The necessity of using high ...

Need to use high doses of tricyclic antidepressants for long treatment courses (from six months and above) is largely limited by the side effect profile of these drugs. Such undesirable phenomena such as sedation, weakening of concentration, decreased the reaction rate, lead to certain difficulties in social and professional spheres (education and other intellectual activities, work that requires speed and precision of action, including driving). These circumstances are responsible for high risk patients with non-prescribed treatment regimen until the refusal of medication. Moreover, adequate use of tricyclic antidepressants can not be in patients with several concomitant somatic diseases (severe cardiovascular disease, benign prostatic hyperplasia, open angle glaucoma). As a result of anti-depressants are used either in the notoriously inefficient doses, either through short courses, which invariably leads to poor therapeutic response and risk of recurrence of anxiety disorders. Antidepressants are the next generation, because of their greater security, were more than adequate to treat anxiety disorders. Currently, the most commonly used drugs of the selective serotonin reuptake inhibitors (paroxetine, citalopram, fluoxetine, fluvoxamine, sertraline). Selective serotonin reuptake inhibitors with tricyclic antidepressants with equal effectiveness for anxiety disorders are significantly more favorable spectrum of side effects. To date, clinically proven that prolonged use of selective serotonin reuptake inhibitors does not lead to a significant change in the social activity of patients and does not require professional limitations. Drugs in this group proved to be significantly safer in patients with concomitant somatic diseases. To date, selective serotonin reuptake inhibitors are first-line drugs in the treatment of anxiety disorders. They are used in monotherapy and in combination with other medications. In the treatment of panic disorder is most common combined use of antidepressants and anxiolytics. Recent nominated short (no more than two weeks) courses in order to relieve panic attacks. Selective serotonin reuptake inhibitors are used for a long time - not less than six months. It should be noted that the daily dosage of an antidepressant significantly higher than the doses used for relief of depressive disorders. For example, if the average dose of paroxetine in treating depression is 20-40 mg / day., Then in cases of panic disorder drug is used at a dosage of 40-60 mg / day. (This dosing regimen and stick to the use of citalopram and fluoxetine). To prevent a recurrence of panic disorder (in cases of chronic course) is carried out maintenance therapy reduced (usually twice) doses of the drug used previously.