This second, revised and enlarged ...

This second, revised and expanded edition is published in 2003), but the volume of this publication can confine ourselves to brief information on the use of antidepressants. As with other psychotropic drugs, antidepressants are classified depending on the application (general medicine - Psychiatric Clinic) for first and second series (Table 1). Among the first-line drugs including antidepressants past generations (pharmacological properties of antidepressants are considered in accordance with the modern unitary theory of the pathogenesis of depression, which postulates an imbalance of serotonin-and noradrenegricheskih systems in the brain, affecting the classification of contemporary antidepressants are subdivided into selective serotonin reuptake inhibitors - SSRIs, reversible inhibitors of monoamine oxidase type A - OIMAO-A selective blocker of the reuptake of norepinephrine - SBOZN, double-acting drugs (selective serotonin reuptake inhibitors and norepinephrine - SIOZSiN, noradrenergic and specific serotonergic antidepressant - ASCRAS), selective serotonin reuptake stimulants - SSOZS.) best suited to the requirements of primary care network. This is the minimum severity of adverse neurotrophic and somatotropic effects that could disrupt the function of internal organs and central nervous system and / or lead to a worsening of somatic and mental pathology, limited signs of behavioral toxicity; minimal teratogenic, embryotoxic and neonatal effects, does not preclude the ( although in exceptional cases) pharmacotherapy during pregnancy and lactation, low probability of adverse interactions with somatotropic drugs, safety in overdose, ease of use (ability to assign a fixed dose or minimal need for its titration). Among this group should be given the drug Zoloft (sertraline), widely used in the treatment of depression and obsessive-compulsive disorders. Zoloft (sertraline) - a drug bicyclic structure, a derivative of naphthylamine - a powerful selective serotonin reuptake inhibitor, it does not cause blockade of muscarinic, serotonin, adrenergic and GABA-ergic receptors. Therefore, the drug had little cholinolytic, cardiotoxic and sedative properties. Pharmacokinetic characteristics as Zoloft would accumulate the positive properties of the whole group of antidepressants. Drug concentration in blood is reached 6-8 hours after his admission. Equilibrium concentration of drug in the blood is set in a week. The basis of the profile of psychotropic activity is distinct timoanalepticheskoe action with a weak stimulant component. Although the first signs of improvement already appear in the 1 st week of therapy, to achieve an obvious effect requires 3-4 weeks and sometimes 6-8 weeks.