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Medications play an important role in the treatment of depression, and patients with persistent negative emotional and physical symptoms often require the use of antidepressants as the primary treatment. Many patients find no effect after taking depression drugs for 2 or 3 days, and they begin to suspect the effect of drugs, in fact, in general, taking drugs for about 2 to 3 weeks will gradually appear therapeutic effect, and three months can achieve the therapeutic effect. Patients should have confidence in the treatment and drugs, and should not stop or change the drug on their own.
Professor Rong Xinqi, a psychologist, explained that antidepressants are divided into four categories, namely "tricyclic antidepressants", "selective serotonin recovery inhibitors", "orthergic and serotonin recovery inhibitors", "other agents" and other categories. These 4 classes of antidepressants have different effects and side effects.
1. Tricyclic antidepressant.
There are many side effects, and the current amount of use is less.
Currently the lowest rate of use, is the earliest appearance of antidepressants, due to more side effects, the current use of less. Shutian Clinic psychiatrist Rong Xinqi to "random guns and birds" to describe the "three-ring antidepressant", mainly acting on dopamine, serotonin, adrenaline and other receptors, the effect seems to be extensive, but because it is difficult to specialize, so that the effect is poor, common side effects include palpitations, want to sleep, nausea, gastrointestinal discomfort, dry mouth, dry mouth, poor spirits, difficulty concentrating and so on.
2. Selective serotonin recovery inhibitors.
It is currently the first line of medication for the treatment of depression. The disadvantage is that the libido is suppressed and blood pressure may be elevated.
Selective serotonin recovery inhibitors are the most commonly used antidepressant drugs in outpatient clinics, depression is related to insufficient secretion of serotonin and epinephrine, such drugs act solely on serotonin, selective inhibition of serotonin reabsorption, can be said to be the first choice for the treatment of depression.
However, the biggest disadvantage of selective serotonin recovery inhibitors is to inhibit sexual desire, many people can not accept that after eating antidepressant drugs, the heart is like water, there is no desire at all, for men, may not be able to meet the needs of the other half. However, Rong Xinqi stressed that if sexual dysfunction occurs, he should tell the doctor when he returns to the clinic that he should not rush to stop the drug.
In addition, common side effects of selective serotonin recovery inhibitors include nausea, diarrhea, headache, and insomnia, which usually gradually improve after two weeks of taking the drug. In addition, selective serotonin recovery inhibitors may also cause weight gain, easy agitation, and higher blood pressure.
3. Norepinephrine and serotonin recovery inhibitors.
Increases adrenaline receptors, which regulate mood. The disadvantage is that the libido is suppressed and blood pressure may be elevated.
The dosage of n-adrenaline and serotonin recovery inhibitors is close to that of selective serotonin recovery inhibitors, and the rotation of action is similar, but the addition of orthrenergic receptors can regulate mood. The biggest side effect of such drugs is to suppress libido, and the remaining common side effects are nausea, dizziness, insomnia, sedation, constipation, sweating, etc. It may also cause high blood pressure, which should be monitored daily if taken in high doses, or if you have hypertension yourself.
Rong Xinqi said that these two types of drugs, in addition to depression, can also be used to improve addiction, anxiety, obsessive-compulsive disorder, and treat impulse control, compared to other drugs, the side effects are lower, many doctors are accustomed to using these drugs.
4. Other types of drugs
The machine turns are different, and the side effects are different.
Contains a variety of other antidepressants with different effects, such as metopine, Wick tired, mesotra, annoyance and so on. Rong Xinqi takes annoyance as an example, the drug acts on melatonin receptors, which can improve sleep disorders, but the antidepressant effect is poor. Zhang Jiaming pointed out that the advantage of annoyance is that there are fewer side effects, which increases the interest and vitality of depressed patients, and is also suitable for long-term treatment of depression and depression in the elderly. Other drugs have different side effects due to different mechanisms of action, different receptors, and different side effects.
Failure to follow the doctor's instructions to take the drug has poor effect and is prone to recurrence
To analyze trends in the use of antidepressants for depression from 105 to 107 years, the most used is still selective serotonin recovery inhibitors, but the percentage of use is declining. Depression is a complex disease, the past serotonin hypothesis can not fully explain depression, the effects and limitations of selective serotonin recovery inhibitors have also been challenged in recent years, and the use of various other different mechanisms of antidepressants is increasing, providing more options for depressed patients.
Ideally, the complete treatment of depression can be divided into three stages, starting with an acute phase, with an average of about three months of treatment, a duration period (four to nine months of treatment), and a maintenance period (at least one year or more) in order to achieve the goals of symptom relief, functional recovery, and avoidance of recurrence.
If there are mild side effects such as nausea and dizziness when taking antidepressants, they usually appear within one to three days of taking the drug, but the effect on mood improvement sometimes takes one or two weeks. Many patients will feel that taking medicine is ineffective, or feel that their mood has improved slightly and they do not follow the doctor's instructions to take the medicine, making the treatment effect worse or relapse. It is recommended that treatment should be continued until there is a response, and if it is very uncomfortable, it should be discussed with a doctor and not discontinued on its own.
Rong Xinqi, a traditional Chinese medicine expert and psychological expert, pointed out that many patients with depression and anxiety who have just come to the clinic for the first time have not returned to the clinic, in fact, this is not appropriate, and even the best antidepressants must continue to take more than three months to gradually see the effect, if you do not want to take drugs, you also need to do psychological treatment, such as psychological counseling, hypnotherrapy, etc., can not let the disease develop.
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