The clinical picture of endogenous ...

The clinical picture of endogenous depression diverse as the manifestations of gravity, and on the structure of psychopathology, but the primary to endogenous depression is the presence of so-called triad of depressive disorders - symptoms of emotional, motor and ideatornoy inhibition, which include diffuse feelings of sadness, depression, despair , anxiety, accompanied by a number of distressing bodily sensations (vitality) and daily fluctuations in the intensity of symptoms. Ideological motor retardation combined with depressive monoideizmom ("crush of thoughts"), delayed the formation of associations, as well as temporary loss of familiar consumer and professional skills and a violation of social work adaptation. Characterized as painfully experienced a sense of insensitivity, the initial feelings of guilt with ruthlessly low moral evaluation itself, until the delusions of guilt and ideas self-incrimination, as well as a high risk of suicidal behavior. These symptoms constitute the content of classical melancholic (depressed, inhibited) depression. Depending on the dominance of certain disorders produce different variants of endogenous depression: sad, alarming, anesthetic, inhibited, adynamic, dysphoric, etc. Its basic types of sad, alarming and adynamic depression. The main method of treatment of endogenous depression is pharmacotherapy. Since the late 50-ies of XX century was the beginning of the synthesis of anti-depressants (timoanaleptikov) - psychotropic drugs, the main feature being the ability to work on low mood, eliminate depression and increase the vital psychomotor activity of depressed patients. The spectrum of psychotropic activity of antidepressants include, but are actually a common antidepressant action, as a sedative (or anxiolytic) and / or stimulating (activating) effects, which in the aggregate, and determine the features of the therapeutic activity of each of antidepressant drugs, subdividing them, respectively, on anti-depressants, and antidepressants-sedatiki stimulants. Directed synthesis of antidepressants from the outset has been associated with the idea of ??involvement of biogenic amines and their metabolites in the pathogenesis of endogenous depression. Among them, the main importance is attached to metabolic disorders and deficits in the synapses of brain norepinephrine and serotonin. Tricyclic chemical structure antidepressants (TCA), synthesized among the first representatives of this class of compounds, the most widespread in psychiatric practice and today is traditionally considered as basic in antidepressant therapy. The therapeutic effect of tricyclic antidepressants is associated with their ability to potentiate the effects of norepinephrine and serotonin, activate noradrenergic and serotonergic processes, compensating for the lack of these monoamines. TCA antidepressants are large and are subdivided into-sedatiki antidepressants and antidepressants, stimulants.