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Inhibition of neuronal reuptake of serotonin in the central nervous system, a decrease in the sensitivity of β-adrenoreceptors, an increase in the affinity of ligands for certain subtypes of serotonin receptors.
Absorption is high. Communication with plasma proteins 89-95%. Biotransformation in the liver by hydroxylation. The half-life is 5-9 hours. The maximum concentration is 2 hours (with food), 1 hour (without food). Elimination by the kidneys – 75%, with faeces – 20%.Indications:
- Anxious and depressive states of endogenous nature (including involutional depressions).
- Psychogenic depressions (including reactive and neurotic depressions).
- Anxiety and depressive states against the background of organic diseases of the central nervous system (dementia, Alzheimer’s disease, cerebral atherosclerosis).
- Depressive states with prolonged pain syndrome.
- Alcoholic depression.
- benzodiazepine addiction.
- Disorders of libido and potency, including in depressive states.
Hypersensitivity; pregnancy, breastfeeding; ventricular arrhythmia, tachycardia, myocardial infarction (early recovery period); history of priapism.Carefully:
Heart disease, arterial hypertension (dose adjustment of antihypertensive drugs is necessary due to possible hypotensive effect), renal and / or liver failure, age up to 18 years.Pregnancy and lactation:
On animals, embryotoxic and teratogenic effects are shown at doses 50 times higher than the maximum therapeutic for humans. Penetrates into breast milk. Do not apply!
FDA recommendations – category C.Dosage and administration:
Adults are prescribed an initial dose of 100 mg 1 time per day after meals at bedtime. On the 4th day, you can increase the dose to 150 mg. In the future, in order to achieve the optimal therapeutic effect, the dose is increased by 50 mg per day every 3-4 days until the optimal dose is reached. A daily dose of more than 150 mg should be divided into 2 doses, with a smaller dose taken after dinner, and the main one at bedtime.
For elderly and debilitated patients, the initial dose is up to 100 mg per day in divided doses or 1 time per day at bedtime. The dose may be increased under the supervision of a physician, depending on the effectiveness and tolerability of the drug. Usually no dose exceeding 300 mg per day is required.
Children aged 6-18 years: initial daily dose of 1.5-2 mg / kg per day, divided into several doses. If necessary, the dose is gradually increased to 6 mg / kg per day with an interval of 3-4 days.Side effects:
From the side of the central nervous system and peripheral nervous system: increased fatigue, drowsiness, agitation, headache, dizziness, weakness, myalgia, discoordination, paresthesia, disorientation, tremor.
From the side of the cardiovascular system: a decrease in blood pressure, orthostatic hypotension (especially in people with vasomotor lability) due to the adrenolytic effect of the drug, arrhythmia, conduction disturbances, bradycardia, leukopenia and neutropenia (usually minor).
From the digestive system: dryness and bitterness in the mouth, nausea, vomiting, diarrhea, loss of appetite.
Other: allergic reactions, eye irritation, priapism (patients who experience this side effect should immediately stop taking the drug and consult a doctor).Overdose:
Symptoms: drowsiness, epileptiform seizures, nausea, vomiting.
Treatment is symptomatic. There is no specific antidote.Interaction:
Alcohol and other CNS depressants – increased CNS depression.
Antihypertensive drugs – increased hypotensive action.Special instructions:Compared with placebo, new generation antidepressants do not cause a clinically significant improvement in patients with moderate or even severe depression, show a clinically significant effect only in the most severely depressed patients. The effect in these patients is likely due to a decrease in placebo response rather than an increase in antidepressant response. The researchers conclude that there is no reason to prescribe new-generation antidepressants to anyone but the most severely depressed patients, and then only after alternative treatment options have been shown to be ineffective. The fact that highly depressed patients respond less to placebo than less severe patients, but show similar response to antidepressants, is very important for understanding the nature of the response of depressed patients to antidepressants and to placebo.fluoxetine, 8 – nefazadone, 16 –paroxetine, which united 5,133 patients, of whom 3,292 were randomized to receive an antidepressant and 1,841 to placebo. 4 RCTs, 486 participants (sertraline) and 1 RCT, 274 participants (citalopram), which did not show a statistically significant positive effect of antidepressants, were not included, as they did not provide information on the severity of depression on a scale
There can be a very unique term called comorbidity and this is often a term which is used to describe a situation where a person is struggling with two or more mental illnesses at the same time. These can happen together or they can happen one after another. Either way, they are able to feed off of each other and they also might actually make each other worse every once in awhile.
It may not all be down to rudeness though! There could be a far more deeply rooted problem – grounds because of their behaviour that causes the crooks to be like that. They may not want to share with you it, and might get the reason embarrassing. Due to the underlying result in the talking and movement just doesn’t abate, just one more time their behaviour might be completely normal. The trouble using this type of is you never know the way to receive the person.
What I’m speaking about are eating disorders which affect nearly 24 million people of all ages and genders with at least 50% receiving care for depression and anxiety. Statistically, eating disorders contain the highest mortality rate associated with a mental illness; although, these numbers vary as a result of final cause mentioned around the death certificate. Many people having an eating disorder develop heart disease, kidney problems, cancer, experience malnutrition or just tend to end their life. However, it doesn’t want to get until now. There are plenty of early warning signs and with ample sensitivity, understanding, love and guidance us members, friends and patients can successfully cope with this difficult time.
There is a chemical inside the brain which is accountable for directing messages in one part of the body to a new area of the body. This chemical is termed serotonin. Individuals that have obsessive-compulsive disorder have been tested and studied at depth and it has been learned that most all patients seem to have less serotonin than those that will not have this mental illness.
These are just a few signs a whole lot of from the human race has lost conditions major part of its mind, and that is seriously endangering our survival. Human beings have survived this long precisely because we’ve got had the use of a whole mind, in additional “primitive times,” that gave us new solutions to new problems if we needed them. We are no more using our whole mind, along with the small part were using can not give to us the solutions we need today. We can will no longer “see” the difficulties clearly enough, nor shall we be open to the solutions, because we can’t discover their whereabouts either.