{"id":11,"date":"2016-03-06T17:40:48","date_gmt":"2016-03-06T16:40:48","guid":{"rendered":"https:\/\/filozofia.nett.to\/farmakologia\/2016\/03\/06\/antidepresiva-volba-lieku\/"},"modified":"2026-01-28T00:43:51","modified_gmt":"2026-01-27T23:43:51","slug":"antidepresiva-volba-lieku","status":"publish","type":"post","link":"https:\/\/filozofia.nett.to\/farmakologia\/sk\/antidepresiva-volba-lieku\/","title":{"rendered":"Antidepres\u00edva: vo\u013eba lieku"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_83 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Table of Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/filozofia.nett.to\/farmakologia\/sk\/antidepresiva-volba-lieku\/#SSRI\" >SSRI<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/filozofia.nett.to\/farmakologia\/sk\/antidepresiva-volba-lieku\/#Buspiron_Spitomin\" >Buspir\u00f3n (Spitomin)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/filozofia.nett.to\/farmakologia\/sk\/antidepresiva-volba-lieku\/#Tofisopam_Grandaxin\" >Tofisopam (Grandaxin)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/filozofia.nett.to\/farmakologia\/sk\/antidepresiva-volba-lieku\/#Mirtazapin_Mirzaten\" >Mirtazap\u00edn, (Mirzaten)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/filozofia.nett.to\/farmakologia\/sk\/antidepresiva-volba-lieku\/#Vortioxetin_Brintellix\" >Vortioxet\u00edn (Brintellix)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/filozofia.nett.to\/farmakologia\/sk\/antidepresiva-volba-lieku\/#Bupropion_Wellbutrin\" >Bupropi\u00f3n (Wellbutrin)<\/a><\/li><\/ul><\/nav><\/div>\n<p>To ak\u00e9 s\u00fa to sra\u010dky benzodiazep\u00edny \/ sedat\u00edva to sn\u00e1\u010f nie je treba ani hovori\u0165, nako\u013eko na ne vznik\u00e1 extr\u00e9mne r\u00fdchlo tolerancia a okrem psychickej z\u00e1vislosti vznik\u00e1 aj z\u00e1vislos\u0165 fyzick\u00e1. To u\u017e potom m\u00f4\u017eu lek\u00e1ri predpisova\u0165 na \u00fazkosti aj hero\u00edn, sedat\u00edva nemaj\u00fa o ni\u010d men\u0161\u00ed potenci\u00e1l z\u00e1vislosti ako hero\u00edn.<br \/>\nLep\u0161ie s\u00fa niektor\u00e9 antiepileptick\u00e9 lieky, ktor\u00e9 s\u00fa selekt\u00edvne agonisti na GABA receptory.<br \/>\n<a href=\"https:\/\/cs.wikipedia.org\/wiki\/Benzodiazepin\" target=\"_blank\" rel=\"noopener\">https:\/\/cs.wikipedia.org\/wiki\/Benzodiazepin<\/a><\/p>\n\n<h2><span class=\"ez-toc-section\" id=\"SSRI\"><\/span><strong>SSRI <\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n<p>SSRI m\u00e1 aj svoje men\u0161ie nev\u00fdhody. Seroton\u00ednov\u00fdch receptorov je nesmierne ve\u013ea druhov a SSRI, p\u00f4sobia na v\u0161etky druhy, aj tie, ktor\u00e9 nemaj\u00fa na depresie \u017eiaden vplyv.<br \/>\n<a href=\"https:\/\/en.wikipedia.org\/wiki\/5-HT_receptor#Families\" target=\"_blank\" rel=\"noopener\">https:\/\/en.wikipedia.org\/wiki\/5-HT_receptor#Families<\/a><br \/>\nJeden z typov seroton\u00ednov\u00fdch receptorov m\u00e1 dokonca tak\u00fa vlastnos\u0165, \u017ee svojou zv\u00fd\u0161enou aktivitou bude zni\u017eova\u0165 ostatn\u00fa aktivitu ostatn\u00fdm seroton\u00ednov\u00fdm receptorom, \u010do nemus\u00ed by\u0165 \u017eiad\u00face (ale to s\u00fa len zanedbate\u013en\u00e9 ved\u013eaj\u0161ie vplyvy). To m\u00f4\u017ee vysvetlova\u0165 slab\u0161iu \u00fa\u010dinnos\u0165 liekov SSRI ako by sa o\u010dak\u00e1valo, v niektor\u00fdch pr\u00edpadoch.<br \/>\nA pokia\u013e viem, tak pod\u013ea ofici\u00e1lnych \u0161tatisk\u00edk, SSRI pom\u00e1haj\u00fa len 50% pacientom, \u010do je dos\u0165 m\u00e1lo. U\u017e aj na Slovenskom trhu m\u00e1me podstatne lep\u0161ie lieky ako Buspiron.<br \/>\nKombinova\u0165 antipsychotik\u00e1, ktor\u00e9 s\u00fa agonisti na seroton\u00ednov\u00e9 receptory m\u00e1 svoje rizik\u00e1 a malo by sa to robi\u0165 so zv\u00fd\u0161enou opatrnos\u0165ou (ob\u00e1bam sa, \u017ee ten biedny amat\u00e9rsky \u0160\u00daKL na to neupozor\u0148uje). D\u00e1vka SSRI by mala by\u0165 v takom pr\u00edpade podstatne ni\u017e\u0161ia<br \/>\n <\/p>\n\n<h2><span class=\"ez-toc-section\" id=\"Buspiron_Spitomin\"><\/span><strong>Buspir\u00f3n (Spitomin)<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n<p>Rozhodne by tento liek mal by\u0165 liekom prvej vo\u013eby pri \u00fazkostiach a depresiach. Hoci je ofici\u00e1lne ur\u010den\u00fd len na \u00fazkosti, bude dobre zara\u0165 aj na depresie. Princ\u00edp fungovania je agonizmus na niektor\u00e9 seroton\u00ednov\u00e9 receptory.<br \/>\nTento liek asi nie je vhodn\u00e9 kombinova\u0165 s antipsychotikami, ktor\u00e9 s\u00fa agonisti na rovnak\u00e9 serotoninov\u00e9 receptory ako buspir\u00f3n.<br \/><br \/><a href=\"http:\/\/www.sukl.sk\/buxus\/generate_page.php?page_id=386&#038;lie_id=14967\" target=\"_blank\" rel=\"noopener\">http:\/\/www.sukl.sk\/buxus\/generate_page.php?page_id=386&#038;lie_id=14967<\/a><br \/>\n<a href=\"http:\/\/www.sukl.sk\/buxus\/generate_page.php?page_id=386&#038;lie_id=14968\" target=\"_blank\" rel=\"noopener\">http:\/\/www.sukl.sk\/buxus\/generate_page.php?page_id=386&#038;lie_id=14968<\/a><br \/>\n<a href=\"https:\/\/en.wikipedia.org\/wiki\/Buspirone\" target=\"_blank\" rel=\"noopener\">https:\/\/en.wikipedia.org\/wiki\/Buspirone<\/a><br \/>\n <\/p>\n\n<h2><span class=\"ez-toc-section\" id=\"Tofisopam_Grandaxin\"><\/span><strong>Tofisopam (Grandaxin)<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n<p>Je netradi\u010dn\u00fd benzodiazep\u00edn, ktor\u00fd nem\u00e1 vlastnosti ako benzodiazep\u00edny. \u010ci m\u00e1 proti\u00fazkostn\u00e9 vlastnosti je ale sporn\u00e9. Nemala by zrejme na neho existova\u0165 z\u00e1vislos\u0165.<br \/>\n <\/p>\n\n<h2><span class=\"ez-toc-section\" id=\"Mirtazapin_Mirzaten\"><\/span><strong>Mirtazap\u00edn, (Mirzaten)<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n<p><a href=\"http:\/\/en.wikipedia.org\/wiki\/Mirtazapine\" target=\"_blank\" rel=\"noopener\">http:\/\/en.wikipedia.org\/wiki\/Mirtazapine<\/a><br \/>\nNie je to \u017eiaden inhib\u00edtor sp\u00e4tn\u00e9ho vychyt\u00e1vania.<br \/>\nM\u00e1 indik\u00e1ciu proti depresiam. Antagonista na seroton\u00ednov\u00e9 receptory a v kone\u010dnom d\u00f4sledku v komplexnom p\u00f4soben\u00ed, zvy\u0161uje aktivitu adrenal\u00ednov\u00fdm receptorom.<br \/>\nJe zauj\u00edmav\u00e9, \u017ee aj antagonista na seroton\u00ednov\u00e9 receptory m\u00f4\u017ee ma\u0165 proti\u00fazkostn\u00e9 \u00fa\u010dinky. Ak pacientovi nepom\u00f4\u017ee napr. SSRI, tak vysk\u00fa\u0161a\u0165 tento liek m\u00f4\u017ee by\u0165 zauj\u00edmav\u00e1 vo\u013eba<br \/>\n <\/p>\n\n<h2><span class=\"ez-toc-section\" id=\"Vortioxetin_Brintellix\"><\/span><strong>Vortioxet\u00edn (Brintellix)<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n<p><a href=\"https:\/\/en.wikipedia.org\/wiki\/Vortioxetine\" target=\"_blank\" rel=\"noopener\">https:\/\/en.wikipedia.org\/wiki\/Vortioxetine<\/a><br \/>\nJe netradi\u010dn\u00fd inhib\u00edtor sp\u00e4tn\u00e9ho vychyt\u00e1vania seroton\u00ednu a noradrenal\u00ednu. Na niektor\u00e9 seroton\u00ednov\u00e9 receptory je agonita a in\u00e9 antagonista. Pri kr\u00e1tkodobom a dlhodobom u\u017e\u00edvan\u00ed tohoto lieku bud\u00fa zrejme podstatn\u00e9 rozdiely, je zrejm\u00e9 je inhib\u00edcia sp\u00e4tn\u00e9ho vychyt\u00e1vania sa bude prejavova\u0165 a\u017e po ur\u010ditom \u010dase u\u017e\u00edvania<br \/>\n <\/p>\n\n<h2><span class=\"ez-toc-section\" id=\"Bupropion_Wellbutrin\"><\/span><strong>Bupropi\u00f3n (Wellbutrin)<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n<p>Inhib\u00edtor sp\u00e4tn\u00e9ho vychyt\u00e1vania noradrenal\u00ednu a dopam\u00ednu. Vo vy\u0161\u0161\u00edch d\u00e1vkach m\u00e1 aj viacer\u00e9 negat\u00edvne ved\u013eaj\u0161ie \u00fa\u010dinky &#8211; najv\u00e1\u017enej\u0161ie epilepsia.<br \/>\nTlak zrejme tento liek ve\u013emi nezvy\u0161uje, nako\u013eko by mal by\u0165 antagonista na adrenal\u00ednov\u00e9 receptory.<br \/><br \/><strong>Na okraj:<\/strong> Mimochodom jedna franc\u00fazska farmaceutick\u00e1 firma jeden \u010das vyr\u00e1bala selekt\u00edvny inhib\u00edtor sp\u00e4tn\u00e9ho vychyt\u00e1vania dopam\u00ednu so siln\u00fdm \u00fa\u010dinkom (n\u00e1zov lieku si nepam\u00e4t\u00e1m ale dalo by sa to dohlada\u0165). Tento liek bol extr\u00e9mne n\u00e1vykov\u00fd (ako nejak\u00fd pervit\u00edn), tak ho nesk\u00f4r stiahli.<br \/>\n <\/p>","protected":false},"excerpt":{"rendered":"Ak\u00e9 druhy antidepres\u00edv existuj\u00fa?","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2],"tags":[],"class_list":["post-11","post","type-post","status-publish","format-standard","hentry","category-farmakologia"],"_links":{"self":[{"href":"https:\/\/filozofia.nett.to\/farmakologia\/wp-json\/wp\/v2\/posts\/11","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/filozofia.nett.to\/farmakologia\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/filozofia.nett.to\/farmakologia\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/filozofia.nett.to\/farmakologia\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/filozofia.nett.to\/farmakologia\/wp-json\/wp\/v2\/comments?post=11"}],"version-history":[{"count":0,"href":"https:\/\/filozofia.nett.to\/farmakologia\/wp-json\/wp\/v2\/posts\/11\/revisions"}],"wp:attachment":[{"href":"https:\/\/filozofia.nett.to\/farmakologia\/wp-json\/wp\/v2\/media?parent=11"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/filozofia.nett.to\/farmakologia\/wp-json\/wp\/v2\/categories?post=11"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/filozofia.nett.to\/farmakologia\/wp-json\/wp\/v2\/tags?post=11"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}