Risk of depression during the ...

The risk of developing depression during their lifetime ranges from 10 to 25% in women and from 5 to 12% in men. Depression can occur at any age, in individuals of every race and socio-economic status. The era of psychopharmacology of depression began in 1950 with the opening timoanalepticheskogo effect of imipramine and development of a whole group of drugs timoanalepticheskogo action - tricyclic antidepressants. At the same time created another class of antidepressants with particular mechanism of action, labeled as "inhibition of monoamine oxidase (MAOIs). Tricyclic antidepressants (TCAs) are still considered the "gold standard" pharmacotherapy, but the large number of side effects greatly limits their application. Poor tolerability of TCAs leads to a decrease in quality of life of patients due to the so-called behavioral toxicity, which often prompts a doctor to reduce the dosage of antidepressants and the use of designated drugs in this group lack subtherapeutic doses. The use of MAOIs is also accompanied by a large number of side effects, primarily due to the incompatibility of these drugs with a variety of foods. The use of TCAs and MAOIs in the last decade is becoming increasingly limited, not only because of the high risk of side effects, but also because of the potential danger to the life of an overdose and interactions with a number of somatotropic drugs in the clinic of general therapy (depression in patients after myocardial infarction , unstable angina, cardiac arrhythmias and conduction of the heart, stomach ulcer, cancer, etc.). Synthesis in 1988, the first drug of the group of selective serotonin reuptake inhibitors (SSRIs) - fluoxetine, marked a new stage in the pharmacotherapy of depression. This drug had a significantly better tolerability profile and safety compared with TCAs and MAOI antidepressant class. Therapeutic effect of SSRIs is associated with inhibition of reverse penetration of serotonin from the synaptic cleft into the presynaptic neuron. Drugs selectively affect one subtype of serotonin receptor - 5HT-1. SSRIs are widely used in the treatment of endogenous nozogennyh (somatogenic and psychogenic) depression and dysthymia, depressive disorders in organic brain lesions. Along with these drugs of this group (to varying degrees each) show a fairly high efficacy in the treatment of anxiety and phobic disorders - generalized stress disorder, panic attacks, social phobia, posttraumatic stress disorder, as well as eating disorders and obsessive-compulsive disorder. SSRIs do not affect the adrenergic and cholinergic system. Side effects of SSRIs in the treatment of developing relatively rare. Nevertheless, the side effects of these drugs should not be underestimated. Among the adverse effects of therapy is most often observed violations of the gastrointestinal tract, loss of appetite, nausea, at least - vomiting, diarrhea, and constipation.