Abstract | Antidepresivi su raznovrsna skupina lijekova koja se može klasificirati na puno načina, ali najviše se spominje njihova podjela po mehanizmu djelovanja. Tako postoje skupine antidepresiva kao što su selektivni inhibitori ponovne pohrane serotonina (SIPPS), selektivni inhibitori ponovne pohrane serotonina i noradrenalina (SNRI), inhibitori ponovne pohrane noradrenalina (NARI), noradrenergički i specifični serotoninergički antidepresivi (NASSA), inhibitori ponovne pohrane noradrenalina i dopamina (NDRI), serotoninski antagonisti i inhibitori ponovne pohrane serotonina (SARI), multimodalni antidepresivi, agonisti melatoninskih receptora i antagonisti 5-HT2 receptora, triciklički antidepresivi (TCA) te inhibitori monoaminooksidaze (MAOi). Što se tiče podjele antidepresiva po brzini djelovanja, treba spomenuti brzodjelujuće antidepresive, koji predstavljaju važan pomak u farmakoterapiji psihijatrijskih poremećaja. Iako su ovi lijekovi najpoznatiji po svom učinku na simptome depresije, mogu biti od velike koristi i u liječenju stanja kao što su anksiozni poremećaji, opsesivno kompulzivni poremećaj (OKP) te posttraumatski stresni poremećaj (PTSP).
Anksiozni poremećaji očituju se stresom koji je toliko jak da ometa normalno funkcioniranje osobe, a ne tek simptomima obične anksioznosti koje svatko ponekad osjeti (napetost, nemir, strah). U najpoznatije anksiozne poremećaje ubrajaju se dijagnoze kao što su panični poremećaj, generalizirani anksiozni poremećaj (GAP), agorafobija te socijalni anksiozni poremećaj.
Opsesivno-kompulzivni poremećaj (OKP) odlikuje se opsesijama (misli ili osjećaji koji se pacijentima stalno nameću protiv njihove volje) i kompulzijama (ponavljajuće, svjesne radnje koje osoba izvodi, ali doživljava ih kao nametnute). Simptomi koje osoba koja boluje od OKP-a pokazuje najčešće se mogu svrstati u neku od kategorija kao što su strah od onečišćenja ili nesreće, kompulzivno provjeravanje, intruzivne misli i težnja simetriji.
PTSP je poremećaj koji se javlja nakon proživljenog traumatskog događaja i ima tri karakteristične skupine simptoma: izbjegavanje svega što podsjeća na traumu, flashback epizode i noćne more, te simptomi povišene pobuđenosti. DSM-5 klasifikacija dodaje i četvrtu skupinu: negativno raspoloženje i kogniciju.
Depresija je poremećaj raspoloženja koji se očituje gubitkom volje i energije, smetnjama nagona i osjećajem krivnje te sniženim raspoloženjem. Ovaj poremećaj nije obična tuga, već je tuga koja se pojavljuje bez razloga te ometa normalno funkcioniranje pacijenta. |
Abstract (english) | Antidepressants are a diverse drug group that can be classified in many ways, the most common classification being the one by their mechanism of action. Therefore, there are groups of antidepressants such as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), noradrenaline reuptake inhibitors (NARI), noradrenergic and specific serotonergic antidepressants (NASSA), norepinephrine and dopamine reuptake inhibitors (NDRIs), serotonin antagonists/reuptake inhibitors (SARIs), multimodal antidepressants, melatonin receptor agonists and 5-HT2 receptor antagonists, tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). As far as classifying the antidepressants by their onset of action is concerned, rapid-acting antidepressants should be mentioned, for they represent an important shift in the pharmacotherapy of psychiatric disorders. Although antidepressants are most famous for their effect on the symptoms of depression, they can also be of great use in treating the conditions like anxiety disorders, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD).
Anxiety disorders are characterized by stress so strong that it interferes with normal functioning of the person, and not by mere symptoms of ordinary anxiety that are felt by everyone from time to time. The most well-known anxiety disorders are conditions such as panic disorder, generalized anxiety disorder (GAD), agoraphobia and social anxiety disorder.
Obsessive-compulsive disorder is characterized by obsessions (thoughts or feelings that are constantly imposed on patients against their will) and compulsions (repeating, conscious actions which a person performs but perceives them as imposed). Symptoms shown by people suffering from OCD can usually be classified in some of the categories like fear of pollution or accidents, compulsive checking, intrusive thoughts and a desire for symmetry.
PTSD is a disorder that occurs after experiencing a traumatic event and manifests by three typical groups of symptoms: avoiding everything that is a reminder of the trauma, „flashback“ episodes and nightmares, as well as the symptoms of increased arousal. DSM-5 classification also adds the fourth group: negative mood and cognition.
Depression is a mood disorder characterized by the loss of will and energy, impaired impulses and the feeling of guilt, as well as feeling down. This disorder is not mere sadness but rather the sadness that appears for no reason and interferes with normal functioning of the patient. |