What western medicine is used to treat depression?
Depression is a common mental disorder characterized by symptoms such as persistent low mood, loss of interest, and slow thinking. In recent years, the incidence of depression has increased year by year and has become a health issue of global concern. Western medicine is one of the main treatments for depression. This article will introduce in detail the commonly used antidepressant drugs and their mechanisms of action, indications and side effects.
1. Classification of commonly used antidepressant drugs
Antidepressant drugs can be divided into the following categories based on their mechanism of action:
| Drug Classification | Representative medicine | Mechanism of action |
|---|---|---|
| Selective serotonin reuptake inhibitors (SSRIs) | Fluoxetine, paroxetine, sertraline | Selectively inhibits serotonin reuptake and increases serotonin concentration in the synaptic cleft |
| Serotonin and norepinephrine reuptake inhibitors (SNRIs) | Venlafaxine, duloxetine | Simultaneously inhibits serotonin and norepinephrine reuptake |
| Tricyclic antidepressants (TCAs) | Amitriptyline, clomipramine | Inhibits serotonin and norepinephrine reuptake and has anticholinergic effects |
| Monoamine oxidase inhibitors (MAOIs) | Phenelzine, tranylcypromine | Inhibit monoamine oxidase and reduce degradation of monoamine neurotransmitters |
| Other antidepressants | Mirtazapine, bupropion | Regulates neurotransmitter levels through different mechanisms |
2. Comparison of characteristics of various types of antidepressant drugs
| Drug Classification | Onset of effect | Common side effects | Things to note |
|---|---|---|---|
| SSRIs | 2-4 weeks | Nausea, insomnia, sexual dysfunction | The dose needs to be gradually increased to avoid sudden discontinuation |
| SNRIs | 2-4 weeks | Increased blood pressure, sweating, headache | Monitor blood pressure, use with caution in patients with high blood pressure |
| TCAs | 2-4 weeks | Dry mouth, constipation, blurred vision, arrhythmia | It is contraindicated for patients with heart disease and electrocardiogram monitoring is required. |
| MAOIs | 3-6 weeks | Orthostatic hypotension, liver toxicity | Strict dietary restrictions are required and avoid combination with certain drugs |
| Other antidepressants | 1-4 weeks | Varies by drug | Use according to specific drug characteristics |
3. Principles for Selection of Antidepressant Drugs
1.The principle of individualization:Select appropriate drugs based on the patient's symptom characteristics, age, gender, comorbid diseases and other factors.
2.Security principles:Give priority to drugs with few side effects and high safety, such as SSRIs.
3.Effectiveness principle:Choose drugs based on the severity and characteristics of depressive symptoms. For example, those with obvious anxiety symptoms can choose antidepressants with sedative effects.
4.Economic principles:Consider the patient's financial affordability and choose reasonably priced drugs.
4. Precautions for antidepressant drug treatment
1.Medication compliance:Antidepressant drugs usually need to be taken continuously for 4-6 weeks to be effective, and patients should adhere to the medication as directed by their doctor.
2.Dosage adjustment:You should start with a low dose and gradually increase to a therapeutic dose to avoid adverse reactions.
3.Drug interactions:Certain antidepressants may interact with other drugs, so special attention is needed.
4.Drug withdrawal reactions:Sudden discontinuation of medication may cause withdrawal reactions, and the dose should be gradually reduced under the guidance of a doctor.
5.Regular follow-up visits:During treatment, regular follow-up visits should be conducted to evaluate efficacy and adverse reactions.
5. Research progress on new antidepressant drugs
In recent years, some new antidepressant drugs have been launched one after another, providing more options for the treatment of depression:
| Drug name | Mechanism of action | Features |
|---|---|---|
| Vortioxetine | 5-HT3 receptor antagonists and 5-HT1A receptor agonists | Improves cognitive function with fewer side effects |
| Esketamine | NMDA receptor antagonist | Rapid onset of action, suitable for treatment-resistant depression |
| Dextromethorphan/Bupropion | NMDA receptor modulation and norepinephrine/dopamine reuptake inhibition | New combination drug with faster onset of action |
6. Comprehensive treatment of depression
Although drug treatment is the mainstay of depression, comprehensive treatment is more effective. Treatment for depression should include:
1.Psychotherapy:Cognitive behavioral therapy, interpersonal psychotherapy, etc. can help patients change negative thinking patterns.
2.Lifestyle adjustments:Regular work and rest, moderate exercise, and a healthy diet can help improve symptoms of depression.
3.Social support:Understanding and support from family and friends is very important in recovering from depression.
4.Physical therapy:For severe or treatment-resistant depression, physical treatments such as transcranial magnetic stimulation may be considered.
The treatment of depression is a long-term process, and patients should remain patient and actively cooperate with the doctor's treatment plan. If adverse drug reactions occur or symptoms worsen, you should seek medical advice promptly to adjust the treatment plan.
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