What drugs are effective in treating depression and have few side effects?

I think SSRI drugs have fewer side effects. SSRI drugs are currently the most widely used antidepressant drugs, mainly including fluoxetine, paroxetine, sertraline, fluvoxamine, and citalopram. . SSRI is a selective serotonin reuptake inhibitor. Its main pharmacological effect is to selectively inhibit the recycle of serotonin, causing a significant increase in the 5-hydroxytryptamine content in the synaptic cleft.

Among the SSRI drugs, citalopram has relatively fewer adverse reactions, while escitalopram oxalate is a purified product of citalopram, with smaller adverse reactions and relatively faster curative effect.

Especially in the treatment of depression in the elderly, because it has a relatively small impact on chronic diseases such as hypertension and cardiovascular disease, it is recognized as the first choice drug for depression in the elderly.

The possible adverse reactions of escitalopram oxalate are generally similar to other SSRI drugs, mainly including:

Gastrointestinal tract: nausea, vomiting, anorexia, diarrhea, constipation;

Nervous system: dizziness, headache, anxiety, nervousness, insomnia, fatigue, dry mouth, sweating, tremor;

Allergic reaction: rash;

Sex Functional disorders: impotence, delayed ejaculation, anhedonia;

Other symptoms: leukopenia, rare hyponatremia.

Possible adverse reactions are only possible. Generally, patients taking escitalopram oxalate rarely experience obvious adverse reactions.

Selection of other drugs

In fact, drug treatment for depression has always been individually selected, with the purpose of finding the one that is most suitable for you, with the best efficacy and the least adverse reactions. Generally, in the acute phase of a depressive episode, it is best to choose drugs such as citalopram, venlafaxine, and sertraline, which have a relatively faster onset of action; for patients with obvious somatization symptoms, duloxetine is the best choice; for patients with high blood pressure, The safest option for patients is escitalopram oxalate; the best option for patients with refractory suicide is venlafaxine and mirtazapine; the best option for patients with bipolar depression is olanzapine and fluoxetine...

Your doctor will only help you choose your treatment drugs based on the characteristics of your condition, so there is no best drug, only the best doctor.

Depression is a common mental disorder with a high incidence rate and can be caused by a variety of reasons, including significant and lasting low mood, loss of interest, slow thinking, reduced speech, lack of energy, etc. It is the main clinical feature and is often accompanied by physical symptoms, cognitive or psychomotor disorders. Some patients may be accompanied by anxiety and agitation, and in severe cases, mental symptoms such as hallucinations and delusions may occur. The onset of depression is usually slow. Symptoms such as headache, dizziness, insomnia, and loss of appetite may initially appear, and gradually develop into symptoms such as depression, anxiety, and suspicion. It usually manifests as severe symptoms in the morning and mild symptoms in the evening. In severe cases, suicidal tendencies may occur.

Drug therapy is an effective method to treat depression. Currently, drugs for the clinical treatment of depression are mainly divided into 5 categories, namely selective serotonin reuptake inhibitors, serotonin and norepinephrine. steroid reuptake inhibitors, noradrenergic and specific serotonin reuptake inhibitors, serotonin reuptake inhibitors and tricyclic antidepressants, etc. So which of these drugs are effective in treating depression? , and few side effects? Pharmacist Sun will give you a brief introduction today.

In short, depression is a common clinical mood disorder, and drug treatment is currently the main treatment method. Among the treatment drugs, fluvoxamine, escitalopram, and venlafaxine Mirtazapine and other drugs have strong antidepressant activity and are suitable for various types of depression, including severe and refractory depression. They have few and mild side effects, and are safe and tolerable when taken for a long time.

References:

Guidelines for the Prevention and Treatment of Depressive Disorders (2006)

What are the drugs that are effective in treating depression and have few side effects? In fact, there is not necessarily a clear answer to this question, because every loss must have a gain. Drugs that take effect quickly must have a wider range of effects in terms of receptors, so in comparison, the side effects they bring will definitely be smaller. Bigger.

Because of side effects, monoamine oxidase inhibitors and cyclic depressants have basically lost their competitiveness. Let’s focus on SSRI and SNRI types.

As clinicians, we often believe that venlafaxine, mirtazapine, and duloxetine have significant therapeutic effects because they act on 5-HT and NE receptors at the same time, but they may also have disadvantages. It is also more obvious than other drugs. In fact, upon careful analysis, this is not the case.

Depression can be simply divided into three subtypes: typical depression, latent depression, and depression with psychiatric symptoms. According to the three subtypes, different antidepressant drugs can be selected. This often results in better and more accurate treatment results.

Typical depression is what we often call “low mood” as its core feature, followed by loss of interest, slow thinking, and depression. For typical depression, we usually have more drugs to choose from, and almost all first-line clinical drugs are available.

Latent depression refers to some atypical depression, such as physical discomfort, dizziness, fatigue, or lack of energy. Depending on the subtype selection, such patients may be more sensitive to antidepressants with activating properties, such as fluoxetine, venlafaxine, duloxetine, etc. Even for individual refractory individuals, a small dose of alfa may be added. Ripiprazole.

For depression accompanied by psychotic symptoms, it is recommended to avoid drugs that can cause an increase in norepinephrine (NE), because increasing NE may cause the patient to become more agitated.

In addition: Many patients with brain trauma may also experience symptoms similar to depression. At this time, it is best to avoid antidepressant drugs that can easily cause convulsions or epilepsy, such as tricyclics and bupropion.

To answer the question, which drug has relatively fewer side effects?

At present, the first-line drugs in clinical use are still SSRIs. Among SSRIs, citalopram, escitalopram, and sertraline are relatively well tolerated by the body, and pharmacokinetic interactions rarely occur. However, comparing these three drugs, citalopram may cause cardiac Q-T interval prolongation when exceeding 40 mg per day. Theoretically, its risk of accidents is higher than the previous two.

In summary, in terms of drug efficacy, duloxetine or venlafaxine, which has a "dual-channel" effect, is more effective and takes effect faster. However, as for the side effects of the drug, everyone's The focus is different, so it is difficult to generalize which one has fewer side effects.

Generally speaking, for patients who are afraid of gaining weight, fluoxetine and bupropion have fewer side effects;

For patients who are worried about sexual dysfunction, SSRIs should be avoided. , you can choose bupropion or mirtazapine;

For patients who are worried about the impact of cardiovascular disease, they should avoid duloxetine, venlafaxine, and citalopram, and they can choose parasertrax Lin;

For those with a history of epilepsy, avoid bupropion;

If the question is: a treatment that is effective and has few side effects, I will answer—— Electroconvulsive therapy without convulsions. I believe that patients who have adopted this treatment plan will understand that simple electroconvulsive therapy does avoid the impact of drugs on the liver and kidneys caused by accumulation in the body, and at the same time has the advantage of quick onset, but the biggest drawback is that Treatment costs are relatively high.

I hope my answer will be helpful to you, please pay attention, I will update relevant questions every day

The main reason why depression is difficult to cure and easy to relapse is that psychological factors and drugs are not removed Only some symptoms of the disease are controlled, but they may relapse when stimulated by social and psychological factors. Therefore, it is recommended that drugs combined with psychological treatment can achieve good therapeutic effects. At the same time, combined with psychological treatment, the disease can be fundamentally treated. To achieve satisfactory treatment results, the reason for the recurrence of the disease is that there is no treatment for psychological factors. Only by removing the psychological factors can we achieve a radical cure

As a patient with depression for ten years, let me talk about my experience with medication.

My personal experience is that generally speaking, more expensive antidepressants have fewer side effects. I have used venlafaxine and paroxetine. The side effects of these two drugs are only discomfort, dry mouth, and bitter taste in the first few days of taking the medicine. After a few days, I got used to it without any discomfort.

Moreover, the effects of these two drugs are also very good, and there is no dependence.

Some drugs vary from person to person due to individual differences. For example, mirtazapine is mainly used to treat patients with severe depression who suffer from insomnia. I use it with good results. I sleep well after taking mirtazapine, but mirtazapine I lost my sense of taste when I took Mirtazapine, and almost everything I ate tasted the same. The most important thing was that I gained weight quickly after taking Mirtazapine. Generally speaking, it takes at least a few months to stop taking antidepressants. Therefore, unless I have severe insomnia and have to do so, I will not take mirtazapine easily, because every time I take mirtazapine, I will gain weight by 20 to 30 years. pounds, or even more.

But this medicine is not the same for everyone. Some patients who take mirtazapine like me are not obese.

Therefore, my personal experience is: venlafaxine and paroxetine have relatively small side effects, good effects, and the price is relatively easy to accept.

Methods for choosing antidepressant drugs:

Citalopram is used for elderly people with poor health.

Sertraline is used for depression accompanied by mild anxiety.

Use paroxetine for depression accompanied by severe anxiety.

Use fluoxetine if you have insufficient motivation.

Use venlafaxine in patients with psychotic symptoms.

Mirtazapine is used for sleep disorders.

Duloxetine is used for low blood pressure.

Amitriptyline is used for people with poor finances, anxiety and insomnia.

Use new drugs with caution, because any drug requires a long period of observation...

It is best not to be depressed.

Treatment of depression requires face-to-face consultation.

The above is not medical advice.

Everyone’s symptoms are different, so the medicines they take are also different. You have to make yourself better. The doctor will prescribe the medicine based on the side effects.

Your body will be damaged if you don’t take medicine, which is no worse than if you take medicine