Sometimes a person comes "dark" period in your life constantly oppresses depressed mood, life becomes empty, bleak and uninteresting, disturbed sleep, and a thought about whether it is worth living. This state is called a depression, it is dangerous, especially if the last. In order to relieve depression, there is a group of drugs called antidepressants.

The mechanism of depression and antidepressant action

In the occurrence of depression Depression - a little more than a bad mood   the main role is played by the lack of some neurotransmitters (norepinephrine and serotonin) - biologically active substances that can transmit electrical impulses in nerve cells. Norepinephrine is particularly needed in stressful situations a person, he cites the body as "embattled" and serotonin is responsible for the emotional stability, self-control, sleep, improves mood. For serotonin require sunlight, it is the lack of light in winter is a frequent cause of depression.

The first antidepressants appeared in the mid-fifties of the last century. We view them by accident in the course of anti-TB drugs production. Study of one of the first antidepressants showed that it has a characteristic of inhibiting (retard effect) monoamine oxidase (MAO) - an enzyme that causes destruction of the neurotransmitter (biologically active substances which take part in the transmission of nerve impulses in the central nervous system (CNS) - noradrenaline, dopamine and serotonin). When depressive states indicated an increased breakdown of norepinephrine and serotonin, and antidepressants - MAO inhibitors (MAOIs) prevent the destruction, which helps to reduce depression.

Almost simultaneously opened and another group of antidepressants, whose operation is based on the fact that they block the reuptake of norepinephrine and serotonin by nerve endings at the site of transmission pulses from one nerve cell to another, resulting in their accumulation and transmission of impulses in the CNS improves, It helps to improve the mood of the patient. According to its chemical structure, this group of drugs called tricyclic antidepressants.

Later it was opened, and other groups of antidepressants, but the first two groups and today continue to be successfully used in medical practice.

The mechanism of action of tianeptine

Coaxil (INN - tianeptine) - a tricyclic antidepressant energizing action (occupies an intermediate position between soothing and stimulating antidepressants). Increases uptake of serotonin (ie, blocking its reuptake) nerve cells of the cerebral cortex and subcortical region, increases the activity of nerve cells and speeds up the recovery of their activity after a braking function (for example, after a dream). As a result, the patient improves mood, relieve motor inhibition, increases the overall tone of the body. And as depression and anxiety are often the cause of a variety of unpleasant sensations in the internal organs (nausea, headache, palpitations, and so on), and it improves the general condition of the patient.

Coaxil almost no effect on the cardiovascular system, sleep, motor and mental activity, is not addictive. When administered koaksil rapidly and completely absorbed from the gastrointestinal tract, distributed in tissues, is then decomposed by the liver and excreted in urine.

Indications and contraindications for use

Application coaxil shown in the doldrums, arising:

• the elderly;
• in patients with chronic alcoholism in abstinence period (separation of alcohol, which leads to a number of changes in the central nervous system and internal organs);
• in patients suffering from various diseases of internal organs, which are accompanied by anxiety and depression.

Admission coaxil contraindicated in hypersensitive to the components of the drug, pregnancy, breast- Breastfeeding - a personal choice   chest and for children under 15 years. It does not take koaksil with other antidepressants - MAO inhibitors.

Side effects that may occur while taking coaxil

Admission coaxil may be accompanied by the following side effects:

• From the nervous system: insomnia or drowsiness, frightening dreams Dreams: how to understand our dreams , Weakness, fatigue, dizziness Dizziness - if the ground is slipping from under his feet , Headache, fainting, trembling limbs, feeling hot, feeling of "lump" in his throat;
• from the gastrointestinal tract: abdominal pain, dry mouth, decreased appetite, nausea, vomiting, constipation, bloating;
• on the part of the cardiovascular system: heart attacks, heart rhythm disturbances, pain in the heart, shortness of breath;
• on the part of the musculoskeletal system: pain in mice and in the lumbosacral spine.

Overdose causes increased side effects of the drug. In such cases, gastric lavage and emergency care at the hospital.

Coaxil manufactured by the French pharmaceutical company "Servier Laboratories Industry".

Galina Romanenko

Manifestation, during (including seasonal exacerbation) and outcome of schizophrenia are extremely varied, in some cases it is difficult to distinguish from other mental illnesses. Close to the study of this disease started in the second half of the XIX century, but today it is a lot of mysterious and unexplained.

What is schizophrenia

Schizophrenia - is endogenous (arising due to internal reasons) mental illness Mental illness - ashamed to ask for help?   continuous or paroxysmal course, personality changes manifested in the form of schizophrenic defect (loss of mental activity, emotional impoverishment, isolation, thought disorders) and disorders such as delirium, hallucinations. Thus in patients with preserved ability of the so-called formal intelligence (memory, acquired knowledge).

Schizophrenia is the most common mental illness and is characterized by a wide variety of manifestations and forms. But basically there are three great forms of schizophrenia:

• nepreryvnotekuschaya schizophrenia;
• episodic-like progressive (shift-like) - with each attack (Shub) the patient's condition worsens;
• periodic - attacks occur periodically, but the patient's condition does not deteriorate.

The reasons are varied and schizophrenia is not fully understood. Matters genetic predisposition, biochemical changes in the brain, various external factors (stress, infections).

The main symptoms of schizophrenia

The most common symptoms of schizophrenia can be divided into three main groups: positive, negative and disorganized.

Positive signs - those that do not happen in a healthy individual (ie this emerging signs). They include delusions (beliefs and ideas that have nothing to do with reality) and hallucinations (patients see, hear and feel what is actually there).

Negative symptoms - these are signs that must be present in a healthy person, but they are not sick, that is, they fall. The negative features include: reduction or complete lack of emotion Emotions and culture: how to decipher the emotional code , The desire to protect themselves from contact with others and from any activity, reduction of energy (lethargy, confusion), the lack of desire and interest in life, indifference to their appearance, inability to "fit" into the social life, lability (quick change) mood, catatonia (stay stationary, "wax" state for a long time)

Disorganized symptoms - is the inability of a person to think clearly, speak and act. These signs include: frequent leap from one thought to another in the process of communication, the use of meaningless phrases and words, very slow movements and speech, inability to make decisions, forgetfulness, often - every day repeated misunderstanding of visual images, sounds, feelings.

Does the schizophrenia of seasonality

This fact was not recognized for a long time, however, the statistical studies in recent years (in spring and autumn is hospitalized and a half times more than the mentally ill) confirm that the seasonality of exacerbations of schizophrenia (as well as exacerbation of any mental illness) is. This is especially true of attack-like progressive (shift-like) form of schizophrenia, which attacks (fur) include both depressive (with a reduction in the mood), and manic (with elevated mood) state. Such seasonal fluctuations composure at mentally ill people are called seasonal affective disorder (SAD).

It was found that mentally ill people are starting to feel worse when daylight increases in the spring for two hours and fall for the same two o'clock decreases. This occurs most likely because strays rhythm of life, and with it the internal biological rhythms. A healthy person feels in this period lethargy, decreased performance, irritability Irritability - you try to control my temper But he is able to overcome the discomfort and leads a normal life. And the mentally ill person begins exacerbation as arrhythmias are reflected primarily on the central nervous system and the secretion of hormones that regulate the activity of the whole organism.

Most often, seasonal affective disorders tend to emotionally unstable patients, with frequent changes of mood, which is characteristic of episodic-like progressive schizophrenia.

How to prevent exacerbation of schizophrenia in the offseason

First of all, such patients need to be protected from any external impact, especially such that they are unpleasant. The cause of acute schizophrenia during the offseason can be any change in the form of a small stress How to beat stress? Create an oasis , Sharp sound, the sudden glare. Patients with schizophrenia are prone to seasonal affective disorder, in spring and autumn should receive preventive treatment, even if they do not relapse.

Galina Romanenko