Desyrel
Desyrel (Trazodone)Pharmacological action
Does not render anticholinergic action, MAO does not inhibit, does not change body mass. Eliminates as mental (affective intensity, irritability, pavor, a sleeplessness), and somatic implications of uneasiness (palpitation, a headache, the speeded up emiction, the strengthened diaphoresis). Enlarges depth and duration of a dream at patients in a depression condition, restores its physiological structure. Reduces a pathological inclination to ethanol. The therapeutic effect at 50 % of patients is observed in 3-7 days, at 25 % - through 2-4 weeks.
Desyrel Indications
Various forms of depressions (endogenous, psychotic, neurotic, somatogenic) including with the expressed uneasiness, including at least 4 from signs: disturbances of a dream, appetite, psychomotor agitation or block, depression of interest to surrounding, depression of sex activity, feeling of fault, undue fatigability, thinking retardation, depression of ability to concentration of attention, suicidal attempts/thoughts; a bulimia, a kleptomania, uneasiness, phobias. Benzodiazepine medicinal dependence; an acute alcoholic abstinent syndrome. Preventive maintenance of attacks of a migraine.
Contraindications
Hypersensitivity, pregnancy, the lactemia period, ventricular arrhythmia, tachycardia, myocardial infarction (the early regenerative period).C care. Heart diseases, an arterial hypotension, an arterial hypertensia, renal and-or hepatic insufficiency, age till 18 years.
Desyrel Side effects
Drowsiness, undue fatigability, giddiness, sleeplessness, headache, excitation, paresthesias, a disorientation, consciousness blackout, a tremor; an arrhythmia, conductivity disturbance, a bradycardia, fibrillation of ventricles, BP depression, an orthostatic hypotension, syncopal conditions; a nausea, vomiting, a diarrhoeia, dryness and bitterness in a mouth, sight disturbance, a boring of eyes, a leukopenia, a neutropenia (usually insignificant), a priapism with the subsequent impotency, allergic reactions. An overdosage. Symptoms: a nausea, drowsiness, BP depression, a priapism, respiratory standstill, epileptiform attacks, changes on an electrocardiogram, increase and weighting of side effects. Treatment: the specific antidote is not present; a gastric lavage, symptomatic therapy, an artificial diuresis. A priapism (treatment): At an easy ischemia or without it (monitoring of gas saturation of blood and its pressure in cavernous bodies) - an irrigation of cavernous bodies Epinephrinum; at a serious ischemia - delete stagnant blood and spend shunting that promotes metabolism normalisation in tissues.
Way of application and dose
Inside. An initial dose for adults - 150 mg/sut in 2 receptions: 2/3 general daily doses accept before a dream (in order to avoid drowsiness, giddiness), and the rest - in the morning or within day, in the parted doses. If necessary the daily dose is enlarged by 50 mg/sut, with intervals by 3-4 days, before achievement of optimum effect. The maximum daily dose for ambulatories - 450 mg, for inpatients - 600 mg. The initial daily dose for elderly and weakened sick - 75 mg, if necessary it can be gradually enlarged with an interval 3-4 days, but no more than to 300 mg. At easy forms of depression an average maintenance dose - 150 mg/sut, at the moderate and serious forms - 300 mg/days the Initial dose for children of 6-18 years - 1 mg/kg/sut in the parted doses, At treatment of an impotency in case of monotherapy - 200 mg/sut, as a part of complex therapy - 50 mg. At treatment of benzodiazepine medicinal dependence the recommended scheme is based on a gradual dose decline of benzodiazepine. Each time at reduction of its dose by 1/4 or 1/2 tablets simultaneously is added by 50 mg of Trazodonum. The given parity remains invariable during 3 weeks, then continue to reduce a dose of benzodiazepine up to its full cancellation. After that pass to daily dose depression to 50 mg everyone 3 weeks. Children of 6-18 years: the initial dose of 1 mg/kg/sut parted on some receptions. At necessity (taking into account shipping) the dose is raised gradually to 6 mg/kg/sut with an interval by 3-4 days.
Special indicatings
At preparation reception the control of peripheric blood in connection with possibility of depression of number of leucocytes is necessary. Does not render anticholinergic action, it is possible to prescribe to the patients, suffering a prostatauxe, a glaucoma, and also the patient of advanced age. Sedative and hypotensive effects become perceptible at patients of advanced age is more often. Patients of a male are necessary for warning about necessity of the immediate reference to the doctor (thus having cancelled a preparation) at occurrence of long and inadequate erections. Before operation with use of the general anaesthesia it is necessary to cancel a preparation beforehand. Corresponding researches of interrelation of effects of Trazodonum and age to pediatrics it is not spent, therefore application of a preparation for persons more youngly is necessary for spending 18 years with care. Doses for children till 6 years are not established. Dryness in a mouth can lead to development of caries, a candidiasis and to occurrence of unpleasant sensations in an oral cavity. For simplification of a condition it is necessary to use not containing Saccharum chewing elastic or sugar candies; if dryness in a mouth remains more than 2 weeks, consultation of the therapist or the stomatologist is necessary. In treatment it is necessary to be careful at driving of motor transport and employment by other potentially dangerous kinds of the activity demanding raised concentration of attention and speed of psychomotor reactions.
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