Reksetin

Rexetine is an antidepressant that is included in the category of drugs SSRIs.

Indications Reksetina

It is used in the following conditions:

• a state of depression that has a diverse nature (especially pathologies, in which there is a regular feeling of anxiety);
• episodes with the development of depression or BAR as a result of schizophrenia;
• therapy for OCD or its prevention (the drug can prevent the development of active relapses even in the case of a prolonged treatment cycle);
• organic lesions in the central nervous system (these include lesions affecting the deep brain structures);
• readjustment for the episodic occurrence of manic-depressive syndrome (during the depressive phase);
• social phobia or generalized symptoms observed with persistent anxiety syndrome;
• PTSD, often manifested in connection with a catastrophe or a highly life-threatening situation;
• neuropsychic disturbances in which panic or agoraphobia develops.

Release form

The release of the substance is realized in tablets of 20 or 30 mg, which are packaged in blisters in the amount of 10 pieces. The box contains 3 such blisters.

Pharmacodynamics

The active drug element, paroxetine, is a complex organic compound with a bicyclic structure. It slows down the ability of the vesicles of the presynaptic walls to compensate for the loss of active serotonin mediators, which is why it lingers inside the synaptic cleft. As a result, together with the main therapeutic effect, it has a pronounced activating effect on the central nervous system - because the mediator of nerve impulses has a longer effect (stimulates the serotonergic system).

It should be noted that the active component of drugs, as its chemical basis, also has an anxiolytic effect, because the state of anxiety is mostly due to the increased excitability of the structures of brain subcortex, which are affected by the drug. Suppression of these parts of the central nervous system (thalamus, limbic formation and hypothalamus) leads to a reduction in the symptoms of anxiety syndrome.

The use of Rexetine also leads to a decrease in the severity of OCD.

Paroxetine has a high specificity of therapeutic effects. It does not affect the activity of opioid, muscarinic or nicotinic endings, as well as adrenoreceptors, which does not lead to the development of drug addiction and addiction of a generalized nature. In addition, there is no change in the intensity of the processes of the reuptake of some mediators (dopamine and norepinephrine).

Pharmacokinetics

After oral administration, the drug is absorbed at high speed inside the gastrointestinal tract. Eating does not have a significant effect on the degree of absorption of the substance. The drug has high rates of protein synthesis (approximately 93-95% of paroxetine), due to which its active elements circulate for a long time inside the main blood flow.

Rexetine undergoes intrahepatic metabolism, in which inactive metabolic products are formed. After transformation, the drug in the form of metabolic products is excreted in the urine through the kidneys (mostly). Half-life varies in the range of 15-24 hours (a more accurate indicator depends on the individual metabolic rate).

With a short-term conservative cycle of therapy, the drug slightly accumulates, reaching equilibrium values after 7 days of constant intake of tablets. But with prolonged use of the drug does not accumulate.

Dosing and administration

Tablets consumed inside, in the morning, along with food. At the same time they do not need to chew, so as not to damage the tablet shell. Taking into account the clinical condition of a person, the portion size can be adjusted after 2-3 weeks from the start of the treatment cycle.

The size of the dosage of the drug varies significantly depending on the diagnosis of the patient.

In depressive conditions, 20 mg of the substance is taken daily. The therapeutic effect develops rather gradually, due to which, in extremely difficult conditions, it may be necessary to increase the portion. With 1-week intervals, the dosage may increase by 10 mg until the desired result is obtained. A maximum of 50 mg of the drug is allowed per day.

People with OCD first need to take 20 mg of medication per day. As with depressions, the drug effect does not develop immediately, therefore, with a 1-week interval, the applied dose can be increased by 10 mg. At the same time per day is allowed to consume a maximum of 60 mg of the drug.

It is necessary to begin treating panic disorders with the use of a small daily dosage (10 mg), and later every week to increase it until the required rehabilitation effect is obtained. The use of such a small initial portion is due to the fact that the intensity of manifestations of the underlying disease may increase due to adverse symptoms (negative reactions are most pronounced at the initial stage of the conservative cycle). The size of the maximum allowable portion per day is 60 mg.

With social phobia, 20 mg of Rexetine are first taken per day. In the absence of improvements in a person’s condition after 14 days of treatment, a dose of drugs should be raised by +10 mg every week until the desired effect or the maximum allowable dose of 50 mg per day is achieved. The standard maintenance dosage for sanitation is usually 20 mg.

With anxiety syndrome of generalized nature or with PTSD, the mode of conservative therapy is similar to the scheme used in the treatment of social phobia.

When the active stage of conservative sanation is completed (the severity of all the leading symptoms of the underlying CNS disease is significantly reduced), a supportive treatment is required to prevent the occurrence of relapses. Such cycles often last for 4-6 months. In addition, at the end of therapy, the risk of withdrawal syndrome should be taken into account, and therefore, the use of drugs should be stopped gradually.

In people with kidney or liver failure (at a CC level below 30 ml / minute), the ability to metabolize paroxetine decreases dramatically, which is why they are allowed to take no more than 20 mg of the drug per day. In the presence of strict vital indications, the portion can be increased, but it is recommended to keep it within the minimum.

Use Reksetina during pregnancy

The drug can be used during pregnancy only in the presence of strict vital indications, because its use can have a significant impact on the development of the fetus inside the womb. For example, in the first trimester, the probability of the development of a congenital defect of the cardiovascular system increases greatly (defects in the area of the septum between the atrium and the ventricle are very often noted). In the case of the use of drugs in the 3rd trimester, premature labor or other prenatal complications may occur (such as extensive cyanosis, RDS-syndrome, lethargy, hyperreflexia, epilepsy and a decrease in blood pressure).

If there is a need for a conservative treatment cycle using Rexetine during lactation, it is necessary to discuss with the attending doctor the issue of temporarily stopping breastfeeding, because the active elements of the drug cannot be used in children, and a small part of paroxetine is excreted with breast milk.

Contraindications

Main contraindications:

• the presence of intolerance, idiosyncrasy, and in addition acquired or hereditary hypersensitivity to the components of the drug;
• use in conjunction with drugs MAOI (their use is allowed only after 3 weeks from the end of the treatment cycle with the use of antidepressants);
• conservative treatment using tryptophan or its derivatives;
• prolonged QT interval syndrome;
• liver failure;
• glaucoma of a closed-angle nature (in this case, an excessive increase in IOP values may occur);
• arrhythmia with ventricular nature;
• prostatic hyperplasia;
• appointment to older people.

Side effects Reksetina

During active conservative therapy with medication, the following side effects may occur:

• disorders affecting the work of the PNS or CNS: headaches or dizziness, tremor, disorder of the daily regimen, trembling of the extremities, increased fatigue, feeling of irritability, hyperhidrosis, paresthesia, and in addition a disorder of visual function, having a nervous origin, and dryness of the oral mucosa. In addition, there is information about the development of oromandibular dystonia or extrapyramidal signs, but this happens only once;
• problems with digestive function: disorders of the stool (diarrhea and constipation can be observed), dyspepsia, appetite deterioration, and besides, an increase in the activity of liver enzymes, resulting in impaired hepatic activity;
• disturbances in the cardiovascular system: decrease or increase in pressure indices (depending on the patient’s predisposition), heart rhythm disorder, changes in ECG values and vasodilation, which can reach fainting due to the lack of blood circulation in an acute form;
• lesions affecting the urogenital system: decreased libido, problems with urinary processes and active ejaculation disorders;
• other manifestations: skin reddening due to vascular hyperemia, salt balance disorder (hyponatremia), hematomas, increased production and secretion of vasopressin (antidiuretic hormone), hypo-or hyperglycemia, thrombocytopenia, muscle pain, myopathy and influenza-like myopathy, thrombocytopenia, pain in the area of muscles, myopathy and influenza-like swelling, thrombocytopenia, pain in the area of muscles, myopathy and influenza-like sinuses, thrombocytopenia, pain in the area of muscles, myopathy and influenza-like sinuses, thrombocytopenia, pain in the area of muscles, myopathy and influenza-like sinuses, thrombocytopenia, pain in the area of muscles, myopathy and influenza-like sinuses, thrombocytopenia, pain in the area of muscles, myopathy and influenza-like sinuses (rhinorrhea, temperature increase, etc.).

In addition, symptoms of allergy may occur, manifested in the form of epidermal rashes, hives, itching, bronchospasm, swelling of the upper body (hands and face), as well as Quincke edema.

It is necessary to pay attention to the fact that negative manifestations when using drugs have a stronger severity at the initial stage of therapy, and already in its course they are usually significantly weakened.

Abrupt withdrawal of the drug can lead to withdrawal syndrome, in which such signs as vomiting, feeling of confusion, pronounced tremor, disorder of peripheral sensitivity, nausea and disorder of the daily regimen are noted.

To avoid the development of dependence or withdrawal syndrome, it is necessary to cancel the drugs gradually and only after the completion of the full treatment cycle.

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Overdose

Often the use of Rexetin does not lead to the appearance of complications, because it has a wide range of safe dosages. But when using a 1-fold portion that is more than 2 g of a substance, or in combination with medicines containing paroxetine, the toxic properties of the active element can develop, followed by acute intoxication, manifested by such signs:

• dilated pupils;
• vomiting with nausea;
• severe trembling of the limbs;
• dryness of the oral mucosa;
• feeling sleepy or excited;
• dizziness or headaches;
• redness of the upper body, especially the skin on the face.

The medication does not have an antidote, therefore symptomatic procedures are used to eliminate the violations. It is necessary to closely monitor the work of vital systems, as well as to ensure free flow to the respiratory ducts. As soon as possible after an overdose, it is required to perform gastric lavage and give the patient enterosorbents. Oxygen therapy is also considered effective.

Interactions with other drugs

It is forbidden to combine the drug with MAOI, because with such a combination, there is a mutual potentiation of negative manifestations. If you do not comply with this prohibition, it is even possible death.

The combination of drugs with drugs or dietary supplements, which include tryptophan, can lead to potentiation of the severity of negative symptoms of therapy. Usually in such cases, there are severe headaches, vomiting, regular dizziness and nausea. This effect when combined with Rexetine have anticonvulsants and antidepressants from various categories (amitriptyline, nortriptyline, as well as fluoxetine and others).

Simultaneous use with sumatriptan is possible only under the condition of being under the regular supervision of experienced medical workers, because with this combination a feeling of weakness appears, reflexes increase (hyperreflexia develops) and motor coordination is disturbed. Therefore, if necessary, the use of a therapeutic regimen with the introduction of both of these drugs, therapy should be performed at the hospital.

The combination of medication and anticoagulants for oral administration may increase the PTV values and increase the risk of bleeding, because the effect of anticoagulants is potentiated.

Drugs that stimulate the activity of liver enzymes (among them, the drug that induces the oxidation of microsomes, phenytoin), can lead to a change in the metabolism of paroxetine. The rate of decomposition of the component into inactive metabolic products increases and the half-life increases (as a result, the drug effect does not develop even in the case of a gradual increase in the dose of drugs).

Funds from the phenobarbital category also have a negative effect on drug metabolism. But in this case, the elements of drugs increase the rate of renal metabolism. Therefore, the bioactive components of drugs are excreted at a higher rate, due to which their plasma indices decrease significantly.

The drug increases the values of theophylline and procyclidine inside the plasma, but during clinical tests the mechanism of this interaction could not be determined. Because of this, with such a combination, it is necessary to monitor the plasma values of the active elements of drugs.

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Storage conditions

Rexetine is required to be kept in a place protected from moisture and access by small children. Temperature level - in the range of marks 15-30 ° C.

Shelf life

Rexetine is allowed to apply within 2-4 years from the date of release of the medication.

Application for children

It is completely forbidden to use the medicine in pediatrics, because its admission before the age of 18 can lead to changes in the development of internal organs and personal development.

Analogs

Analogues of the drug are drugs such as Xet and Parelax with Luxote.

Reviews

Rexetine generally receives positive feedback, because it has a large range of drug activity. Its components not only eliminate depression in a short period, but also eliminate the complication of the disease, such as the anxiety syndrome, and prevent the development of relapse.

In addition, those people who took the medicine say that after the course of therapy, the ability to solve difficult life situations was eased. Direct evidence of this, obtained during clinical tests, is not available, but the selection of drugs used for the treatment of nosological units relating to the central nervous system and PNS, you can not reject these subjective data completely.

Doctors speak positively about the drug. Although he has a rather large number of negative manifestations, their severity is significantly weakened after the first 7 days of conservative treatment. Among the advantages of the drug, doctors also note its anxiolytic properties and the ability to eliminate social phobia at the therapeutic level.