultaneously with food, the absorption rate decreases, the substance is removed longer, its concentration becomes slightly lower. It is better to take on an empty stomach. Trazodone rapidly penetrates biological fluids and tissues. Easily overcomes histohematogenous barriers. Trazodone has a high degree of binding to plasma protein 87 - 96%. The active metabolite 1m-chlorophenylpiperazine is formed in the liver. With a single dose of trazodone, the drug is displayed for 3-6 hours, with a systematic reception up to 9 hours. Fully medicine Trazodone is displayed after 98 hours.
Tricyclic antidepressants what is it?
One of the main conditions for the recovery of depressed patients is the reception of appropriate antidepressants. Positive or negative effects of the drug can be seen only after a few weeks. To date. Tricyclic antidepressants are considered the most effective.
Tricyclic antidepressants give a long lasting positive effect, provided they are properly taken. Usually the course duration is at least 6 months. Although significant changes occur within 2 to 3 weeks. Tricyclic antidepressants should not be used without the supervision of your doctor. Incorrect dosage or abrupt refusal of the drug can lead to tragic consequences. Successful treatment of depression, the suppression of all symptoms of depression begins after a long reception. This is a feature of tricyclic drugs. They give a long lasting positive effect, provided they are properly taken.
With proper use of tricyclic drugs, there are practically no side effects. If any side effects occur they quickly pass. At the end of the course of the drug is prescribed in smaller doses. It helps to keep withdrawal syndrome to a minimum or eliminate it altogether.
The use of tricyclic drugs in medicine.
The use of tricyclic drugs is not limited to the diagnosis of depression. They are prescribed with diagnoses: painful symptoms of various etiologies, panic attacks, migraine, obsessive compulsive disorder, headaches of a regular nature. Tricyclic antidepressants have been used successfully in the treatment of various types of sleep disorders. The reason for such a large range of use of these drugs in its chemical formula and their impact on the chemical processes of the brain. The drug is called tricyclic because the structure of its chemical compound consists of three cycles. Remember that tricyclic drugs are not the solution to all problems and are selected individually. ---- The effectiveness of the drug depends on many factors:
- Depth of depression
- Regular use
- Previous treatments
- Compatibility with other drugs
- Somatic condition of the patient
- Possible side effects
What antidepressants to take "strong" or "weak"?
The decision on which antidepressants to prescribe: strong or weak, should take a doctor. Sometimes long-term treatment with weak drugs is required, and sometimes a greater effect is achieved by the short-term use of strong antidepressants. Very often, to select the desired drug, you have to use several types of drugs.
A feature of the use of tricyclic drugs is that they are prescribed in small doses, gradually increasing to the desired concentration.
The appointment of tricyclic antidepressants. We need to remember that depression needs to be cured. If she is not treated, the symptoms will definitely come back, because improvement does not mean healing. If a person has a relapse after treatment, then the next course of treatment should be deeper and longer than the previous one.
Tricyclic drugs are not suitable for everyone. The reason for this is their prolonged action. Some patients, especially those prone to suicide, will not feel relief from taking this group of antidepressants. In addition, an overdose of these drugs can be fatal. Tricyclic drugs are also contraindicated in some chronic diseases.
Tricyclic drugs: Trazodone, Imipramine, Mianserin, Doxelin, Lofepramine. Ideal drugs do not exist, but still it is tricyclic drugs that most often achieve a lasting effect.
Side effects of the substance Trazodone
Central nervous system: confusion, dizziness, insomnia, tremor, drowsiness, blurred vision, diplopia, large seizures, dyskinesia, paresthesia, weakness, muscle twitching, aphasia, psychosis, hallucinations, agitation, fatigue, headache, ataxia, dizziness.
Cardiovascular system and blood (hemostasis, blood formation): hemolytic anemia, leukocytosis or leukopenia, atrial fibrillation, congestive heart failure, bradycardia arrhythmias, ectopic ventricular rhythms), hypotension, orthostatic hypotension.
Organs of the gastric intestinal tract: increased plasma bilirubin and amylase, diarrhea, vomiting, constipation, dry and unpleasant taste in the mouth, nausea, flatulence, oral candidiasis, dental tissue diseases, increased appetite, caries, nausea.
- Increased libido,
- Premature menstruation,
- Retrograde ejaculation,
- Increased urination,
- Urine retention,
- Skin rash
Can Trazodone be addictive? The difference between tricyclic drugs and tranquilizers.
Tricyclic drugs such as Trazodone are not addictive. This judgment is erroneous and devoid of truth. The tricyclic group of antidepressants does not belong to the group of tranquilizers. There are two important differences between these groups:
- Tranquilizers have a calming effect on the Central Nervous System
- Tricyclic drugs act as pathogens of the Central Nervous System
These are two completely different types of medications. Of course, both of these areas are designed for one purpose, for the successful treatment of mental health of a person. Only the doctor decides which direction to take.
Tricyclic drugs can not be canceled abruptly. Termination of the course of treatment is gradual with a gradual decrease in the dosage of the drug for 3-4 weeks. There may be withdrawal syndrome. The withdrawal syndrome is characterized by:
- Sleep disorders
- Abdominal pains of a spasmodic nature
Some patients confuse it with addiction. The withdrawal syndrome passes on its own after a few weeks. If you follow the instructions of your doctor and gradually reduce the dosage of the drug, nothing will happen. Withdrawal syndrome is a rare occurrence, in most patients it does not happen.
How do antidepressants affect the conception of a child?
In men, antidepressant medication causes a decrease in sperm activity. The number of cells with destroyed DNA increases, by 30% of the normal rate. Such cells occur when taking antidepressants of both the old and the new generation.
In women, the completion of antidepressants reduces the chances of conception. Indeed, the deepening of depression reduces the ability to conceive.
Planning a pregnancy is better after a course of treatment with antidepressants. After 2-3 months after the gradual (note!) Cancellation of antidepressants and only in mild cases of depression! In severe forms of depression, it is impossible to refuse a man from antidepressants, therefore antidepressants of a new generation are prescribed. They allow you to more gently transfer the effects of drugs to the fetus.
Application of trazodone during pregnancy.
Sometimes the use of drugs can not be abandoned. During pregnancy, women in many ways deny myself that would not harm her baby. But it happens that the abolition of drugs can harm the mother and her child. Acceptance of antidepressants occurs only under the supervision of a physician !!! Complete failure of antidepressants can cause withdrawal syndrome. This may adversely affect the health of the child and the mother. Increased depressive state may trigger:
- Increased depression
- The birth of a dead child
- Postpartum depression
- Negative fetal development