The main reasons for discontinuing antidepressants

  1. Side effects of therapy, especially gastrointestinal
    (nausea, vomiting, flatulence, etc.), cardiac (heartbeat, arrhythmias, orthostatic hypotension, etc.), neurological (headache, tremor, sweating, etc.) endocrinological (weight gain, changes in menstruation cycle, etc.), manifestations sexual dysfunction
  2. Reducing the quality of life of the patient due to the intake of an antidepressant (the need for long-term use of the drug, its high cost, refusal to take alcohol, etc.)
  3. The lack of rapid therapeutic effect of the drug, its inadequate dosage
  4. Concerns about the formation of dependence with long-term drug intake
  5. Negative interaction with other medicines (tranquilizers, neuroleptics, cardiovascular drugs, etc.)
  6. Temporary improvement of the patient’s condition
  7. The lack of information on the required duration of anti-drug therapy.
    depressant, including the stage of long-term maintenance therapy and therapy aimed at preventing the recurrence of depression
  8. Negative suggestibility of the patient regarding the occurrence of possible side effects of the drug (annotations on drugs, the opinions of other patients, close relatives, etc.)
  9. Belief in one’s own strength to combat depression, psychologization of manifestations of depression, orthodox religiosity or conviction in the effectiveness of psychotherapy
  10. Adherence to alternative therapies (unconventional therapy)

In case of a negative result, the doctor may increase the dose of the drug, and it should be remembered that the most frequent mistakes in the treatment of depression are: treatment with low doses of antidepressant and its rapid cessation after the patient’s condition improves.

With resistance to depression therapy, a psychiatrist can replace one antidepressant with another, use a combination of them, activate psychotherapeutic intervention, or connect a different method of biological treatment, for example, electroconvulsive therapy. In the case of especially resistant conditions, it is necessary to specify the diagnosis, active treatment of associated diseases: cardiovascular, gastroenterological, endocrine, etc. Special care in the process of treatment with antidepressants should be exercised in the presence of pregnancy, liver disease, kidney or indications of cardiovascular disorders. It is important to emphasize that antidepressants are not always combined with the medicines used in the treatment of the above diseases. With depression, the tendency to unsystematic administration of various drugs, especially painkillers and sleeping drugs, is quite common; tranquilizers relieving panic attack. All these medicines may not be combined with antidepressants, cause pronounced side effects, distort the effect of drugs or level it completely.

Cases of incompatibility of antidepressants with a number of food additives and medicinal herbs are noted. Alcohol combined with antidepressants, on the one hand, causes a feeling of weakness, on the other hand, reduces the effectiveness of the antidepressant, but a rare use of a small amount of alcoholic beverages is quite acceptable and safe.

The reason for the resistance of depression to therapy in 20-30% of cases is the patient’s latent resistance to the process of therapy: the conditional “benefit from the disease.” The reason for the sustainability of depression can also be: the cohesion of the symptoms of the disease with the patient’s personality, the presence of concomitant somatic diseases, fear of psychotropic drugs, a categorical refusal to accept them (religious beliefs, peculiar ideas about a healthy lifestyle, a perceived opinion about the possibility of addiction due to prolonged use of antidepressants) , attempts to independently reduce or increase the dose of antidepressants, failure to comply with the regimen of therapy in relation to the time of his admission or prolonged However, self-withdrawal of the drug after a temporary improvement in the condition. Finally, due to the severity of his condition, the appearance of distraction or despair, the patient may forget about taking the medication and lose faith in its effectiveness.

Patients have a negative attitude towards treatment with psychotropic drugs and antidepressants, in particular, because of false myths prevalent in society. To these myths belong: the belief that antidepressants will have to take a lifetime; recognition of weakness due to the inability to cope with manifestations of depression; unfounded belief that these drugs cause addiction, negatively affect a person’s thinking and memory, change his personality and limit creative activity. The doctor must explain to the patient that in many diseases there is a need for long-term medication, that antidepressants cannot change a person’s character, do not cause drug addiction, do not affect his mental abilities in a negative way, but on the contrary, contribute to the restoration of mental health. Before starting treatment with antidepressants, it is necessary to identify those diseases that the patient suffers, since the use of many drugs used to treat these diseases may be incompatible with antidepressants.

local_offerevent_note March 25, 2019

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