Prozac
International name:
Fluoxetine(Prozac)
Group belonging:
Antidepressant
Description of operating matter (MNN):
Fluoksetin
Medicinal form:
capsules
Pharmacological action:
Antidepressed mean, selective ingibitor of reverse capture of serotonin. Improves a mood, reduces tension, anxiety and sense of fear, disforiyu removes. Does not cause ortostaticheskoy gipotenzii, sedativnogo effect, not cardiotoxic. A proof clinical effect comes through 1-2 ned of treatment.
Testimonies:
Depressions (regardless of degree of the depressed disorder - weak, moderate, heavy), bulimiya, anorexia, alcoholism, obtrusive states.
Contra-indications:
Hypersensitiveness, KHPN (KK less than 10 ml/mines), expressed hepatic insufficiency, suitsidal'naya attitude, simultaneous reception of ingibitorov of MAO (in preceding 2 ned), pregnancy, period of lactation.C by a carefulness. Saccharine diabetes, epileptic syndrome of different geneza and epilepsy (including in anamnesis), illness of Parkinsona, compensated kidney hepatic insufficiency, cachexy.
Side actions:
From the side of the nervous system: dizziness, head pain, somnolence or insomnia, languor, promoted fatigueability, asthenia, tremor, azhitatsiya, anxiety, suitsidal'naya tendency (peculiar a patient with the depressed disorders), craze or gipomaniya. From the side of the digestive system: decline of appetite, dryness in to the mouth or gipersalivatsiya, nausea, diareya. Allergic reactions: skin rash, hives. Other: promoted potootdelenie, pokhudanie, decline of libido, system violations outside of lights, buds or liver, vaskulity.Overdose. Symptoms: nausea, vomiting, state of excitation, cramps. Treatment: washing of stomach, setting of absorbent carbon, at cramps - anksioliticheskikh LS (tranquilizers), symptomatic therapy.
Method of application and dose:
Inward, at depression initial dose - 20 mg/day 1 time, in the morning; at a necessity a weekly dose is increased on 20mg/day. Maximal day's dose is 80 mgs in 2-3 receptions. At bulimii and for elderly patients are 60 mgs in 3 receptions, at the obtrusive states - 20-60 mg/day. Supporting therapy - 20 mg/day. Course of treatment - 3-4 ned.
Special pointing:
At treatment of patients with the deficit of mass of body it is necessary to take into account anoreksigennye effects (the making progress loss of mass of body is possible). At patients by saccharine diabetes, setting of fluoksetina is promoted by the risk of development of gipoglikemii and giperglikemii - at his abolition. The dose of insulin and any other of gipoglikemicheskikh LS, applied inward, must be adjusted in this connection. Before the offensive of considerable improvement in treatment patients must be under the supervision of doctor. During treatment it is necessary to hold back from the reception of ethanol and employments potentially by the dangerous types of activity, requiring the promoted attention and quickness of psychical and motive reactions. An interval between completion of therapy ingibitorami of MAO and beginning of treatment of fluoksetinom must make at least 14 days; between completion of treatment of fluoksetinom and beginning of therapy ingibitorami of MAO - no less than 5 ned. At the diseases of liver and in a sear and yellow leaf it is necessary to begin treatment with a 1/2 dose.
Co-operation:
Strengthens the effects of alprazolama, diazepama, ethanol . Promotes the concentration of fenitoina in plasma, maprotilina, trazodona in 2 times (it is necessary on 50% to reduce the dose of tritsiklicheskikh antidepressants at simultaneous application). On a background conducting of electro-convulsive therapy development of long epileptic attacks is possible. Triptofan strengthens serotoninergicheskie properties of fluoksetina (strengthening of azhitatsii, motive anxiety, violations outside ZHKT). Ingibitory of MAO promote the risk of development of serotonin syndrome (gipertermiya, chill, promoted potootdelenie, mioklonus, hyperreflection, tremor, diareya, violations of co-ordination of motions, vegetative labil'nost', excitation, delirium and coma). LS, rendering the oppressive influencing on TSNS, promote the risk of development of side effects and strengthening of oppressive action on TSNS. At simultaneous application with LS, possessing the high degree of binding to the squirrel, especially with anticoagulants and digitoksinom, the increase of concentration is possible in plasma of free (unrelated) LS and increase of risk of development of unfavorable effects.
Long time scientists supposed only, that one of mechanisms of action of antidepressants, such as prozac
, tseleksa, paksil and zoloft (Prozac, Celexa, Paxil and Zoloft), is stimulation of formation of new nervous cages of cerebrum. It was a few years back shown on animals, that the protracted reception of antidepressants indeed strengthens neyrogenez in grown man gippokampe.
Possibly, this growth of number of new neurons is needed for realization of influencing of antidepressants on a conduct. However until now was clear, on what class of cages these preparations influence in the cascade of neyronal'noy differentsirovki.
Scientists from Cold Spring Harbor Laboratory worked with the specially shown out line of transgennykh mise which authentication and classification of early neyronal'nykh predecessors is possible at. In addition, for such mise the exact count of changes of amount of cages is possible in every separate subclass of neyronal'nykh predecessors in reply to influence of neyrogennykh matters.
Utillizing this line of mise, they showed that selective ingibitor of reverse capture of serotonin antidepressant of fluoksetin (commercial name - prozac) does not influence on the division of nervous barrel cages in the toothed beard of gippokampa, but strengthens the symmetric division of early predecessors. Scientists showed that these cages (amplifying progenitors) are the unique class of neyronal'nykh predecessors, on which fluoksetin influences in a grown man brain. It talks that indutsirovannyy fluoksetinom growth of number of new neurons is a result of reproduction exactly of this class of cages. The number of grown man neurons begins to be increased in 3-4 weeks after strengthening of reproduction of these early predecessors. It explains why antidepressants start acting only in 3-4 weeks after the beginning of reception. As a result of this work the cellular purpose of influence of these medications was certain.
antidepressants rescued life the enormous number of Americans. Lately medical public was disturbed given that ingibitory of reverse capture of serotonin (IOZS) promote the risk of suitsida. However much scientists set under the direction of Julio Licinio, that the amount of suicides diminished steadily, since 1988, when fluoksetin appeared at the market (prozac).
An amount of suicides was approximately identical during 15 years, preceded appearance of fluoksetina. As sales were increased, a death rate from suitsidov began to diminish .
«Certainly, these information does not eliminate possibility of increase of risk of suitsida in the certain small in numbers groups of population», - Julio Licinio talks.
In 2004, as a result of appearance of information about connection of reception of antidepressants for children and adults with the promoted risk of suicide, Management on Food and Medications of the USA placed the special warning on packing of prozac. «Most psychiatrists consider absence of treatment at depression more dangerous, than possible action of medicine for separate patients. People, deciding on suitsid, more frequent than all, suffer nelechenoy depression. Our purpose consists of that, to study connection between the reception of IOZS and depression, but to shut out, that patients remained without effective treatment», - a research author talks.
Approximately 10% men and 20% women suffer in the USA depression (large depressed episode).
Fluoksetin is the most popular antidepressant in the world and the unique antidepressant which Management on Food and Medications of the USA lets to apply for children.
