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Psychoactive substances and drugs. Antidepressants Zvereva Mila school of pharmacy

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Overview 10700 y.a. – The betel nut was chewed in Thailand 7000 y.a. – Coca was being used in the Andes Before European contact – Native Americans used tobacco

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Legality The resolution of the government of Russian Federation N 681 (30.06.1998) 1) list I: mescaline and its derivatives, hashish, heroin, marijuana, methadone, MMDA, opium, psilocybin , psilocin, ephedrine, etc. 2) list II: codeine, cocaine, morphine, ethylmorphine, omnopon, fentanyl, promedol, etc. 3) list III: barbital, nitrazepam, diazepam, taren, etc. 4) list IV:ephedrine, pseudoephedrine, acetone, sulphuric acid, hydrochloric acid, potassium permanganate, acetic acid, etc.

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Mechanisms and effects Agonists: increasing the synthesis of one or more neurotransmitters reducing its reuptake from the synapses mimicking the action by binding directly to the postsynaptic receptor Antagonists: interfering with synthesis blocking postsynaptic receptors

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Mechanisms and effects

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Addiction psychological dependence physical dependence

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Usage Anxiolytics Example: Benzodiazepine Euphoriants Example: MDMA (Ecstasy), MDA, 6-APB, Indopan Stimulants ("uppers") Examples: amphetamine, caffeine, cocaine, nicotine Depressants ("downers"), including sedatives, hypnotics, and narcotics. Examples: ethanol (alcoholic beverages), opioids, barbiturates, benzodiazepines Hallucinogens, including psychedelics, dissociatives and deliriants Examples: psilocybin, LSD, Salvia divinorum and nitrous oxide

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Ritual and spiritual

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Recreation alcohol –in most areas of the world it is legal for those over a certain age tobacco – a legal drug cannabis caffeine - a legal drug, contained in coffee, tea, energy drinsks, and some soft drinks MDMA cocaine amphetamines – prescribed for ADHD psilocybin mushrooms LSD –banned in October 1968 by US President Lyndon B Johnson. opiates and opioids – available by prescription. tranquilizers – barbiturates, benzodiazepines - commonly prescribed for anxiety nitrous oxide - legal ketamine – used by paramedics in emergency situations for its dissociative and analgesic qualities amyl nitrite – a vasodilator (legal) other drugs (antidepressants, tranquilizers, analgesics, etc)

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Pharmacoyherapy Anesthesia Pain management Mental disorders

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Depression and Antidepressants Key facts: Depression is a common mental disorder. Globally, more than 350 million people of all ages suffer from depression Depression is the leading cause of disability worldwide, and is a major contributor to the global burden of disease More women are affected by depression than men At its worst, depression can lead to suicide There are effective treatments for depression

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Drugs used for the treatment of depression: Selective serotonin reuptake inhibitors (SSRIs) Serotonin/norepinephrine reuptake inhibitors (SNRIs) Atypical antidepressants Tricyclic antidepressants (TCAs) Monoamine oxidase inhibitors (MAOIs) St. John’s wort ( Hypericum perforatum)

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Selective serotonin reuptake inhibitors, SSRIs Citalopram (Celexa) Escitalopram (Lexapro) Fluoxetine (Prozac) Paroxetine (Paxil) Sertraline (Zoloft) Vilazodone (Viibryd) Vortioxetine (Brintellix)

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Serotonin/norepinephrine reuptake inhibitors, SNRIs Desvenlafaxine (Pristiq) Duloxetine (Cymbalta) Venlafaxine (Effexor, Effexor XR) Levomilnacipran (Fetzima)

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Other Antidepressants Bupropion (Wellbutrin) Mirtazapine (Remeron, Remeron SolTab) Trazodone (Desyrel, Oleptro)

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Tricyclic antidepressants, TCAs Amitriptyline (Elavil) Desipramine (Norpramin) Imipramine (Tofranil) Clomipramine (Anafranil) Nortriptyline (Pamelor) Protriptyline (Vivactil) Doxepin (Sinequan, Silenor) Trimipramine (Surmontil) Amoxapine