The world's latest antidepressant drug

As people's work pressure gradually increases, more and more people begin to suffer from mental illnesses, especially the incidence of depression, which is becoming higher and higher. Many celebrities we are familiar with have suffered from depression. If depression patients are not given timely psychological counseling, they may even have a tendency to commit suicide. One of the treatments for depression is medication. So, what are the drugs that can treat depression?

1. Monoamine oxidase

Iprohydrazine was the first antidepressant drug to be introduced in the 1950s. Isoprohydrazine was originally an anti-tuberculosis drug. Because of its central nervous system stimulant effects such as hyperactivity, insomnia and euphoria, it was successfully tried on depressed patients in 1957. Animal experiments have confirmed that it can reverse the apathy and hypoactivity caused by reserpine, and at the same time, increase the level of brain monoamines. It is speculated that its central excitatory and antidepressant effects are due to the inhibition of monoamine oxidase in the brain, which reduces monoamine degradation and increases the monoamine content in the catalytic gap. This suggests the relationship between animal behavior and monoreceptor neurotransmitters in the brain, which has important theoretical and practical significance and lays the foundation for the study of psychopharmacology and the etiology of mental illness.

Other drugs that belong to this category include isocarboxazid, phenelzine, and tranylcypromine. These drugs were once widely used, but were soon eliminated due to interactions with certain foods and drugs, causing serious adverse reactions such as hypertensive crisis and acute yellow liver atrophy.

In the late 1980s, a new generation of semi-diurnal oxidase inhibitors appeared, namely reversible monoamine oxidase isoform (MAO-A) depressants. Its characteristics are: 1. It has high selectivity for MAO-A and low selectivity for another isoenzyme MAO-B, so it can still degrade amides in food, thereby reducing the risk of hypertensive crisis.

II. Tricyclic

Its chemical structure is similar to chlorpromazine, and it was originally thought to be a new antipsychotic drug. However, the results of clinical trials were beyond expectations. The drug was ineffective for schizophrenia but could improve depressive mood. Later, it was confirmed by a large number of double-blind placebo-controlled studies, thus replacing monoamine oxidase inhibitors and becoming the first choice drug for the treatment of depression, monopolizing the antidepressant market for 30 years.

There are more than 10 tricyclic antidepressant products in my country. In addition to imipramine, there are also amitriptyline, doxepin and clomipramine. Although maprotiline has a tetracyclic structure, its pharmacological actions are consistent with those of tricyclic antidepressants. Tricyclic antidepressants are indicated for various types of depression, with an efficacy of about 70%-80%, an onset of effect of 1-2 weeks, a dosage range of 50-250 mg/d, and the dose should be increased slowly in divided doses. Because of its strong sedative effect, a larger dose should be taken at night. The therapeutic range of blood concentrations of imipramine and amitriptyline is 50-250 ng/ml.

For patients with severe side effects of antidepressants, it is advisable to reduce the dosage, stop taking the drug, or switch to other drugs. It is generally not recommended to use more than two antidepressants in combination. Since this disease has a high relapse rate, treatment should be maintained for 4-6 months after symptoms are relieved in order to consolidate the therapeutic effect and prevent relapse.

3. New Drugs

Selective serotonin reuptake inhibitors (SSRIs) are a new class of antidepressant drugs. This type of drug has been developed since the 1970s, and dozens of types have been developed. Commonly used clinical drugs include fluoxetine, paroxetine, sertraline, fluvoxamine, citalopram, etc. This type of drug has a small sedative effect, does not impair psychomotor function, and has little effect on the cardiovascular and autonomic nervous system functions. This type of drug also has dual effects of antidepressant and antianxiety, and is mostly used for depression caused by a decrease in 5-HT in the brain.