Clinical classification of antidepressants
There are various classifications of antidepressant drugs:
· Historical classification;
· Pharmacological classification;
· Clinical classification.
The most convenient classification of antidepressants is the clinical separation of drugs that affect different manifestations of depression:
In this regard, antidepressants are divided into drugs:
- sedative action, suppressing anxiety, agitation, insomcia (amitriptyline, mianserin )
- stimulating action, relieving lethargy ( moclobemide , desipramine , melipramine );
- balanced action ( sertalin , citalopram , clopipramine )
Balanced antidepressants have stimulating properties, therefore, when using them, anxiolytics must be added in order to prevent psychovegetative syndrome.
Treatment with antidepressants has its own patterns. Under their influence, the leveling of anxiety, excitement, an improvement in the structure of sleep, and an increase in psychomotor activity first occur . After 1-2 months, the main antidepressant effect occurs.
When treating with antidepressants, it is necessary to regularly observe the patient, since therapy is prescribed with small doses with an increase every 10-14 days. Cancellation is necessary if side effects appear. More careful monitoring of elderly patients is necessary, as their threshold of sensitivity to antidepressants is reduced.
Contraindications for the appointment of antidepressants are:
• suicidal attempts;
· Atony intestine;
Treatment with antidepressants must be carried out according to some principles:
· Gradual increase and decrease in dose;
· Duration – six months;
· Monotherapy with individual selection of the drug;
· Undesirability of drug replacement;
· Control over the drug intake.
Treatment of depressive episodes presents difficulties due to their different genesis and disguise for other diseases, including somatic ones. Therefore, the need to objectify diagnostics is in the first place in psychiatric practice.