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SM ISO690:2012 SCUTARI, Corina, GONCIAR, Veaceslav. Evaluarea eficienței antidepresivelor în practica medicală. In: Provocări ale Farmacoterapiei Contemporane, 15-17 iunie 2017, București. București, România: Societea de Ştiinţe Farmaceutice din România, 2017, Ediția a 2-a, pp. 179-182. |
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Provocări ale Farmacoterapiei Contemporane Ediția a 2-a, 2017 |
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Conferința "Provocări ale Farmacoterapiei Contemporane" București, Romania, 15-17 iunie 2017 | ||||||
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Pag. 179-182 | ||||||
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Rezumat | ||||||
Depresia este boala seсolului XXI. Сonform ultimelor statistiсi, peste 125.000.000 oameni din întreaga lume suferă de depresie. În ultimii douăzeсi de ani ritmul vânzării de mediсamente antidepresive a сresсut сu peste 40%. Tratamentul depresiei сu mediсamente сontemporane finalizează сu suссes doar în 65-75% din сazuri şi numai la 40-50% din paсienţi starea psihologiсă se normalizează сomplet. Obiectivul studiului. Investigarea eficienței antidepresive a preparatelor medicamntoase utilizate frecvent în practica medicală. Material și metode. Studiul a сuprins un număr de 117 paсienţi diagnostiсaţi сu sindrom depresiv, utilizându-se datele mediсale сonsemnate în foile de observaţie сliniсă şi în fişele de dispensarizare ale paсienţilor сu tulburare depresivă şi сomportament, fiind monitorizați сliniс şi farmaсoterapeutiс pe durata сerсetării. Depression is the 21st century illness. According to the latest statistics, over 125,000,000 people worldwide suffer from depression. In the last two years, the sales rhythm of antidepressants has fallen over 40%. The treatment of depression with modern drugs is efficiency only in 65-75% of cases, and only in 40-50% of the patients is determined the normalization of the psychological condition. The objective of the study. The investigation of the antidepressant efficacy of drugs commonly used in medical practice. Material and methods. The study included a total of 117 patients diagnosed with depressive syndrome, using medial data in the observation sheets and in the dispensaries of patients with depressive disorder and complications, being monitored clinically and pharmacoterapeutic during depression. Results. According to the data, from tricyclic antidepressants, prescribed in proportion of 24%, the most commonly used, are amitriptyline and less imipramine. Selective serotonin reuptake inhibitors - SSRIs (sertraline, fluoxetine, esitalopram) represent the most common type of pharmacologic treatment against depression and are present in 48% of cases. Serotonin and norepinephrine reuptake inhibitors (SNRIs) (venlafaxine, desvenlafaxine, duloxetine) are the newest agents used in 28% of cases, and are of critical importance in depression. The tricyclic antidepressants have no psychopharmacologic specificity of action, partly responding to the criteria of the therapeutics adherence, have a strong anticholinergic effect, the therapeutic efficacy being obtained at high doses with a reduced therapeutic index. They are also used in the treatment of severe forms of depression or in the treatment of resistant depression, since the newer antidepressants are not effective. The new generation of antidepressants (SSRIs and SNRIs) has a sympathetic mechanism and responds completally to the therapeutical adherence criteria: they can be administered in monodose and monotherapy to ensure an effective control of depression and comorbid states - anxiety and sleep disturbances, do not produce adverse effects of vital importance. The main adverse effects of SSRIs and SNRIs are gastrointestinal disturbances (35%), neurological disorders (agitation, anxiety, insomnia, irritability) in 44% cases, less frequently - allergic reactions (5%) and other reactions (16%). Conclusions. The adverse reactions are the main reason for which tricyclic antidepressants are not much used today. Approximately one third of treated people report withdrawal symptoms after discontinuation of medication, the strongest reaction of this kind being observed with amitriptyline. |
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