| Abstract | Depresija se sve češće javlja u modernoj populaciji i čini velik javnozdravstveni problem.
Svaka sedma osoba ima šansu da oboli od depresije tijekom svojeg života. Značajnu ulogu u
nastajanju depresije čine monoamini, ponajprije serotonin, noradrenalin i dopamin.
Antidepresivi su lijekovi kojima, djelovanjem na monoaminski sustav, možemo smanjiti
jačinu i učestalost depresivnih simptoma s ciljem ozdravljenja i smanjenjem relapsa.
Antidepresive dijelimo obzirno na njihovo djelovanje na monoaminski sustav, tako u
kliničkoj praksi razlikujemo tricikličke antidepresive (TCA), inhibitore monoaminooksidaze
(MAOI), inhibitore ponovne pohrane serotonina (SSRI), inhibitore ponovne pohrane
noradrenalina (NRI), inhibitore ponovne pohrane serotonina i noradrenalina (SNRI),
inhibitore ponovne pohrane noradrenalina i dopamina (NDRI), noradrenergičke i specifične
serotonergičke antidepresive (NASSA), multimodalne antidepresive, agoniste melatoninskih
receptora i antagoniste 5-HT2C receptora i modulatore unosa serotonina. Zbog pogodnog
djelovanja i malog broja nuspojava, danas se najviše koriste SSRI. Osim u liječenju depresije,
antidepresive možemo koristiti i u terapiji anksioznih stanja, u bipolarnom afektivnom
poremećaju, shizofreniji, poremećajima osobnosti, PTSP-u, fobičnim poremećajima,
opsesivno-kompulzivnom poremećaju, palijativnoj skrbi, kroničnoj boli. Moramo obratiti
pozornost prilikom davanja antidepresiva djeci i starijima zbog razlike u farmakokinetici,
mogućim komorbiditetima i nuspojavama s drugim lijekovima. Antidepresivi su danas među
najpropisivanijim lijekovima i osobito je važno da znamo njihovo djelovanje i nuspojave. |
| Abstract (english) | Depression is increasingly affecting the modern population and is a serious public health
issue. On average, every seventh person has the chance to develop depression during their
lifetime. Monoamines, mainly serotonine, norepinephrine and dopamine, have a vital role in
depression development. Antidepressants are drugs which can modulate the monoamine
system to reduce and mellow the symptoms of depression and help cure the patient and
prevent relaps. Antidepressants are classified according to their modulation of the monoamine
system. In clinical practice there are tricyclic antidepressants (TCA), monoamine oxidase
inhibitors (MAOI), selective serotonine reuptake inhibitors (SSRI), norepinephrine reuptake
inhibitors (NRI), selective norepinephrine and serotonine reuptake inhibitors (SNRI),
norepinephrine and dopamine reuptake inhibitors (NDRI), noradrenergic and specific
serotonergic antidepressants (NASSA), multimodal antidepressants, melatonin agonists and 5-
HT2C antagonists and serotonine reuptake modulators. SSRI are now most commonly
perscribed due to their beneficial effects and low number of adverse effects. Besides
depression treatment, antidepressants can be used to treat anxiety disorders, bipolar affective
disorder, schizophrenia, personality disorders, PTSD, phobic disorders, OCD, palliative care,
chronic pain. While administering antidepressants to children and elderly we must take care
of the pharmacokinetic differences and possible comorbitidies as well as drug interactions.
Antidepressants are one of the most perscribed drugs and it is of paramount importance we
know their mechanism of action as well as possible adverse effects. |
