Adepress
Adepress: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. For violations of liver function
- 13. Use in the elderly
- 14. Drug interactions
- 15. Analogs
- 16. Terms and conditions of storage
- 17. Terms of dispensing from pharmacies
- 18. Reviews
- 19. Price in pharmacies
Latin name: Adepress
ATX code: N06AB05
Active ingredient: paroxetine (paroxetine)
Manufacturer: Veropharm, JSC (Russia)
Description and photo updated: 2019-27-08
Prices in pharmacies: from 346 rubles.
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Adepress is an antidepressant drug intended for the treatment of emotional disorders.
Release form and composition
Dosage form - film-coated tablets: round, biconvex, almost white or white (10 pcs. In blisters, 3 packs in a cardboard box and instructions for use of Adepress).
Composition of 1 tablet:
- Active ingredient: paroxetine (in the form of hemihydrate hydrochloride) - 20 mg;
- Auxiliary components: sodium carboxymethyl starch (primogel), calcium hydrogen phosphate (disubstituted calcium phosphate), magnesium stearate, corn starch;
- The composition of the film shell: Opadry II [lactose monohydrate, titanium dioxide, macrogol (polyethylene glycol 3350, polyethylene glycol 4000), hypromellose (hydroxypropyl methylcellulose)].
Pharmacological properties
Pharmacodynamics
The active ingredient of Adepressa - paroxetine, is a selective inhibitor of the reuptake of serotonin (5-hydroxytryptamine, 5-HT) by neurons in the brain, an antidepressant, effective in the treatment of panic disorders and obsessive-compulsive disorder (OCD).
Selective uptake of 5-HT neurons during the metabolism of paroxetine is not impaired. The substance is characterized by low affinity for m-cholinergic receptors. In contrast to tricyclic antidepressants, paroxetine has low affinity for α 1 -, α 2 - and β-adrenergic receptors, 5HT 1 -like, 5HT 2 -like, dopamine and H 1 -histamine receptors.
Adepress does not have a negative effect on psychomotor functions, does not enhance the depressing effect of ethanol on them.
According to a study that examined the behavior and electroencephalography of patients, paroxetine shows weak activating properties when used in higher doses than is necessary to inhibit the uptake of 5-HT. In healthy volunteers on the background of drug therapy, no significant changes in blood pressure, heart rate and electroencephalography were detected.
Pharmacokinetics
After taking Adepress inside, paroxetine is well absorbed from the gastrointestinal tract and is metabolized during the first passage through the liver.
The maximum plasma concentration of 61.7 ng / ml is reached within 5.2 hours.
Equilibrium concentrations are reached within 7-14 days after the start of taking the drug; during further long-term therapy, the pharmacokinetic parameters of paroxetine do not change. The clinical effects of Adepress (therapeutic and side effects) do not correlate with its plasma concentration.
Paroxetine undergoes the first passage through the liver, so its amount in the systemic circulation is less than that absorbed from the gastrointestinal tract. In the case of an increase in the dose of the drug or repeated dosing, there is a partial absorption of the effect of the first passage through the liver and a decrease in plasma clearance. As a result, in patients who, when taking Adepress in low doses, achieve low plasma concentrations of paroxetine, an increase in the plasma concentration of the drug and fluctuations in pharmacokinetic parameters are possible.
The active substance is extensively distributed in the tissues. According to pharmacokinetic calculations, only 1% is present in plasma, while at therapeutic concentrations 95% is associated with plasma proteins.
Paroxetine is an inhibitor of the CYP2D6 enzyme system, it is metabolized in the liver to form the main metabolites - polar and conjugated oxidation and methylation products, which have weak pharmacological activity, do not affect the therapeutic effect of the drug and are quickly excreted from the body.
Paroxetine is excreted from the body mainly in the form of metabolites in two phases: phase 1 - as a result of the first passage through the liver, phase 2 - is controlled by systemic elimination. The half-life of paroxetine varies, but averages 21 hours.
It is excreted: by the kidneys with urine - 64% of the dose (unchanged - no more than 2%), through the intestines (probably through bile) - 36% of the dose (unchanged - less than 1%).
With an increase in the dose and / or duration of treatment, there is a non-linear dependence of the pharmacokinetic parameters of paroxetine on the dose.
In patients with impaired renal / hepatic function and in the elderly, the plasma concentration of the drug increases, but coincides with the concentration range in healthy adult volunteers.
Indications for use
The following conditions are indicated as indications in the instructions for Adepress:
- All types of depression, including reactive, severe endogenous, anxious;
- Obsessive-compulsive disorder (obsessive thoughts and actions);
- Panic disorder, agoraphobia (fear of open space);
- Social anxiety disorder;
- Generalized anxiety disorder (general persistent anxiety);
- Post-traumatic stress disorder.
Contraindications
- Unstable epilepsy;
- Pregnancy and lactation period;
- Childhood;
- Simultaneous use of monoamine oxidase inhibitors and a period of 14 days after their cancellation;
- Hypersensitivity to the components of Adepress.
The drug should be used with caution in the following cases: hepatic / renal failure, convulsive conditions, epilepsy, heart disease, prostatic hyperplasia, angle-closure glaucoma, mania, old age, electro-pulse therapy, the presence of diseases or factors that increase the risk of bleeding, as well as simultaneous the use of drugs that increase the likelihood of bleeding.
Adepress, instructions for use: method and dosage
The medicine must be taken 1 time / day in the morning with meals. The tablet is not chewed and washed down with plenty of water.
It should be noted that Adepress cannot be used without a doctor's prescription. The doctor selects the dosage of the medication individually, empirically for 1-2 weeks.
The recommended dosage of the drug, depending on the disease and its stage, is as follows:
- Depression. The average dose is 20 mg per day (1 tablet), if necessary, it is gradually increased, adding 10 mg once a week. The daily dose should not exceed 50 mg / day;
- Obsessive-compulsive disorder. The initial therapeutic dose is 20 mg / day. The dose is increased weekly by 10 mg until a therapeutic response is achieved. The recommended amount of Adepress is from 40 to 60 mg per day;
- Panic disorder. The initial dose is 10 mg / day. It is recommended to increase the dosage by 10 mg. The average therapeutic dose is 40 mg / day. Maximum - no more than 60 mg / day;
- Social anxiety disorders. The starting dose is 20 mg / day. If the effect is absent within 2 weeks, it can be increased to 50 mg / day. The dose should be increased by 10 mg at intervals of at least a week, depending on the clinical effect;
- Post-traumatic stress disorder. The initial dosage is 20 mg / day. In individual cases, it is recommended to increase the dose to 50 mg / day. The dose should be increased by 10 mg every week depending on the clinical response;
- Generalized anxiety disorder. The initial and therapeutic doses are 20 mg / day.
The dose prescribed for patients with renal or hepatic impairment should not exceed 20 mg / bitch.
In the instructions for Adepress, attention is drawn to the fact that for elderly patients the amount of paroxetine taken per day should not exceed 40 mg.
In order to prevent recurrence of the disease, it is necessary to carry out preventive therapy. After the disappearance of vivid symptoms, the course should last at least 4-6 months, and in case of more complex diseases (such as panic disorders), the period of use of Adepress increases.
It must be borne in mind that abrupt withdrawal of the drug can lead to a worsening of the condition and relapse, therefore, the discontinuation of Adepress should be carried out gradually.
Side effects
The use of Adepress can lead to drowsiness or, conversely, insomnia, as well as to attacks of dizziness, anxiety. Rarely, taking the drug leads to hallucinations, seizures, manias, and even less often panic disorders are possible. According to reviews, this antidepressant causes similar reactions in isolated cases.
In the course of taking the drug, disorders of the musculoskeletal, urinary system, disorders of the reproductive system, gastrointestinal tract, cardiovascular system, as well as visual impairment can be observed.
Most often, the use of Adepressa causes such a side effect as a temporary indigestion, as well as allergic reactions (often in the form of various kinds of skin rashes) and increased sweating.
Overdose
Overdose of Adepress can manifest itself in the form of nausea, dilated pupils, fever, changes in blood pressure, tachycardia, headache, involuntary muscle contractions, agitation, anxiety.
In rare cases, in patients who simultaneously took alcohol and / or other psychotropic drugs with Adepress, changes in the electrocardiogram may be noted, coma is possible.
In case of an overdose, it is recommended to perform a gastric lavage and take activated charcoal. There is no specific antidote to paroxetine. Further treatment is symptomatic.
special instructions
During the first few weeks of treatment, the patient should be closely monitored, which is associated with possible suicidal attempts.
Adepress should be used with extreme caution in patients receiving antipsychotics, since there is a risk of neuroleptic malignant syndrome.
In some diabetic patients, when taking paroxetine, correction of insulin and / or oral hypoglycemic agents is required.
During the period of therapy, it is strongly recommended to refrain from drinking alcoholic beverages due to the high probability of increasing the toxic effect of ethanol.
If seizures develop or the first signs of mania appear, Adepress should be discontinued immediately.
Influence on the ability to drive vehicles and complex mechanisms
Paroxetine does not adversely affect human cognitive and psychomotor functions. Nevertheless, patients are advised to refuse, or at least observe extreme caution when driving a car and performing any other potentially hazardous work that requires speed of reactions and increased attention.
Application during pregnancy and lactation
Adepress is contraindicated in pregnant and breastfeeding women.
Pediatric use
The efficacy and safety profile of paroxetine in childhood and adolescence has not been established, therefore Adepress is not recommended for use in pediatrics.
With impaired renal function
In case of renal failure, the drug should be used with caution. The recommended daily dose is 20 mg.
For violations of liver function
In liver failure, the drug should be used with caution. The recommended daily dose is 20 mg.
Use in the elderly
For the treatment of elderly patients, Adepress should be used with caution. The likelihood of developing hyponatremia should be considered.
Drug interactions
Antacids and food do not affect the degree of absorption and pharmacokinetics of paroxetine.
Adepress can enhance the toxic effects of ethanol.
When combined with warfarin, paroxetine increases bleeding time, but does not affect prothrombin time.
Adepress should not be prescribed during the period of therapy with MAO inhibitors and within 14 days after their withdrawal.
In the case of the simultaneous use of atypical antipsychotics, phenothiazine drugs, tricyclic antidepressants, non-steroidal anti-inflammatory drugs, acetylsalicylic acid, a violation of the blood coagulation process is possible.
Patients receiving liver enzyme inhibitors may need to reduce the daily dose of Adepress.
Paroxetine can potentiate the effects of serotonergic drugs (eg, tramadol, sumatriptan).
With the simultaneous use of lithium and tryptophan preparations, a mutual enhancement of the action is noted.
Paroxetine is much weaker than antidepressants that inhibit the seizure of norepinephrine, suppresses the hypotensive effect of guanethidine.
Phenytoin and other anticonvulsants may decrease the plasma concentration of paroxetine and increase the incidence of side effects.
Paroxetine inhibits the cytochrome P 450 system, therefore, it can enhance the effects (including side effects) of indirect anticoagulants, barbiturates, phenothiazine neuroleptics, tricyclic antidepressants, class 1 C antiarrhythmics, phenytoin and metoprolol.
Analogs
Analogs of Adepress are: Zoloft, Fluoxetine, Lenuxin, Serlift, Serenata, Cipralex, Siozam, Serlift, Lenuxin, Sedopram, etc.
Terms and conditions of storage
Store in a dry place, out of reach of children, at a temperature not exceeding 25 ° C.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Adepress
Reviews about Adepress are mostly positive: the drug improves mood, effectively eliminates anxiety and other symptoms accompanying depression. With the correct dose, the condition improves after a week of treatment. Patients note the convenience of taking (1 time per day) and good tolerance even with prolonged use of the tablets.
The disadvantages of Adepress include the relatively high cost, the prohibition on alcohol intake during the treatment period, and the duration of therapy (at least 4 months).
Of the side effects, the most commonly mentioned are dry mouth, headache, low blood pressure when changing body position, drowsiness, loss of appetite.
Price for Adepress in pharmacies
The approximate price of Adepressa is 503-610 rubles. per pack of 30 film-coated tablets.
Adepress: prices in online pharmacies
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Drug name Price Pharmacy |
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Adepress 20 mg film-coated tablets 30 pcs. 346 r Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
