The best and most effective antidepressants in 2022

The modern rhythm of life leads people to a number of problems of the psychological spectrum - mood drops and emotional stress rises, they become apathetic and anxious, suffer from sleep and appetite disorders. Antidepressants, which have been used to treat depressive syndrome and correct other mental disorders since the 1950s, have been very successfully combating these problems.

In this article, we will talk about the history of the emergence of antidepressants, their types, how these drugs act on the body, and what are the best and most effective antidepressants in 2022 on the drug market. We will also highlight their advantages and disadvantages, as well as much more.

History of appearance

Until the 19th century, in medicine, for the treatment of depressive conditions, substances with a strong stimulating effect were actively used (various opiates, ginseng extracts, valerian, caffeine, bromine salts), which temporarily brought patients into a state of euphoria.

By the end of the 1950s, the practice began to include the use of the first antidepressants. They were obtained through the synthesis of iproniazid, which was used for the complex treatment of tuberculosis. It was noticed that in patients with time the mood rises and the emotional background evens out. However, the side effects were too great, and as a remedy for tuberculosis, it did not justify itself.

Around the same years, the German doctor R. Kuhn discovered imipromin. He gave his patients various substances and observed the result. So, from imipromine there was an increase in mood. The drug was included in the official list of the World Health Organization and was the leader in sales until the advent of new generation products.

Today, the pharmacological industry offers more than 130 drugs that can overcome depression.

How antidepressants work

Our brain consists of a huge number of neurons that are connected not directly, but through synaptic gaps (synapses). The exchange between neurons occurs through the release of special substances into the synapses - mediators.

Biologists believe that one of the main causes of depression is a decrease in the concentration of certain mediators in the synapse. Currently, more than 30 mediators have been discovered, of which only three are associated with depressive disorders. This is a group of biogenic amines - norepinephrine, serotonin and dopamine.Their concentration is designed to be controlled by antidepressants, which allow you to correct the work of the brain and get rid of the disease.

Tranquilizers have a similar, stimulating or calming effect on the body. However, antidepressants, due to the short duration of courses (up to 1 year), do not cause strong dependence, which is how they differ from tranquilizers.

Classes and scope of antidepressants

The first classification divides stimulants into 4 main groups according to the principle of action:

1. Tricyclic antidepressants or tricyclics (TCAs)

This group includes drugs that are quite strong in effect and contain a triple carbon ring at their core. The tricyclic was the first antidepressant developed by the transnational pharmaceutical company Ciba-Geigy, Imipramine. It is still used today due to its high efficiency. Other TCAs include amiltriptyline, trazodone, clomipramine, maprotiline, mianserin, nortriptyline, and imipramine.

Tricyclics prevent the capture of norepinephrine, dopamine, the “hormone of happiness” - serotonin, inhibit anticholinergic and antihistamine effects.

These drugs are prescribed for the treatment of anxiety, depression of various nature, suicidal tendencies, panic attacks, manic-depressive psychosis. They give a calming effect.

However, it is worth noting that TCAs are a group of older generation drugs. They have very strong and varied side effects, causing patients to refuse further treatment, in about a third of cases.

The spectrum of side effects is wide, but the most common are:

• Weight gain;
• Drowsiness;
• constipation;
• problems with urination;
• Tachycardia, worsening of the conduction of the heart;
• drop in blood pressure;
• problems with sexual function;
• Decreased appetite;
• Seizures.

In light of these problems, TCAs cannot be purchased at a pharmacy without a doctor's prescription. It is problematic to choose a drug suitable for a specific task, it is even more difficult to calculate the correct dosage that will help to cope with depression, without much harm to the body.

In parallel with taking tricyclics, it is required to donate blood to control the volume of the antidepressant, since an overdose is harmful to health.

The average price of drugs is from 300 to 500 rubles.

2. Monoamine oxidase inhibitors (MAOIs)

The action of this group of antidepressants is aimed at increasing the concentration in the blood of substances responsible for good mood. MAOIs provide inhibition of the breakdown of monoaminooxidase and an increase in the volume of hormones such as serotonin, norepinephrine, dopamine, tryptamine, phenylethylamine.

Thanks to this, working capacity, concentration of attention increase, mood improves and a stable emotional background is created.

The drugs of this group treat panic attacks, anxiety, various types of depression, vegetative-vascular dystonia, schizophrenia. They are also used to eliminate pathological drowsiness (give vigor), to reduce weight in eating disorders and treat social phobia (give confidence, emancipation, sociability, reduce stiffness).

MAOIs come in both natural and synthetic origin.

There are three types of monoamine oxidase inhibitors, which have their own characteristics:

1. Non-selective irreversible. In excess - contraindications and side effects. They are toxic, they affect the liver and heart. Therapy is accompanied by constant nausea.A special diet is required that excludes alcohol, soy products, fish, dairy products, legumes, cabbage in any form, smoked meats, sweets, yeast products from the diet. Take such antidepressants only for a short time;
2. Reversible selective. This type is used for depression, apathy, certain types of phobias, nervous disorders. It is addictive - when the drug is discontinued, or if the dosage is reduced, it causes a deterioration in the patient's condition;
3. Irreversible selective. Gives treatment of severe forms of diseases of the central nervous system (for example, Parkinson's disease, Alzheimer's). The main side effect is a decrease in blood pressure.

All of them provide a stimulating effect. The most common side effect is addiction (MAOIs are like drugs), but also:

• For the first type - constipation, headache, dry mouth, blurred vision, swelling, sleep problems, convulsions, hallucinations, pressure surges;
• For the second and third types - problems with urination, heart palpitations, stomach pain, headache, sleep disturbances, anxiety, decreased appetite and libido, problems with ejaculation in men.

This group of drugs is also used exclusively on prescription. Taking MAOIs cannot be combined with many other drugs (for colds, for weight loss, for immunity, diuretics, anthelmintics, amphetamines, and others), they are also contraindicated in diseases of the kidneys, liver, heart, alcoholism, mania and suicidal tendencies.

Entry and exit from therapy occurs at reduced doses. Positive effects usually appear on the second week of administration, when a sufficient concentration of the substance accumulates.The course of treatment lasts 3-9 months, followed by maintenance therapy up to 6 months.

3. Selective serotonin reuptake inhibitors (SSRIs)

This is a class of a new generation of antidepressants, they are the easiest to take for patients - side effects are minimized. They are used to get rid of anxiety and depressive disorders, pain of a psychosomatic nature, phobias, eating disorders, PTSD, alcoholism and a number of other diseases, helping to control the emotional and mental state.

The principle of action is as follows - the inhibitor prevents the absorption of serotonin by brain tissues, it settles on the receptors and prolongs the stimulating effects. This leads to an increase in mood.

This group of drugs is not addictive.

Side effects are less common, but the following problems may occur:

• Gastrointestinal disorders (from nausea and vomiting to constipation);
• Anxiety, sleep disturbance (from drowsiness to insomnia);
• overexcitation, tremor;
• Migraine;
• Skin rashes;
• Decreased sex drive;
• Apathy and emotional dullness;
• Puffiness.

Unlike the above groups, drugs of this class can be prescribed during adolescence and reduce the relevance of suicidal ideation characteristic of this age. They are good in the postpartum period and with menopause. The use of SSRIs is contraindicated in diseases of the kidneys, heart, liver, pregnant women, as well as adults engaged in activities that require concentration.

The first effect of taking appears after 1-1.5 months, complete relief from depression occurs after 3 months. The course, on average, lasts from 4 months to six months. At the beginning and end of the intake, the concentration of medications should be reduced.

It is possible to buy a medicine of this class without a doctor's prescription. In particular, over-the-counter “light” antidepressants include: Maprotiline, Prozac, Paxil, Deprim, Azafen, Persen, Mianserin, Amitriptyline, Mirtazapine. However, their long-term use can also cause negative effects and an increase in the symptoms for which they were directed. The situation will not do without getting used to.

Below is a summary table that shows the classes of antidepressants and their representatives.

Class of antidepressants	Preparations
Tricyclics (1st generation)	Azafen, Saroten Retard, Melipramin, Lyudiomil
Monoamine oxidase inhibitors (2nd generation)	Non-selective irreversible - Iproniazid, Nialamide, Phenelzine, Tranylcypromine, Isocarboxazid; Reversible selective - Inkazan, Befol, Pyrazidol, Moclobemide; Irreversible selective - Selegiline, Rasagiline, Pargiline
Selective serotonin reuptake inhibitors (3rd generation)	Fluoxetine (Prozac), Fluvoxamine (Fevarin), Paroxetine (Paxil), Escitalopram (Cipralex), Sertraline (Zoloft), Citalopram (Cipramil)

Note that there are other, safer means used for the prevention and treatment of depressive conditions. These are various tinctures - valerian, hawthorn, lemongrass, ginseng, leuzea. This also includes a sedative on herbs - Novo-Passit.

You can meet another type of classification of drugs into groups:

1. Timiretics - have a stimulating effect. Used to get rid of depression, depression and feelings of oppression.
2. Thymoleptics - have sedative, soothing properties. They are used if depression is accompanied by excitatory processes. This group includes TCAs and MAOIs.

Rating of high-quality and effective antidepressants

Consider the most popular drugs according to customer reviews, their key characteristics, and also find out how much each of them costs, which ones are better to buy in a given situation. This will help you understand how to choose the right medication that will bring maximum benefit in the fight against depression and have minimal impact on other bodily functions.

Melipramin

The cost is from 350 rubles.

The main active ingredient is imipramine, the drug belongs to the MAOI group. The drug is presented in the form of tablets, 50 pieces per pack. Indicated for depression of various etiologies, panic disorders, OCD in children over 6 years of age. It has obvious sedative properties. The result is visible 2-4 weeks after the start of taking the remedy. Of the minuses, there is a violation of the heartbeat, the work of the gastrointestinal tract, the urinary system.

The required volume of the drug is determined by a specialist. On average, the dose starts at 25 mg (3 times a day), reaches 150-200 mg (per day) during the most intensive periods of therapy, after which it is reduced to 50-100 mg.

Tablets are used only as directed by a doctor.

• Strong healing effect;
• Inexpensive pills;
• Can be taken by children
• Insomnia passes;
• Good quality raw materials;
• Calms the nervous system;
• Relieves headaches and sleep disturbances.

• Strong side effects;
• Makes lethargic and drowsy;
• Many contraindications;
• Not allowed during pregnancy.

Paroxetine

The cost is from 315 rubles.

Another drug with a high antidepressant effect and antiphobic effect. Belongs to the class of SSRIs. It is used in the treatment of various types of depression, obsessive-compulsive, anxiety and panic disorders, social phobia.

Available in tablets, 30 pieces per pack.Take 1 tablet per day, during the first two weeks, in practice, the optimal individual dosage is determined. The maximum amount of active substance per day is 40 ml (2 tablets). The effect occurs 2-4 weeks after the start of the course.

Released only by prescription.

• Budget and effective pills;
• Convenient form of the drug;
• Gives emotional stability;
• Does not cause drowsiness;
• Mild side effects;
• Reduces anxiety.

• Contraindicated in pregnant, lactating women and children;
• Complicated interactions with other drugs;
• It is difficult to deal with withdrawal syndrome;
• A long course of treatment is required.

"Doxepin"

The cost is 800 rubles (30 tablets), 2,500 rubles (100 tablets).

The remedy is indicated for mild to moderate depression. Belongs to the TCA group. The drug has a sedative, antiphobic effect, serves to improve mood and suppress apathy, anxiety. Indicated in the treatment of alcoholism. The result of therapy becomes visible at 2-3 weeks of taking the medication.

At the start of the course, it is recommended to take 10-25 mg 3 times a day, the maximum amount is 300 mg / day. Even with an overdose, the prognosis for the patient is relatively favorable.

Side effects are rare in the form of drowsiness, migraine, problems with the gastrointestinal tract and urination, swelling, decreased libido.

More effective complexes are formed when the drug is used together with Phezam.

• Can be taken by children over 12 years old;
• Relatively inexpensive;
• Gives a lasting effect;
• The effect of enlightenment in the first days of application;
• Improves the functioning of the nervous system;
• Enhances memory.

• delayed effect;
• Difficult to find in pharmacies;
• Causes addiction;
• It worsens the condition of the stomach.

"Persen"

The cost is 240 rubles (20 pieces), 360 rubles (40 pieces), 470 rubles (60 pieces).

This is an antidepressant of plant origin, in the composition - extracts of mint, valerian, lemon balm. Group - sedatives. Reduces the level of anxiety, irritability and nervous tension. The drug is used for mild depression.

Dose - 2-3 tablets 2-3 times a day, but up to 12 pieces per day. Overdose causes nausea, fatigue.

Side effects - allergies, constipation.

Released without a doctor's prescription.

• The result is felt almost immediately;
• Fights irritation;
• No habituation effect;
• Strongly soothes;
• Normalizes sleep;
• Ideal for fatigue;
• Stabilizes the work of the nervous system;
• Natural ingredients included.

• It turns out a little expensive, given the dosage;
• There is no accumulation effect, the reception ends - the symptoms return;
• Only suitable for children over 12 years old;
• Not suitable for diabetics.

Zooloft

The cost is 500 rubles (14 pieces of 50 mg), 950 rubles (28 pieces of 50 mg), 1250 rubles (28 pieces of 100 mg).

The medicine is presented in the form of tablets. Belongs to the class of SSRIs. Suitable for the treatment of mild to moderate depression, phobias, panic disorders, obsessive-compulsive disorder, PTSD.

The drug can not be combined with the intake of MAOIs, used during pregnancy, liver problems, lack of weight, in children under 6 years of age.

Dosage - in the first and last weeks of admission - half a tablet (25 mg / day), then the course - 1 tablet (50 mg / day). The effect appears after 2-4 weeks.

• No withdrawal syndrome;
• Effective remedy;
• There is a therapeutic effect that does not disappear after cancellation;
• Eliminates phobias;
• There is a feeling of lightness and happiness.

• Decreased libido;
• Causes insomnia;
• In the first days of taking the brain refuses to think;
• Vision worsens;
• Affects the hormonal background;
• The weight rises.

So, we reviewed the list of the best antidepressants of 2022 and got acquainted with the principle of their action.

However, do not forget that depression is not just a biochemical process in the brain. Healing is possible only with the involvement of one's own mental resources and professional psychotherapeutic assistance.

Only a specialist is able to objectively assess the state of the psyche, calculate the required dose and a drug that will relieve emotional overload, reduce anxiety and panic. The instruction contains information, but it must be understood that there are individual characteristics, portability of one or another means may occur, which makes it irrelevant.

The main component of success in the fight against depression is the strict implementation of the treatment program drawn up by the doctor.