Effective new generation antidepressants: list of the best drugs

Sooner or later in the life of every person there comes a moment when something inside him seems to break. Apathy sets in, and the ability to work is almost zero. Not everyone knows that depression is not just a bad state of a person, it is a disease.

Without treatment, depression does not go away. If you don’t take care of your health, various accompanying psychological disorders may appear, and a bad mood turns into a way of life.

With depression, not only does the patient’s mood change, the disease affects overall health, behavior and thoughts. Since any medications that are designed to fight this disease affect the entire nervous system, only the attending physician can choose an effective and safe medicine that will not cause harm and at the same time will have the maximum positive effect.

In cases of severe depression, psychologists and neurologists around the world almost always prescribe new generation antidepressants as part of general therapy. Compared to other types of antidepressants, they can be used by almost all patients (with special reservations, even children and pregnant women); there are practically no side effects from such medications.

In addition, new generation antidepressants have a dual effect; not only serotonin is inhibited, but also norepinephrine. Thus, this type of medication is suitable for all cases of depression. Including for chronic types of disease.

Features of the drugs of the group

Since antidepressants act on the nervous system, there are a number of important features.
For example, any drug from this group should never be stopped immediately. The dose should be gradually reduced. This will avoid relapse of the disease. We must not forget about the seriousness of depression. When prescribing antidepressants to patients, you should constantly monitor them during the first weeks of using the drug - this is done in order to avoid suicide attempts.

Types of antidepressants

Depending on the pharmacological action and the effect on metabolic processes in the brain and nervous system, there are three main categories of antidepressants - sedative, stimulating and balanced.

Sedatives

Calming or sedatives help change the physiological reactions of the central nervous system (strengthen the inhibition reaction and weaken excitation during the transmission of impulses between neurons), resulting in a decrease in nervousness, irritability, hysteria, and emotional stress.

The therapeutic effect of sedatives reduces blood pressure, improves sleep and helps restore strength at night, without creating a feeling of “lethargy” and drowsiness. As a rule, sedative antidepressants are drugs based on medicinal herbs - mint, valerian, motherwort, lemon balm.

Stimulating

Stimulants or tonics activate the nervous system, increase the amount of neurotransmitters in neurons, accelerate the transmission of nerve impulses, promote the release of stress hormones (adrenaline and norepinephrine), improve blood circulation and increase heartbeat.

Medicines that have a tonic effect can be used for apathy, drowsiness, lethargy, indifference to what is happening, and lack of strength.

Strong stimulants, such as fluoxetine, milnacipran, moclobemide, are taken only as prescribed by a doctor, but there are medicinal adaptogen herbs that have a tonic effect (eleutherococcus, ginseng, St. John's wort), the purchase of which does not require a prescription.

Balanced

Antidepressants with a balanced effect affect the level of one or more types of neurotransmitters (dopamine, serotonin), normalize neurophysiological processes in the central nervous system, as a result of which depression disappears and the psychological state improves. This category includes:

• monoamine oxidase inhibitors or MAOIs (nialamide, moclobemide, transamine);
• inhibitors of neuronal monoamine reuptake (imipramine, fruoxetine, maprotiline);
• tricyclics (desipramine, maprotiline, imipramine, clomipramine);
• monoamine receptor agonists (mianserin, mirtazapine, trazodone, nefazodone).

Case studies

These medications performed well during clinical trials in Holland. In order to make the most objective assessment, it is worth excluding the placebo effect, especially for this type of new generation antidepressants, such as invitro. A placebo is a change in the state of the body using self-hypnosis; in this case, this is in no way explained by the influence of any biochemical drugs.

Currently, Sertraline is the most popular among all types of new generation antidepressants. All others are compared with this medicine. Clinical trials in Holland revealed some features of this drug.

A drug such as Fluoxetine has shown itself to be very effective; it acts without any side effects, but its effectiveness is somewhat weaker than that of other modern antidepressants of the new generation.

In the case of using several antidepressants at the same time, the most effective drugs will be Escitalopram and Mirtazapine, as well as the same Fluoxetine. When only Sertraline was used, the effect was lower compared to the combined course of treatment.

A new generation antidepressant such as Effexor, or, in other words, Venlafaxine, has also been studied. It blocks all serotonin receptors, but we must not forget that if the dose is increased, the reuptake of a substance such as norepinephrine will be blocked.

There is another remedy with a non-standard principle of action - Remeron, which stimulates the production of histamine. This drug also helps overcome insomnia. However, do not forget that this drug has its side effects, like all other antidepressants.

At one time, such a remedy as Miaser was actively discussed on the pages of newspapers. The creator of this antidepressant guarantees that the drug is absolutely non-addictive. But there are other side effects. Patients who underwent a 2-week course of treatment with this drug had constant drowsiness and also noted unsteadiness in their gait.

↑ Antidepressants with predominantly sedative and anxiolytic effects

• Amitriptyline - Amitriptyline (tryptisol, damylene, amizole, elavil) - 10, 25 mg tablets. It has a thymoanaleptic effect with an inhibitory component. The general antipsychotic effect is strong and has a sedative effect, which makes it effective for anxious depression. The average daily dose is 150-200 mg.
• Azafen - Azaphene - 25 mg tablets. A domestic drug with a thymoanaleptic and sedative effect, the antidepressant property is somewhat weaker than that of other antidepressants. The drug has a tranquilizing, sedative, anxiolytic effect and is indicated for depressive states with asthenic and neurotic symptoms. It is prescribed orally, starting from 25 mg, the average daily dose is 150-200 mg.
• Paroxetine - Paroxetine (Paxil) - 20 mg tablets. Effective anxiolytic.
• Sertraline (Zoloft) - tablets of 10, 20 and 50 mg. An SSRI with a strong antidepressant but weak anti-anxiety effect. Belongs to the group of sedative antidepressants. Prescribe 50-200 mg 1 time per day.
• Ludiomil - Ludiomil - 25 mg tablets. An antidepressant with high thymoanaleptic activity and a balancing effect on various types of depression.
• Mianserin - Mianserin (lerivon, miansan) - 30 mg tablets. An antidepressant with sedative and anti-anxiety effects. Widely used in narcology to relieve cravings for alcohol, normalize sleep and mood, as well as for moderate depression.
• Trimipramine (Herphonal, Surmontil) - 25 mg tablets. A tricyclic antidepressant with a mild sedative effect. It is used more often on an outpatient basis. The average daily dose is up to 150 mg. Incompatible with alcohol.
• Tianeptine (coaxil) – 12.5 mg tablets. Antidepressant with balanced action. It is used for anorexia nervosa, as it is easily tolerated by patients in a state of cachexia. Its action is similar to amitriptyline, but does not have the side effects typical of tricyclics.
• Mirtazapine - Mirtazapine (Remeron) - tablets of 15 and 30 mg. Indicated for anxiety depression of various origins. Does not actualize suicidal thoughts. It is well tolerated, so it is prescribed to elderly patients. The daily dose is 15-45 mg.

The best new generation antidepressants

A study was conducted in the Netherlands that was aimed at comparing new generation antidepressants. For comparison, factors such as treatment effectiveness, side effects and patient tolerance of medications were used. More than 25 thousand people who suffered from depression took part in this study.

Based on the data received, reviews and analysis of open information, we have compiled the following list, which includes only the best modern antidepressants of the new generation, almost all of which are without side effects:

1. Sertraline . The drug has a very good degree of effectiveness and a low price. But don't forget about the side effects. And these are drowsiness, pain in the head, ataxia, aggressiveness, anxiety, dry mouth, decreased appetite and others.
2. Paxil . A fairly well-known antidepressant that is prescribed by a large number of doctors. It should not be used in combination with Thioridazine and MAO inhibitors.
3. Escitalopram . The drug has a high level of effectiveness and excellent tolerability in people over 18 years of age. Children should choose another drug.
4. Citalopram , an antidepressant, has shown good tolerability, and also has quite a few contraindications, including too much sensitivity to the substance or taken together with MAO inhibitors.
5. Bupropion is well tolerated, but price is a big factor for some. The monetary cost of the drug is quite high, but the effectiveness is quite average. For this reason, it is better to turn your attention to other medications.
6. Fluvoxamine . The drug has a fairly good level of effectiveness and is well tolerated. Among the side effects, it is worth noting pain in the head area, respiratory tract infections, decreased libido and others.
7. Milnacipram . The drug occupies the middle of the list and is something average in all respects. If you are pregnant, you should refrain from undergoing treatment with this drug.
8. Fluoxetine has a low level of effectiveness, but there are practically no side effects. This medicine can be used even by pregnant women, but during the course of treatment you should stop breastfeeding.
9. Mirtazapine . The drug also showed a very high level of effectiveness, however, more than 15% of the subjects interrupted treatment due to increased appetite, confusion, strange dreams, asthenia and other side effects.
10. Insidon . Most often it is prescribed for outpatient treatment. It has an anti-vomiting and anti-convulsant effect, and is also an analgesic.
11. Venlafaxine , an antidepressant, showed excellent effectiveness, but a large number of side effects were noted. Almost every 5 people who took it experienced side effects. These include insomnia, increased drowsiness, asthenia, nausea and others.
12. Paroxetine , like fluoxetine, is not highly effective. Side effects such as urticaria, myalgia, nausea and vomiting, and sweating may also occur. The drug is poorly tolerated.
13. Duloxetine . It has an average degree of effectiveness and side effects occur quite often, so it is better to turn your attention to other antidepressants.
14. Agomelatine . An antidepressant that appeared not so long ago and showed excellent results. However, it is not recommended for use by children or those with lactose intolerance. If mania occurs, you should stop using the drug.
15. Last on the list is Reboxetine . Poor tolerability and low effectiveness indicate that this is far from the best medicine for depression.

Modern antidepressants. Review

In the search for effective remedies for depression, many methods and substances have been tried - from opiates to malaria therapy by Nobel laureate in medicine Julius Wagner-Jauregg [1]. But the real struggle began only in the 1950s. Iproniazid was invented in 1952. In fact, it was intended to fight tuberculosis, but the side effect of improving the mood of patients with depression forced us to look at the drug in a new way.

What should antidepressants treat? Theories of depression

Now there are several biological theories of the occurrence of depression.

Until recently, the most common ones were those that linked the appearance of depression and a lack of production of monoamine neurotransmitters in the human brain: serotonin, norepinephrine, dopamine. The most popular was the serotonin hypothesis. She argued the following: in patients with depression, the production of serotonin is impaired, if this is corrected, this will allow one to overcome depression and various anxiety disorders (of which a person has not just a lot, but a lot).

However, science did not stand still; scientists delved deeper and deeper into the human brain and learned more and more about the biological background of human emotions. And the more we learned, the more questions arose about the “monoamine theory” [2].

For example, drugs that block serotonin receptors can belong to completely different classes and have varied effects on the human body: the 5HT2 and 5HT3 receptor blocker mirtazapine is an antidepressant, the 5HT2 blocker quetiapine is an antipsychotic. On the other hand, agonist blockers - conditional depressants - are not such. LSD, mescaline or psilocybin are not substances that cause depression. In addition, it turned out that a substance such as glutamate plays an important role not only as a neurotransmitter, but also a significant role in the development and functioning of the brain in general [3]. Theories have emerged explaining its role in the formation of human emotions, learning processes and brain aging [4 ].

And then we remembered that the brain has such a thing as “neuroplasticity.” The theory according to which it is not some single neurotransmitter that is responsible for the formation of a person’s emotional background, but the result of the joint activity of various parts of the brain, quickly began to gain popularity [5]. Its main difference from previous theories is that a drop or increase in the concentration of serotonin (or any other monoamine) in the synaptic cleft (meaning the gap between two nerve cells) does not in itself lead to the formation of mood, and therefore cannot be responsible for the improvement/ worsening mood. More attention has been paid to the factors of gray matter thinning in depression, reduction in the branching of nerve cells and others, for example, those responsible for the growth of neurons and connections between them. [6]

Types of Antidepressants

Although the development of science has a direct effect on the development of antidepressants, many of those currently being produced were developed at a time when there was simply no talk of any “neuroplasticity”.

First of its kind

The first mass-produced “real” synthetic antidepressants developed by pharmaceutical companies were tricyclic drugs - imipramine (first synthesized in 1948, began to be widely used in the 1960s), etc. They received their name because of the structure of the molecule - they have three rings in molecule, although their structure and attached radicals are different.

Trimipramine, a member of the class of tricyclic antidepressants.

The action of tricyclic antidepressants is based on blocking the reuptake of neurotransmitters (mainly norepinephrine and serotonin) by the presynaptic membrane. As a result, their concentration increases and, as a result, their mood should improve.

Drugs of this group were especially actively used to treat severe depression. However, the severe side effects accompanying treatment - from an increased risk of having a heart attack to provoking epileptic seizures, serious neurological disorders, paranoid states, general deterioration of cognitive functions and body condition - together with the development of less toxic and potent drugs, have actually brought these drugs out of the mainstream to the margins . For example, in the US and EU they are no longer used as the main antidepressants in the treatment of severe depressive conditions.

Although, due to their low price, they can still be actively used in some places. In Russia, drugs of this type are still in use. These are, for example, medications based on amitriptyline (commercial name - Amitriptyline Nycomed) or clomipramine (commercial name - Anafranil).

Power and toxicity of the first inhibitors

In 1952, the antidepressant iproniazid was invented - a monoamine oxidase inhibitor (MAO), which also belongs to the first generation antidepressants (together with tricyclics).

The action of antidepressants of this type is based on inhibiting MAO, which is contained in nerve endings, and thereby preventing its destruction of monoamines - serotonin, dopamine, tryptamines, norepinephrine and others. Thus, the drugs help to increase the concentration of monoamines in the synaptic cleft.

Work of MAO inhibitor (noradrenergic synapse).
From the book Drugs The Straight Facts, Antidepressants , 2004.
The problem with almost all antidepressants is toxicity and a variety of side effects. Especially with non-selective inhibitors that act simultaneously on MAO-A and MAO-B. Iproniazid, due to side effects and high toxicity, has practically ceased to be used as an MAOI.

In addition, the need to follow a specific tyramine diet is a problem. It should be adhered to especially strictly when taking non-selective irreversible MAOIs. The fact is that the simultaneous use of MAOIs and foods “rich in tyramine” can lead to “tyramine syndrome” - the rapid development of a hypertensive crisis. When dieting, you should avoid consuming foods such as cheeses, milk, smoked meats (including fish), legumes, wine, vodka, beer and products containing brewer's yeast, as well as spices and cookies.

But this is not the last difficulty. MAOIs do not combine well with a number of medications due to the suppression of a number of liver enzymes, including painkillers, cough and cold medications, antiasthmatics, antihistamines, and others. [7]

At the same time, modern MAOIs - moclobemide, pyrazidol, incasan, befol, selegiline - do not require diet (however, overdoing it with food containing tyramines is not recommended), they have fewer side effects, are better tolerated, and their use is wider. . However, they are still far from the most popular antidepressants - selective serotonin reuptake inhibitors (SSRIs).

Antidepressants are taking over the masses

So we have come to the most popular antidepressants in the world at the moment - SSRIs. They belong to the second generation, and the most famous of them is, without a doubt, Prozac (fluoxetine) from Eli Lilly

.

The action of drugs of this type (SSRIs) is based, as the name implies, on inhibition of serotonin reuptake, which leads to an increase in its concentration in the synaptic cleft, with all that it implies.

How fluoxetine (commercially known as Prozac) works. From the book Drugs The Straight Facts, Antidepressants, 2004.

As the effects of drugs such as SSRIs were studied, it became clear that they have side effects, so-called secondary pharmacological qualities. They affect the uptake of norepinephrine and dopamine, stimulate serotonin receptors such as 5-HT2C, etc. Moreover, each of the SSRIs has its own special secondary pharmacological qualities.

Among the popular drugs in this group are: fluoxetine, paroxetine, citalopram, escitalopram, sertraline and others. They are present on the market under commercial (trade) names - sertraline is better known as Zoloft, fluoxetine as Prozac, and escitalopram as Cipralex. Unlike first-generation antidepressants, SSRIs are relatively well tolerated, they have fewer side effects, despite the fact that their effects are quite comparable to the drugs of the previous generation.

Further development and new types of selective reuptake inhibitors

Further development of drugs based on the inhibition of several neurotransmitters (or other than serotonin) led to the creation of modern antidepressants. These include selective norepinephrine reuptake inhibitors (SNRIs), serotonin and norepinephrine (SSRIs), and norepinephrine and dopamine (SNRIs).

The meaning of the action is similar to SSRIs - an increase in the concentration of neurotransmitter(s) in the synaptic cleft. But the drugs are easier to tolerate and show better results in the treatment of depression, including severe ones. For example, a number of studies have shown that atomoxetine and reboxetine (SSRIs) are more effective than SSRI drugs in the treatment of severe depression. And drugs of the SSRI group are similar in effectiveness to tricyclics, but are easily tolerated and not as toxic as the latter. The most famous of this group are venlafaxine, duloxetine, milnacipran.

If we compare the groups of SSRIs and SSRIs, then, according to a number of studies, the former have more pronounced side effects: problems with the cardiovascular system, with the gastrointestinal tract, with the nervous system. Taking venlafaxine and milnacipran affects the genitourinary system - for example, problems with libido and ejaculation. [8]

The SSRI group includes bupropion, which is actively used in the treatment of apathetic depression and disorders. This is due to the characteristics of the drug, which at one time was considered by a number of specialists not as an antidepressant, but as a psychostimulant.

Emphasis on the specificity of action of new agents

In addition to these types of antidepressants, there are also specific ones (mirtazapine, mianserin), which, by increasing the concentration of norepinephrine and serotonin, block α2-adrenergic receptors. At the same time, they block serotonin receptors such as 5-HT2 and 5-HT3, thereby sharply reducing the side effects for which they are responsible, such as: sexual disorders, nausea, vomiting, insomnia, etc.

Mirtazapine works by blocking α2-adrenergic receptors. From the book Drugs The Straight Facts, Antidepressants, 2004.

Other drugs, such as trazodone, inhibit reuptake and block serotonin 5-HT2 receptors. As in the previous case, this leads to a decrease in the occurrence of side effects from the use of the drug - sexual disorders, anxiety, insomnia and others.

Some antidepressants do not affect monoamines at all, in the sense of inhibiting reuptake. The drug agomelatine blocks serotonin receptors of the 5-HT2C type and stimulates melatonin receptors (MT1 and MT2). Blocking serotonin receptors leads to the release of dopamine and norepinephrine, and stimulation of melatonin receptors restores sleep function, often impaired in depression, and eliminates insomnia. Since the drug does not affect other serotonin receptors and does not stimulate the uptake of neurotransmitters, it is virtually devoid of the side effects of most antidepressants. But some still exist: dizziness, headache, nausea.

Problems of antidepressants and attempts to find their solutions

A serious scientific problem regarding modern antidepressants, which has been increasingly discussed lately, is the effectiveness of their effects and the variety of side effects.

A number of analyzes of antidepressant trials have found that, when all available data, including unpublished data, are taken into account, the effectiveness of many drugs can be questioned: in some cases, the result of their use is no better than that obtained in the placebo control group [9]. Some studies suggest that SSRI-type antidepressants may increase the risk of suicide in adolescents [10].

The effectiveness of various antidepressants compared with placebo. On average, the effect was 42% more effective than the changes observed in the placebo groups [9].

As depression and methods of its treatment were studied, it became clear that in mild or moderate forms, the most ordinary physical exercises were able to improve the condition of the sick, albeit short-term. They should not be overestimated; physical exercise has a moderate effect at best [11]. In addition, it is not easy to encourage someone suffering from depression to exercise.

The search and invention of new antidepressants is fueled not only by new data, for example, the discovered influence of interleukins (or cytokines) formed during the inflammatory process on the course of depression [12], but also by a decrease in the effectiveness of antidepressants in large-scale studies. Thus, a large-scale STAR*D study, which studied mainly the newest drugs - bupropion, citalopram, mirtazapine, sertraline and others - revealed almost no difference in the effectiveness of treating depression between them [13]. And subsequent ones showed that 30-50% of patients taking antidepressants, the latter practically did not help in treatment [14]. During the course of taking an antidepressant, its effectiveness decreased [15]. In general, according to clinical studies, approximately a third of those taking antidepressants achieved complete remission, a third were helped, despite the constant possibility of relapse, and the remaining third were not [16].

In experimental practice for the treatment of depression and depressive conditions, for example, in the United States, in recent years, psychostimulants such as ketamine and its derivatives—one of the most common drugs in Southeast Asia—have begun to be actively used [17]. And when developing new drugs, they are already experimenting with psilocybin (a hallucinogen) [18]. Perhaps we can cautiously say that psychopharmacology, having made a circle, has returned to the “basics” and again wants to try to treat depression with narcotic drugs and their derivatives. However, this is in the USA, not in Russia, and so far only experimentally.

Conclusion

Despite the active search for an effective and universal cure for depression, it is not yet available, and there are certain doubts that it will be created. Especially considering the fact that has been increasingly discussed lately: the term “depression” hides various disorders of various etiologies. However, even existing medications, possibly combined with physical activity, can improve the patient’s quality of life and lead, in most cases, to remission.

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Literature

[1] Inflammatory illness: Why the next wave of antidepressants may target the immune system, Nature Medicine 23, 1009—1011 (2017), doi:10.1038/nm0917-1009 [2] From Stress to Inflammation and Major Depressive Disorder: A Social Signal Transduction Theory of Depression, Psychol Bull. May 2014; 140(3): 774–815. doi: 10.1037/a0035302 ; PATHOPHYSIOLOGY OF DEPRESSION: DO WE HAVE ANY SOLID EVIDENCE OF INTEREST TO CLINICIANS? World Psychiatry. Oct 2010; 9(3): 155–161. [3] Imaging extrasynaptic glutamate dynamics in the brain, PNAS 2010 April, 107 (14) 6526-6531. https://doi.org/10.1073/pnas.0913154107 [4] Glutamate: its role in learning, memory, and the aging brain, July 1993, Volume 111, Issue 4, pp 391—401 [5] Neuronal plasticity: A link between stress and mood disorders, Psychoneuroendocrinology (2009) 34S, S208—S216 [6] Effects of Acute Tryptophan Depletion on Mood and Facial Emotion Perception Related Brain Activation and Performance in Healthy Women with and without a Family History of Depression, Neuropsychopharmacology (2007 ) 32, 216—224; Role of Brain-Derived Neurotrophic Factor in the Aetiology of Depression, CNS Drugs 2010; 24 (1): 1-7; The role of BDNF and its receptors in depression and antidepressant drug action: Reactivation of developmental plasticity. Dev Neurobiol 2010 Apr;70(5):289-97. doi: 10.1002/dneu.20758. [7] Markova I.V., Mikhailov I.B., Nezhentsev M.V. Pharmacalogy 2nd. - St. Petersburg: Foliant, 2001; George Arana, Gerald Rosenbaum. Guide to psychopharmacotherapy. Per. from English - Moscow: BINOM Publishing House, 2004 (George Arana, Jerrold Rosenbaum “Handbook of Psychiatric Drug Therapy”, 4th ed., 2001) [8] Serotonin and norepinephrine reuptake inhibitors: pharmacological properties, clinical efficacy and tolerability compared with other classes of antidepressants . Part 2, Consilium Medicum, 2007, Vol. 2, No. 3. [9] Antidepressants versus placebo in major depression: an overview. World Psychiatry. 2015 Oct;14(3):294-300. doi: 10.1002/wps.20241. For other data, see Randomized, placebo-controlled trials of antidepressants for acute major depression: thirty-year meta-analytic review. Neuropsychopharmacology. 2012 Mar;37(4):851-64. doi: 10.1038/npp.2011.306. [10] Selective serotonin reuptake inhibitors and risk of suicide: a systematic review of observational studies. CMAJ. 2009 Feb 3; 180(3): 291–297. doi: 10.1503/cmaj.081514 [11] Exercise for depression. Cochrane Database of Systematic Revies.Editorial Group: Cochrane Common Mental Disorders Group DOI: 10.1002/14651858.CD004366.pub6 ; Benefits from aerobic exercise in patients with major depression: a pilot study. British Journal of Sports Medicine 2001;35:114-117. ; [12] Inflammatory mechanisms in major depressive disorder. Curr Opin Psychiatry. 2011 Nov;24(6): 519-25. doi: 10.1097/YCO.0b013e32834b9db6. ; Antidepressants and Neuroinflammation: Can Antidepressants Calm Glial Rage Down? Mini Rev Med Chem. 2011 Jun;11(7):555-64. [13] The STAR*D project results: A comprehensive review of findings. Current Psychiatry Reports December 2007, Volume 9, Issue 6, pp 449–459 [14] Recent Progress in Pharmacological and Non-Pharmacological Treatment Options for Major Depression. Current Pharmaceutical Designb Volume 12, Issue 4, 2006. DOI: 10.2174/138161206775474422; [15] Early Onset of Selective Serotonin Reuptake Inhibitor Antidepressant Action. Arch Gen Psychiatry. 2006 Nov; 63(11): 1217–1223. doi: 10.1001/archpsyc.63.11.1217 [16] Acute and Longer-Term Outcomes in Depressed Outpatients Requiring One or Several Treatment Steps: A STAR*D Report. THE AMERICAN JOURNAL OF PSYCHIATRY. Volume 163, Issue 11, November, 2006, pp. 1905-1917 [17] New Hope for Depression, https://time.com/4876098/new-hope-for-depression/ [18] Novel psychopharmacological therapies for psychiatric disorders: psilocybin and MDMA, Lancet Psychiatry Volume 3, No. 5, p481—488, May 2021.

Voice of the people

Reviews from people who have undergone treatment with new generation antidepressants.

I used Reboxetine a few weeks ago. I had panic attacks. I don't have any side effects. This was my first time taking antidepressants.

Karina, 34

I had astheno-depressive syndrome. I tried many antidepressants, but only Liberax helped me. No side effects. The only drawback is the high price.

Maxim, 54

I had anxiety depression. The attending physician prescribed me Fevarin. Since I had already taken antidepressants before, I decided to stop using them myself. As a result, I quit too abruptly. The result was a condition similar to that in the first days of the illness, as well as vomiting and diarrhea.

The moral of my story, when you finish the course, go see your doctor again, don’t stop taking this antidepressant abruptly.

Alina Vyacheslavovna

Summing up

Do not forget that antidepressants of both new and previous generations have features of use and side effects, so you should carefully study the instructions for the medication and under no circumstances should you use the medication if you have contraindications to it.

In addition, before purchasing this or that antidepressant, consult a medical specialist. Each antidepressant is necessary for a certain type of depression; not all of them can have a positive effect on the body and the general condition of the body.

To undergo a course of treatment, be sure to consult with your doctor, he will help you correctly calculate the dose to avoid relapse of the disease. Also, you should not take the initiative and try to stop taking the drug on your own.