Ципралекс

Ципралекс – drug from group of antidepressants which mechanism of action consists in the selection inhibition of the return serotonin reuptake. It leads to increase in content of this neuromediator substance in a synaptic gap, to strengthening and prolongation of its action on receptor sites of the postsynaptic area. Active ingredient – to estsitalopra which has very high selectivity is Tsipraleks's part, that is practically does not contact other receptors, including serotoninovy 5-HT1A-, 5-HT2-, dopamine, adrenergic, H1-histamine, M-holinoretseptorami, benzodiazepine and opioid receptors. Thanks to these properties treatment of depressive syndromes by Tsipraleks very effectively. Drug is very widely used in psychoneurological practice, and positive reviews about Tsipraleks speak about high activity of this medicine.

Release form

Drug of Tsipraleks in the form of the coated tablets containing 5, 10, 20 mg of active ingredient.

Indications to use of drug of Tsipraleks

According to the instruction, Tsipraleks is applied at the following states:

• depressive episodes regardless of severity;
• panic frustration with an agoraphobia or without it.

Contraindications to use of drug of Tsipraleks

In the instruction to Tsipraleks the following contraindications to use of this drug are specified:

• hypersensitivity to the active ingredient and auxiliary components which are a part of drug;
• concomitant use of drugs of group of MAO inhibitors;
• pregnancy;
• lactation;
• age up to 15 years.

Use during pregnancy and a lactation

Treatment by Tsipraleks during pregnancy and a lactation is contraindicated. At use of inhibitors of the return serotonin reuptake during pregnancy at newborns the psychophysical symptoms testimonial of serotonergic effect, and also about emergence of a withdrawal were observed. Therefore in case of Tsipraleks's use or analogs at pregnancy their use should not be interrupted sharply.

By-effects

At Tsipraleks's use according to the instruction by-effects arise seldom, more often on the first week of therapy, then their intensity considerably decreases. Emergence of the following side effects is possible:

• from the alimentary system emergence of nausea, diarrhea, loss of appetite, locks, vomitings, dryness in a mouth, disturbances of functional indicators of a liver is possible;
• from a nervous system: dizziness, sleeplessness or drowsiness, visual disturbance, tremor, convulsive attacks, disturbances of a physical activity, flavoring feelings, hallucinations, confusion of consciousness, mania, serotoninovy syndrome, agitation, depersonalization, alarm, panic attacks;
• from a reproductive system: at men decrease in a libido, disturbance of an ejaculation, impotence is possible, women have an anorgazmiya;
• from vascular system development of orthostatic hypotension is possible;
• from bodies of endocrine system: galactorrhoea, insufficient secretion of ADG;
• other side effects: development of anaphylactic reaction, skin rash, itch, a purpura, ecchymomas, arthralgias, mialgiya, ischurias is possible.

These phenomena often serve as the reason of negative reviews of Tsipraleksa from patients, however at the correct use of drug side effects are quickly enough stopped.

Treatment by Tsipraleks needs to be stopped smoothly as possibly development of a withdrawal: nausea, dizziness, headache.

Overdose

Symptoms of overdose of Tsipraleks are dizziness, agitation, a tremor, drowsiness, consciousness disturbance, convulsive attacks, changes on an ECG (change of a tooth of T, ST segment, the QRS expansion, QT lengthening), arrhythmia, breath disturbance, vomiting, a metabolic acidosis, рабдомиолиз, a hypopotassemia.

At overdose by Tsipraleks the symptomatic and maintenance therapy as the specific antidote does not exist is carried out. The intensive gastric lavage is carried out, adequate access of oxygen, monitoring of activity of respiratory and cardiovascular systems is necessary.

Route of administration and dosage of drug of Tsipraleks

According to the instruction, Tsipraleks applies orally, regardless of meal, a daily dose - at one time.

In case of depressive episodes the therapeutic dose makes 10, at most 20 mg a day.

The antidepressive effect of Tsipraleks develops 2-4 weeks later from an initiation of treatment. After achievement of therapeutic effect it is necessary to continue treatment by Tsipraleks at least 6 months.

At panic frustration the following scheme of reception of Tsipraleks and analogs is recommended: the dosage on the first week of treatment – 5 mg, then increases to 10 mg. The maximum daily dosage of Tsipraleks – 20 mg.

The therapeutic effect at this pathology develops in 3 months. Treatment by Tsipraleks in this situation also has to continue several months.

The recommended daily dosage of Tsipraleks for patients of advanced age is twice less.

At patients with pathology of kidneys and a liver (an easy or medium-weight current) dose adjustment is not necessary. However at decrease in clearance of creatinine less 30ml/mines it is necessary to apply Tsipraleks and analogs with extra care.

For the purpose of the prevention of development of a withdrawal it is necessary to reduce Tsipraleks's dosage smoothly, within two weeks.

Interaction with other drugs

At simultaneous use of Tsipraleks and MAO inhibitors the risk of emergence of a serotoninovy syndrome considerably increases. The same complication is possible at a concomitant use of serotonergic drugs. Increase in risk of development of spasms at the simultaneous use of Tsipraleks and drugs reducing a threshold of convulsive readiness is possible. Ципралекс strengthens effect of the medicines reducing coagulability of blood therefore at co-administration of these drugs constant control of a gemogramma is necessary. Ципралекс increases the content in blood of such drugs as desipramine and метопролол.

Responses

Thanks to high performance reviews of Tsipraleksa rather good. This medicine considerably reduces manifestations of psychoneurological frustration with a depressive syndrome. However drug has many side effects therefore it is necessary to study carefully the instruction to Tsipraleks before use of this medicine.

Analogs

Now in drugstores the following analogs of Tsipraleks meet: Lenuksin, Miratsitol, Santsipam, Selektra, Elitsey, Estsitalopram-Tev.

Storage conditions

Drug of Tsipraleks belongs to the B. Tsipraleks list it is necessary to store at the room temperature out of access for children. It is released only according to the recipe.

It is possible to use this drug only for designated purpose the attending physician.