Should everyone in a bad mood or depression take antidepressants?
Although depression is very common among older people, not every person with a chronic bad mood or depression must take these powerful drugs.
Varieties of depression
Depression because the medication
Privratno of fate that a type of depression that can not be treated with drugs, it is depression, which is caused by the intake of drugs. If the patient is depressed, which began after a new drug, it is possible and it caused a depression. Below is a list of frequently occurring preparations, which may cause depression.
* Barbiturates such as phenobarbital.
* These tranquilizers like diazepam (ì), and triazolam.
* Kardiotropnyh drugs containing reserpine.
* These beta-blockers like propranolol (Inderal).
* These antihypertensive drugs like clonidine (Clonidine), methyldopa (dopegit) and prazosin (POLPRESSIN).
* Preparation for the treatment of arrhythmias, such as disopyramide (RITMODAN).
* These drugs used in the treatment of peptic ulcers, as tsimetedin (Tagamet) and ranitidine (Zantac).
* These anti-Parkinsonian medications like levodopa (PARIMDIN) and bromocriptine (Parlodel).
* Corticosteroids such as prednisone and cortisone (DEKORTIN).
* Anticonvulsants such as phenytoin (phenytoin), ethosuximide (SUKSILEP) and primidone (geksamidinom).
* Antibiotics such as cycloserine, etionimid, ciprofloxacin (Tsiprobay) and metronidazole (Cliona).
* Such drugs for weight loss, like amphetamines (during drug withdrawal).
* Pain or antiarthritics drugs like pentazocine (Fortran), indomethacin (indomethacin) and ibuprofen (SOLPRAFLEKS).
* These preparations against acne as isotretinoin (Roaccutane).
* Other drugs, such as disulfiram (Teturam) – is used in the treatment of alcoholism.
The best means of treatment for a depression – reduce the dose or possibly even stop taking it. If necessary, go to a different drug that does not cause depression.
Another cause of depression, alcoholism is to be treated fairly difficult.
Other causes of depression that do not require drug treatment – is situational or reactive depression – the “normal” reactions to life’s problems, such as loss of a spouse, friend, relative or work, and any other situation that may lead to discouragement any person. If the source of depression lies in the body’s response to the crisis, the antidepressants are ineffective. We should use alternative methods, such as the support of family and friends, a change of scenery or psychological advice from a specialist. Make yourself something nice to talk to one another and to exercise daily – all of which help you to overcome difficult situations.
Diseases which can lead to depression
Depression can be caused by thyroid disease, some cancers, such as pancreatic cancer, colon cancer, brain cancer, lymphosarcoma, viral pneumonia or hepatitis. In addition, there is evidence that people who have had a stroke or suffering from Parkinson’s disease or Alzheimer’s easy to depression which in some cases can be treated with antidepressants.
What kinds of difficult to treat depression drugs?
If depression combined with more of the following symptoms are observed for at least several weeks, and medical history, examination and laboratory tests indicate the presence of a particular type of depression, the possible diagnosis – primary depression. Symptoms include depression, interferes with normal life, difficulty concentrating, low self-esteem, guilt, thoughts of suicide, chronic fatigue, lack of energy or agitation, sleep disturbances (increase or decrease the duration), change in appetite (increased or decreased) with a corresponding change in weight. Because depression is often characterized by thoughts of suicide, the patient is often a chance to make suicide attempt using antidepressants, and therefore at a time can be assigned to only a small amount of the drug. This severe form of depression characterized by the fact that the patient shows – and talking about it if asked – the feeling of “helplessness, hopelessness, worthlessness and uselessness … and a strong sense of guilt from the real or imagined shortcomings or reckless acts.”
Other types of inappropriate use of antidepressants
In addition to the depression caused by drugs, depression caused by various diseases, and situational or reactive depression – none of which is not treated with antidepressants – there are other instances of inappropriate use of antidepressants. According to one study, over 50% of older people taking antidepressants for more than a year, began receiving without a clear diagnosis of “depression.” One-fifth of them (or one of the four people who use antidepressants) used this drug as an alternative to sleeping pills or tranquilizers. Given the significant adverse effects of these drugs, their use for such purposes is not justified, since the risk of side effects outweigh the therapeutic efficacy ..
Best and Worst of treatments for depression
Any patient suffering from severe depression should be examined by a psychiatrist who recommend needed in each case antidepressants.
The decision to choose a particular formulation depends mainly on the frequency of adverse drug effects in particular as antidepressants, all have about the same efficiency. If a person is suffering from depression, and a drug that does not cause the development of significant side effects proved to be effective, then this preparation and will be the best choice.
The main side effects of antidepressants
The four most common adverse effects include groups anticholinergic, sedative, hypotensive (blood pressure lowering) and cardiotropic effects. Because of these effects are frequently observed fractures of the hip and car accidents.
The advertisement states that the selective serotonin reuptake inhibitors such as fluoxetine (PROZAC), sertraline (Zoloft) and paroxetine (Paxil) cause fewer adverse effects than tricyclic antidepressants known as amitriptyline (TEPERIN) and imipramine (imipramine). Canadian researchers recently reported that selective serotonin reuptake inhibitors have no advantage over the previously used antidepressants in terms of the risk of hip fracture.
Anticholinergic effects. Mental effects: disorientation in time and space, delirium, worsening short-term memory, the weakening of attention. Physical effects: dry mouth, constipation, difficulty urinating (especially in men with an enlarged prostate), blurred vision, decreased sweating, combined with increased body temperature, sexual dysfunction, deterioration in glaucoma.
The antihypertensive effects: decreased blood pressure to unacceptable levels
Orthostatic hypotension or decrease in blood pressure that occurs when a sharp rise of a sitting or lying position, – frequent adverse effect of antidepressants, especially in the elderly. It may be more pronounced if the patient is at risk as a result of antihypertensive drugs. The result of a sharp drop in blood pressure can be a trauma, heart attacks and strokes. Therefore, before reception of such drugs should measure blood pressure in supine and standing after two minutes. This procedure must be repeated after a few weeks of preparation.
As antipsychotics, many antidepressants can cause parkinsonism drug. This disease is characterized by the following symptoms: difficulty speaking or swallowing, loss of balance, a face like a mask, muscle spasms, tremor of limbs, unusual body movements.
These drugs can cause increased heart rate. They also reduce the conductivity, which is especially dangerous for people who have already been observed atrio-ventricular block. Therefore, before you start taking antidepressants should do an electrocardiogram.
All currently available antidepressant can cause hypomanic and manic states. It is extremely important for people taking antidepressants group serotonin reuptake inhibitors, which include medications such as fluoxetine, and antidepressants such as imipramine, which inhibits reverse neuronal capture of both serotonin and norepinephrine. This can lead to the development of strong psychotic reactions or require isolation of the patient because of his over-excitement.
If the negative effect of the preparation used is too large, or if you think that the drug is not effective, consult your doctor with a request to change the medication.
How to reduce the negative effects of antidepressants
It is important to recognize that long-term antidepressant treatment is not always necessary, even if there is a direct indication for the use of the drug. In one study, after achieving sustained remission for four months, half of the patients continue taking the drug and the other half took a placebo. After two months of relapses were observed in only 25% of patients, the same in both groups.
Before starting drug therapy of some form of depression, the physician should carefully monitor the dynamics of treatment and, if necessary, to vary the dose or change the drug produces.
If administration is carried out with a view to a possible diagnosis of depression, you should be aware that this diagnostic procedure, and that the drug will only last for a while.
Before the treatment remove the electrocardiogram and measure blood pressure.
Start with a dose of 1/3 or 1/2 the conventional therapeutic dose for an adult, 15 – 25 mg a day, at bedtime. Increase the dose very slowly. To complete development efeekt may take three weeks. Analysis of drug should continue as long as the desired effect is achieved or until a negative response will develop stable.
You should know that your depression is a temporary condition that will recover and that the drug may be discontinued.
Take the prescription of the drug sufficient for only one week of use, as a large dose of the drug increases the chances of successful suicide attempts in people with severe depression.
Once for a few months there will be a stable remission, gradually reduce the dose.