Depresse

Depress is an antidepressant-psychoanaleptic. It belongs to the SSRI drug category. The active ingredient is fluoxetine.

Indications Depression

It is used for: depressions of various origins, OCD and bulimia.

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Release form

Released in capsules, 8 pieces inside a blister pack. A separate pack contains 2 blisters with capsules.

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Pharmacodynamics

Depres is an antidepressant, a derivative of propylamine. In its chemical composition, it differs from tricyclic and tetracyclic antidepressants. The effect of the drug is due to the slowing of the process of reverse serotonin uptake by neurons within the central nervous system. The active component prevents serotonin uptake, but does not affect norepinephrine.

The drug helps improve mood, remove dysphoria, and reduce feelings of tension and fear. It does not have sedative properties. When taken in moderate medicinal doses, it has almost no effect on the functioning of the cardiovascular system and other systems.

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Pharmacokinetics

When using a single dose of 40 mg of the drug, the active component reaches a peak in plasma over a period of 6-8 hours (equal to 15-55 ng/ml). Food intake does not change the level of bioavailability of the drug, although absorption of the substance may be delayed. Synthesis with plasma protein is 94.5%.

Fluoxetine undergoes rapid hepatic metabolism, resulting in the formation of norfluoxetine and other inactive decay products. The drug is then excreted through the kidneys. The half-life of the active component is 2-3 days, and the active decay product, norfluoxetine, is 7-9 days.

The half-life of fluoxetine with norfluoxetine is prolonged in people with liver failure. Long-term treatment in people with severe forms of this pathology may cause accumulation of the substance.

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Dosing and administration

For adults.

The daily required dosage for depression or OCD is 20 mg, which must be taken in the morning. If there is no effect after 3-4 weeks of the course, it is allowed to increase the daily dose to 80 mg. Doses that exceed 20 mg per day must be divided into 2 doses, morning and evening.

For bulimia, it is recommended to take 60 mg of the drug per day. The maximum permissible daily dose is 80 mg.

Since the drug has a long half-life (2-3 days; and its active decay product has a half-life of 7-9 days), its concentration in the plasma continues to be maintained for several weeks.

In older people.

It is allowed to take no more than 60 mg of Depress per day.

Persons with liver or kidney failure.

In case of moderate renal dysfunction (glomerular filtration rate <15-50 ml/min) and liver failure, the dosage should be reduced or the drug should be taken every other day. This is especially true for elderly people with concomitant pathologies who take several drugs in combination.

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Use Depression during pregnancy

Depress is prohibited for use in pregnant women.

Contraindications

Main contraindications:

• hypersensitivity to fluoxetine;
• severe renal failure (glomerular filtration rates are less than 10 ml/min);
• combined use with MAOIs, as well as use of drugs in the period less than 2 weeks before starting to take MAOIs;
• breastfeeding period;
• age under 18 years (the components of the medicine are dyes, which are prohibited for use by children under 18 years of age).

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Side effects Depression

Taking the medicine may lead to the development of certain side effects.

The following are often observed:

• rash with pruritus, anaphylactoid manifestations, chills with vasculitis, urticaria, photosensitivity and angioedema;
• vomiting, dysphagia, diarrhea, dyspeptic symptoms, nausea, dry mouth and taste bud disorders;
• sleep problems and insomnia, headaches, anorexia and dizziness, feelings of drowsiness, fatigue, nervousness, anxiety, excitement or euphoria, temporary pathological conditions (such as tremor and ataxia or myoclonus), mania, decreased concentration and development of depersonalization, the appearance of psychomotor instability, seizures and hallucinations, as well as panic attacks (such symptoms may be part of the disease);
• urinary disorders, erectile dysfunction (delayed or absent ejaculation, as well as anorgasmia), as well as galactorrhea or priapism;
• the appearance of yawning or the development of alopecia;
• hyperhidrosis, visual disturbances (mydriasis or blurred vision), and vasodilation;
• myalgia or arthralgia, the appearance of bruises, the development of hyponatremia or orthostatic hypotension.

Occasionally, pharyngitis, functional liver disease and respiratory disorders may occur.

Occasionally, the following may occur: serotonin intoxication, Lyell's syndrome, idiopathic hepatitis, bleeding in the gastrointestinal tract or of a gynecological nature, as well as other bleeding in areas of the mucous membranes and skin.

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Overdose

Signs of overdose: vomiting, CNS stimulation and nausea.

The medicine has no antidote. Symptomatic treatment is required to eliminate the disorders. It is necessary to take activated carbon together with sorbitol or perform gastric lavage. Dialysis or forced diuresis procedures do not help.

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Interactions with other drugs

With a combination of Depres:

• with drugs that have a suppressive effect on the central nervous system, and also with ethyl alcohol, a significant potentiation of the above-mentioned effect can be observed, and along with this, an increase in the likelihood of seizures;
• with drugs that have a high level of synthesis with protein (especially with digitoxin or anticoagulants), plasma values of free drugs may increase and the risk of adverse reactions may increase;
• with lithium drugs, as well as phenytoin - the level of these drugs may increase, and toxic effects may also occur;
• with the substance tryptophan - motor restlessness may increase, and in addition, the severity of disorders in the gastrointestinal tract may increase;
• with other antidepressants - their plasma values increase;
• with benzodiazepines - in some patients, the half-life of the substance diazepam may be prolonged;
• with MAOIs (including moclobemide or selegiline) - due to an increase in serotonin levels, as well as the inhibition of its reuptake processes, a significant increase in the volume of serotonin inside the synapse is observed. As a result, serotonin intoxication develops, against the background of which muscle rigidity, hyperthermia, and also myoclonus with signs of imbalance in the physiological and mental state of a person (with a possible fatal outcome) appear.

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Storage conditions

Depress must be kept in a dark, dry place, out of reach of small children. Temperature values are maximum 25°C.

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Shelf life

Depress is permitted to be used for a period of 2 years from the date of release of the drug.