Antidepressants are the drugs used to relieve or prevent the symptoms of depression. Before antidepressants were discovered, the substances that had excitatory influence were actively applied in the treatment of the depression. These substances were capable to cause an euphoria condition (opium and others opiates, caffeine, ginseng). Valeriana and bromine salts were used to reduce the symptoms of anxiety and excitability. But the real revolution in psychopharmacology was the discovering of antidepressants in the early fifties. Since then throughout half a century, these preparations are the basic means for struggle against depression. In spite of the fact that the era of antidepressants has just begun, it has already created numerous myths.
From the beginning of the twentieth century researchers have investigated various substances, trying to synthesize a preparation that could relieve the symptoms of depression, but all experiments ended in failure. The first antidepressant was discovered in 1957 by a chance when doctors paid attention to the iproniazid action which was applied in complex treatment of tuberculosis. Except a preparation main effect, also a side effect has been observed which consisted in unusual increase in mood in patients treated for tuberculosis.
Soon this drug was begun to use for relief the symptoms of depression, all the more that the drug did not present itself as effective in treatment of tuberculosis.
Under another version, the action of the drug was discovered by Nathan Kline and this discovery was too more than accidental, he tried to prove with help of the drug the theory about the “ego” location. During psychoanalytic sessions, Kline has noticed that some patients who took the drug experienced the loss of interest to the problems they had. Iproniazid has been launched at the drug market, but it has soon appeared that it increases the risk of jaundice disease, and preparation sales have been stopped.
At the same time in Germany Ronald Kuhn discovered imipromine. Kuhn gave various preparations to the patients to construct on their reaction the global classification of mental diseases with which German psychiatrists of that time were literally afflicted. As well as in previous cases, the preparation action has been revealed, when the mood of patients began to rise. In difference from iproniazid, imipromine still enters into the list of official preparations of the WHO and before appearance of Prozac was the most sold antidepressant.
When the first antidepressants were discovered, nobody could assume that in several decades therapy with antidepressants practically would supersede other kinds of depression therapy, and by results of the interrogation in the end of 20 century in the USA, the greatest discovery of the last century will be recognized not the relativity theory, and not the Internet, but a small capsule of Prozak.
How do antidepressants work? If not to go into details, antidepressants are capable to correct work of some mechanisms of the brain. Our brain consists of a large quantity of nervous cells – neurons. Though between neurons there are connections, but directly they are not connected with each other – there is a gap between them, which is called synaptic gap or simply synapse.
The function of an information transfer from one neuron to another and its carrying over through synapse is carried out by the chemical intermediary – mediator (from lat. mediator – the intermediary). According to the biological theory of depression – during depression concentration of some mediators in the brain in synapse is reduced. Biochemical processes of our brain are very difficult, and hundreds of various mediators take part in them. For today from them it is allocated only 30, and the direct relationship to depression have only three mediators. They are noradrenaline, thrombotonin and dopamine. They are called biogenic amines. Antidepressants by regulating the concentration of one or several biogenic amines, correct mechanisms of the brain work which have been broken as a result of depression. Let’s pass from mechanisms of action of preparations which, probably, are not so interesting to all, to household questions.
Among “normal” people there is an anecdotal evidence that “antidepressants are very harmful”, “it is possible to go mad of them”, “drugs become addictive” and etc. Is it truth? Certainly, there is no smoke without fire, but the fire is outgoing of the Soviet psychiatry when patent agents “just in case” were prescribed in the high doses leading to corresponding results. In the rest of the world the relation to preparations is absolutely different. For today about 65 percent of the population of the USA use psychotropic preparations (first of all antidepressants and tranquilizers).
There is a stereotype that the usage of antidepressants is a manifestation of weakness of character. But at the same time, people who suffer from other diseases, for example hypertension or polyarthritis use medicines during the periods of aggravations and it is considered as normal. For example, aspirin is not capable to cure polyarthritis, but can kill a pain in joints and by that relieve physical sufferings of the patient. Unfortunately, in our society there is a stereotype that depression is a weak will, and only the few understand that depression is the same disease which should be treated. That is truth that antidepressants not always can relieve depression, but they can reduce the pain. Not the physical pain, but the psychic pain.
For many people the question about the drug addiction is very important. Whether the organism will demand the next portion of pills of pleasure and after exit from depression?
It is possible to answer more than unequivocally – the preparations which are used today in treatment of depression, do not cause addiction independent of duration of treatment. They just help an organism to restore those mechanisms which have been broken by depression.
Those people, whose work is connected with creativity, often worry about a question, whether the usage of antidepressants will break processes which are responsible for creative abilities? In most cases depression not in the best way affects creativity, and more often make it impossible. Antidepressants are capable to restore broken inward piece and to return ability to create. Because creativity often is stimulated after all by mental health.
The aim of the psychiatrists is to prescribe the correct drugs. Only half of the patients experience improvement after the first course of therapy so it is possible to name selection of preparations a cut and try method. The doctor can prescribe several preparations before find out the most effective. Many doctors offer free preparations prescription for people who are under the observance at the psychiatric clinics. As cost of preparations of last generations can reach 50-100$, and some of them can be sold only under prescription, you can imagine how much it can cost.
Though, they say that for last 30 years there is nothing better and stronger than good old amytriptyline and it has not been invented. New preparations basically are notable for their precautions (they are much less) and the price (it is essentially higher).
The action of the drug does not appear at once, usually, not less than 2-3 weeks pass between the beginning of drug using and the positive effect though in certain cases positive changes of mood may appear in one week of the treatment. For someone, preparations are panacea, and the person who tried to get out of depression unsuccessfully for many months, revives visibly. For someone, they are capable to treat only some of depression symptoms. But there are people who medicinal therapy does not affect at all. Do not hasten to rank yourself to the last category: everything is very individually, and in certain cases the stable result can appear only in some months. Often preparations are prescribed together with other methods of treatment. More often antidepressants are not capable to make you feel perfect and completely to relieve of depression, but they are capable to give sensation of stability, to weaken depression symptoms.
One more important moment is the name of preparations. For example, fluoxetine which today is the most popular drug both in America, and in Europe, it is presented at the Russian market almost by 20 pharmaceutical companies. That means that the same preparation is sold under 20 various names. And if it is simply written “fluoxetine” in a prescription, you can consider price-quality ratio. The Russian and Indian preparations are the cheapest, but they may quite often cause a considerable quantity of side effects. The preparations which are produced by the western pharmacists are more expensive, but side effects are not so often.
In my practice I saw many people who suffered from depression not the first year, and often in severe forms, but they had never taken antidepressants. Many of them have a stereotype like “I am without drugs – I can consider myself as a normal person” And what, what will come later? Look what already happened with your life. I will say again that preparations do not cause addiction, and you can stop the therapy at any moment without damage to health even if you have used preparations for many years.
Often, depression does not allow to take advantage of any described technique as to try something you need forces and the sensation of stability, but depression takes this all away. Preparations are capable to give a necessary basis to change your attitude, to weaken depression and then when you use preparations, you can go to GYM, to the psychotherapist, you can get rid of sleep disorders and make many other things. I have used antidepressants for many years, and they played important role in the therapy of my depression, and after years when I managed with my depression, and its symptoms became much weaker, I have simply ceased to take them. Do you understand? Simply.