Asipi

Antidepressants, whose action is based on selectively blocking the reuptake of the neurotransmitter serotonin, are actively used in the fight against depression. Unlike tricyclic analogues, these medications are able to cope with simultaneous manifestations of tardive dyskinesia, and not aggravate this condition. The extensive list of effective remedies includes the drug “Aisipi”. According to the instructions for use, the product is able to relieve depressive episodes of any severity and alleviate the clinical picture of obsessive-compulsive disorder. The medicine copes with the symptoms of panic attacks and is well tolerated by patients.

The drug is able to relieve depression of any severity.

Pharmacological properties

The medicinal properties of the drug "Asipy" are associated with its ability to provide selective reuptake of serotonin. This leads to an increase in the concentration of the neurotransmitter in the synaptic cleft, and an additional prolongation and potentiation of its effect on the receptors is noted. The description of the medication indicates minimal or no connection of the active substance with a number of receptors in the brain. This ensures the stability and clarity of the drug. The body's therapeutic response becomes obvious on days 14-30 of therapy. The result reaches its peak after a 3-month course.

Asipi tablets are taken orally, after which the active substance is absorbed by the gastrointestinal mucosa. After 4 hours, a peak concentration of the composition in the blood plasma is observed. After 7 days of systematic use, the equilibrium content of the chemical compound in the body is achieved. The active component is destroyed in the liver with the release of active metabolites. The functionality of a number of isoenzymes can affect the level of drug concentration in the blood. When taking the drug "Asipy" in a course, its half-life is about 30 hours. The composition and its metabolites are excreted primarily by the kidneys and liver.

pharmachologic effect

Antidepressant. Selectively inhibits serotonin reuptake; increases the concentration of the neurotransmitter in the synaptic cleft, enhances and prolongs the effect of serotonin on postsynaptic receptors. Escitalopram practically does not bind to serotonin (5-HT), dopamine (D1 and D2) receptors, α-adrenergic, m-cholinergic receptors, as well as benzodiazepine and opioid receptors.

The antidepressant effect usually develops within 2-4 weeks. after starting treatment. The maximum therapeutic effect of treatment for panic disorders is achieved approximately 3 months after the start of treatment.

Active substance

The active component of the drug "Asipy" is escitalopram. This is a white powder, perhaps a yellow tint. The compound is poorly soluble in water and ethyl alcohol. According to the manufacturers of the antidepressant, its active substance is more effective than its chemical predecessor. The formulation has been observed to be better tolerated by patients, but skeptics point to a lack of evidence to support such conclusions. Conducted research and statistical data make it possible to regularly include drugs based on the substance escitalopram in the lists of the most effective antidepressants.

The main component of the drug is escitalopram.

Indications for use

The medication has a fairly powerful effect and is characterized by increased chemical activity, so its use must be coordinated with a doctor. The drug "Aisipi" is prescribed for various forms of depressive and panic disorders, phobias, and obsessive states.

The medicine works well as an independent remedy or as part of an integrated approach.

The drug course begins with minimal doses of the product in order to reduce the risk of increased patient anxiety in the first weeks of therapy. If such symptoms occur, they usually subside without external help as you continue to take the drug.

Contraindications

The possibility of using the antidepressant "Asipi" is assessed by a specialist in each specific case. The manufacturer identifies a number of general contraindications to the use of the medication, but in some situations they can also be treated by a doctor.

In some situations, the doctor may use the drug, despite the contraindications described by the manufacturer in the instructions.

The use of the drug "Aisipi" is prohibited against the background of the following conditions:

• unstable or uncontrollable epilepsy;
• intolerance to product components;
• pregnancy, natural feeding of a newborn;
• the patient’s age is less than 18 years (in some cases the drug is prescribed to persons 15-17 years old);
• taking MAO inhibitors;
• disruption of the sugar processing process due to the presence of lactose in the film shell.

Relative contraindications to drug therapy are epilepsy, the course of which can be controlled with drugs. If attacks become more frequent, the issue of stopping the antidepressant "Aisipi" is considered. Therapy is carried out with increased caution if the patient has a history of mania or hypomania. Against the background of the patient's tendency to bleeding or during the simultaneous use of the composition with anticoagulants, increased attention is paid to the state of the body.

The medicine is prohibited during pregnancy.

Contraindications for use

Despite the high level of effectiveness of the stimulant, it is characterized by the presence of certain contraindications. The drug should not be taken by the fairer sex while pregnant. An antidepressant should not be used when breastfeeding newborns. If there is a need for treatment with pills during this period, then breastfeeding should be abandoned.

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The antidepressant is not recommended for use in patients who have hypersensitivity to the components. If a person is under 18 years of age, taking the medication is strictly prohibited. This is explained by the possibility of suicidal behavior. Experts do not prescribe an antidepressant for lactase deficiency. If lactose intolerance occurs, then taking an antidepressant is not recommended.

Directions for use and doses

Only a doctor can decide how best to take the drug depending on the diagnosis, goals of therapy and the patient's medical history. The instructions given in the annotation for the ASIP product are intended for specialists, not consumers. Using them yourself can aggravate the situation and create additional problems.

There is only one basic rule - the tablets are taken once a day, without connecting the procedure with meals.

Universal recommendations for selecting an antidepressant dosage:

• depressive disorders - 10 mg of the active substance per day with the possibility of increasing the dose by 2 times in the absence of the desired effect. The maximum daily volume is 20 mg of the composition. After achieving a stable therapeutic response, it is recommended to continue therapy for another six months according to the same regimen in order to prevent new exacerbations;
• panic attacks, including those provoked by agoraphobia - the starting dose is 5 mg of the active ingredient per day. After 7-10 days of therapy, the volume of medication is doubled. The maximum daily dosage is 20 mg of the active substance. Treatment is carried out over several months, the exact duration is determined by the doctor;
• obsessive-compulsive disorder syndrome - a therapeutic daily volume of 10 mg is maintained throughout the entire treatment course. In exceptional cases, a maximum dose of 20 mg per day is applied. The minimum duration of therapy is six months, and to prevent relapses it is recommended to take the medicine for at least a year;
• treatment of patients over 65 years of age - the therapeutic and maximum doses are halved, amounting to 5 and 10 mg of the active substance, respectively;
• with reduced liver functionality, start with 5 mg of the active ingredient per day. After 2 weeks of the course, the patient’s general condition and the results of his tests are assessed. If indicators allow, the daily dosage is increased to 10 mg of Asypi per day.

For depression, use 10 mg of the active substance per day.
Doctors do not recommend abruptly stopping taking the medication after completing the treatment course. The dosage should be gradually reduced over 1-2 weeks, reducing it to the possible minimum. This will prevent the development of withdrawal syndrome, which in the case of an antidepressant causes dizziness, headaches, and nausea.

Instructions for use

The medication should be taken according to a specific regimen, which will ensure maximum effectiveness of therapy. The tablets must be taken orally by the patient with plenty of water. The stimulant is taken regardless of food.

For panic attacks, during the first week of therapy, patients need to take 5 milligrams of medication per day. After this time, the daily dose of the antidepressant should be increased to 10 milligrams. In these cases, patients increase the dosage to 20 milligrams. When using this regimen, the maximum therapeutic effect is achieved within 3 weeks. The duration of therapy for the pathological condition is several months.

For depressive episodes, it is recommended to take 10 milligrams of the stimulant daily. In accordance with the individual reaction of the patient, the dosage of the medication can be increased to 20 milligrams. The development of an antidepressant effect appears after 2-4 weeks after the start of therapy. If symptoms of depression disappear. The patient is recommended to continue treatment for 6 months.

For obsessive-compulsive disorder, the dosage of the medication is 10 milligrams per day. If the need arises, the amount of medication taken can be doubled. Since this disease has a chronic course, the medication should be taken over a long period. In order to eliminate the possibility of relapse, it is recommended to take an antidepressant for a year.

Elderly patients are recommended to take an antidepressant in a reduced dosage. In most cases, they are recommended to take 5 milligrams of medication daily.

Precautions for use

The annotation for the drug "Aisipi" lists a number of conditions that are not considered official contraindications to its use, but require special attention.
This list includes renal failure, history of suicide attempts, diabetes mellitus, and old age. Increased caution is required when taking an antidepressant simultaneously with other medications. Here are a few more points to consider during therapy:

• During therapy it is necessary to stop drinking alcohol;
• a course based on an antidepressant can be started 14 days after stopping irreversible MAO inhibitors and one day after reversible ones. No earlier than a week after stopping the use of Asipy, you can start taking non-selective MAO inhibitors;
• if epileptic seizures develop or become more frequent, or signs of a manic state appear, the antidepressant is discontinued;
• against the background of diabetes mellitus, dose adjustment of hypoglycemic drugs may be required;
• The first days of drug therapy may be accompanied by an increased risk of suicidal tendencies in the patient. During this period, the patient needs careful monitoring.

If epileptic seizures appear or become more frequent, the drug is discontinued.
Children's age is an official contraindication to the use of Escipi. Doctors do not use the drug in pediatrics due to the high risk of an outburst of aggression and hostility in the patient. There is also a possibility that the child will develop suicidal thoughts. If it becomes necessary to use an antidepressant in a minor, it should be under medical supervision.

special instructions

Use with caution in patients with renal failure (creatinine clearance less than 30 ml/min), hypomania, mania, pharmacologically uncontrolled epilepsy, depression with suicidal attempts, diabetes mellitus, elderly patients, cirrhosis of the liver, a tendency to bleeding, simultaneously with taking medications that lower the threshold for convulsive readiness, causing hyponatremia, with ethanol, with drugs metabolized with the participation of isoenzymes of the CYP2C19 system. Escitalopram should be prescribed only after 2 weeks. after discontinuation of irreversible MAO inhibitors and 24 hours after discontinuation of therapy with a reversible MAO inhibitor. Non-selective MAO inhibitors can be prescribed no earlier than 7 days after discontinuation of escitalopram. Some patients with panic disorder may experience increased anxiety at the beginning of treatment with escitalopram, which usually disappears over the next 2 weeks. treatment. To reduce the likelihood of anxiety, it is recommended to use low initial doses. Escitalopram should be discontinued if epileptic seizures develop or become more frequent in pharmacologically uncontrolled epilepsy. If a manic state develops, escitalopram should be discontinued. Escitalopram can increase blood glucose concentrations in diabetes mellitus, which may require dose adjustment of hypoglycemic drugs. Clinical experience with escitalopram indicates a possible increase in the risk of suicide attempts in the first weeks of therapy, and therefore it is very important to carefully monitor patients during this period. Hyponatremia associated with decreased ADH secretion occurs rarely while taking escitalopram and usually disappears when it is discontinued. If serotonin syndrome develops, escitalopram should be immediately discontinued and symptomatic treatment prescribed. Impact on the ability to drive vehicles and operate machinery

During the treatment period, patients should avoid driving vehicles and other activities that require high concentration and speed of psychomotor reactions.

Overdose

Doctors do not name the volume of the drug, the use of which can lead to drug poisoning, due to the individual reaction of the body to escitalopram.

An overdose of an antidepressant is manifested by tremor, dizziness, pathological excitability or drowsiness, clouding of consciousness. Convulsive attacks, vomiting, metabolic acidosis, and respiratory depression are possible. Examination of the victim reveals arrhythmia, increased heart rate, changes in the ECG graph, and a drop in the level of potassium in the blood.

In case of overdose, the patient needs to rinse the stomach.

Treatment is symptomatic; there is no specific antidote for the substance. The patient should rinse the stomach and ensure the maintenance of respiratory and other body functions. Regardless of the severity of symptoms, the victim requires examination by a specialist.

Side effect

The chemical compound escitalopram is well tolerated.
The drug "Aisipi" rarely causes a negative response from the body. Elderly people and patients weakened by somatic pathologies more often note the appearance of discomfort. Possible side effects of using the antidepressant "Aisipi":

• neurological - sleep disturbances, weakness, dizziness, tremors or convulsions, problems with motor control. In severe cases, serotonin syndrome develops;
• mental – confusion, irritability, anxiety, hallucinations, disturbances of perception, paradoxical reaction in the form of panic attacks;
• dyspeptic – nausea with or without vomiting, dry mouth, distortion of taste perception, problems with stool, loss of appetite, liver dysfunction;
• endocrine - secretion from the nipples that is not associated with pregnancy or lactation;
• dermatological – skin rashes and itching, purpura, profuse sweating;
• immune - allergic response up to anaphylactic reaction, angioedema;
• metabolic – decreased sodium levels in the blood;
• from the heart and blood vessels - a drop in blood pressure when the body moves from a horizontal to a vertical position;
• from the genitourinary system - urinary retention, decreased libido and anorgasmia in women, impotence and impaired ejaculation in men;
• from the musculoskeletal system – pain in muscles and joints;
• others - withdrawal syndrome, inflammation of the sinuses, increased body temperature, yawning, decreased quality of vision.

The drug may cause loss of appetite.
Many of the listed manifestations occur at the start of therapy and go away on their own within a few weeks. Even if symptoms are mild, they should be reported to your doctor.

The specialist will assess the potential risks, decide on the possibility of continuing therapy, and possible dose adjustments.

Adverse reactions

The use of the medication must be carried out in strict accordance with the instructions. Otherwise, undesirable effects may occur. In most cases, there are malfunctions in the central nervous system, which manifest themselves in the form of:

• Mediator syndrome;
• Headache;
• Convulsive symptom.

A certain circle of people were diagnosed with mental disorders - confusion, panic, high levels of irritability. Improper use of the medication leads to disturbances in the functioning of the respiratory system, which occur in the form of yawning and sinusitis. The effect of the medication may negatively affect the functioning of the digestive system. In this case, people complain of diarrhea or constipation, dry mouth, attacks of nausea and vomiting, decreased appetite, decreased sense of smell, and weight loss.

During drug therapy, patients were diagnosed with orthostatic hypotension. In a certain circle of people, the secretion of antidiuretic hormone decreases. Irrational use of medication leads to visual impairment. Representatives of both sexes are diagnosed with disorders of the genitourinary system. They are manifested by decreased libido, galactorrhea, impotence, anorgasmia in women, and impaired ejaculation.

Side effects in patients manifest themselves in the form of myalgia and arthralgia. The patients were diagnosed with anaphylactic reactions and hyperthermia. Undesirable effects in humans are observed on the skin. Patients complain of itching, skin rash, angioedema, and increased sweating.

Interaction with other drugs

Combining the antidepressant Asipi with MAO inhibitors increases the risk of side effects in the patient and creates conditions for the development of serotonin syndrome. The likelihood of the latter also arises when the drug is combined with triptans, Tramadol. Combining the drug with medications that lower the threshold for seizure activity can lead to seizures.

The possibility of serotonin syndrome also occurs when the drug is combined with Tramadol.

The active substance in Asipi potentiates the properties of lithium and tryptophan preparations, as well as medications that affect blood clotting. The product increases the toxicity of drugs based on St. John's wort, doubles con and "Desipramine" in plasma. The content of escitalopram itself increases under the influence of Haloperidol, Nortriptyline and a number of other drugs.

ASIP instructions for use

Indications for use of the drug Asipi: - depressive episodes of any severity; — panic disorders with/without agoraphobia; - obsessive-compulsive disorder. Active ingredient, group: Escitalopram, Antidepressant

Dosage form: film-coated tablets Contraindications: - hypersensitivity to escitalopram and auxiliary components of the drug; - lactase deficiency, lactose intolerance, glucose-galactose malabsorption (ASIPY tablets contain lactose); - children's and youth's age (up to 18 years); - simultaneous use with monoamine oxidase inhibitors (MAO); - pregnancy, breastfeeding period.

Method of administration and dosage: ASIP is prescribed orally once a day, regardless of food intake. Depressive episodes: usually prescribed 10 mg once daily. Depending on the patient’s individual response, the dose can be increased to a maximum of 20 mg per day. The antidepressant effect usually develops 2-4 weeks after the start of treatment. After the symptoms of depression disappear, therapy must be continued for at least another 6 months to consolidate the effect. Panic disorder with/without agoraphobia: During the first week of treatment, a dose of 5 mg per day is recommended, which is then increased to 10 mg per day. Depending on the patient’s individual response, the dose can be increased to a maximum of 20 mg per day. The maximum therapeutic effect is achieved approximately 3 months after the start of treatment. Therapy lasts several months. Obsessive-compulsive disorder: usually prescribed 10 mg once daily. Depending on the individual response of the patient, the dose can subsequently be increased to a maximum of 20 mg per day. Because obsessive-compulsive disorder is a chronic disorder, treatment should be long enough to provide complete relief of symptoms, lasting at least 6 months. To prevent relapses, treatment for at least 1 year is recommended. Elderly patients (over 65 years of age): It is recommended to use half the usually recommended dose (i.e., only 5 mg per day) and a lower maximum dose (10 mg per day). Children and adolescents under 18 years of age: Antidepressants, including ACIPY, should not be prescribed to children and adolescents under 18 years of age due to an increased risk of suicidal behavior (suicidal attempts and thoughts), hostility (with a predominance of aggressive behavior, tendency to to confrontation and irritation). If a decision is made to initiate antidepressant therapy, the patient should be closely monitored. Reduced renal function: For mild to moderate renal failure, no dose adjustment of ASIP is required. Patients with severe renal failure (creatinine clearance below 30 ml/min) should prescribe the drug with caution. Reduced liver function: The recommended starting dose for the first two weeks of treatment is 5 mg per day. Depending on the patient's individual response, the dose may be increased to 10 mg per day. In cases of severe liver failure, care must be taken during titration. Reduced activity of cytochrome P4502C19: for patients with weak activity of the P4502C19 isoenzyme, the recommended initial dose of ASIPI during the first two weeks of treatment is 5 mg per day. Depending on the patient's individual response, the dose may be increased to 10 mg per day. Discontinuation of treatment: When discontinuing treatment with ASPI, the dose should be gradually reduced over 1-2 weeks in order to avoid withdrawal symptoms.

Pharmacological action: ASIP (escitalopram) is an antidepressant that selectively inhibits serotonin reuptake (SSRI); increases the concentration of this neurotransmitter in the synaptic cleft, enhances and prolongs the effect of serotonin on postsynaptic receptors. The antidepressant effect usually develops 2-4 weeks after the start of treatment. The maximum therapeutic effect of treatment for panic disorders is achieved approximately 3 months after the start of treatment.

Side effects: From the central nervous system: dizziness, weakness, insomnia or drowsiness, convulsions, tremor, movement disorders, serotonin syndrome (agitation, tremor, myoclonus, hyperthermia), visual disturbances. From the psyche: hallucinations, mania, confusion, agitation, anxiety, depersonalization, panic attacks, increased irritability. From the respiratory system: sinusitis, yawning. From the digestive system: nausea, vomiting, dry mouth, taste disturbances, loss of appetite, diarrhea, constipation. From the cardiovascular system: orthostatic hypotension. From the endocrine system: decreased secretion of antidiuretic hormone (ADH). From the genitourinary system: urinary retention. From the organs of vision: visual impairment. From the reproductive system: galactorrhea, decreased libido, impotence, ejaculation disorders, anorgasmia (in women). From the skin: skin rash, itching, ecchymosis, purpura, angioedema, increased sweating. From the musculoskeletal system: arthralgia, myalgia. Laboratory parameters: hyponatremia, changes in laboratory parameters of liver function. Other: hyperthermia, anaphylactic reactions. If you suddenly stop taking ASIP, withdrawal symptoms (dizziness, headaches and nausea) may occur. To avoid withdrawal syndrome, gradual withdrawal of the drug over 1-2 weeks is recommended. An overdose of ASIP may cause dizziness, tremor, agitation, drowsiness, confusion, seizures, tachycardia, changes in the electrocardiogram (ECG) (changes in ST-T, widening of the QRS complex, prolongation of the QT interval), arrhythmias, respiratory depression, vomiting, rhabdomyolysis , metabolic acidosis, hypokalemia. There is no specific antidote. Treatment is symptomatic and supportive: gastric lavage, adequate oxygenation. Monitoring the function of the cardiovascular and respiratory systems.

Special instructions: ASIPY should be prescribed only 2 weeks after discontinuation of irreversible monoamine oxidase inhibitors (MAOIs) and 24 hours after discontinuation of therapy with a reversible MAO inhibitor. Non-selective MAO inhibitors can be prescribed no earlier than 7 days after discontinuation of escitalopram. Some patients with panic disorder may experience increased anxiety at the start of SSRI treatment, which usually resolves within the next 2 weeks of treatment. To reduce the likelihood of anxiety, low initial doses are recommended. The drug should be discontinued if seizures develop. Use in patients with unstable epilepsy is not recommended; Controlled seizures require careful monitoring. If the frequency of convulsive seizures increases, the drug should be discontinued. ACPY should be used with caution in patients with a history of mania/hypomania. If a manic state develops, the drug should be discontinued. Escitalopram may increase blood glucose concentrations in diabetes mellitus, which may require dose adjustment of hypoglycemic medications. The risk of committing suicide is inherent in depression and can persist until a significant improvement in the condition occurs spontaneously or as a result of therapy. Careful monitoring of patients being treated with antidepressants is necessary, especially at the beginning of treatment, due to the possibility of clinical deterioration and/or the emergence of suicidal manifestations (thoughts and behavior). This precaution should also be observed when treating other mental disorders due to the possibility of concurrent depressive episodes. Hyponatremia, associated with decreased secretion of antidiuretic hormone (ADH), occurs rarely when taking escitalopram and usually disappears when the drug is discontinued. When taking escitalopram, skin manifestations may develop: ecchymosis, purpura. Caution must be exercised when prescribing the drug to patients prone to bleeding or taking anticoagulants. Concomitant use of ACP and MAO type A inhibitors is not recommended due to the risk of developing serotonin syndrome. Caution must be exercised when used concomitantly with drugs that have serotonergic effects. A combination of symptoms such as agitation, tremor, myoclonus, and hyperthermia may indicate the development of serotonin syndrome. In this case, concomitant use of SSRIs and serotonergic drugs should be discontinued and symptomatic treatment initiated. Although escitalopram does not affect psychomotor activity, it is not recommended to drive a car or operate machinery during the treatment period.

Interaction: When taken simultaneously with MAO inhibitors, as well as at the beginning of taking MAO inhibitors in patients who have recently taken escitalopram, the risk of developing serotonin syndrome increases. Concomitant use with serotonergic drugs (including tramadol, sumatriptan and other triptans) may lead to the development of serotonin syndrome. Concomitant use of ASPI with drugs that lower the seizure threshold (tricyclic antidepressants, SSRIs, antipsychotics - phenothiazines, thioxanthenes, butyrophenones) increases the risk of developing seizures. Enhances the effect of tryptophan and lithium preparations. Increases the toxicity of St. John's wort preparations. When used simultaneously with oral anticoagulants and drugs that affect blood clotting (for example, atypical antipsychotics and phenothiazines, most tricyclic antidepressants, acetylsalicylic acid, non-steroidal anti-inflammatory drugs, ticlopidine, dipyridamole), a violation of blood clotting is possible; careful monitoring of relevant indicators is necessary. The simultaneous use of ACP and alcohol is not recommended. Drugs metabolized by the CYP2C19 system (including omeprazole, esomeprazole, fluvoxamine, lansoprazole, ticlopidine), cimetidine, as well as drugs that are inhibitors of CYP3A4 and CYP2D6 (including flecainide, propafenone, metoprolol, desipramine, clomipramine, nortriptyline, risperidone , thioridazine, haloperidol), increase the concentration of escitalopram in the blood plasma of patients. Escitalopram increases plasma concentrations of desipramine and metoprolol by 2 times.

Use during pregnancy and breastfeeding

Officially, the antidepressant is prohibited for use during pregnancy. In rare cases, doctors violate this rule by setting special conditions for therapy for a woman. If a woman taking Asipi finds out that she is pregnant, the product should not be abruptly abandoned due to the high likelihood of developing withdrawal syndrome. Use of the medicine in the third trimester and immediately before childbirth often leads to the appearance of neurological symptoms in the baby. The active substance of the drug passes into breast milk, so it is incompatible with lactation.

Analogs

Pharmacies offer numerous analogues of the drug "Aisipi", many of which are not inferior to it in effectiveness and safety. Any substitutions can only be made by a doctor - this even applies to synonyms of a product based on a similar active ingredient. The most common drug substitutes are Escitalopram, Cipralex, Selectra, and Lenuxin.

Cipralex is an analogue of the drug.