(1) Tricyclic antidepressant, TCA): Commonly used drugs include imipramine, amitriptyline, doxepin, clomipramine, etc. The therapeutic dose is 50 ~ 200 mg/day, which is mainly suitable for depressive symptoms in diseases such as internal depression. It can also be used to treat symptoms and panic attacks. It is forbidden for patients with serious heart, liver and kidney diseases and glaucoma, and should be used with caution for the elderly, pregnant women, patients with prostatic hypertrophy and epilepsy.
The antidepressant mechanism of TCA is not that TCA blocks the amine pump, reduces the recovery of biogenic amines in presynaptic membrane, especially reduces the recovery of norepinephrine (ne) and 5- hydroxytryptamine (5-HT), and increases the concentration of effective neurotransmitters in postsynaptic receptors, thus playing an antidepressant role.
The sedative effect of TCA first appeared, followed by the progress of diet and behavior, and generally the mood improved after 2 ~ 4 weeks. In application, the dose-time increasing method is adopted. After the therapeutic effect is achieved, the therapeutic dose lasts for 4 ~ 6 weeks, and then it is reduced to half of the dose for 6 months.
The side effects of TCA are more common than peripheral anticholinergic side effects, such as dry mouth, constipation, blurred vision, dysuria and postural hypotension, which can lead to urinary retention and intestinal paralysis in elderly patients. It has a great influence on blood pressure, is toxic to the heart and can cause myocardial damage. The changes of heart rhythm and electrocardiogram should be closely observed. There are also side effects such as mania, hand tremor and anticholinergic delirium.
(2) Monoamine oxidase inhibitor (MAOI) is the earliest antidepressant, which mainly produces monoamine oxidase (MAO) through depression, reduces the damage of monoamine transmitters in the central nervous system, increases the concentration in synaptic cleft, and plays a role in improving mood. MAOI has been gradually replaced by TCA in recent 20 years because of its many side effects and low antidepressant effect.
Commonly used drugs are phenelzine (hydrazine), starting from 15mg, twice a day, and gradually increasing the dose, with the highest daily dose of 75mg；; The daily dose of perphenazine is 10 ~ 30 mg. During the treatment, we should pay attention to observe its anticholinergic side effects and damage to the liver, and it is not suitable for those with cardiovascular, liver and kidney diseases. Do not eat food (such as cold milk, chicken liver, beer, etc. ) Use high content of cool amine during medication, otherwise it will easily lead to hypertensive crisis. The interaction between MAOI and many drugs or foods should arouse the vigilance of medical staff and remind patients.
Usually, it is not used with TCA. If it is necessary to switch to TCA, MAOI2 should stop for 2 weeks and then take TCA.
(3) The representative drug of Tetracyclina is maprotiline, which is similar to TCA, but it has the advantages of quick onset, few side effects and wide antidepressant spectrum. Because it is less toxic to the heart, patients have better tolerance to the drug, which is more suitable for elderly or depressed patients with cardiovascular diseases.
The medication method is the same as TCA, and the maximum daily dose is 200mg. One: Although the prices of the following drugs are the latest prices, they are different due to different places of origin, wholesale channels and purchases. So for reference only.
Second; The price is arranged according to the pill/yuan, which makes people worry. Imagine taking 100 pills for thousands of dollars, and I don't want to treat it.
Three: some high-end drugs are facing patent expiration, so don't buy and keep them in large quantities to avoid losses caused by price reduction.
Common name-user name [customized name of manufacturer or company]-weight [mg]/ unit/yuan
Mianserin-Misorin, Benzpyrazole, Meianshining and Delphine -60mg// capsule/10.80 Yuan.
Deanxit-20.5 mg/capsule /3.80 yuan
Trazodone hydrochloride-Meishuyu and Meishuyu-50mg/ capsule /4.25 yuan
Venlafaxine hydrochloride -Enos sustained-release capsules; Bolexin; Valsartan-75mg/capsule /9.64 yuan
Paroxetine hydrochloride-florfenicol; Solbuterol-20mg/capsule /7. 17 yuan
Maprotiline Hydrochloride-Mabiling, Rutimei, Maprotiline -25mg// Capsules/1.27 yuan.
Clomipramine hydrochloride-Clomipramine hydrochloride, anafenib -25mg// capsules/1.38 yuan.
Sertraline hydrochloride-jintraline hydrochloride; Zoloft-50mg/capsule /9.28 yuan
Fluoxetine hydrochloride-fluorophenoxypropylamine, Prozac, Youke, Omron-20mg/pill /5.43 yuan.
Imipramine hydrochloride-Imipramine-25mg/capsule /0.89 yuan.
Amitriptyline hydrochloride-amitriptyline -25mg// capsule /0. 17 yuan.
Remeron-Mirtazapine and Mitazapine -30mg// Capsule/16.20 Yuan
Citalopram Hydrobromide-Sipram -20mg/ capsule/13.00 Yuan
Shi Lan-fluvoxamine maleate, Fluvoxamine, Triflupentyl Oxime Amine, Flupentyl Oxime Amine-50mg/ granule /4.60 Yuan.
Tatilan-tianeptine-12.5mg// capsule /3. 1 1 yuan.
Doxepin hydrochloride-doxepin-25mg/capsule /0.94 yuan.
Moclobemide-100 mg/capsule /3.83 yuan
The following fifteen drugs have not been sold in the market due to side effects or limitations, so it is difficult to find the price.
Bupropion-Bupropion
Opioid peptides-propafenone, indolone
Nomifen-aminobenzoquine
Noramitriptyline
Protein-propylamino cyclic heptene
Capipamine-casimipramine
Desipramine-norimipramine
Dithiophene-diphenyl titanium heptyl
Anti-amphetamine-cycloamphetamine
Isocarbohydrazide-isoxazole hydrazide, isoxazole hydrazide, tasteless cola
phenelzine
Indidipine
Toloson-
Amoxapine-clozapine, chlorpromazine
Trimipramine-trimethoprim