List of drugs with ...

The list of drugs with a greater or lesser extent depressogennymi properties exceeds 120 titles. It should be borne in mind that iatrogenic depression associated with prolonged intake of medicines. The fact that when lifting depression symptoms disappear, can attest to this relationship. In geriatric practice orientation of the doctor to the possibility of depression should occur if the following drug groups: - psychotropic drugs (haloperidol, risperidone, and others) - antihypertensive (Rauwolfia alkaloids, propranolol, verapamil, nifedipine) - cardiac glycosides (digoxin); - Class 1 antiarrhythmic drugs (novokainamid) - hormonal (glucocorticoids, anabolic steroids) - antacids (ranitidine, cimetidine) - lipid lowering (statins, cholestyramine) - Antibiotics - chemotherapeutic agents. With so often in elderly patients polifarmakoterapii problem of iatrogenic depression is becoming more acute, but a doctor should not be guided by information about depressogennyh properties of drugs for initial treatment, but have them in mind when identifying symptoms of depression in long-term (many months, sometimes years of) their application. Treatment of elderly patients with major depressive disorder Maintenance and treatment of elderly patients with depressive disorders are in the competence of the psychiatrist. Patients with severe manifestations of depression are subject to inpatient care. With moderately severe depression is often treated by a day hospital or outpatient setting. In milder forms of depression is possible to conduct treatments in general somatic institutions (hospitals, clinics). Appointment of antidepressant therapy and follow-up carried out a psychiatrist, and the necessary cooperation is a physician-internist and his full awareness of the treatment. Close and constructive cooperation internist (geriatrician) and psychiatrist provides a more rational management of these patients taking into account the peculiarities of the course and treatment of mental and physical illness. Appropriate to combine the use of drug treatment and psychotherapy. The role of the latter increases as the severity of depression and in remission. The process of drug therapy is a complex maneuvering between the light of clinical evidence and the desire to avoid possible side effects and complications, the risk which is known to be increased in patients with middle and old age. The most common rules are: - the principle alone - the use of smaller doses of drugs (2-3 times) than those provided for patients young and middle age - the beginning of treatment with minimal doses - the slow pace of increasing doses - compulsory registration of somatic contraindications (glaucoma, prostate adenoma, cardiac arrhythmias) - according to the compatibility with other antidepressant drugs, as designated at the somatic illness. Optimal for the treatment of late-life depression is antidepressant action balanced with high timolepticheskim potential and simultaneously with anxiolytic properties.