In the practice of psychiatry in the past ...

In the practice of psychiatrists over the past 20 years have gradually been introduced five drugs in this group of compounds - fluoxetine (Prozac, prodep) flyuvoksamin (Luvox), sertraline (Zoloft), paroxetine (Paxil) and citalopram (tsipramil). antidepressants SSRI group is distinguished by low toxicity, rapidity of onset of therapeutic effect (3-7 days of treatment) and high overall therapeutic efficacy (in 64,3-100,0% of patients). Despite the frequency of side effects in treating cholinolytic drugs SSRI (from 40.9 to 78.7% of patients), they do not prevent the therapy. The experience of their use showed that, despite belonging to one group of chemical compounds, the spectrum of antidepressant activity of each of them has its own characteristics, which determine the preferential indications for their individual settings. Ambiguity their clinical action of antidepressants as probably related to the individual characteristics of carbocyclic compounds and radicals, supplementing the benzene ring, the underlying chemical structural formula preparations. The study of clinical properties of SSRI-antidepressants showed a fairly high percentage of significant improvement in depression (reduction depressive disorders for more than 50% of Hamilton depression scale) at the end of a course of treatment (see Table 2.), but found especially in the forms and the ratio of actual timolepticheskogo, sedative-anxiolytic and stimulating action of these components of antidepressants (see Table. 3 ). Personal antidepressant properties of each of the SSRI-drugs possible to determine the preemptive testimony to their destination when the main clinical types of endogenous depression, melancholy, anxiety and apathy, adynamic. The most "universal" treatment for different types of endogenous depression, both heavy and moderate gravity is Paxil, featuring a relatively uniform expression of all three components in the spectrum of psychotropic activity. In melancholic depression is the most effective Paxil (at 100% of patients). According to the "universality" of the clinical actions and a range of therapeutic activity of close to paksilu worth tsipramil. particularly high therapeutic effect, he found in patients with apathy, adynamic and anxious depression as severe or mild. Luvox have found a somewhat less pronounced therapeutic effect is approximately the same for different types of moderate depression, but some preferred indications in anxiety and melancholy of its type. The spectrum Zoloft antidepressant activity prevails sedative-anxiolytic action. The most effective when he was phobic anxiety-depression, but only mild to moderate severity. Prozac can be defined as a highly effective and least toxic among SSRI. primary indication for him are apatite-adynamic depression, but because of the high proper timoanalepticheskogo and anxiolytic effect of Prozac, is revealed only to the fourth week of treatment, and growing by the end of a course of treatment, when it advisable to appoint melancholic depression and anxiety mild to moderate severity, but with the addition of tranquilizers in the first 2-3 weeks of treatment to neutralize dominant stimulatory effect in the spectrum of its psychotropic activity and to avoid exacerbation of depression.