Thymoanaleptic therapy of depressive conditions
In the treatment of depressive disorders with antidepressants, it is necessary to differentiate between the various forms of depression. And in accordance with this, prescribe this or that antidepressant.
In asthenic -depressivnyh syndromes with neurological symptoms antidepressants used with stimulating and vegetostabiliziruyuschim action:
· Pirlidol ;
· Maprotiline ;
· Moclobimide ;
· Maprotiline .
For depression with insomnia, antidepressants with sedative properties should be prescribed at night:
· Tradazone ;
· Doxepin ;
· Mirtazapine .
For depression with obsessive and phobic components, use drugs that affect the concentration of serotonin:
For depression with paranoid and delusional syndromes, the drugs of choice are:
· Mirtazapine ;
· Clomipramine .
They are combined with antipsychotics.
For depression with mixed affect, therapy begins with:
· Carbamazepine ;
· Valproate ;
For dysthymic depression with panic attacks and hypochondria, the following are prescribed:
· Antidepressants with serotonergic action;
· MAO inhibitors.
Suicidal tendencies require hospitalization, close supervision, and high doses of sedative antidepressants.
The general principle of antidepressant therapy is the correspondence of the drug activity to the psychopathological characteristics of depression, the neurological and somatic status of the patient.
It is difficult to base an individual approach to the choice of treatment only on clinical symptoms of depression, history, degree of social adaptation, and organic disorders.
Therefore, the need to objectify the selection of antidepressants is an urgent problem in psychiatry.