Antidepresivi – istraživanja i primjena

• Post by: Psyche General
• 23.07.2024.
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Sažetak

Jedni od najkorištenijih psihofarmaka zasigurno su antidepresivi – lijekovi koji se koriste u liječenju depresije, ali i anksioznih smetnji, poremećaja ličnosti, psihoza, poremećaja hranjenja, pa čak i neuralgija. U radu se nalazi kratka povijest i podjela antidepresiva, opis mehanizama njihovog djelovanja na primjeru SIPPS antidepresiva (selektivni inhibitor ponovne pohrane serotonina) te prikaz istraživanja efikasnosti antidepresiva kod različitih patologija. Također, izneseni su potencijalni prediktori dobrog terapijskog odgovora, od kojih se posebno ističu polimorfizmi određenih gena. Razmatraju se i različite strategije pri odabiru i provođenju terapije antidepresivima uz poseban naglasak na kombinaciju sa psihoterapijom (najviše s onim pravcima koji se temelje na kognitivno – bihevioralnim paradigmama). Dan je i kratki prikaz nuspojava koje se vezuju uz različite antidepresive. Na koncu se donosi sažeti prikaz smjernica britanske NICE za terapiju antidepresivima te se razmatraju određeni razlozi otpora prema terapiji antidepresivima i psihofarmacima općenito.

Ključne riječi: antidepresivi, geni, monoamini, psihoterapija, prediktori, serotonin,
terapijski odgovor

Abstract

One of the most widely used psychopharmaceuticals are certainly antidepressants – drugs
used in the treatment of depression, but also anxiety disorders, personality disorders,
psychosis, eating disorders and even neuralgia. This paper contains a brief history and
division of antidepressants, a description of their mechanisms based on an example of SSRI antidepressants (selective serotonin reuptake inhibitor), and a presentation of research dealing with the effectiveness of antidepressants in various pathologies. Also, potential predictors of a good therapeutic response are presented, of which polymorphisms of certain genes stand out. Different strategies in the selection and implementation of antidepressant therapy with special emphasis on the combination with psychotherapy (mostly with those directions based on cognitive-behavioral paradigms) are also considered. A brief description of side effects associated with different antidepressants is also given. At the end, a summary of the British NICE guidelines for antidepressant therapy is given, and certain reasons for resistance to antidepressant therapy and psychopharmaceuticals in general are considered.

Key words: antidepressants, genes, monoamines, predictors, psychotherapy, serotonine,
therapeutic response